Information On Pick’s Disease
Pick’s disease is a form of dementia characterized by a slowly progressive deterioration of social skills and changes in personality, along with impairment of intellect, memory, and language. Onset typically occurs sometime in the 50’s, though it can occur as early as age 20 or as late as age 80. As with all FTDs, the course of Pick’s disease will vary from one person to another.Pick’s disease is a relatively rare, degenerative brain illness that causes dementia. The first description of the disease was published in 1892 by Arnold Pick. Until recently it was thought that Pick’s disease could not be distinguished from Alzheimer’s disease during life. Consequently, it has been little studied, and much less is known about it than about Alzheimer’s disease.
People with Pick’s disease tend to behave the wrong way in different social settings. The changes in behavior continue to get worse and are often one of the most disturbing symptoms of the disease. Some patients will have difficulty with language (trouble finding or understanding words or writing).
Causes
Pick’s disease is a rare disorder similar to senile dementia/Alzheimer’s type. What differentiates it from Alzheimer’s disease is that it seems to affect predominantly circumscribed areas of the brain, not all regions. Alzheimer’s disease is a more diffuse process that can affect any part of the brain as it progresses. Pick’s disease affects about 1 out of 100,000 people. It affects both sexes, but it is more common in women than men.
Whilst other pathologies causing frontotemporal lobar degeneration are associated with a genetic cause, there is no evidence in the modern literature that classical Pick’s disease pathology can run in families or has a genetic cause.
It is the early appearance of a personality changes that help distinguish Pick’s disease from Alzheimer’s. (Memory loss is often the main symptom of Alzheimer’s.) People with Pick’s disease tend to behave inappropriately in different social settings. The changes in behavior continue to get worse and are often one of the most disturbing symptoms of the disease.
Symptoms
The frontal lobes of the brain are where we plan and monitor performance and where we control our behavioural and emotional responses. Damage to the frontal lobes may cause a variety of symptoms that differ greatly from one individual to another. There are however a common “core” of symptoms and some or all of these may be present at different stages of the illness. The temporal lobes are responsible for our speech and comprehension of language. Damage to these areas of the brain may cause speech loss.
Because the frontal lobes affect behavior and emotional response, people with Pick’s Disease will usually show signs of changes in personality before they manifest evidence of dementia. This may begin as impulsiveness or a lack of inhibition. While the progression of symptoms in Pick’s Disease is fortunately slow, symptoms do worsen over time.
Treatment
At the present time there are no drugs available that cure or help with Pick’s disease. The drugs used in Alzheimer’s disease generally do not help as they tend to increase aggression. As with Alzheimer’s disease and other types of dementia maximizing quality of life is the key area for treatment. Drugs can be helpful to try to deal with some of the more disturbing behavior that can occur.
A brain scan may help to define Pick’s disease by showing the degree and location of the degeneration in the brain. There is no cure and no effective treatment yet available. The risk factors for Pick’s disease are less well understood than for Alzheimer’s disease. Some people with Pick’s disease and frontal lobe dementia can live for a very long period of time, while others have a more rapid illness.
Sometimes patients with Pick’s take the same medications used to treat other types of dementia, such as medications that decrease the breakdown of the chemical messenger, acetylcholine (anticholinesterase inhibitors) and memantine (Namenda).
Prognosis
The outcome for people with frontotemporal dementia is poor. The disease progresses steadily and often rapidly, ranging from less than 2 years in some individuals to more than 10 years in others. Eventually some individuals with frontotemporal dementia will need 24-hour care and monitoring at home or in an institutionalized care setting.
