What is Pick's Disease ?

Pick’s disease is a rare form of frontotemporal dementia (FTD) that is a progressive neurodevelopmental condition that usually affects people 40-60 years of age. However, can affect those in their 20’s. FTD leads to a progressive loss of cognition in the prefrontal and temporal lobes of the brain. This section of the brain is responsible for thinking, problem solving, planning, speaking, time management, memory and aspects of personality. FTD share some of the same characteristics as Alzheimer’s disease but the stages of development will be quite different from each other. Making an accurate distinction in conditions can only be done by a doctor.

The earliest symptoms of Pick’s disease usually reveal themselves in difficulties in speech. Whereas, in Alzheimer’s disease this typically happens later in life and in other cognitive areas of the brain.

Pick’s disease as it progresses over time will make behavioral changes that will appear in speaking and communication, thinking, problem solving, memory and confusion.

What is Pick’s Disease?

Pick’s disease is a rare degenerative type of dementia that was first diagnosed by Arnold Pick, a Czech neurologist and psychiatrist in 1892.

The most notable and first symptoms of Pick’s disease is difficulty in speech. While other types of dementia may first present themselves primarily in changes in behavior or personality.

It was determined that Pick’s disease is a result of an accumulation of tau proteins in the frontal portions of the brain, which cause formations of plaques called Pick bodies.

These same type of tau protein formations show up in those with Alzheimer’s disease as well. But, only one kind of them exists in those with Pick’s disease. The only way to detect the difference of the two conditions is during an autopsy.

Symptoms of Pick’s Disease

Symptoms of Pick’s disease will be gradually revealed in one’s behaviors, speaking and thinking ability.

Symptoms of Pick’s disease may include:

- Behavioral symptoms

  • compulsive behaviors

  • impulsive behaviors

  • inability to hold a job

  • social communication difficulties

  • lack of personal hygiene

  • forgetfulness

  • repetitive behavior

  • isolation due to social withdrawal

Language and Communication

  • difficulty with speech

  • limited vocabulary

  • lack of understanding of words

  • searching for words for expression

  • repeating words others say while talking

Emotional Changes

  • minimal interest in everyday activities

  • not noticing behavioral changes in themselves

  • lack of appropriate moods

  • uncaring attitude towards others and events

Problems in Nervous System

  • loss of short and long-term memory

  • lack of coordination

  • limited mobility

  • muscle weakness

  • stiff muscle tone

Stages of Progression

Although there is no specific rating scale for Pick’s disease; cognitive dementia diagnosis has a Global Deterioration Scale doctors commonly use. The rating scale used is called the Reisberg Scale.

  • Stages 1-3: These people usually have very mild symptoms of cognitive decline with slight signs that wouldn’t call for a diagnosis of dementia.

  • Stage 4: Represents early signs of dementia and moderate levels of decline over an average period of two years.

  • Stage 5: Mid-level cognitive decline and moderate dementia that usually will occur 18 months in length.

  • Stage 6: Severe levels of cognitive decline lasting about 30 months on average.

  • Stage7: This stage is about 18-36 months in duration of late stage dementia with severe cognitive decline.

Causes of Pick’s disease may have genetic or predisposition factors, according to researchers.

The build-up of tau proteins, Pick bodies (cells) or sometimes called tangles are found inside the nerve cells.

A proper diagnosis is done by a doctor starting with examination into other types of dementia.

Testing will include:

  • Ct head scan

  • MRI of the brain

  • PET brain scan

  • EEG (electroencephalogram)

  • cerebrospinal fluid examination

Pick’s Disease and Alzheimer’s Differences

Some of the same symptoms from other types of dementia can cause concern about the probability of Alzheimer’s disease. But, with Pick’s disease the earliest signs are in the areas of speech. This is a key difference of the two conditions.

Also, with Pick’s disease the speech and behavioral symptoms show up earlier in life than that of Alzheimer’s disease. While memory loss is not as much of an issue early on in Pick’s disease, it’s only once it progresses that it can impact neurological function.

Pick’s disease rarely if ever involves delusional behaviors and hallucinations like Alzheimer’s disease.

The outlook for someone with Pick’s disease is sadly not a positive one. Most will become disabled in time as the disease progresses and will succumb to death in 6-8 years from infection or a body system failure.

Though this rare form of frontal/temporal lobe dementia has no known cure. Medication and other therapies like neurofeedback are available to treat the other involved symptoms like depression, irritability and anxiety.

Finding answers to why Pick’s disease occurs and learning more about what neurophysiological mechanisms are in play will only be accomplished through diligent research and development.

-A Balanced Brain is a Better Brain-

Jon Stuart