Pick's Disease - Causes, Symptoms, Diagnosis, and Treatment

What Is Pick's Disease?

Pick's disease is a form of dementia that resembles Alzheimer's but is far less prevalent. It has an impact on brain regions in charge of emotion, behavior, language, and personality. Frontotemporal dementia, also known as frontotemporal lobar degeneration, is another name for this particular illness.

The brain uses a transportation system to help transport the nutrients it requires. Proteins make up this system, which acts as a set of ‘tracks for trains’ to transport nutrients. Tau proteins are the ones that maintain the tracks' alignment.

The tau proteins do not function properly in individuals with Pick's disease. Our transport system gets "derailed" by pick bodies. The brain can no longer receive the necessary nutrients since the track is no longer straight. This results in irreversible brain damage.

Arnold Pick, a Czech neurologist, and psychiatrist, identified Pick's disease as a degenerative form of dementia for the first time in 1892. Speech problems are a distinctive feature of Pick's disease and may appear as the first symptom.

What Causes Pick's Disease?

Pick's disease and frontotemporal dementias are brought on by aberrant levels or varieties of tau, a protein found in nerve cells. The nerve cells contain these proteins. They frequently gather into spherical clumps, known as Pick bodies or Pick cells, if an individual has Pick's disease. They kill the nerve cells in the frontal and temporal lobes of the brain when they build up in those areas. The brain's tissue shrinks as a result, which causes dementia symptoms.

Scientists are yet unsure of what leads to the formation of these aberrant proteins. But faulty genes connected to Pick's illness and other frontotemporal dementias have been discovered by geneticists. They have also provided evidence of the disease in members of connected families.

What Are the Symptoms of Pick's Disease?

The frontal and temporal lobes of the brain are where pick bodies generally develop. These sections govern how people act, think, and speak. The symptoms frequently manifest themselves as:

• Aggressive behavior towards others.

• Showing no interest in routine activities.

• Always be extremely mindful of whatever the person does.

• Feel angry or irritated.

• Possess abrupt, jarring emotional swings.

• Having a hard time empathizing, being sympathetic, or caring about others.

• Having issues with unforeseen events.

• Making snap judgments.

• Saying and doing unethical things repeatedly.

• Some people constantly feel hungry, while others have an unhealthy "sweet tooth" and consume far more sugar than they should.

Language issues typically appear early in the illness. Pick bodies in the brain's speech area might lead to issues with:

• Remembering the names of typical objects.

• Using a pencil and paper to replicate simple forms.

• Interpreting written text.

• Speaking problems due to halting or stilted speech.

Pick's disease sufferers occasionally may additionally have:

• No memory.

• Issues with moving.

• Weak or rigid muscles.

• Trouble urinating.

• Having coordination issues.

How to Diagnose Pick's Disease?

The medical professional will inquire about the patient's health history and symptoms.

In order to help rule out additional causes of dementia, such as metabolic dementia, tests may be required. Frontotemporal dementia is determined by symptoms and test results, such as:

• Evaluation of the conduct and thinking (neuropsychological assessment).

• Electroencephalogram (EEG).

• Brain MRI (magnetic resonance imaging).

• Examination of the nerve system and the brain (neurological exam).

• Examination of the cerebrospinal fluid following a lumbar puncture, the fluid that surrounds the central nervous system.

• Brain's computed tomography (CT) scan.

• Examinations of the senses, the capacity for thought and reason, and the ability to move.

• Future diagnostic techniques that measure protein deposition or brain metabolism may enable a more precise diagnosis.

• Brain scan using positron emission tomography (PET).

Only a brain biopsy can definitively determine the diagnosis.

How to Treat Pick's Disease?

Pick disease is not specifically treated. Medications may be used to control mood swings. Pick disease sufferers occasionally use the same medications prescribed for other forms of dementia. In some instances, reducing or switching out medications that cause disorientation, which is unnecessary, can enhance thinking and other mental processes. Among medicines are:

• Analgesics.

• Anticholinergics.

• Depressants for the central nervous system.

• Lidocaine.

• Cimetidine.

Treatment for any conditions that may lead to confusion is crucial. These consist of the following:

• Anemia.

• Decreased oxygen level (hypoxia).

• Heart attack.

• High levels of carbon dioxide.

• Infections.

• Renal failure.

• Liver problem.

• Dietary disorders.

• Thyroid conditions.

• Disturbances in the mood, such as depression.

• In order to regulate aggressive, hazardous, or irritating behaviors, medication may be required.

Some people may benefit from behavior modification to control undesirable or risky behaviors. Inappropriate behaviors are disregarded, while acceptable or pleasant behaviors are rewarded (when it is safe to do so).

Psychotherapy in the form of talk therapy does not always work. This is due to the potential for increased confusion or disorientation. Disorientation may be lessened through reality orientation, which reinforces indications from the environment and other sources. Monitoring and assistance with personal hygiene and self-care may be required, depending on the severity and symptoms of the disease. Eventually, 24-hour care and supervision may be required at home or in a particular institution. The person may benefit from family therapy to help them adjust to the changes required for home care.

Care may consist of the following:

• Assistance for protecting adults.

• Community assets.

• Homemakers.

• Aides or nurses on call.

• Voluntary assistance.

Early on in the development of the condition, the disease sufferers and their families might need to consult a lawyer. Making decisions about the care of the patient may be made easier by advance care directives, powers of attorney, and other legal steps in the long term.

Conclusion:

Individuals may feel less alone if they share their experiences and difficulties with people who share similar circumstances. By joining a support group, one can reduce the stress caused by the disorder.

The disorder progressively worsens over time. Early on in the disease's progression, the person becomes completely handicapped. Dementia and Pick's disease frequently result in mortality within 8 to 10 years, typically from infection but occasionally from malfunctioning physiological systems. If mental function deteriorates, contact the healthcare professional or visit an emergency facility. No recognized preventive measures exist so far.