Pick’s Disease - Causes, Symptoms, Prognosis
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. Not every symptom will be experienced by every person, nor will these symptoms develop in a pre-ordained sequence. All patients with Pick’s disease will experience a gradual, steady decline in functioning.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.
Pick disease (named after Arnold Pick) is a progressive dementia defined by clinical and pathologic criteria. Unlike Alzheimer disease, which typically presents with impairment of recent memory associated with entorhinal cortex and hippocampal dysfunction, Pick disease typically affects the frontal and/or anterolateral temporal lobes. First described in 1892, with the defining pathologic characteristics first reported by Alois Alzheimer in 1911, Pick disease is now considered by some to be part of a “complex” of neurodegenerative disorders with similar or related histopathologic and clinical features
Causes and Pick’s Disease
Pick’s Disease is the result of a build-up of protein in the affected areas of the brain. The accumulation of abnormal brain cells, known as Pick’s bodies, eventually leads to changes in character, socially inappropriate behavior, and poor decision making, progressing to a severe impairment in intellect, memory and speech. Pick’s Disease usually strikes adults between the ages of 40 and 60, and is slightly more common in women than in men. While the cause is still unknown, there is a strong genetic component: FTDs tend to run in families, and approximately 40% of Pick’s Disease cases are believed to be hereditary.
Symptoms of Pick’s Disease
Many of the early symptoms of Pick’s disease are frontal lobe symptoms. It is these symptoms that tend to mark out the differences between Pick’s dementia and the other types, such as Alzheimer’s. In Alzheimer’s disease the initial symptoms tend to be memory impairment. In Pick’s disease because the frontal lobes of the brain are affected, the first symptoms occur in emotional and social functioning. It is the mood changes, often biased towards euphoria, disinhibition and a deterioration in social skills that are so noticeable.
Treatment
No treatment has been shown to slow the progression of FTD. Behavior modification may help control unacceptable or dangerous behaviors. Aggressive, agitated, or dangerous behaviors could require medication. Anti-depressants have been shown to improve some symptoms.
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.
