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Frontotemporal Dementia

Frontotemporal Dementia (FTD) is a progressive neurodegenerative disease, which leads to changes in behavior and difficulty with language and decision-making.  FTD is caused by misfolded proteins that cause damage to the frontal and temporal lobes in the brain. 

At the onset, FTD can appear similar to other illness such as depression, bipolar disorder, or schizophrenia.  There can be a significant delay between onset of changes and accurate diagnosis of FTD. The early stages of FTD are often confusing and frustrating for patients and their families.  At Vanderbilt, we are here to help. 

Key Points:

  • FTD is just as common as Alzheimer’s disease in patients under the age of 65
  • FTD patients may present like psychiatric patients, delaying diagnosis
  • Common symptoms include socially inappropriate behavior, disinhibition, loss of empathy, apathy, eating more sweet foods, repetitive or compulsive behaviors, changes to decision-making, and language problems
  • Unlike Alzheimer’s disease, memory may be normal

Why choose Vanderbilt?

At Vanderbilt, we offer:

  • Top specialists: Vanderbilt offers a specialized Frontotemporal Dementia Clinic, which is one of the few of its kind in the region.  Our neurologists and neuropsychiatrists are experts in FTD and other neurocognitive disorders.  As an academic center, we welcome referrals from patients, families, and other providers seeking diagnostic clarity.    
  • Team approach: At Vanderbilt, our team of clinical neuroscience experts collaborate to develop a personalized treatment plan for you or your loved one.  At times, this may include imaging, neuropsychological testing, or genetic testing, which can all be completed at our clinic.  We offer referrals to other departments within Vanderbilt such as physical therapy, occupational therapy, speech and language therapy, and social work as necessary. 
  • Caregiver Support: Caring for a loved one with FTD can be challenging. We offer information and resources to assist in this journey. Our clinic also has direct connections to the only FTD caregiver support group in the area.

What is Frontotemporal Dementia?

Frontotemporal Dementia (FTD) is a neurodegenerative disorder that causes changes in behavior, language, decision-making, and movement.  The hallmark of FTD is the degeneration of the frontal and temporal lobes.  This pattern is distinct from the brain regions of affected by Alzheimer’s disease.  FTD is the second most common dementing illness in persons under age 65.  While there are multiple types of FTD, the behavioral variant (bvFTD) is the most common.  Patients with bvFTD can experience changes in personality and display inappropriate and impulsive behaviors.  There are other types of FTD which include specific language and movement variants.  Around 10% of cases are caused by a known genetic mutation. 

Journey to Diagnosis

In the early stages, the behavioral variant (bvFTD) appears similar to psychiatric disorders such as depression or bipolar disorder. Often changes in personality precede any noticeable issues with memory. A significant delay can occur between initial presentation of symptoms and accurate diagnosis, which increases the stress on patients and families.  It is important to include FTD in the differential diagnosis of any older adult with new psychiatric symptoms, particularly if there is a family history of dementia.  In order to diagnosis FTD, imaging such as MRI or PET scans is necessary.  Often neuropsychological testing is performed as well.  Additional testing can include lumbar puncture, genetic testing or electromyography (EMG). 

Consultation and Treatment

Our clinic offers consultation appointments for patients.  We welcome referrals from patients, families and outside providers for cases where the diagnosis is either unclear or concerning for FTD.  We will review any notes, testing, and imaging from prior appointments during this time. Should additional testing be necessary, we can arrange this at our clinic.  Once a diagnosis of FTD is made, a personalized treatment plan will be developed, which can include medications and referrals to other support services.  Unfortunately, at this time there are no treatments for FTD.  We can, however, offer medications for specific symptoms, which may be bothersome for the patient or family members.  We can also offer information regarding clinical trials should that be of interest.

Caregiver Support

We know that caring for a loved one with dementia can be challenging. We are here to support families and patients on this journey.  Through our clinic, we offer education and resources for caregivers.  Our clinic is aligned with the Nashville Frontotemporal Dementia Caregiver Support Group, which meets monthly.  For more information about this group and other resources please follow this link.