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The hidden side of dementia praecox: Why does frontotemporal dementia often strike between the ages of 45 and 65?
Frontal lobe dementia (FTD) is a neurodegenerative disease mainly characterized by the progressive degeneration of the frontal and cutaneous lobes of the brain. Both men and women can be affected, and symptoms usually first appear between the ages of 45 and 65. Although the onset of this disease can sometimes be as early as 35 years old or as late as over 70 years old, its early onset makes it very well-known and focuses on changes in social behavior and language skills, making it the most common form of early dementia. A form of attention.
There is currently no cure or approved symptomatic treatment for FTD, although some off-label medications and behavioral approaches are used in patients.
Characteristics and symptoms of FTD
The main characteristics of FTD are behavioral disorders or language disorders, which usually appear gradually. Common symptoms include emotional suppression, social maladjustment, loss of empathy, insufficient emotion regulation, and deficits in expressive and receptive language. Clinically, many FTD patients may begin to show gradual deterioration in behavioral or language abilities several years ago, and may even experience significant decline in quality of life before seeking medical attention.
Subtypes and related diseases
There are different subtypes of FTD, of which behavioral variant (bvFTD) and the two main progressive aphasias (PPA), semantic (svPPA) and non-fluent (nfvPPA) are the most common. FTD related to amyotrophic lateral dementia (ALS) is also often discussed. These different subtypes represent the clinical diversity of the disease and influence diagnostic and management strategies.
Behavioral variant frontal tetanus dementia (bvFTD) is the most common form of FTD, characterized by social inhibition and emotional alienation.
Genetic factors and pathology
Many cases of FTD run in families, and the genetic component appears to be more pronounced than other neurodegenerative disorders. Scientists have confirmed that multiple gene mutations are related to the development of this disease, especially the MAPT gene located on chromosome 17, which encodes the tau protein and is closely related to the pathological characteristics of FTD. Most notably, this may affect neuronal apoptosis and fiber changes.
In the later stages, the clinical manifestations of FTD may overlap, making diagnosis more difficult, and the diversity of symptoms may change as the disease progresses.
Diagnosis and Assessment
Because the symptoms of FTD are diverse and varied, it can be difficult to correctly diagnose the disease. Structural MRI often reveals prefrontal and/or prefrontal lobe atrophy. However, in early cases, imaging studies may appear normal. As technology advances, various new diagnostic criteria and methods have been proposed to help clinicians identify FTD earlier.
In order to diagnose FTD more comprehensively, researchers have introduced a variety of neuropsychological tests, including cognitive and emotional function tests, which can make a sensitive but not specific assessment of FTD in the early stages.
Management and prognosis
Currently, treatment for FTD focuses on managing behavioral symptoms, although there is currently no cure for the disease. Utilizing supportive therapies and psychosocial interventions can be tailored to assist patients in their daily functioning. Additionally, medications can be used to control patient symptoms, but be aware of the side effects and potential risks of these medications. Patient prognosis often varies from individual to individual, with survival times ranging from 2 to 20 years, and each patient requires different clinical support and care services.
FTD is a rich and complex combination of symptoms, with the interaction of social, mental and physiological factors, making us wonder: How can we decode this disease hidden between nerve cells in future research?
