What is Frontotemporal Dementia in plain English?
Frontotemporal Dementia (FD) affects nearly 16,000 people it is one of the rarer forms of dementia, however it is a main cause for early onset dementia, i.e. dementia diagnosis below 65 years old. There is also a hereditary link- 1/3rd of patients have a family history of the same thing.
As protein deposits, or tau’s, kill off nerve cells forcing communication lines to be redirected within the brain, our daily functions are altered considerably. These deposits are left in two key parts of the brain the Frontal Lobe, right at the front of our brain, and the Temporal lobe, just below it- hence the name Frontotemporal Dementia.
The Frontal Lobe significantly affects our daily life controlling things like:
- Decision Making
- Planning and Organisation
- Fluency of speech
- Personality Projection
The Temporal Lobe also significantly affects our daily life controlling things like:
- Helps us to comprehend words
- Selective Hearing
- Provokes Meaningful Responses in relation to the conversation
- Distinguishes Pitch
Frontotemporal Dementia is the overall umbrella word for three sub types of illness, it is rare that they would be referred to on their individual merit, the FD term is much more common. But just so you know the three types we are going to break them down a little bit for you. Behaviour Variant Frontotemporal Dementia, Semantic dementia which affects the Temporal Lobe and Progressive non Fluent Aphasia which affects a little bit of both lobes.
Behaviour variant Frontotemporal Dementia
So when deposits of tau’s occur within the Frontal lobe we notice significant behavioural changes. This is called Behavioural variant Frontotemporal Dementia. As the damage in the Frontal lobe sets in and it starts to shrink in size, one may become erratic in behaviour, the way they hold themselves may be entirely different to how they’ve always been. Oppositely, they can become withdrawn and compulsive about certain routines and behaviours.
An attack on the Temporal Lobe by the Tau protein deposits means one still has the fluency to speak but they lack the capability to know what words mean. Reasoning when hearing someone else speaking is diminished, so all that is heard as gobbledy gook and therefore the response is non sensical either.
Progressive Non Fluent Aphasia
This is when a little bit of both Lobes are attacked, so we know what we are trying to say but we have a problem in locating the correct word quickly. This can lead to stuttering or slurred speech as we try to find what we want to say, but in most cases eventually the words will come. As the illness progresses though it is even harder to locate the words, almost impossible, and we may start to leave out linking words, such as ‘the’ or ‘to’, so sentences become even harder to follow.
Invariably in time most aspects will depreciate, speech and behavioural dementia come together and cause incomprehension and withdrawal. From this point the progression of the illness is similar to that of Alzheimer’s.
What are the symptoms?
As you can see above the two lobes work on conjunction with one another to project our personality. However when there is an unhealthy build up of Tau’s in particularly the Frontal lobe, behaviours change abruptly as we cannot reason appropriately, and we swing from mood to mood with minimal provocation. This can be distressing for loved ones.
The key word for Frontotemporal Dementia is Reasoning. Our ability to interpret and then reason successfully is incapacitated, initially for short periods of time, through to the majority of the time in later stages. So when outbursts occur due to significant mood swings it can sometimes follow that the individual has limited or no understanding as to why you may react in a certain way. Their capability to empathise and be sympathetic diminishes, they cannot place themselves in other shoes any more and acknowledge wrong doing or apologise for hurting others feelings.
Speech can be affected in a number of ways by FD. Some may find that they have problems interpreting what is said to them, struggling to tag meanings to the words that are said to them, all they hear are a string of non connected words, and this can quite often lead to a similar string of non sensical words. There are also those who understand what is said to them but whom cannot locate the correct words to respond, they too can come across as responding in a confused way, its purely that the right word association just isn’t there anymore. Alternatively some may also find that they can interpret what is said to them as they always have, they know the response they want to give but struggle with the recall of the words, and whilst they try to capture the words for the sentence they may sound slurred or speak very slowly.
In some circumstances those with FD have been found to crave sweet and fatty foods, all the foods that are bad for you. The reason why is not really known but it could well be to do with the brains desire for stimulation and enjoyment in some capacity.
With Thanks to:Alzheimer’s Society,The BMJ, AFTD,NHS Choices
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