2-Minute Neuroscience: Frontotemporal Dementia (FTD)

Frontotemporal dementia, or FTD, is a term used to describe a collection of related brain disorders that involve the neurodegeneration of the frontal and temporal lobes. In this video, I discuss the symptoms and subtypes of FTD as well as the pathological brain mechanisms underlying FTD.
TRANSCRIPT:
Frontotemporal dementia, or FTD, is a term used to describe a collection of related brain disorders that involve the neurodegeneration of the frontal and temporal lobes. The neurodegeneration in FTD is associated with a variety of symptoms, and different presentations of symptoms have been used to establish multiple subtypes of FTD. The three main subtypes are: behavioral variant FTD, semantic variant primary progressive aphasia, and nonfluent variant primary progressive aphasia. In behavioral variant FTD, patients display a variety of changes in behavior, emotions, personality, and executive control. For example, they may exhibit compulsive behavior, apathy, and/or socially inappropriate behavior. In primary progressive aphasias, the main impairment is with language. Patients who have the semantic variant of primary progressive aphasia display deficits in word comprehension as well as trouble recalling certain words, along with other language difficulties. Patients who have the non-fluent variant primary progressive aphasia have difficulty producing fluent speech, which might involve trouble speaking at all or problems with the use of grammar to produce understandable speech.
FTD is associated with a pathological process called frontotemporal lobar degeneration, which involves the death of neurons and other pathological changes in the frontal and temporal lobes, as well as other areas of the brain such as the anterior cingulate cortex and insular cortex. In FTD, the degeneration of neurons is associated with the accumulation of structurally abnormal proteins, which might contribute to cell death through multiple mechanisms. The protein accumulation and associated damage spreads, causing the symptoms of FTD to get progressively worse over time. While initially a patient may display symptoms linked to just one of the FTD subtypes, the spreading neurodegeneration may eventually lead to the manifestation of symptoms from multiple subtypes. Unfortunately at this point there are no drugs approved to treat FTD, so treatment primarily involves managing symptoms.
REFERENCES:
Bang J, Spina S, Miller BL. Frontotemporal dementia. Lancet. 2015 Oct 24;386(10004):1672-82. doi: 10.1016/S0140-6736(15)00461-4. PMID: 26595641; PMCID: PMC5970949.
Olney NT, Spina S, Miller BL. Frontotemporal Dementia. Neurol Clin. 2017 May;35(2):339-374. doi: 10.1016/j.ncl.2017.01.008. PMID: 28410663; PMCID: PMC5472209.
Young JJ, Lavakumar M, Tampi D, Balachandran S, Tampi RR. Frontotemporal dementia: latest evidence and clinical implications. Ther Adv Psychopharmacol. 2018

[@swimorjunk]

Excellent brief summary, but don’t forget logopenic variant FTD (which given the AD pathology is probably more common), and that many nfFTDs may also be the start of PSP or CBD. Progressive prosopagnosia can also be a variant (usually right-sided). Each PPA also has a unique language profile, and it’s important to rule out strokes and other acquired or neurodevelopmental causes.

[@Neuroscientificallychallenged]

Logopenic is an important PPA variant, but because it's primarily linked to Alzheimer's disease I stuck with the main PPA variants linked to FTD---I have to be restrictive about what I put in to keep it to 2 minutes :)

[@swimorjunk]

@@Neuroscientificallychallenged in fairness, trying to summarise the complexity in diagnosis and subtyping of PPA in 2 minutes is a serious challenge, so kudos for doing so, almost always needs neuropsychological assessment let alone recognising and identifying potential symptoms in primary care :)

[@Neuroscientificallychallenged]

Thanks!

[@figrollin]

​@@swimorjunk Dementias, and how we quantify them, is such a good example of trying to categorise a continuum.

[@swimorjunk]

@@figrollin to a point, in that cognitive symptoms are on a continuum, but there are typical patterns we see in neuropsychological tests depending on the variant; but further, the current theories on underlying pathologies are discrete (Tau 3/4R, TDP-43, Amyloid, Lewy-bodies etc). As treatments hopefully eventually become available, it will be even more important to distinguish between the likely subtype to help guide treatment, not just prognosis and support.

[@pandemicnova]

Thanks for this

[@ahemadkunjada1309]

Nice information!

[@desiredecove5815]

This can happen with Multiple Sclerosis lesions in the area as well.

[@Ellipsis115]

The behavioral variant especially sounds a lot like ADHD but with a different cause, yikes ADHD really is an overlooked condition in terms of severity if it compares to dementia :/

[@figrollin]

ADHD (which I have) is definitely not comparable in severity to FTD. a) The exec dysfx in FTD is progressive and worsening and b) FTD is associated, as per the video, with many additional disabling symptoms. FTD is a good example of how similar symptom profiles (e.g. exec dysfx) can occur in the brain when different pathologies effect similar regions (frontal lobe). That being said, not all dysexecution is frontal!

[@montazaraldujeili2475]

💪🏻💪🏻💪🏻💪🏻💪🏻💪🏻

[@user-xs7uv9xe5s]

what app/software have you used to create this video? Thank you!

[@Neuroscientificallychallenged]

I draw the images myself using Sketchbook, then I create the animation using Videoscribe.

[@GTNSHORTS]

This is what Wendy Williams has 😮

[@user-ry2ek1nd2l]

How long can a person live with this disease

[@silviavousden3316]

A maximum of 10 years.

[@divelostmind]

Fuck I might have this

[@beartrap7065]

Do not despair, there is hope for the future.

[@VeganYeshua]

2 Minute Neuroscience - The stoner brain

[@nathannicholson-ro7uz]

Yeah it hits the spot after a sesh hahaha 🤌🤌🤌

[@MaoRatto]

1:46 You got a typo. It has three S's not 2. Fix this 1:56 .... Why can I spot it so easily?

[@Neuroscientificallychallenged]

Yep, it was bound to happen eventually. Once a video is uploaded, KZbin doesn't let you "fix" it. Does the typo upset you?

[@MaoRatto]

@@Neuroscientificallychallenged No, don't make a big deal about it. It looks funny, that's all.

[@raresmihaioglavie4704]

My testimonity:i suffred from fronto temporal dementia at 15 yr old(idk how) and by the energy(grace) of the Heavenly Father i was HEALED❤❤

[@mx4life560]

Your brain regrew?

[@raresmihaioglavie4704]

@@mx4life560 Yes,with the power of God everything is possible.Praise the lord🙌🙏❤️