额颞叶 痴呆
Overview
额颞叶 dementia (FTD) is a group of degenerative diseases that gradually damage or shrink the brain's frontal and anterior temporal lobes, 位于大脑前部的. These lobes are the center of many important brain functions, including language skills and the abilities to focus attention, 制定计划和决定, 控制冲动. FTDs include frontotemporal lobar degeneration, 皮克病, progressive aphasia and semantic dementia.
Symptoms often involve personality or mood changes, 强迫性或重复性行为, 缺乏情感, 抑制或社交技巧.
FTD affects an estimated 1 in 5,000 to 10,000 people. Calculating its prevalence is difficult because most experts believe it is underdiagnosed.
Researchers now believe FTD is the second leading cause of dementia in middle age. 在过去, it was often confused with 阿尔茨海默病 or other forms of dementia, but FTD appears earlier in life than 阿尔茨海默病. Most patients are diagnosed during their 50s and 60s, and the disease lasts an average of eight years. 男性和女性同样受到影响.
About 40 percent of patients have a clear family history. The remaining 60 percent of cases occur randomly. If a parent has frontotemporal dementia, one in two of the children are likely to develop the disease. 在某些情况下 where the disorder appears to be inherited, there is an apparent change or mutation in a gene on chromosome 3, 9 or 17. Other genes may be involved as well. The cause of the illness, however, is unknown.
Our approach to frontotemporal dementia
UCSF is home to one of the few centers in the country that specialize in research and diagnosis of frontotemporal dementia. We offer extensive assessments to correctly diagnose FTD, which may be mistaken for other conditions, as well as medications to minimize 症状. Because caring for a loved one with FTD can be very challenging, we hold a monthly support group to provide information and comfort for 家庭和照顾者. We also work to connect families with outside support services.
奖 & 识别
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Among the top hospitals in the nation
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加州最好，排名第一. 神经病学全国排名第二 & 神经外科
迹象 & 症状
在过去, patients with frontotemporal dementia (FTD) often were misdiagnosed with 抑郁症, schizophrenia or 阿尔茨海默病. Because some FTD cases still may be misidentified, doctors at the UCSF Center for 内存 and Aging say it's difficult to determine the prevalence of the disorder but they believe FTD is the most common dementia diagnosed in patients under age 60 and is as common as 阿尔茨海默病 among patients age 45 to 64.
Early 症状 typically involve personality or mood changes such as 抑郁症 and withdrawal, sometimes obsessive behavior and language difficulties. Many patients lose their inhibitions and exhibit antisocial behavior.
十大赌博平台排行榜 at UCSF have identified a small group of patients who develop extraordinary visual or musical creativity, while experiencing language and social impairment.
随着FTD的进展, it takes a toll on mental abilities, affecting memory and other functions that are more common in 阿尔茨海默病 还有其他痴呆症. In Alzheimer's, one of the first 症状 is memory loss. 与FTD, unusual or antisocial behavior as well as loss of speech or language are usually the first 症状.
在后期阶段, patients develop movement disorders such as unsteadiness, 刚性, 缓慢, 抽搐, muscle weakness or difficulty swallowing. 有些病人会发展成 卢伽雷氏症 or amyotrophic lateral sclerosis (肌萎缩性侧索硬化症). People in the final stages of FTD cannot care for themselves.
行为症状
Early signs of frontotemporal dementia may involve the following 症状:
- 冷漠:冷漠或不愿说话
- Change in personality and mood, such as 抑郁症
- Lack of inhibition or lack of social tact
- Obsessive or repetitive behavior, such as compulsively shaving or 收集物品
- Unusual verbal, physical or sexual behavior
- Weight gain due to dramatic overeating (Read more about FTD和暴食.)
病人 may neglect hygiene and resist encouragement to attend to themselves. They also may lack awareness or concern that their behavior has changed.
At the UCSF 内存 and Aging Center, doctors have found a small group of FTD patients who develop new creative skills in music and art. The artistic talents developed when brain cell loss occurred predominantly in the left frontal lobe, which controls functions such as language. It is believed that the right side of the brain regulates more abstract reasoning.
语言的症状
Language problems are less common but do occur in the early stages of FTD before other thought processes, 比如记忆, 受影响. 病人 may experience difficulty speaking or finding the correct word when naming objects. Difficulties reading and writing then develop. As the disease progresses, less and less language is used, until the patient becomes virtually mute. Other patients may have a severe problem recalling words and understanding word meaning, but continue to have otherwise normal speech.
诊断
Because the first 症状 tend to affect personality and behavior, frontotemporal dementia may be mistaken as a psychiatric disorder. 诊断 requires a thorough physical examination and interview with family members.
At the UCSF 内存 and Aging Center, patients undergo an extensive neurological, neurophysicial and nursing assessment, 通常需要三个小时. 看护人也接受了采访.
Because memory loss and other related 症状 are often complex, the evaluation may require two to three visits to determine the cause of the 症状 and recommend treatment.
评估结束后, the medical team meets to discuss the diagnosis and potential treatments and then discusses its findings with the patient and the family. 在某些情况下, a diagnosis will be deferred until more information from blood tests or brain imaging is collected.
FTD leads to loss of brain tissue that is visible on imaging tests, such as 磁共振成像(MRI), which are key in identifying the characteristic shrinking of the frontal and temporal lobes, 位于大脑前部的. 其他测试包括 正电子发射断层扫描, 计算机断层扫描 and single photon emission computed tomography (SPECT).
作为诊断的一部分, a written report is sent to the patient's primary care physician or specialist who referred the patient to UCSF.
治疗
If FTD is diagnosed early in the course of the disease, doctors can prescribe medications and help families prepare and cope with 症状. The condition may last from three to 17 years before death, with an average duration of eight years after diagnosis.
Therapy is designed to relieve the 症状 or behaviors caused by frontotemporal dementia, but there is no treatment to stop or reverse the underlying brain deterioration. Antidepressants called selective serotonin reuptake inhibitors (SSRIs) may offer some relief from apathy and 抑郁症 and help reduce food cravings, loss of impulse control and compulsive activity.
十大赌博平台排行榜 may prescribe anti-psychotics, medications that can alleviate extremely unrealistic or disorganized thinking such as hallucinations, 妄想和攻击性. Older anti-psychotic medications that block dopamine may be dangerous for FTD patients because some of them have 帕金森病, which causes a loss of dopamine, a chemical messenger that transmits signals within the brain.
Cholinesterase inhibitors – the class of drugs currently used to treat memory 症状 in Alzheimer's – do not help FTD patients. These drugs temporarily increase supplies of the messenger chemical acetylcholine to failing nerves, but FTD does not affect nerves in the acetylcholine communication system.
有些FTD患者会发展 卢伽雷氏症, also known as amyotrophic lateral sclerosis (肌萎缩性侧索硬化症). 十大赌博平台排行榜 don't yet fully understand the connection between the two diseases but are studying the trend.
Many FTD patients remain at home and others require nursing home care. Being a caregiver of an FTD patient can be physically and emotionally exhausting. If you are a caregiver, you should seek as much help as possible to carry out your day-to-day tasks. The UCSF 内存 and Aging Center sponsors a 额颞叶 痴呆 支持组 that meets monthly to provide support and education to families of FTD patients and referrals for community resources.
加州大学旧金山分校健康 medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
