Causes and risk factors
The two lobes involved in FTD are – frontal and temporal .The frontal lobe is responsible for functions such as motor functions, concentration, thinking, judgement, personality, behaviour emotions and language skills. Temporal has following functions – auditory reception, expressed behaviour, receptive speech, memory or information retrieval, language comprehension. FTD is caused when the nerve cells in the two lobes die. It hampers the nerve pathways that connect the cells. There is also loss of neurotransmitter which leads to the condition. Gradually there is shrinkage of the lobes. FTD mostly affects at the age between 45 to 65 years. it is seen that FTD commonly runs in the families.
Clinical presentation
In early stages, FTD can present in three ways – behavioural variant FTD, progressive non-fluent and semantic dementia. Behavioural variant FTD shows symptoms like – losing social inhibitions such as passing comments on anyone without reason, loss of interest, loss of sympathy, certain obsessions , craving for specific type of food e.g. sweets or binge eating, smoking cigarettes. Planning, organisation and taking decisions becomes difficult in this type of dementia. In progressive non fluent type, there are language difficulties such as errors in grammar, slow hesitant speech, impaired comprehension of complex sentences. In semantic dementia the person’s speech is fluent but understanding of the objects is lost such as difficulty in remembering names of objects or persons, meaning of familiar words, difficulty in finding the right word. In later stages, the difference between three types becomes faded. The damage becomes more widespread. Associated symptoms like aggression, agitation, restlessness may be present. FTD is also accompanied by motor disorders like tremors, rigidity, muscle spasms, poor coordination, difficulty swallowing, and muscle weakness.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Blood tests, neuropsychological testing is recommended. Imaging studies such as CT scan and MRI may be useful for further evaluation.
Treatment
Psychotherapy is required for treating FTD. It involves cognitive behavioural therapy, and relaxation techniques. Speech and language therapy is advised. Medications like anti psychotics, anti depressants, anti anxiety drugs, mood stabilizers, antioxidants, cholinesterase inhibitors help in management of the disease. Electroconvulsive therapy [ECT] may be required in FTD. Individual and family counselling will also help in managing FTD. Physiotherapy, occupational therapy contributes further to the treatment.
Other Modes of treatment
The other modes of treatment can also be effective in treating FTD. Bach flower therapy gives very good results in treatment of FTD. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating FTD.
