Frontotemporal disorders (FTD) are brain conditions that affect two lobes in the brain: the frontal lobe and the temporal lobe. Personality, language, and behavior are governed by these parts of the brain. Frontotemporal dementia of bvFTD is one of three types of FTD, and it causes ten to 20 percent of dementia cases.
In a person with frontotemporal dementia, one or both of these lobes begin to shrink or atrophy. Depending on which lobe is affected, the symptoms will differ, causing difficulty with impulse control, speaking, or emotional reactions.
Due in part to how these symptoms differ from more familiar types of dementia, frontotemporal dementia can be misdiagnosed as a psychiatric condition or Alzheimer’s disease. However, FTD usually develops at a younger age, often between 40 and 65.
In addition to atrophy or shrinking of the frontal or temporal lobes of the brain, frontotemporal dementia is caused by the accumulation of excess proteins in the brain. Researchers don’t yet know much about what prompts these causes to develop in the first place.
Genetic mutations seem to be linked to the risk of developing bvFTD, though this doesn’t appear to be behind at least half of the cases. There is also evidence of shared genetics and molecular pathways between bvFTD and ALS or Lou Gehrig’s disease. The only clear, predictive risk factor, however, is a family history of dementia.
Symptoms of frontotemporal dementia often develop in clusters and can be grouped into three categories: behavioral, speech and language, and movement.
Behavior changes are the most common with this type of dementia. They include inappropriate social behavior, lack of judgment or inhibition, declining personal hygiene, and a compulsive urge to put things in the mouth. Some people also develop a lack of interest that may be misdiagnosed as depression.
Primary progressive aphasia is closely related to frontotemporal dementia and is sometimes considered a precursor or secondary condition. Issues with speech and language that affect people with these disorders include struggling to find the right word to describe a situation or name an object, hesitant speech patterns, and sentence construction errors.
Movement issues are less common in the dementia type of frontotemporal disorders. When they do develop, they present as similar to Parkinson’s disease or ALS and include tremors and muscle spasms, muscle weakness, difficulty swallowing, and poor coordination.
If a doctor suspects their patient has frontotemporal dementia, they will look for a variety of symptoms and run multiple tests. So many of the early symptoms overlap other conditions that it can be quite difficult to reach the correct diagnosis quickly.
Blood tests can rule out other disorders, as can sleep studies because some symptoms of bvFTD are shared with obstructive sleep apnea. Neuropsychological tests of memory and reasoning are often used to help diagnose dementia, and brain scans, including MRIs, can identify clots or tumors that could also cause similar symptoms.
There is no cure for frontotemporal dementia nor a treatment specifically for the condition. Alzheimer’s treatments are found to have little effect or, in some instances, even worsen symptoms of bvFPD.
As such, doctors primarily seek to treat the symptoms, which can include prescribing antidepressants or antipsychotic medications and encouraging patients to explore speech therapy to help them retain or retrain their communication abilities.
In addition to exploring the clinical trials for bvFTD treatment, people with the condition, and their caregivers, can take various steps to help reduce the negative impact of the dementia, even as the symptoms progress.
Experts recommend avoiding events that trigger unwanted behaviors, such as poor impulse control, and removing negative cues—the car keys, for instance—that could lead to dangerous problems. Like with other types of dementia, keeping day-to-day life routine and simplifying as many regular tasks as possible can also help avoid triggers.
If someone believes they might have frontotemporal dementia, they should schedule an appointment with a doctor as soon as possible. In order to make the process as seamless as possible, it can be useful to prepare the following information:
Frontotemporal dementia is one of three frontotemporal disorders, the other two being primary progressive aphasia and movement disorders.
Primary progressive aphasia affects a person’s ability to communicate, making it difficult to understand words and create speech. Often, people with PPA develop other dementia symptoms as well.
Movement disorders such as corticobasal syndrome and progressive supranuclear palsy make it difficult to balance and control their movements. Some people also develop frontotemporal dementia with parkinsonism and FTD-ALS.
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