Frontotemporal dementia: what it is, symptoms and treatment

Frontotemporal dementia, formerly known as Pick's disease, is a set of disorders that affect specific parts of the brain, called the frontal lobes. These brain disorders cause changes in personality, behavior and lead to difficulty understanding and producing speech.

This type of dementia is one of the main types of neurodegenerative diseases, which means that it gets worse over time, and can happen even in adults under 65 years old, and its appearance is related to genetic modifications transmitted from parents to children.

The treatment of frontotemporal dementia is based on the use of drugs that reduce symptoms and improve the person's quality of life, as this type of disease has no cure and tends to evolve over time.

Main signs and symptoms

The signs and symptoms of frontotemporal dementia depend on the areas of the brain that are affected and may differ from person to person, however, the changes may be:

• Behavioral: personality changes, impulsiveness, loss of inhibition, aggressive attitudes, compulsions, irritability, lack of interest in other people, ingestion of inedible objects and repetitive movements such as clapping or teeth constantly can occur; Language: the person may have difficulty speaking or writing, problems understanding what they say, forgetting the meaning of words and in the most severe cases, total loss of ability to articulate words; Motor: tremors, muscle stiffness and spasms, difficulty in swallowing or walking, loss of movement of the arms or legs and, often, difficulty in controlling the urge to urinate or defecate can occur.

These symptoms may appear together or the person may have only one of them, and they usually appear mildly and tend to get worse over time. Therefore, if any of these changes occur, it is important to seek assistance from a neurologist as soon as possible, so that specific examinations are performed and the most appropriate treatment is indicated.

Possible causes

The causes of frontotemporal dementia are not well defined, but some studies indicate that they may be related to mutations in specific genes, linked to the Tau protein and the TDP protein43. These proteins are found in the body and help cells to function properly, however, for reasons not yet known, they can be damaged and cause frontotemporal dementia.

These protein mutations can be triggered by genetic factors, that is, people who have a family history of this type of dementia are more likely to suffer from the same brain disorders. In addition, people who have suffered traumatic brain injury may have brain changes and develop frontotemporal dementia. Learn more about head trauma and what the symptoms are.

How the diagnosis is made

When symptoms appear, it is necessary to consult a neurologist who is going to make a clinical evaluation, that is, he will make an analysis of the reported symptoms and then he can indicate the performance of tests to investigate whether the person has frontotemporal dementia. Most of the time, the doctor recommends performing the following tests:

• Imaging tests : such as MRI or CT scan to check the part of the brain that is being affected; Neuropsychological tests: serves to determine memory capacity and identify problems with speech or behavior; Genetic tests: consists of blood tests to analyze which type of protein and which gene is impaired; CSF collection: indicated to identify which cells of the nervous system are being affected; FBC: performed to exclude other diseases that have symptoms similar to those of frontotemporal dementia.

When the neurologist suspects other diseases such as a tumor or brain clot, he may also order other tests such as a pet scan, brain biopsy or brain scan. See more what brain scintigraphy is and how it is done.

Treatment options

The treatment for frontotemporal dementia is done to reduce the negative effects of the symptoms, improve the quality of life and increase the life expectancy of a person, as there are still no drugs or surgery to cure this type of disorder. However, some medications can be used to stabilize symptoms such as anticonvulsants, antidepressants and antiepileptics.

As this disorder progresses the person may have more difficulty walking, swallowing, chewing and even controlling the bladder or intestine and, therefore, physiotherapy and speech therapy sessions, which help the person to perform these daily activities, may be necessary..

Difference between frontotemporal dementia and Alzheimer's disease

Despite having similar symptoms, frontotemporal dementia does not present the same alterations as Alzheimer's disease, because most of the time, it is diagnosed in people between 40 and 60 years old, differently from what happens in Alzheimer's disease in which the diagnosis is made, mainly after 60 years.

In addition, in frontotemporal dementia, behavior problems, hallucinations and delusions are more common than memory loss, which is a very common symptom in Alzheimer's disease, for example. Check out what are other signs and symptoms of Alzheimer's disease.