A number of clinical and imaging findings can help distinguish a patient from frontotemporal dementia (FTD, Pick disease) from Alzheimer Disease (AD).


Features seen in FTD:

(1) early and prominent changes in behavior

(1a) loss of social graces

(1b) impaired control of personal conduct

(1c) loss of insight

(1d) emotional blunting

(1e) inappropriate eating or sexual behaviors

(2) onset at a relatively early age, often presenile. Onset is usually between 35 and 75 years. It is rare after 75.

(3) relative preservation of memory, language, praxis and visuospatial skills

(4) characteristic imaging findings

(4a) severe anterior atrophy

(4b) anterior hypometabolism on PET scanning

(4c) sometimes caudate atrophy


Additional findings may include:

(1) family history positive for a degenerative dementing illness with similar features

(2) mutation of the tau gene on chromosome 17q21-q22

(3) alteration of speech output (pressing speech, echolalia, stereotypy, mutism)

(4) parkinsonism

(5) performance on memory tasks improved by cuing


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