FTDs

Q: Which symptom is most common in frontotemporal dementias (FTDs)? - Select one

A) Visual disturbances

B) Aphasia

C) Metallic taste

D) Cochlear degeneration

E) Temperature deregulation

Answer: B

Although FTD occurs as frequently as Alzheimer disease (AD), it remains one of the most under diagnosed neurodegenerative disorders, due to its early occurrence with mean age of 58 and as most patient either have changes in social behavior and personality or become somnolent with ptimary progressive aphasia (PPA), and get refer to psychiatry service. 

It involves the frontal and/or temporal lobes. To complicate matters, many patients simultaneously develop concomitant parkinsonism or motor neuron disease (MND). The underlying etiology is genetic.

It is usually classified into three subtypes:

• Behavioral variant FTD (bvFTD) 
• Nonfluent PPA or "agrammatic PPA." 
• Semantic PPA

Patients need a neurology consult and may undergo various imaging and neuropsychiatric testing. Social support and speech therapy are the mainstays of the treatment, though trazadone and citalopram may help.

#neurology

#psychiatry

References:

1. Antonioni A, Raho EM, Lopriore P, Pace AP, Latino RR, Assogna M, Mancuso M, Gragnaniello D, Granieri E, Pugliatti M, Di Lorenzo F, Koch G. Frontotemporal Dementia, Where Do We Stand? A Narrative Review. Int J Mol Sci. 2023 Jul 21;24(14):11732. doi: 10.3390/ijms241411732. PMID: 37511491; PMCID: PMC10380352.

2. Kirshner HS. Frontotemporal dementia and primary progressive aphasia, a review. Neuropsychiatr Dis Treat. 2014 Jun 12;10:1045-55. doi: 10.2147/NDT.S38821. PMID: 24966676; PMCID: PMC4062551.

3. Neylan KD, Miller BL. New Approaches to the Treatment of Frontotemporal Dementia. Neurotherapeutics. 2023 Jul;20(4):1055-1065. doi: 10.1007/s13311-023-01380-6. Epub 2023 May 8. PMID: 37157041; PMCID: PMC10457270.

4. Magrath Guimet N, Zapata-Restrepo LM, Miller BL. Advances in Treatment of Frontotemporal Dementia. J Neuropsychiatry Clin Neurosci. 2022 Fall;34(4):316-327. doi: 10.1176/appi.neuropsych.21060166. Epub 2022 May 17. PMID: 35578801.