Frontotemporal dementia (FTD) is a neurological disorder that affects the frontal and temporal lobes of the brain. It is a progressive disease that causes significant changes in behaviour, personality, and language. FTD is a relatively uncommon form of dementia, accounting for approximately 5%–10% of all dementia cases.
Approximately 20% of presenile dementia patients are diagnosed with FTD, which is characterised by a series of clinical neurologic syndromes. These include early-onset, relatively retained memory, progressive behavioural abnormalities, personality changes, and language disorders. Research on FTD has revealed heterogeneity in neuromuscular pathology, and different subtypes of FTD syndromes may vary in their aetiology and pathogenesis. Despite this, recent years have seen great progress in studies on FTD neuropathology and pathogenesis.
FTD is the second most common neurodegenerative dementia in patients under 65 years old, and its onset has a significant impact on a patient’s life expectancy. Patients with FTD have a survival time of only about 3–14 years after onset. In contrast, FTD patients bear an estimated two- to three-fold greater economic burden than AD patients.
Symptoms
FTD is characterised by a gradual decline in behaviour and personality. This decline is typically more rapid than that seen in other forms of dementia, such as Alzheimer’s disease.
The symptoms of FTD can be broadly classified into three categories:
- Changes in behaviour. The affected individuals may exhibit inappropriate social behaviour, such as making inappropriate comments, neglecting personal hygiene, and being impulsive. They may also lose their inhibitions and exhibit socially unacceptable behaviour. Individuals with FTD may also lose interest in activities they once enjoyed, become apathetic, and lose motivation.
- Changes in language. Individuals with FTD may experience difficulty expressing themselves, and understanding language, and may have trouble finding the right words. They may repeat words or phrases or struggle to communicate effectively.
- Changes in movement. FTD can also affect movement, causing individuals to experience difficulty with balance and coordination. Muscle weakness, tremors, and stiffness are also common symptoms.
Causes
The exact cause of FTD is not fully understood. However, researchers have identified a genetic component to the disease. FTD is caused by the buildup of abnormal proteins in the brain. These proteins, called tau or TDP-43, accumulate in the frontal and temporal lobes of the brain, causing nerve cells to die.
Diagnosis
Diagnosing FTD can be challenging as its symptoms can be similar to those of other neurological disorders. A comprehensive evaluation by a neurologist is required to diagnose FTD. The evaluation includes a detailed medical history, neurological examination, and cognitive testing. Imaging studies, such as magnetic resonance imaging (MRI), can help identify changes in the brain associated with FTD.
Treatment
Currently, there is no cure for FTD. However, there are treatments available to manage the symptoms of the disease. Medications, such as antidepressants, may be prescribed to alleviate the symptoms of depression and anxiety. Speech and language therapy can also help individuals with FTD improve their ability to communicate. Supportive care, including occupational and physical therapy, can help individuals maintain their independence for as long as possible.
Takeaway
FTD is a complex neurological disorder that affects the frontal and temporal lobes of the brain. Its symptoms can be difficult to diagnose, and there is currently no cure. However, with the right care and treatment, individuals with FTD can live fulfilling lives. It is essential to recognize the signs of FTD and seek medical help as soon as possible to manage the symptoms of the disease.
Dennis Relojo-Howell is the managing director of Psychreg.
