Frontotemporal dementia



Frontotemporal dementia (FTD) is one of three clinical syndromes associated with frontotemporal lobar degeneration. FTD selectively affects the frontal lobe of the brain and may extend backward to the temporal lobe. There are two main types: Pick's disease, which has been recognised for many years, and Dementia of the Frontal Lobe Type (DFLT), more recently described. The pathology of these two conditions is different although the clinical manifestations are similar.

The frontal lobe is involved in many aspects of mental function. These include motivation and drive, classifying and categorizing, emotion and personality. Social behaviour is also influenced as is appetite. People affected by frontaltemporal dementia (FTD) often display marked changes in personality over a very short period of time. This is often the first clue for family members that there is a health concern. As the disease progresses, sufferers develop many different symptoms that are different from one person to another. Sexual inhibition is not uncommon, and a person with frontotemporal dementia should be monitored around young children. Sudden obsessions with food often leads to weight gain, and some care givers report an increased focus upon schedules and time. The vast majority of people with FTD lose their ability for insight. They often do not realize they are seriously ill and losing their ability to accurately judge their skills. Many victims of this disease have a very hard time with the loss of freedom that the disease brings; they feel fine, and can't understand why the doctor has taken their driver's license.

Because the disease usually displays in people who are younger in life, the affects on families are severe. Oftentimes, victims still have children living in the home. Financially, it can be devestating. The disease strikes at the time of life that are often the top wage earning years.

Usually in the mid stages of the disease, the victim begins to lose his or her ability to speak. As time progresses and the disease spreads to other parts of the brain, the victim loses the ability to control muscle functions. Eventually, the disease leads to death.

Frontal dysfunction may therefore lead to apathy or conversely disinhibition, disordered high level thinking- perseveration, and personality change. The manifestation will depend on which part of the lobe is more affected &mdash; dorsolateral or orbitomedial. Many routine dementia assessments do not test the frontal lobe.

Frontotemporal dementia sometimes occurs with Motor neurone disease.