Frontotemporal dementia: causes, symptoms and treatment

Unlike other dementias, this one does not produce memory failures until it is very advanced.

Over the years, people's brains are susceptible to some kind of condition or disorder that affects a number of abilities such as alertness and speech or moods.

One such condition is frontotemporal dementia.. It is a genetically based disease that we will talk about in this article, explaining its symptoms, causes, how it is diagnosed and how it is treated.

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 also affect the temporal lobe. Frontotemporal dementia is also the most common type of dementia after Alzheimer's disease.

Within the category of frontotemporal dementia we find a number of progressive dementias, which manifest themselves through alterations in the person's personality, behavior and oral language..

Diseases related to this type of dementia are:

• Pick's disease.
• Deterioration of the frontotemporal lobe.
• Progressive aphasia..
• Semantic dementia.
• Corticobasal impairment.

The main difference between frontotemporal dementia and other types of dementia is that in frontotemporal dementia, memory is not affected until the disease is at a very advanced stage. memory is not affected until the disease is at a very advanced stage..

In addition, this dementia also differs in that it appears in people who are not as old as the other diseases. It usually appears in people between 40 and 60 years of age, although it can appear at any age.

What are the symptoms?

Within the symptomatology of frontotemporal dementia there are two main groups: personality alterations and deterioration of the ability to communicate orally.. As mentioned above, memory is not affected early in this dementia.

Personality alterations

The deterioration of the frontal and right brain area causes judgment, personality and the ability to perform complex tasks to be severely compromised in these patients.

Individuals with prefrontal dementia may engage in negative behaviors such as inappropriate behavior in public places, disinhibition, aggression, or apathy.. Likewise, social skills may also be affected, causing the person to lose empathy, discretion or diplomacy when engaging in conversation.

On many occasions, these patients are affected in their ability to solve problems and make decisions; affecting their daily tasks in a very serious way.

When this symptomatology is very obvious or of considerable magnitude, it can be mistaken for depression or a psychotic disorder. can be confused with depression or a psychotic disorder such as schizophrenia or such as schizophrenia or bipolar disorder.

Speech disturbances

As discussed above, prefrontal dementia can interfere with the person's ability to use and understand spoken language. When these symptoms are manifested we can speak of semantic dementia or primary progressive aphasia, depending on the combination of symptoms they present.

In semantic dementia, both temporal lobes are affected, impairing the ability to recognize and understand words, faces and meanings.. Meanwhile, in primary progressive aphasia it is the left side of the brain that is impaired, thus interfering with the ability to articulate words, as well as to find and use the correct word when speaking.

What are the causes of FTD?

Although the exact causes of this dementia are not yet known, about 50% of the population suffering from frontotemporal dementia has a history of frontotemporal dementia or some other type of dementia in their family history, 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 forms the so-called Pick bodies, which interfere with the work of the brain cells in a manner similar to the plaques that appear in Alzheimer's disease.

However, in frontotemporal dementia the main areas affected are the frontal and temporal lobes, which are responsible for reason, speech and behavior.

How is the diagnosis made?

It is common for frontotemporal dementia to show no significant symptoms during the early stages of the disease, so it tends to go unnoticed. tends to go unnoticed, in many cases for more than three years before the diagnosisThe patient's family is then led to believe that something strange is happening to the patient, until some significant alteration in behavior induces the family to think that something strange is happening to the patient. It is then when most diagnoses of the disease are made.

As established by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the guidelines for the evaluation of frontotemporal dementia are essentially clinical. They should include a record of behavioral changes and an examination for language impairment.. In addition, a series of neuroimaging and neuropsychological tests will be performed.

Structural analysis using magnetic resonance imaging tests is intended to find signs of atrophy in the frontal lobes characteristic of the early stages of the disease.

To rule out the possibility of Alzheimer's disease, it is necessary to perform an MRI scan. it is necessary to perform a positron emission tomography (PET) scan.This must show an increase in frontal and/or temporal metabolism for it to be considered frontotemporal dementia.

What is the treatment?

As with other dementias, no remedy has yet been found for this type of condition. However, a number of medications are available to alleviate the effect of the symptoms of frontotemporal dementia. medications to alleviate the effect of the symptoms of frontotemporal dementia, as well as to try to slow its progression.as well as to try to slow its progression.

Usually, the practitioner 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, coupled with psychosocial support and assistance in performing daily tasks are essential for the patient to enjoy an optimal quality of life. Usually, the average life expectancy given to these patients is about 8 years from the time of diagnosis.