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Pick’s Disease: Symptoms and Stages

pick's disease

Pick’s disease is one of the varieties of senile frontotemporal dementia, in which atrophic changes occur, most often in the frontal and temporal lobes of the brain. In clinical manifestations, it is similar to Alzheimer’s disease, but it is less common and more malignant. In women, it is diagnosed twice as often as in men.

Often, the disease is diagnosed against the background of mental disorders, but they are not considered the root cause of the disease, although they provoke its development. Not only the temporal and frontal lobes can undergo atrophy – sometimes, it also goes beyond and affects the subcortex. At the same time, there is no inflammation; vascular disorders are either absent or weakly expressed.

The manifestation of disease begins in the anterior frontal regions of the brain, which immediately affects a person’s behavior and personality characteristics. Later, the temporal lobes undergo changes, which are responsible for intelligence, memory, and concentration. The cortex of the speech analyzer is also destroyed, which immediately causes speech problems.

Unlike other neurodegenerative pathologies in psychiatry, the disease is characterized by deep damage to the entire lobe of the brain and not just part of it. First, the upper layers are affected, then the process extends inward.

picks disease 1

Symptoms of Pick’s disease

Symptoms

The severity of symptoms and their set depend on the stage at which Pick’s disease is. The main signs of the disease:

  • Loss of moral principles. The patient can relieve their natural needs in inappropriate places, not control their behavior, make improper statements, selfish character traits are exacerbated, and in general, the behavior becomes asocial.
  • Immediate realization of instincts. The possibility of waiting disappears – all the physiological needs of the patient must be realized as quickly as possible. For example, bulimia may develop – eating large amounts of food uncontrollably even after satiety.
  • Speech problems. It becomes indistinct. There are multiple repetitions of jokes, words, and individual phrases that can be traced; this is called the phonograph record symptom.
  • Mood swings. It can range from euphoria to complete apathy; moreover, it can take only a few minutes between this.
  • Dementia. Its severity depends on how the atrophic processes in the brain develop. But in general, emotional instability, periods of disinhibition and rigidity, loss of desires, goals, and complete lack of a will can be traced. Depression may develop, and sometimes – a combination of inappropriate behavior with euphoria.

The more Pick’s disease progresses, the more severe the symptoms become:

  • lack of understanding of the speech of others;
  • loss of basic skills in counting, writing, and reading;
  • inadequate perception of what is happening around;
  • memory losses;
  • inability to consistently and logically perform actions;
  • in the end, profound dementia, disorientation, and loss of self-care skills develop;
  • if at first, such violations are episodic, then by the end of the second and third stages, they become permanent, progressing to the complete destruction of intellect.

The death of patients with Pick’s disease is most often caused by a combination of several factors:

  • cerebral insufficiency;
  • pressure ulcers infection followed by sepsis;
  • congestive pneumonia due to constantly being in a horizontal position;
  • ascending pyelonephritis, etc.;
  • the changes affect the physical and mental spheres of a person. Some develop obesity or, on the contrary, exhaustion; their intellect suffers greatly – vocabulary gradually decreases, a person loses previously acquired knowledge.

types of pathology

Causes of Pick’s disease

The etiology of Pick’s disease has not yet been clarified. There are “family” episodes of the disease, but it is more often diagnosed in siblings than transmitted from parent to child. Nevertheless, the hereditary factor is completely refuted.

The etiological factors are:

  • Negative impact on humans, in particular on the brain, chemicals;
  • Incorrect dosing and/or frequent use of anesthesia;
  • Mental disorders;
  • Not the main, but a provoking factor can be a lack of B vitamins, traumatic brain injury, intoxication. Some experts believe that a disruption in the metabolism of tau protein, a component that is an element of the cell membranes of neurons, can also become a provoking factor.

It occurs mainly in the elderly after 50 years old. The risk group includes female patients over 50–55 years old, in whose family there are cases of this type of frontotemporal dementia. Traumatic brain injuries and infections do not serve as a provoking factor but significantly accelerate and aggravate the course of the disease.

The disease can be diagnosed in younger people from 40–45 years old. But at this age, it progresses slowly, the symptoms are poorly expressed, so patients rarely go to the doctor, and at the time of diagnosis, the second stage is already revealed. The debut is usually not so pronounced and can manifest in increased anxiety, impaired control over their actions, depressive states, which the patients usually justify by stress or other similar reasons.

Stages of Pick’s disease

The disease is divided into three stages. From detection to the end of the third stage, a maximum of 10 years passes, more often 6-7.

 Types of pathology:

  1. First stage. It is characterized by disinhibition, actions that have no motive. For example, a patient may have a leveling out of basic instincts, a lack of control over their actions and emotions. Another characteristic feature of the onset of the disease is selfishness. In addition, libido sometimes increases, sexual disinhibition occurs. There are speech problems – multiple repetitions of the same words, sentences, or stories. The emotional sphere at this stage is relatively stable – most often, there is euphoria, which manifests itself in high spirits, but it can suddenly be replaced by complete apathy. There is no memory impairment yet, but a person at this stage cannot explain their strange behavior or justify it with impatience.
  2. Second stage. All of the symptoms described above are aggravated. Focal signs of frontotemporal dementia appear, and speech becomes even less intelligible. It is difficult for the patient to understand and assimilate information; they may forget events that happened long ago or very recently. It can be difficult for them to count and perform purposeful movements – fine motor skills are impaired. At this stage, the disease is almost identical to Alzheimer’s, but there are no epileptic seizures. Another characteristic feature is the imitation of the movements / facial expressions of other people and the automatic repetition of new words. The pain threshold also increases (cutaneous hyperalgesia).
  3. Third stage. It is characterized by complete insanity, decreased muscle tone, and, ultimately, the vegetative state of the patient. They cannot move, solve everyday issues, for example, eat, relieve their natural needs, or dress. At this stage, an incurable disability is diagnosed, which ends in death.

Frontotemporal dementia in the third stage is irreversible. At this time, the patient needs constant care. They are not able to perform even the simplest things since their capacity, both mental and physical, has been lost.

treatment of picks disease

Treatment of Pick’s disease

Unfortunately, there is currently no effective therapy for Pick’s disease. The main task of the doctor after diagnosing this disease is to support the patient’s body and slow down the destructive processes in the brain. It can be:

  • antidepressants;
  • MFO inhibitors;
  • neuroprotectors to stimulate metabolic processes in the brain and increase the activity of cells, which can slow down atrophic processes;
  • sometimes anti-inflammatory therapy is needed;
  • sedatives stabilize the psycho-emotional background, reduce aggressiveness.

Accordingly, treatment is selected based on the stage of the pathology and the presence of certain symptoms.

FAQ

  • What is the name of the disease in which atrophic changes occur?

Pick’s disease is one of the varieties of senile frontotemporal dementia, in which atrophic changes occur, most often in the frontal and temporal lobes of the brain.

  •   At what age can Pick’s disease occur?

It occurs mainly in the elderly after 50 years old. But sometimes it can occur in younger people. 

  • How is Alzheimer’s and Pick’s disease different?

Alzheimer’s disease causes a rapid deterioration in the ability to read and write. Pick’s disease destroys these skills much later. People with Alzheimer’s disease are more likely to suffer from apraxia (inability to perform complex motor acts).

  • What disorders of mental activity and mental functions are observed in frontotemporal dementia?

The central defect in patients of this group is impaired short-term memory and active information retrieval after interfering exposure, inactivity, impaired awareness of their own actions, and uncriticality.

  • What are the functions of the frontal lobe?

The frontal lobes are responsible for voluntary actions, organizing and planning them, and mastering skills. In the dominant (usually left) frontal lobe, there are many zones responsible for the infectious aspects of a person’s speech, attention, and abstract thinking. Finally, note the participation of the frontal lobes in maintaining the vertical position of the body.

  • Can dementia be treated?

Dementia is not currently considered a completely curable disease, although its symptoms can be alleviated. The most reasonable solution is to place the patient with dementia in a geriatric center under the constant supervision of qualified medical personnel.

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Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been prepared.read more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well together.read more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your business.read more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any cookies.read more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going there.read more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my treatment.read more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to finish.read more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 stars.read more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his staff.read more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best treatment.read more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my doctor.read more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding solutions.read more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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