What is fronto-temporal lobar degeneration (FTLD)?

Symptoms and treatment of FTLD

FTLD is the term used to describe a group of dementias that affect the frontal lobes (the front top part of the brain) and/or the temporal lobes (the lower left and right sides of the brain). This group of diseases is thought to be responsible for about 15-20% of dementia cases.

The most common types of FTLD are:

• Fronto-temporal dementia (FTD) (including Pick’s disease)
• Primary progressive aphasia (PPA)
• Semantic dementia

Patients suffering from FTDs may show personality change and impaired or altered social behaviour and a loss of inhibition. They may neglect personal hygiene, show signs of obsessive behaviour and have difficulties with spoken language, among other symptoms.

In primary progressive aphasia (PPA) the main sign is a breakdown in speech and language. Over a fairly long period of time the sufferer will lose their ability to speak, read, write, and/or understand what they hear. This is because the disease affects the part of the brain that controls our ability to use language. As with the FTDs, this illness mainly affects adults between 40 and 60.

Semantic dementia is caused by a shrinking of the temporal lobe of the brain, and affects our knowledge of objects, people, concepts and words (known as the semantic memory). It affects a slightly older group than the other dementias in this group, striking usually between the ages of 50 and 65. People with semantic dementia may find they forget the meaning of words, and fail to recognise faces and objects. They may even find it hard to recognise familiar sounds, smells and tastes. Their speech is not affected however, and their personal memory remains unaffected.

What causes FTLD?

These dementias are caused by damage or atrophy to the front and temporal lobes of the brain, while the rest of the brain remains undamaged. Between one-third and a half of patients have a family history of the disease. The cause of non-inherited FTLDs is not known.

The importance of specialist diagnosis

FTLD  dementias are sometimes mistaken for mental illnesses, depression or Alzheimer’s disease, because of the nature of the early symptoms.

Specialists can diagnose the conditions by taking very detailed histories and arranging cognitive and other tests. Although a positive diagnosis is not possible through blood tests, these may help rule out other conditions. CT and other scans may also help specialists determine the extent of damage to the brain.

Treatment of FTLD

At present there is no cure for FTLD dementias, and it is not possible to slow the progression of the diseases. Drugs used for Alzheimer’s disease, such as Aricept, are not effective in treating FTLD and may even make symptoms worse.

The aim of treatment is therefore to lessen the effect of the symptoms. This is one reason why a proper diagnosis is so important. The more that is known about the person’s condition, the easier it is to help them and their families cope, particularly with the behavioural changes associated with these diseases.

Some useful therapies:

• Patients with FTD and semantic dementia sometimes benefit from treatment with SSRI antidepressants.
• Behavioural therapy may be helpful in reinforcing positive behaviour in patients showing challenging symptoms.
• Spectacles and hearing aids may help in the case of hearing and visual impairment.
• Speech therapists may be helpful for language problems.
• Carers and relatives of FTLD sufferers may benefit from help in developing coping strategies to deal with the person’s altered behaviour rather than confronting them directly.

How Clinical Partners can help

Simply call our clinical team in confidence on 0203 326 9160 and we will recommend the most suitable therapist or support group for your individual situation.

Read more about diagnosis of FTLD.