A 55-year-old man running naked in the streets and yelling obscenities may not be under the influence of any substance, but actually be suffering from a dementia that affects the frontal lobes of the brain, known as frontotemporal dementia (FTD).
FTD, formerly known as Pick’s disease, is a common cause of dementia that affects people younger than 65, unlike the other dementias that primarily affect people older than 65. FTD has such a gradual progression that is difficult to diagnose and is commonly misdiagnosed as a primary psychiatric disorder such as schizophrenia.
The frontal and temporal lobes play a critical role in daily functioning. These two areas in the brain control speech, language, and social, emotional and executive functioning. That is why patients with FTD will exhibit malfunctioning in at least one or two of these areas.
Signs and symptoms
Although patients with frontotemporal dementia generally have fairly preserved memory, they experience substantial changes in their behavior and language, according to an article titled “Frontotemporal Dementia: A Review for Primary Care Physicians,” published in the Dec. 1, 2010, issue of American Family Physician.
Common behavioral features include loss of insight, social inappropriateness and emotional blunting. Common language features are loss of comprehension and object knowledge, and nonfluent and hesitant speech.
Patients with FTD will not uncommonly display impulsivities, such as screaming obscenities in public, walking around naked or neglecting their personal hygiene. A sweet, nurturing lady may slowly transform into an apathetic woman with a sarcastic sense of uninhibited humor.
Unfortunately these personality and behavioral changes occur so slowly over time that it is often difficult to link them together. Instead, family members or caretakers may just assume their loved one is becoming “senile” or developing a purely psychological disorder.
Brain imaging by MRI often demonstrate cerebral atrophy, which means degeneration of the white matter in the brain. This is also seen in many other disorders, including Alzheimer’s disease.
Current and future treatments
As with most other dementias, no specific treatment for FTD exists. However, treatment can help to manage some of the symptoms. Selective serotonin reuptake inhibitors (SSRIs) are generally used in this population to treat the depression that is commonly associated with FTD. Researchers are still searching for a treatment protocol that targets one of the genes responsible for this disease.
If you or someone you know has a mental illness or substance abuse disorder, get in touch with the California Dual Diagnosis Helpline. Call our helpline at 855-980-1736 any time to speak with a representative and get referred to a rehabilitation or recovery center in your area.