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Frontotemporal dementia (FTD)

Overview

FTD affects individuals between 45–65 years. Fifty percent of cases show autosomal dominant inheritance pattern. Those individuals with parkinsonian features present with tau mutations on chromosome 17. FTD shows MND link association to chromosome 9.

Caused by anterior temporal and frontal lobe atrophy.

  • Family history in case of familial FTD
  • Head trauma
  • Thyroid disease
  • Other risk factors including cardiovascular comorbidities, diabetes, and autoimmune condition

Symptoms differ based on the types of disease:

  • Frontotemporal dementia
    • Altered personality, personal behaviour and social skills. (apathetic/disinhibited/overactive)
    • Progressive non-fluent aphasia
    • Perseveration
    • Loss of insight
    • Pure language deficit
      • Effortful and non-fluent speech
      • Impairment of well-rehearsed series, e.g. days of the week
      • Anomia
      • Comprehension intact
      • Impaired repetition
  • Semantic dementia
    • Loss of understanding of words
      • Cannot recognize faces/objects
      • Effortless and fluent speech, but without content
    • Semantic paraphasia, e.g. cat for dog
      • Impaired comprehension
      • Anomia
  • Frontotemporal dementia with MND
    • Amyotrophic lateral form of MND presented after dementia onset

Neurologist

  • Normal EEG
  • Anterior temporal and frontal lobe atrophy seen on MRI
  • FDG PET scan- shows hypometabolism of frontal and temporal areas

  • No specific treatment
  • Supportive care for behaviour abnormalities
  • Cognitive therapy
  • Social support
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