About Frontotemporal Dementia (FTD): Symptoms and Diagnosis

By July 29, 2013Dementia

 

According to the Alzheimer’s Association website, “Frontotemporal dementia (FTD) is a group of disorders caused by progressive cell degeneration in the brain’s frontal lobes (the areas behind your forehead) or its temporal lobes (the regions behind your ears).” FTD is thought to affect 10 to 15 percent of all dementia cases, but in people under the age of 65, it is thought to account for 20 to 50 percent of cases. FTD causes cell shrinkage in the frontal and temporal lobes of the brain, which control certain kinds of movement, emotions, judgment, and speaking and understanding speech. Though FTD includes a range of different disorders, scientists and doctors have identified overlapping symptoms as well as specific brain abnormalities in all of these disorders.

 

Symptoms

In 1892, a physician named Arnold Pick described a disorder a patient had that affected speech and language. Thus, FTD used to be called “Pick’s Disease” and many doctors still use the term today. Today, doctors have classified FTD into three categories:

  • FTD Movement Disorders
    • These disorders affect certain muscle functions, specifically those that are involuntary. There are two major disorders classified under the FTD Movement Disorders category:
      • Corticobasal Degeneration (CBD) causes muscle spasms, shakiness, muscle rigidity, and a lack of coordination.
      • Progressive Supranuclear Palsy (PSP) causes problems with walking and balance, muscle stiffness, specifically in the neck and upper body, and eye movements.
      • Primary Progressive Aphasia (PPA)
        • Initially language and speech are affected, but as these disorders progress, behavior is also affected.
          • Semantic dementia: speech comes easily, as always, but words become more and more vague. For example, a person wants to indicate a dog, but can only say “animal.” Language comprehension deteriorates as well.
          • Progressive Nonfluent Aphasia: the person cannot think of or speak words as easily, speech is not grammatical, and their ability to read and write may deteriorate as well.
          • Behavioral variant frontotemporal dementia (bvFTD)
            • These disorders begin typically with subtle behavior changes, which many people perceive as depression. A hallmark of bvFTD is the loss of social inhibition. A person with bvFTD may do or say things that are completely out of line in social situations.

 

Diagnosis

Because there are no tests that can detect FTD, doctors must rely on their own judgment and expertise to diagnose a patient. If you suspect a loved one is suffering from FTD, it is important to schedule an MRI, because FTD physically affects the brain, causing shrinkage in the frontal and temporal lobes. One of the most important aspects of FTD that differentiates it from Alzheimer’s is the age at which it affects a person. Most people who have FTD are diagnosed in their 50s and 60s, whereas only about 10 percent are diagnosed after age 70. Alzheimer’s is more common the older people get. Another hallmark symptom of FTD that doesn’t typically affect Alzheimer’s patients are related to speech and language. People with Alzheimer’s may not be able to remember the word for something, but when they do speak they can be understood. FTD patients lose the ability to speak pretty quickly with the advancement of the disease.

 

Causes

There is no specific cause for FTD, but family history plays a large role. Scientists have also found protein deposits in the brains of those who have died from FTD, but they do not know what causes this, nor do they know why the disease affects the frontal and temporal lobes of the brain. Research has indicated a possible connection between FTD and Lou Gehrig’s disease.

 

Frontotemporal Dementia is one of the lesser known types of dementia; it is not as common as Alzheimer’s, vascular dementia, and Lewy body dementia. Knowing the symptoms of FTD can help you prevent a misdiagnosis and mistreatment.

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