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Behavioral Variant Frontotemporal Dementia

This Disease Is Also Known as Pick's Disease

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Updated November 05, 2012

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Behavioral variant frontotemporal dementia (bvFTD) is one of several types of dementias that fall into the "frontotemporal degeneration" category. This category affects approximately 50,000 to 60,000 Americans.

As the name indicates, this kind of dementia primarily affects the frontal and temporal lobes of the brain. The most common frontotemporal dementias are of the behavioral-variant type. Behavioral-variant frontotemporal dementia is sometimes referred to as Pick's disease.

Symptoms

The most common symptoms of bvFTD are behavioral or emotional challenges, including compulsively overeating, having an emotionally-detached demeanor, making socially inappropriate responses, acting hypersexual in conversation and thought, along with irritability, agitation, apathy and selfishness.

Some individuals with bvFTD also experience movement difficulties similar to Parkinson’s disease, including decreased facial expressions, muscle stiffness, weakness and rigidity.

Unlike Alzheimer's, memory loss does not usually develop until the disease is very late-stage. As a caregiver, you may then notice some memory difficulties, as well as challenges with planning or attention.

In severe bvFTD, language also is affected, making communication very difficult.

Diagnosis

Diagnosis is often delayed because initially it may be thought that an affected person is just being rude, selfish, depressed or acting out of character. As symptoms progress, however, families usually seek a clinician's assistance for diagnosis and treatment. Diagnosis depends on the presence of multiple symptoms that are outlined above, as well as the ability to rule out other dementia such as Alzheimer's or vascular dementia. You can view detailed international criteria in this document: Criteria for Behavioral Variant FTD

Prognosis or Long-Term Outlook

Average life expectancy from onset of symptoms is approximately eight to nine years, though some people may live 20 years or so with the disease. As with any dementia, it can be a challenging disease for caregivers. Treatment may consist of attempting to use non-drug behavior strategies to curb specific behaviors. Some physicians prescribe antidepressants called selective serotonin reuptake inhibitors (SSRIs), which may help with some of the obsessive-compulsive behaviors such as hoarding or overeating.

Sources:

Annals of Neurology. Eating and hypothalamus changes in behavioral-variant frontotemporal dementia. Accessed December 11, 2011. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3084499/

The Association for Frontotemporal Degeneration. http://www.theaftd.org/

The Association for Frontotemporal Degeneration. International consensus criteria for behavioural variant FTD. Accessed January 14, 2012. http://www.theaftd.org/wp-content/uploads/2009/02/Table-3-International-consensus-criteria-for-behavioural-variant-FTD.pdf

Banks, S., Weintraub, S. Journal of Geriatric Psychiatry and Neurology. Neuropsychiatric Symptoms in Behavioral Variant Frontotemporal Dementia and Primary Progressive Aphasia. Accessed January 14, 2012. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892801/

Neurology. Determinants of survival in behavioral variant frontotemporal dementia. Accessed December 12, 2011. http://www.neurology.org/content/73/20/1656.short?rss=1

Neurology. Sensitivity of current criteria for the diagnosis of behavioral variant frontotemporal dementia. Accessed January 14, 2012. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821829/

University of California, San Francisco. Forms of Frontotemporal Dementia. Accessed December 11, 2011. http://memory.ucsf.edu/ftd/overview/ftd/forms/multiple

University of California, San Francisco. Disease Progression: Behavioral variant FTD. Accessed January 14, 2012. http://memory.ucsf.edu/ftd/overview/ftd/progression/multiple

U.S. National Institutes of Health. National Institute on Aging. Types of Frontotemporal Disorders. Accessed December 12, 2011. http://www.nia.nih.gov/Alzheimers/Publications/FTLD/02.htm

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