Diagnosing Frontotemporal Dementia
Frontotemporal Dementia can be diagnosed through a comprehensive evaluation, including a thorough medical history, neurological exams, and cognitive and language tests. Brain imaging tests such as MRI or CT scans can also identify changes in the brain's structure that may indicate this condition. Genetic testing may be recommended if a familial pattern is suspected.
What is Frontotemporal dementia?
Frontotemporal dementia (FTD) is a group of neurodegenerative diseases. In affected individuals, we observe a progressive loss of neurons in the frontal and temporal lobes of the brain [1].
Due to the neuronal loss, patients with FTD are characterized by progressive deficits in behaviour, executive function, or language [1].
The disease has different forms, such as behavioural, aphasic, and motor variants, each presenting with different symptoms [1]. The most prevalent is the behavioural variant and the affected individuals present with personality changes, behavioural problems, and cognitive decline [2].
FTD is a sporadic disease; however, in some cases, it may result from a genetic mutation. If the affected individual has inherited the genetic mutation from their parent, the disease is known as familial FTD [3]. The mutations causing familial FTD are typically on genes MAPT, Progranulin, and C9orf72 [3]. In case your parent has FTD, you may want to read our other blog dedicated to familial Frontotemporal Dementia.
Despite the devastating effects of the disease, there is no effective treatment for the disease. There are challenges in the diagnosis of the disease, the treatment, and even the management of the disease as the symptoms affect significantly not only the individual but the whole family [2, 4].
How can Frontotemporal Dementia Be Diagnosed?
Even though the disease mimics various other psychiatric disorders, which may lead to misdiagnosis due to the behavioural symptoms accompanying the disease, and there are gaps in the current diagnostic tools that would be specific to the disease, let’s look at the possibilities we have today to diagnose FTD.
Firstly, it is essential to state that FTD is a complex disease and cannot be diagnosed with a single test but instead with a combination of different tests. This helps to rule out other conditions that may resemble the disease [5, 6].
Neuropsychological testing is one of the primary diagnostic tools once there is a suspicion of FTD. These psychological tests asses your memory, attention, language, fluency, and other skills, which help to determine which type of dementia the patient might have [5, 6].
We use blood tests and cerebrospinal fluid analysis to identify other possible causes of the individual's symptoms [5, 6].
In addition, if a genetic cause of the disease is suspected, and the patient has a family history of similar diseases, genetic testing may be used [7].
Blood tests are also used in the diagnostic process. These can help identify other possible causes of the symptoms you're experiencing [5]. In some cases, cerebrospinal fluid (CSF) tests may be used to rule out other conditions [6].
Then, neuroimaging techniques like MRI, CT, or PET scans are used. These techniques help us to image the brain and asses for any potential signs of neurodegeneration, or brain loss, within the brain[5]. These imaging tests, including PET scans, can also help gauge the patient's level of physical functioning [6].
Oftentimes, the clinician speaks with a close relative of the patient to have a complete picture of the symptoms that the affected individual presents with.
Lastly, another critical factor is assessing the personal and family medical history and evaluating the current state of the disease and all the present symptoms to get the most accurate diagnosis [6].
Does Diagnosis Of Frontotemporal Dementia Help With The Treatment?
Yes! Diagnosing FTD helps manage and treat the condition. While there is no definitive cure for FTD, accurate diagnosis can be a major help in prescribing a proper management therapy and improving the quality of life for the affected individual [8, 9].
Early detection of FTD can also help minimize behavioural disturbances, especially in the patient's daily life and relationships [8].
For instance, once diagnosed properly, behavioural therapy for behavioural variants of FTD or aphasia can be implemented, and language speech therapy can also be of use for patients with language variants of FTD [10].
To summarize, diagnosing FTD and setting up the proper criteria for such a complex diagnosis is crucial for improving the well-being of patients, carers, and families.