Pick’s disease is a type of frontotemporal dementia (FTD) that causes progressive loss of mental function. It affects the frontal and temporal lobes of the brain.
FTD is rare and usually develops in people between the ages of 40 and 60. However, it can appear in people as young as 20 years old. It causes problems with thinking and speaking, as well as behavioral changes that get progressively worse over time.
Doctors will perform specific tests to distinguish Pick’s disease from Alzheimer’s disease and other forms of dementia.
This article looks at Pick’s disease in more detail, including causes, signs and symptoms, stages, diagnosis, and treatment. It also considers the outlook for people with Pick’s disease.
Pick’s disease is a type of degenerative dementia that Czech neurologist and psychiatrist Arnold Pick first diagnosed in 1892.
Pick’s disease is distinguished by the difficulty it causes with speech, which may present as an initial symptom. Other forms of dementia may have behavioral or personality changes as primary symptoms.
Pick’s disease occurs as a result of tau proteins, which form plaques called Pick’s bodies in the brain.
Although tau proteins are also present in the brains of people with Alzheimer’s disease, only one form of them exists in people with Pick’s disease. However, the difference between the two conditions is only detectable during an autopsy.
People with Pick’s disease have a buildup of tau protein in the brain. These are called tangles, Pick bodies, or Pick cells, and they exist inside nerve cells.
Experts don’t know why some people are prone to tangles. However, they believe genetic factors may play a role, as Pick’s disease appears to be inherited.
Symptoms of Pick’s disease slowly worsen. They can include difficulty speaking, behavioral problems, and a reduced ability to think clearly. People with Pick’s disease may exhibit unusual or inappropriate behavior in social settings.
Specific symptoms may include:
- inability to speak
- word search
- problems speaking or understanding speech
- repeat the words that others say to them
- shrinking vocabulary
- weak speech sounds
- inability to keep a job
- compulsive behavior
- impulsive behavior
- inability to interact socially
- poor personal hygiene
- repetitive behavior
- social withdrawal
- mood swings
- decreased interest in daily activities
- inability to recognize changes in behavior
- lack of emotional warmth
- inappropriate mood
- don’t worry about events
Nervous system problems
- rigid muscle tone
- memory loss
- difficulty with movement or coordination
Urinary incontinence can sometimes also occur.
There is no specific staging scale for Pick’s disease, but there are several scales for dementia.
The most common scale used by doctors is the Global Deterioration Scale (GDS), also known as the Reisberg scale.
The GDS specifies:
- Steps 1 to 3: People at these stages do not meet the criteria for a diagnosis of dementia. They have either no cognitive decline, very mild cognitive decline, or mild cognitive decline.
- Step 4: The average duration of this stage is 2 years and it is a mild cognitive decline or early stage dementia.
- Step 5: Moderately severe cognitive decline or intermediate-stage dementia occurs. The average duration of this stage is 1.5 years.
- Step 6: Severe cognitive decline marks this stage, which lasts an average of 2.5 years.
- Step 7: This stage involves very severe cognitive decline or an advanced stage of dementia. The average duration of this stage is 1.5 to 2.5 years.
To diagnose Pick’s disease, a doctor will perform a complete physical examination, including taking a medical history. They should perform a neurological exam and ask the person about their symptoms. They may also order tests to look for other types of dementia. These tests may include:
- Brain MRI
- electroencephalogram (EEG)
- lumbar puncture to examine cerebrospinal fluid
- CT scan of the head
- PET brain scan
They may also use tests that check brain metabolism or protein deposition, as well as tests that check feeling, thinking, and reasoning.
No specific treatment for Pick’s disease is available, but medications that can help reduce depression, irritability, and restlessness can improve a person’s quality of life.
Although the symptoms of dementia may raise concerns about Alzheimer’s disease, there are some key differences between this disease and Pick’s disease.
People with Pick’s disease tend to have more speech problems than those with Alzheimer’s disease. Speech difficulties can be an early sign of Pick’s disease.
Diagnosis of Pick’s disease usually occurs at a younger age than Alzheimer’s disease, with most people between the ages of 40 and 60 at the time of diagnosis.
In the early stages of Pick’s disease, memory loss is not as pronounced as in Alzheimer’s disease. However, as Pick’s disease progresses, the memory loss will become more acute.
Behavioral changes are an early symptom of Pick’s disease. Although these changes are also a sign of Alzheimer’s disease, they tend to develop later in the disease.
Another difference is that Alzheimer’s disease often causes hallucinations and delusions, unlike Pick’s disease.
Pick’s disease is a progressive disease that steadily worsens. The individual will become increasingly disabled over time.
Death usually occurs within 6 to 8 years, often due to infection or bodily system failure.
Pick’s disease is a rare type of dementia that affects the frontal lobe and the temporal lobe.
Tau deposits build up to form plaques, impairing the ability to speak properly and affecting behavior.
The exact cause of Pick’s disease is unknown, but the condition may have a genetic component. It usually presents first with speech problems, followed by behavioral changes. Unlike Alzheimer’s disease, it rarely affects a person’s memory.
There is no known treatment for Pick’s disease, but medication can treat some of the symptoms, including depression, restlessness, and irritability.