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Pick’s Disease

Pick’s Disease is also called frontotemporal dementia (FTD). As the name suggests, this is a kind of dementia that commonly affects the parts of the brain that controls emotions, behavior, personality & language. This disease is rare and is often categorized under a type of dementia which only affects some parts of the brain, unlike the rest. People with Pick’s disease do not suffer from short-term memory issues like those with Alzheimer's. The name comes from a well-known professor of psychiatry and Neurology, Arnold Pick. In the late 19th & 20th century, Arnold contributed many papers in both fields.  

He was a well-known professor for his work in Prague, who studied in-depth around aphasia (loss of language skills). While observing different patients with symptoms ranging from degeneration of the temporal region to loss of cognitive functions, behavioral abnormalities with frontal dementia came the diagnosis of a new disease that did not affect the whole brain function but only a few parts. 

With around 50,000-60,000 people in the U.S who have currently been diagnosed with Pick’s disease. It usually can be diagnosed between 40-60 years. In some cases, early onset can also occur at the age of 20 years. It affects an individual drastically as it damages the part of the brain that helps in decision making every day. From judgments to planning, emotional control to behavior, the awareness around this becomes significant, especially to the primary and secondary caretakers.  

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Cause

Pick’s disease is found to be caused by abnormal amounts or types of nerve cells proteins called tau. Proteins are carried and stored in nerves. These abnormally grow into spherical clumps known as Pick’s cells or bodies. When these proteins accumulate abnormally in different parts of the brain, they kill the healthy cells to die. When cells die, the tissues start slowly shrinking, resulting in symptoms of dementia. Though there are on-going research and no definite reason for how these proteins abnormally accumulate, links to genetics have been a lead.

Symptoms

Pick’s disease is a progress frontotemporal dementia that slowly gets worse with symptoms with time. Changes in personality help doctors to distinguish FTD from Alzheimer's.

Behavior Symptoms include:

- Compulsive behaviors or repetitive behavior
- Impulsive or inappropriate behaviors (most social situations)
- Problems with personal hygiene

Emotional changes:

- Mood changes
- Lack of empathy, sympathy
- Decreased interest in everyday activities

Language changes: 

- Mutism, inability to speak.
- Decreased ability to read, write, speaking & understanding speech (Aphasia)
- Uncoordinated speech sounds, shrinking vocabulary. 


Other symptoms also include:

- Memory loss can get worse with time
- Weakness
- Movement coordination difficulty
- Urinary incontinence 

Treatments

There are no treatments for Pick’s disease. Different medicines are monitored for symptoms.

- Analgesics
- Anticholinergics
- CNS Depressants
- Lidocaine
- Cimetidine

It's important not to change medicines as confusion for an individual may get worse and lead to multiple other disorders like depression, heart failure, kidney failure, etc. Talk therapy (psychotherapy) can sometimes work but not in all cases. Depending on the symptoms and the degree of it, these medicines and treatments are monitored. Commonly, self-care, personal hygiene, and family counseling for the rest of the members to cope with emotionally.

Individuals with FTD can die around 8-10 years after diagnosis, most of it by a body system failing or by infections. There are no prevention measures for this. However, one can seek help when there are abrupt changes in one's mental function that gets worse quickly.