Frontotemporal dementia: causes, symptoms and treatment
Over the years people's brains are susceptible to suffer some type of condition or disorder that affects a large number of abilities such as lucidity and ability to speak or moods.
One of these conditions is frontotemporal dementia . It is a disease of genetic basis on which we will talk throughout this article, explaining its symptoms, causes, how it is diagnosed and what is its treatment.
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What is frontotemporal dementia?
Frontotemporal dementia (FTD) is a clinical condition caused by a deterioration of the frontal lobe of the brain . This deterioration can expand, also affecting the temporal lobe. Frontotemporal dementia is also the most common type of dementia after Alzheimer's.
Within the category of frontotemporal dementia we find a number of progressive dementias, which are manifested through alterations of personality, behavior and oral language of the person .
The diseases related to this type of dementia are:
- Pick's disease
- The deterioration of the frontotemporal lobe.
- Progressive aphasia .
- Semantic dementia
- Corticobasal deterioration.
The main difference between frontotemporal dementia and other types of dementia is that in this first the memory is not affected until the disease is at a very advanced stage .
In addition, this dementia is also distinguished in appearing in people of not so advanced age as the rest of diseases. It usually appears in people between 40 and 60 years old; although this is likely to appear at any age.
What symptomatology does it present?
Within the symptomatology of frontotemporal dementia there are two major groups: alterations in personality and impairment of the ability to communicate orally . As mentioned earlier in this dementia, memory is not affected early.
Alterations of the personality
The deterioration of the frontal and right brain area causes that the judgment, the personality and the capacity to carry out complex tasks are seriously compromised in these patients.
People with prefrontal dementia can carry out negative behaviors such as inappropriate behavior in public places, disinhibition, aggressiveness or showing apathy . Likewise, social skills can also be affected, causing the person to lose empathy, discretion or diplomacy when engaging in a conversation.
On many occasions, these patients are affected their ability to solve problems and decision making; affecting your daily tasks in a very serious way.
When this symptomatology is very obvious or of considerable magnitude can be confused with depression or with a psychotic disorder such as schizophrenia or bipolar disorder.
Alterations in speech
As discussed above, pre-frontal dementia can interfere with the person's ability to use and understand oral language. When these symptoms manifest we can speak of semantic dementia or primary progressive aphasia, depending on the combination of symptoms they present.
In the semantic dementia are both temporal lobes that are affected, harming the ability to recognize and understand words, faces and meanings . Meanwhile, in primary progressive aphasia it is the left part of the brain that experiences deterioration, thus interfering in the ability to articulate words, as well as to find and use the correct word at the moment of speaking.
What are the causes of the DFT?
Although the causes of this dementia are still not known, about 50% of the population suffering from frontotemporal dementia has a history of dementia or some other type of dementia in their family clinical history; so it is hypothesized that this has an important genetic component.
There are a series of mutations that have been related to frontotemporal dementia. This mutation occurs in the TAU gene and in the proteins that this gene helps generate . The accumulation of these defective proteins forms the so-called Pick bodies, which interfere with the work of brain cells in a similar way to the plaques that appear in Alzheimer's disease.
However, in frontotemporal dementia the main affected areas are the frontal and temporal lobes, responsible for reason, speech and behavior.
How is your diagnosis made?
It is common that frontotemporal dementia does not show significant symptoms during the early stages of the disease, so this it tends to go unnoticed, in many cases for more than three years before its diagnosis , until some significant alteration in the behavior induces the family to think that something strange is happening to the patient. That's when most diagnoses of the disease are made.
Following established by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the guidelines for the evaluation of frontotemporal dementia are essentially clinical. These should include a record of behavioral changes and an examination of language alterations . In addition, a series of neuroimaging and neuropsychological tests will be carried out.
With the structural analysis performed by magnetic resonance tests, we intend to find signs of atrophy in the frontal lobes characteristic of the first stages of the disease.
To rule out the possibility that it is Alzheimer's disease it is necessary to perform a positron emission tomography , which should show an increase in frontal and / or temporal metabolism to be considered frontotemporal dementia.
Which is the treatment?
As in other dementias, a remedy for this type of condition has not yet been found. However, there are a number of Medications to alleviate the effect of frontotemporal dementia symptoms , as well as to try to stop its advance.
Usually, the medical staff relies on the patient's needs when choosing the most effective medication. The pharmacological treatments of choice in these cases include:
- Cholinesterase inhibitors .
- NMDA receptor antagonists.
- Antipsychotic medication .
- Medication for symptoms related to anxiety and depression.
- Dietary supplements.
Pharmacological treatment, together with psychosocial support and assistance in carrying out daily tasks they are essential so that the patient can enjoy an optimal quality of life. Usually, the average life expectancy given to these patients is about 8 years from the time of diagnosis.