Pick's disease is a neurological disorder classified under frontotemporal dementia (FTD) in medical literature, resulting from damage to nerve cells in the frontal and temporal lobes of the brain. The disease begins with changes in behavior and personality and may lead to language disorders and loss of independence in daily life activities over time.
What is Pick's Disease?
Pick's disease is the second most common type of dementia after Alzheimer's and typically appears between the ages of 40-60.
Characterized by shrinkage due to excessive protein accumulation in brain cells, Pick's disease primarily causes personality, social behavior, and speech disorders due to brain damage.
The risk of Pick's disease may be higher in individuals with a family history of the disease and those who have experienced head trauma.
What are the Symptoms of Frontotemporal Dementia?
Symptoms of Pick's disease include behavioral disorders, orally centered repetitive behaviors, and dysfunctions in the nervous system.
Behavioral disorders:
-
Mood changes
-
Irritability and tension
-
Lack of interest in daily social functioning
-
Inability to concentrate
-
Inability to form social connections
-
Loss of empathy
Disorders in orally centered behaviors:
-
Difficulty in speaking
-
Impairment in reading and writing skills
-
Inability to understand spoken words
-
Repeating what is heard
-
Producing incoherent speech sounds
Nervous system disorders:
-
Dystonia
-
Memory loss
-
Apraxia
-
Weight loss
-
Difficulty swallowing and eating
-
Walking disorders
How is Classification Done in Frontotemporal Dementia?
In Pick's disease, examination of brain tissue defines the different subtypes of the disease. These subtypes may vary in clinical progression and which region is primarily affected.
Stages of frontotemporal dementia:
Type A
A form characterized by prominent frontal lobe atrophy. In this case, behavioral disorders are predominant; patients forget social norms, have decreased impulse control, and display emotional indifference. Although speech skills are usually preserved, language functions are affected as the disease progresses.
Type B
A form characterized by prominent temporal lobe involvement. A semantic dementia picture develops because the temporal lobe is responsible for memory and language functions. Patients may forget the meanings of words, have difficulty identifying objects, and experience word-finding difficulty. Behavioral disorders are milder compared to Type A, allowing patients to extend the duration of social compatibility.
Type C
A prominent condition with widespread atrophy of both the frontal and temporal lobes; behavioral problems and speech loss appear simultaneously. Individuals rapidly regress in adapting to social norms and communication abilities, developing dependency in daily activities. In advanced stages of the disease, symptoms such as difficulty swallowing and decrease in motor skills may be observed.
What is the Diagnosis Process for Pick's Disease?
There are specific stages that can be followed to diagnose Pick's disease. Initially, a neurological examination is conducted to evaluate the patient's behavior, memory, language skills, and movement ability. The examination focuses on the patient's cognitive functions, and neuropsychological tests are administered. These tests can help determine the disease by measuring the patient's mental capacity, memory, and language skills.
Brain imaging methods such as magnetic resonance (MR) and computed tomography (CT) scans are performed. These scans can show signs of shrinkage or atrophy in the frontal and temporal lobe areas of the brain.
A differential diagnosis process is also implemented. At this stage, it may be necessary to identify the differences between Pick's disease and other neurodegenerative disorders such as Alzheimer's disease and Parkinson's dementia. As each disease has unique symptoms and pathological features, this distinction is crucial for accurate diagnosis.
What are the Treatment Methods for Pick's Disease?
There is currently no treatment method that can cure Pick's disease. The focus of treatment is to control the symptoms of the disease, which can slow down the progression of symptoms. Management of symptoms such as depression, irritability, and mood changes is typically achieved with medication, potentially improving the patient's quality of life.
Differences Between Pick's Disease and Alzheimer's Disease
Pick's disease is often confused with Alzheimer's disease. However, there are some significant differences:
-
While the initial symptoms of Alzheimer's disease focus on memory loss, the first signs of Pick's disease are behavior changes and language issues.
-
In terms of brain regions, Alzheimer's disease typically affects the hippocampus and temporal lobes; while in Pick's disease, shrinkage of the frontal and temporal lobes is observed.
-
Age is also a distinguishing factor between the two diseases. Pick's disease begins at an earlier stage, between the ages of 45 and 65.
-
The progression of Pick's disease also differs. The disease can lead to social and personality changes more rapidly. Behavioral changes such as sudden anger outbursts and lack of empathy may be noteworthy.
Frequently Asked Questions
How can behavior problems related to Pick's disease be managed?
Behavioral symptoms are challenging for both the patient and their family. Environmental adjustments, a patient approach, and behavior management techniques can help reduce these symptoms.
How long does it take for frontotemporal dementia to progress?
The rate of progression varies from person to person. In most cases, symptoms worsen within 6–8 years after diagnosis, requiring patients to need full-time care. Early diagnosis and regular follow-up can help manage symptoms.
Are there nutritional issues in Pick's disease?
Swallowing difficulties may develop in the advanced stages of the disease. Appropriate nutritional support and, if necessary, special dietary planning can help alleviate these problems.
Is Pick's disease hereditary?
Most cases of Pick's disease are not hereditary, but familial transmission is observed in approximately 10-20% of cases. Some gene mutations may increase the risk of the disease. If there is a history of similar diseases in the family, genetic counseling is recommended.