Frontotemporal Dementia - Causes, Symptoms, Types, Diagnosis, and Treatment

What Is Frontotemporal Dementia?

Frontotemporal dementia (FTD) is a collection of illnesses characterized by the loss of neurons in the frontal and temporal lobes of the brain. The lobes shrink as a result of this. Behavior, attitude, language, and movement can all be affected by frontotemporal dementia. These are some of the most frequent dementias in people under the age of 65. Frontotemporal dementia usually strikes people between the ages of 40 and 65; however, it can also affect young adults and the elderly.

Frontotemporal dementia affects both men and women in the same way. Frontotemporal dementia is a progressive disease, which means that symptoms worsen over time. People may only have one symptom in the early stages. Other symptoms emerge as the disease advances, and more regions of the brain are damaged. It is difficult to say how long someone suffering from frontotemporal dementia will survive. Some people live for more than ten years after being diagnosed, while others live for less than two years.

What Causes Frontotemporal Dementia?

The temporal and frontal lobes of the brain shrink in frontotemporal dementia. Furthermore, some chemicals build up in the brain. It is frequently unclear what causes these shifts. Frontotemporal dementia has been linked to certain genetic alterations. However, more than half of those who develop frontotemporal dementia have no relatives who have had the disease. Researchers have discovered that frontotemporal dementia and amyotrophic lateral sclerosis (ALS) share genetic and molecular mechanisms. However, more research is needed to establish the link between these disorders fully.

When one of three genes has a mutation or a change, it causes genetic frontotemporal dementia:

• Progranulin protein (GRN).

• Tau protein is found in the brain (MAPT).

• C9ORF72.

The sort of mutation a patient develops has an impact on the symptoms they experience.

What Are the Symptoms and the Types of Frontotemporal Dementia?

Frontotemporal dementia symptoms are frequently misunderstood. Family members and friends may believe that a person acts inappropriately, resulting in resentment and conflict. It is crucial to realize that people with such conditions have no control over their behaviors or other symptoms, and they are entirely unaware of their illness.

Since symptoms and the sequence in which they develop vary from person to person, it can be challenging to determine which kind of frontotemporal dementia a person has in the early stages. Also, because different areas of the brain are affected, the same symptoms might emerge across different illnesses and fluctuate from one stage of the disease to the next.

Frontotemporal diseases (FTD) are divided into three categories:

1. Primary Progressive Aphasia:

• Changes in one's ability to speak, write and read, and understand what others are saying are part of primary progressive aphasia. Aphasia is a term used to describe difficulty utilizing or understanding words and difficulty speaking appropriately, for example, slurred speech. One or both of these symptoms may be present in people with primary progressive aphasia. They may be unable to speak or become mute. Many people with primary progressive aphasia acquire dementia symptoms.
• Memory, thinking, and justice issues are not often evident at first, but they might grow with time. Furthermore, as the disease advances, some patients may exhibit severe behavioral abnormalities comparable to those seen in other kinds of frontotemporal dementia.
• Increasing difficulty in comprehending and interpreting spoken and written language, such as difficulty selecting the proper word to use in speaking or naming items. Experiencing trouble in naming objects and using a more general term for specific items. No longer being able to decipher the meanings of words. Having hesitant telegraphic speech. Making errors in sentence structure.

2. Behavioral Variant Frontotemporal Dementia

The most frequent form of frontotemporal dementia, behavioral variant frontotemporal dementia, causes personality, behavior, and judgmental alterations. People with this illness may have cognitive difficulties, although their memory may be unaffected. Extreme changes in behavior and personality are the most common indications of this kind of frontotemporal dementia.Symptoms can include the following:

• Planning and sequencing issues include having difficulty realizing which steps come after another for a task.
• Patients lose interest in their family or the hobbies they used to like.
• Repeating the same act or uttering the same word repeatedly.
• Acting rashly or saying or doing wrong things without considering the impact on others.
• Difficulty in prioritizing tasks and activities.
• Judgment and inhibition lack.
• Alterations in eating habits, eating inedible stuff.
• Language and movement impairments may develop with time, necessitating greater care and monitoring for individuals living with behavioral variant frontotemporal dementia.

3. Movement Disorders

Movement issues comparable to those seen in Parkinson's disease or amyotrophic lateral sclerosis characterize rarer forms of frontotemporal dementia. The following are examples of motor-related issues observed:

• Tremors and rigidity.

• Muscle twitches or spasms.

• Coordination issues.

• Swallowing problems.

• Muscle deterioration.

• Laughter or crying (inappropriate).

• Problems with walking or falls.

How Is Frontotemporal Dementia Diagnosed?

Since the symptoms of frontotemporal dementia are identical to those of other illnesses, it can be difficult to identify.

• Behavioral variant frontotemporal dementia, for example, is frequently misdiagnosed as a mood condition like depression. To further complicate matters, a person can have frontotemporal dementia as well as another type of dementia, such as Alzheimer's disease. Additionally, due to the rarity of this condition, physicians may be inexperienced with the signs and symptoms.

• A clinician can examine the patient and inquire about their symptoms and family's medical history. In order to rule out other conditions, laboratory tests can be used, genetic testing and brain imaging can be ordered, and exams can be conducted to evaluate memory, reasoning, language, and physical abilities.

• A psychiatric evaluation can assist in determining whether other mental health problems are the cause or a contributing factor.

• A diagnosis of frontotemporal dementia can only be confirmed through genetic tests in familial situations or a brain autopsy conducted after a person dies.

• Frontotemporal dementia is being researched to identify it early and more correctly and separate it from other varieties of dementia. Biomarkers, such as proteins or other molecules in the blood or cerebrospinal fluid (CSF) that can be used to track illness development or therapy effects, are one area of study. Researchers are also looking at ways to improve neuropsychological testing and brain imaging.

How to Treat Frontotemporal Dementia?

Frontotemporal dementia presently has no remedy or specific treatment. Drugs used to cure or slow Alzheimer's disease do not seem to assist people with frontotemporal dementia, and some of them may worsen the symptoms. Certain drugs and speech therapy, on the other hand, can assist people with frontotemporal dementia in managing their symptoms.

• Medications

  • Some antidepressants, including Trazodone, may help with the behavioral issues that come with frontotemporal dementia.

  • Frontotemporal dementia is occasionally treated with antipsychotic drugs like Olanzapine or Quetiapine. However, because of the danger of major adverse effects, including an increased risk of mortality, these drugs should be used cautiously in patients with dementia.

• Therapy

  Speech therapy can help those who are having trouble communicating since it teaches them new ways to communicate.

Conclusion:

As the illness worsens, patients will need caregivers to help with everyday activities, protect their safety, offer transportation, and assist with money. The doctor will talk to them about making lifestyle changes. Find a support group for persons with frontotemporal dementia through the doctor or the internet. A support group can provide the patient with useful information targeted to their specific requirements and a place where they can share their thoughts and feelings. Receiving support, care, and compassion from those you trust can be crucial if you have been diagnosed with frontotemporal dementia.