Frontotemporal Dementia (Pick's Disease, Primary Progressive Aphasia, Semantic Dementia)

What is Frontotemporal Dementia ?

Frontotemporal dementia (FTD) describes a clinical syndrome associated with shrinking of the frontal and temporal anterior lobes of the brain. Originally known as Pick’s disease, the name and classification of FTD has been a topic of discussion for over a century.  The current designation of the syndrome groups together Pick’s disease, primary progressive aphasia, and semantic dementia as FTD.  Some doctors propose adding corticobasal degeneration and progressive supranuclear palsy to FTD and calling the group Pick Complex.  These designations will continue to be debated.  As it is defined today, the symptoms of FTD fall into two clinical patterns that involve either (1) changes in behaviour, or (2) problems with language.  The first type features behaviour that can be either impulsive (disinhibited) or bored and listless (apathetic) and includes inappropriate social behaviour; lack of social tact; lack of empathy; distractability; loss of insight into the behaviours of oneself and others; an increased interest in sex; changes in food preferences; agitation or, conversely, blunted emotions; neglect of personal hygiene; repetitive or compulsive behaviour, and decreased energy and motivation.  The second type primarily features symptoms of language disturbance, including difficulty making or understanding speech, often in conjunction with the behavioural type’s symptoms.  Spatial skills and memory remain intact.  There is a strong genetic component to the disease; FTD often runs in families.

Is there any treatment?

No treatment has been shown to slow the progression of FTD. Behaviour modification may help control unacceptable or dangerous behaviours.  Aggressive, agitated, or dangerous behaviours could require medication.  Anti-depressants have been shown to improve some symptoms.

What is the prognosis?

The outcome for people with FTD is poor.  The disease progresses steadily and often rapidly, ranging from less than 2 years in some individuals to more than 10 years in others.  Eventually some individuals with FTD will need 24-hour care and monitoring at home or in an institutionalized care setting.