Introduction about the disease :
Frontotemporal dementia is a neurodegenerative disease in which the frontal variant is the most common form. Today, we will focus on this variant because this form is still misidentified nowadays. It is one of the reasons why the symptom knowledge truly matters. In an anatomical point of view, the disease is characterized by atrophy of the frontal and temporal lobes. It means that in theses cerebral lobes, there are fewer brains cells (called neurons) leading to fewer connections that cause brain damage.
Symptoms :
We must keep in mind that every patient and every disease are unique. Nevertheless, some symptoms remain common. Commonly, the disease starts with slight changes in the patient’s behaviour. The patient or the caregiver often described the changes by an increase of stress, depression or anxiety. In this matter, in an early stage, frontotemporal dementia is usually mistaken with a psychiatric illness. As a second phase, the disease is characterized by the onset and worsening of behavioural disorders and emotional disorders such as :
- physical and domestic carelessness/negligence
- eating disorder (binge eating disorder, gluttony)
- emotional control disorder (fit of anger, irritability)
- apathy (lack of motivation to do things)
- verbal and behavioural disinhibition
- the trend to collect items and splurge
- obsession
Also, some cognitive disorders such as :
- Dysexecutive syndrome: dysfunction in executive function such as planning, flexibility, solving problem, abstract thinking, inhibition
- Episodic memory impairment (memory of events experienced by the patient)
- Difficulty interpreting emotional cues
- Disruption of social cognition
How diagnoses frontotemporal dementia ?
A single clinical test or diagnosis is not sufficient, the patient must pass a set of medical appointment such as :
- A consultation with a neurologist
- A Magnetic resonance imaging (MRI) which is a kind of radiology
- An Electroencephalography (EEG): which is an electrophysiological monitoring method to record the electrical activity of the brain.
- A neuropsychological assessment
- Sometimes, a spinal tap to exclude other diseases
Which treatment ?
Unfortunately at the moment, there is no specific treatment for frontotemporal dementia. However, doctors could prescribe some neuroleptic to control and decrease any dysfunctional behaviour such as impulsiveness, irritability, eating disorder or disinhibition.
Which support?
After the diagnosis has been made, the patient has an appointment with his neurologist every 6 to 12 month. Also, he can have a regular appointment with a speech therapist to deal with the deglutition disorder. A cognitive remediation program and psychological support with a psychologist could be offered to the patient every week to reduce some symptoms.
The caregiver can also have some support: a psycho-education program to help to understand the disease and learn how to deal with some behaviours and symptoms. Furthermore, they can have a psychologist’s support. Finally, they can join an association grouping together people with the same disease or whose relatives suffer from the disease, for example, « France FDT».
As we discussed it, the frontal variant of frontotemporal dementia is a very complex disease with a lot of different symptoms. It is important to be aware of the different symptoms to identify them and enable a diagnosis to be done.
Words I have learned :
Impairment : trouble, déficience
be aware : être attentif
neuropsychological assessment : une évaluation / un bilan neuropsychologique
slight : léger
Written by Pauline Bolgert