What is Frontotemporal dementia? ~ Domenico Pratico

Frontotemporal dementia (FTD) is not a singular ailment but rather a constellation of conditions stemming from the gradual degeneration of the frontal and temporal lobes within the brain of the affected individual. FTD leaves an indelible mark on the person's personality, often resulting in a notable decline in social skills coupled with emotional apathy.

At the cerebral level, in contrast to Alzheimer’s disease, FTD doesn't exhibit the presence of deposits of the amyloid beta protein. Instead, it is primarily distinguished by the progressive accumulation of the toxic tau protein, forming neurofibrillary tangles within these critical brain regions.

Recent advancements in research have unveiled that, alongside tau, another protein, TDP43, also deposits in the brains of individuals grappling with FTD. The accrual of pathological tau proteins (commonly known as tau neurofibrillary tangles) and deposits of TDP43 induce the demise of neuron cells, resulting in a drastic reduction and loss of cells in the frontal and temporal areas of the brain responsible for social skills, emotions, and personality.

The emotional deficits associated with FTD are particularly difficult and include a lack of concern for a loved one's illness, acts of cruelty towards others, a lack of empathy when others are distressed, making rude comments, a diminishing sense of personal space, socially inappropriate behavior, and a decreased response to pain.

Characteristic behaviors of FTD patients include repetition, indifference to boredom, perseveration, and a fixation on inconsequential matters. Notably, unlike other forms of dementia, FTD typically manifests with changes in behavior and personality before the onset of memory loss and speech difficulties. This condition is more prevalent than Alzheimer’s disease in individuals under the age of 60.

In some instances, FTD may be mistakenly diagnosed as a psychiatric issue or confused with Alzheimer's disease. It's important to note that frontotemporal dementia tends to emerge at a younger age compared to Alzheimer's disease.

Check out the recent blog: Smell and Memory ~ Domenico Pratico, MD, FCPP

Domenico Praticò, MD, holds the position of the Scott Richards North Star Charitable Foundation Chair for Alzheimer’s Research and serves as a Professor and the Director at the Alzheimer’s Center at Temple, as well as a Professor of Pharmacology at Lewis Katz School of Medicine at Temple University.

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