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What is Pick's Disease?

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  • Written By: Niki Foster
  • Edited By: Andrew Jones
  • Last Modified Date: 29 August 2016
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Pick's disease is a rare neurodegenerative disorder that causes the atrophy, or gradual wasting away, of the frontal and temporal lobes of the brain, which are responsible for higher cognition, speech and vision processing, and long-term memory. It is characterized by the destruction of nerve cells in the brain and the accumulation of tau proteins, a normally occurring protein in neurons of the central nervous system, into concentrations known as "Pick bodies." Pick's disease is named after German neurologist and psychiatrist Arnold Pick, who discovered the pathology in 1892. It is unknown what causes Pick's disease, but no genetic basis has been identified.

Pick's disease is one of many pathologies that can cause frontotemporal lobar degeneration. There are three different manifestations of frontotemporal lobar degeneration: frontotemporal dementia, progressive nonfluent aphasia, and semantic dementia. Semantic dementia is less associated with Pick's disease than the other subtypes.

Frontotemporal dementia causes two types of symptoms: behavioral symptoms and loss of executive function. Behavioral symptoms can include personality change, either apathy and extreme lethargy, or inappropriate behavior due to complete disinhibition. A patient may become unable to take basic care of himself or herself, or may indulge in risky and socially unacceptable behavior such as openly sexual comments or theft. Loss of executive function is characterized by difficulty in performing tasks that involve complex planning and often manifests through language impairment.

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Progressive nonfluent aphasia is a type of language impairment in which the patient exhibits difficulty speaking. This impairment can take many forms. The patient may exhibit apraxia, or difficulty forming speech sounds, or may develop a stutter. Other possible forms include anomia, an inability to recall names or nouns; agrammatism, or the inability to speak with normal word order and verb tenses; and phonemic paraphasia, in which the patient uses the wrong consonant or vowel sounds in his or her speech. A patient with progressive nonfluent aphasia may exhibit one or many of these symptoms, and the impairment worsens over time.

Semantic dementia was first described by Arnold Pick in 1904, but is not caused by Pick's disease as often as the other two forms of frontotemporal lobar degeneration. Semantic dementia is characterized by an inability of the patient to remember the meanings of words and visual cues. A patient suffering from semantic dementia may exhibit anomia and impaired comprehension of the speech of others. He or she may also be unable to match semantically related images or may frequently call things by the wrong name.

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Post 6

@seag47- that is terrible, and I am so sorry when I hear about elderly people who die in this way. Dementia is so destructive and seems to be on the rise. I hope that before too long we can find ways to prevent dementia, or to slow it. It seems so difficult to know when it will strike, but what else can we do with the elderly? Lock them away? It just seems so hard to deal with these sorts of problems.

seag47
Post 4

My mother had Pick’s disease, but we didn’t know it until after she died. When they conducted the autopsy, they were able to confirm it.

Her speech and certain abilities had started to decline, but not to the extreme, so we kids just chalked it up to aging. We considered her newfound impulsive behavior to do things like take night walks in the moonlight just a result of being cooped up in the house too long.

Unfortunately, she decided to take one of these moonlit walks in the middle of winter in the freezing cold. The police told us that they found her dead in the park, and they needed to determine the cause of death.

Perdido
Post 3

@orangey03 - It is no wonder that the doctor didn’t initially test your grandfather for Pick’s disease. My dad developed it, and his doctor said that even though seven million people in the United States have dementia, only five percent of these people have Pick’s disease.

My dad exhibited many of its symptoms, so they tested him without hesitation. In addition to new speech problems, he became incontinent, developed stiff muscles, and had difficulty moving around. He lost interest in showering and in doing really anything but sitting and staring at the television. For him, this was highly unusual. He had always been a very intelligent and active man.

Another tipoff was that when we confronted him about his new issues, he was totally unaware that he had been acting that way. A few seconds later, he had forgotten that we mentioned it.

orangey03
Post 2

@kylee07drg - That is good that your grandmother got diagnosed correctly with Pick’s disease. My grandfather went for years believing he simply suffered from depression and the beginning of Alzheimer’s.

After he became more apathetic and aggressive, his doctor decided to run a brain scan and EEG to test him for Pick’s. In addition to reacting violently when we attempted to help him find his words, his attention span had begun to dwindle away, and it became impossible to have a conversation with him.

We placed my grandfather in a facility equipped to handle people in his condition, and there, he actually developed a skill no one knew he had. The caregivers said that it is common for those who lose the ability to express themselves through speech to develop hidden skills, and he became quite the artist.

kylee07drg
Post 1

My grandmother developed Pick’s disease at age 58. It was really hard to see her normally pleasant and proper demeanor disintegrate into basic instinct. She had always spoke eloquently, and she started to lose the ability to express herself verbally.

She fit the symptoms. Her doctor said the disease usually occurs before age 65 and starts with personality changes and lack of control. I first noticed this when she, having been a modest eater all her life, started indulging on junk food in large amounts and burping unapologetically.

The big scare came when she went missing. Her neighbors found her roaming in their backyard, peeking in the window and trying to say something that sounded like jibberish. That’s when we took her to the hospital.

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