A group of brain diseases known as frontotemporal dementia (FTD) affects the frontal and temporal lobes of the brain. In FTD, these areas shrink and stop working properly, which affects personality, behavior, and language. It is different from Alzheimer's disease, which affects memory and thinking. As a rule, FTD develops between the ages of 40 and 65, and is often inherited.
In FTD, abnormal protein structures called Pick's bodies are believed to damage the brain cells, but the exact cause is unknown. Genetic mutations can increase the risk of developing FTD. About 40% of those with FTD have a family history of the disease. Other factors include:
Head injury or trauma
Smoking
Alcohol abuse
Exposure to toxins or infections
The symptoms of FTD depend on which part of the brain is affected. There are three main types of FTD, each with different symptoms:
Behavioral-variant FTD (bvFTD): This type affects the personality and behavior of the person. They may become socially inappropriate, impulsive, emotionally indifferent, or compulsive. Additionally, they may lose interest in their hobbies, neglect their personal hygiene, overeat, or eat things they shouldn't.
A semantic-variant primary progressive aphasia (svPPA) affects a person's language and comprehension. They may have trouble finding the right words, understanding the meaning of words, or naming things. They may also have trouble remembering facts and concepts.
People with nonfluent/agrammatic primary progressive aphasia (nfvPPA) may have difficulty speaking, forming sentences, or pronouncing words. They may also have difficulty spelling or writing.
Symptoms of FTD include tremors, rigidity, muscle spasms, poor coordination, difficulty swallowing, or muscle weakness. These symptoms are similar to those of Parkinson's disease or amyotrophic lateral sclerosis (ALS).
To diagnose FTD, a doctor will ask about the medical and family history of the person, and perform a physical and neurological examination. The doctor may also order some tests, such as:
Blood tests: To rule out other conditions that can cause similar symptoms, such as liver or kidney disease, infections, or vitamin deficiencies.
Neuropsychological tests: To assess the cognitive and behavioral abilities of the person, such as memory, attention, language, and judgment.
A brain imaging test examines changes in brain structure or function, such as shrinkage, inflammation, or blood flow. Magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), or single-photon emission computed tomography (SPECT) are some of these tests.
Treatment for FTD aims to manage the symptoms and improve the quality of life of the person and their caregivers. The treatment may include:
Medications can be prescribed for behavioral or psychological symptoms, including depression, anxiety, agitation, or hallucinations. These medications include antidepressants, antipsychotics, mood stabilizers, and sedatives. However, some of these medications may have side effects or worsen some of the symptoms, so they should be taken with caution and under the supervision of a doctor.
Therapy: A variety of therapies that may help a person express themselves, understand others, or perform daily tasks, such as speech, language, or physical therapy.
In addition to emotional, social, and practical support, the person may also receive counseling, education, support groups, respite care, or home care services. Providing these support services may help the person and their caregivers cope with the challenges and stresses of living with FTD.
There is no proven way to prevent FTD, but some lifestyle factors may reduce the risk or delay the onset of the disease. These factors include:
Keeping the brain active and healthy, by engaging in mental, physical, and social activities, such as reading, learning, exercising, or volunteering.
Avoiding smoking, alcohol abuse, or drug use, which can harm the brain and increase the risk of FTD.
Protecting the head from injury or trauma, by wearing a helmet, seat belt, or airbag, which can prevent or reduce the damage to the brain.
Seeking medical attention for any symptoms or signs of FTD, such as changes in personality, behavior, or language, which can help to get an early diagnosis and treatment.
As a result of damage and shrinkage of the frontal and temporal lobes of the brain, frontotemporal dementia affects a person's personality, behavior, and language. In most cases, it starts in youth and runs in families. Although there is no cure or treatment for FTD, some symptoms can be managed with medications, therapy, or support. FTD cannot be prevented, but some lifestyle factors can delay its onset or reduce its risk. FTD is a challenging and progressive condition that requires ongoing care and support for the person and their caregivers.
