Therapeutic development should not forget the symptoms
According to the 1983 edition of the Oxford textbook of psychiatry, “There are no specific clinical features to separate [frontotemporal dementia] from Alzheimer’s, and the distinction is generally made at autopsy not in life”.1 That was a popular view at the time — dementias are clinically all the same but sometimes pathologically different. Since then, the growth in understanding of non-Alzheimer degenerative dementias has been enormous. Careful clinical characterisation has, in turn, paved the way for numerous fundamental discoveries in pathology and genetics.
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- 1. Gelder M, Gath D, Mayou R. Oxford textbook of psychiatry. Oxford: Oxford University Press, 1983. [The original text refers to Pick’s disease, this being the label at the time for what is currently called frontotemporal dementia (FTD). However, the term “Pick’s disease” does remain in use to describe one specific pathological variant of FTD.]
- 2. Piguet O, Kumfor F, Hodges J. Diagnosing, monitoring and managing behavioural variant frontotemporal dementia. Med J Aust 2017; 207: 303-308.
- 3. Diamond A. Executive functions. Annu Rev Psychol 2013; 64: 135-168.
- 4. Godefroy O, Azouvi P, Robert P, et al. Dysexecutive syndrome: diagnostic criteria and validation study. Ann Neurol 2010; 68: 855-864.
- 5. Devenney E, Bartley L, Hoon C, et al. Progression in behavioral variant frontotemporal dementia: a longitudinal study. JAMA Neurol 2015; 72: 1501-1509.
- 6. Bozeat S, Gregory CA, Ralph MA, Hodges JR. Which neuropsychiatric and behavioural features distinguish frontal and temporal variants of frontotemporal dementia from Alzheimer’s disease? J Neurol Neurosurg Psychiatry 2000; 69: 178-186.
- 7. Lima-Silva TB, Bahia VS, Carvalho VA, et al. Neuropsychiatric symptoms, caregiver burden and distress in behavioral-variant frontotemporal dementia and Alzheimer’s disease. Dement Geriatr Cogn Disord 2015; 40: 268-275.
* From November 2017, I will be based at the Queensland Brain Institute, University of Queensland and at the Mater Hospital Brisbane.
No relevant disclosures.