Frontotemporal dementia: causes, symptoms and treatment
Over the years, people's brains are susceptible to some type of condition or disorder. that affects a large number of capacities such as lucidity and the ability to speak or states of cheer up.
One of these conditions is frontotemporal dementia.. It is a genetic-based disease that we will talk about throughout this article, explaining its symptoms, causes, how it is diagnosed and what its treatment is.
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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 spread, 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 in the personality, behavior and oral language of the person.
Diseases related to this type of dementia are:
- The Pick's disease.
- Impairment of the frontotemporal lobe.
- progressive aphasia.
- The semantic dementia.
- corticobasal impairment.
The main difference between frontotemporal dementia and other types of dementia is that in this first memory is not affected until the disease is very advanced.
In addition, this dementia is also distinguished by appearing in people who are not as advanced as other diseases. It usually appears in people between 40 and 60 years old; although this is likely to appear at any age.
What symptoms does it present?
Within the symptoms of frontotemporal dementia there are two large groups: personality changes and impaired ability to communicate orally. As mentioned above, in this dementia, memory is not affected early on.
personality alterations
The deterioration of the frontal and right area of the brain causes that judgment, personality and the ability to carry out complex tasks are seriously compromised in these patients.
People with prefrontal dementia may engage in 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 starting a conversation.
On many occasions, these patients see their ability to solve problems and make decisions affected; affecting their daily tasks in a very serious way.
When this symptomatology is very obvious or of considerable magnitude may be confused with depression or a psychotic disorder as the schizophrenia or the Bipolar disorder.
speech disturbances
As discussed above, prefrontal dementia can interfere with a person's ability to use and understand spoken language. When these symptoms manifest, we can speak of semantic dementia or primary progressive aphasia, depending on the combination of symptoms that they present.
In semantic dementia they are both temporal lobes those who are affected impairing the ability to recognize and understand words, faces, and meanings. Meanwhile, in primary progressive aphasia it is the left part of the brain that is impaired, thus interfering with the ability to articulate words, as well as to find and use the correct word in the time to speak
What are the causes of DFT?
Although the exact causes of this dementia are not yet known, around 50% of the population suffering from frontotemporal dementia have a history of the same or any other type of dementia in your medical history family; so it is hypothesized that it has an important genetic component.
There are a number of mutations that have been linked to frontotemporal dementia. This mutation occurs in the TAU gene and in the proteins that this gene helps to generate. The accumulation of these defective proteins form the so-called Pick bodies, which interfere with the brain cells work in a way similar to the plaques that appear in Alzheimer's disease.
However, in frontotemporal dementia the main areas affected are the frontal lobes and temporal, responsible for reason, speech and behavior.
How is your diagnosis made?
Frontotemporal dementia usually does not show significant symptoms during the early stages of the disease, so this tends to go unnoticed, in many cases for more than three years before diagnosis, until some significant change in behavior leads the family to think that something strange is happening to the patient. This is 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 alterations in language. In addition, a series of neuroimaging tests and neuropsychological tests will be carried out.
With the structural analysis carried out by means of magnetic resonance tests, it is intended find signs of atrophy in the frontal lobes characteristic of the early stages of illness.
To rule out the possibility of Alzheimer's disease positron emission tomography is required, which must 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 medicines to palliate the effect of the symptoms of frontotemporal dementia, as well as to try to stop its advance.
Usually, the medical staff is based on the needs of the patient 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 the depression.
- Dietary supplements.
Pharmacological treatment, together with psychosocial support and assistance in carrying out daily tasks they are essential for the patient to enjoy an optimal quality of life. Usually, the average life expectancy given to these patients is approximately 8 years from the time of diagnosis.
