Frontotemporal Dementia: Symptoms, Diagnosis and Treatment

Introduction to Frontotemporal dementia (FTD)

Frontotemporal dementia (FTD) is a degenerative progressive brain disease which gradually destroys the ability to solve problems and carry out daily activities. FTD patients generally experience personality changes and behavioral problems. It affects the anterior portion of the brain wherein the brain cells in these regions begin to shrink in size. These damaged regions lead to behavioral and language changes. It is usually found in people in the age group between 45- 60 years. Research has shown that 6.7 people per 1, 00,000 are affected by this disorder. Men are noted to be more commonly affected than women. While there is no cure for this disorder, early identification and prompt treatment can improve the quality of life and minimize the symptoms associated with this disorder.

 

Causes of frontotemporal dementia

The exact cause that can result in frontotemporal dementia is not known. However, factors such as heredity and alterations in the gene structures have been suggested to be associated with this progressive brain disorder. Studies have indicated that about 40% of people with FTD have a positive family history of FTD. Some cases of FTD are reported to be due to permanent change in the DNA sequence (referred to as genetic mutation). The symptoms and the pathology in such cases of FTD depend on the specific mutation noted. There are no other risk factors known to be associated with FTD. A sexual preference has been noted wherein men are more prone to develop this disorder when compared to women.
 

Symptoms of frontotemporal dementia

Early symptoms of FTD include mood or personality changes such as depression, change in behavior pattern and language difficulties. The changes noted in behavior patterns can include performing inappropriate actions, lack of judgment, decline in personal hygiene, lack of awareness about changes in one’s behavior and apathy. In addition to it, the affected individuals exhibit two opposite behavioral profile in the initial and middle stage of the disease. While some react over actively and appear distracted, few others remain inert and emotionally blunted.

Symptoms of an elderly adult suffering from FTD include sudden change to depressed mood and loss of an ability to participate in social activities.

Individuals noted to suffer from language difficulties tend to find it difficult to converse and use written and spoken language they knew all through their life. In some cases, the affected individuals may make statements that are grammatically correct but are nowhere related to the topic being discussed.

Some of the major symptoms of frontotemporal dementia include the following:

• Gradual change in social and personal conduct
• Lack of interest towards domestic and financial quality of life
• Lack of occupational responsibilities
• Lack of empathy towards other people
• Severe variations in mood- may have a flat facial expression or repeatedly sing, clap or dance
• Rigid and stubborn nature and impaired judgment
• Stereotype or compulsive behavior
• Change in sleep patterns with long duration of sleepiness
• Excessive eating and even alcohol consumption

Frontotemporal dementia patients in later stages may have the following features:

• Dramatic reduction in speech
• Failure to respond to verbal commands
• Loss of muscle movement (referred to as akinesia)
• Death due to rigidity and immobility of body

Diagnosis of frontotemporal dementia

The diagnosis of frontotemporal dementia is based on a comprehensive review of the signs and symptoms reported, the history of the condition, imaging tests such as MRI and CT scans and neuropsychological examination.

Recording the history of the condition and physical examination are the initial steps in the diagnosis of FTD. Change of personality and social abilities are also evaluated during the diagnosis. Lab tests like complete measure of blood count, kidney function test, and liver function test are done to identify any other related abnormalities.

Imaging test such as magnetic resonance imaging (MRI) are the key in identifying the loss of brain tissue. Other imaging tests such as positron emission tomography (PET), and computed tomography (CT) may also be advised in certain instances. By performing these brain scans, doctors are able to identify the visible abnormalities such as clot or bleeding in the brain that may have resulted in the signs and symptoms of frontotemporal dementia.

Physicians also undertake more complicated neurological assessment known as neuropsychological testing for assessing memory skills and other related mental functions. This testing helps to differentiate the stages of FTD.

Genetic testing can be done to confirm a suspected diagnosis of frontotemporal dementia. This identifies changes in DNA, genes and other related structures. The result of this test can confirm or determine a person’s chance of developing FTD.
 

Treatment of FTD

Currently there are no treatments available to cure frontotemporal dementia. However, following of directions by physician on medications, nutrition supplements and recreational drugs such as alcohol, tobacco and others can be beneficial in reducing the severity of the features of FTD.

Antidepressant and antipsychotic medications are generally advised to improve the symptoms associated with FTD. These medications for behavioral symptoms are usually started at low dose and increased slowly depending on the response noted. Certain antidepressants drugs are effective in treating anxiety disorder, depression and reduce aggressive nature. Antipsychotic medications help manage irrational and compulsive behaviors that develops with frontotemporal dementia.

Medications for stabilizing the memory are given in small doses in some instances to avoid the progression to Alzheimer’s disease.

Several memory and aging centers have been established to provide support to people suffering from FTD.

Speech therapy helps the affected individuals to understand their language difficulties and learn to communicate. Non verbal methods for communication such as gestures, pointing to pictures and so on help FTD affected individuals to express effectively. 

Many occupational speech therapy centers are available through local hospitals to help individuals suffering from FTD.
 

Read More: Active Brain Keeps Dementia Away

Complications of FTD

In aged people FTD can lead to health complications associated with degenerative disease of the brain. The condition may progress with time leading to worsening of symptoms as time progresses. Disorders such as Alzheimer's disease may also develop in some individuals.