Frontotemporal dementia

Fronto-temporal dementias selectively affect the frontal lobe of the brain. The disease may then extend backward to the temporal lobe. There are two main types; Pick's disease which has been recognised for many years and Dementia of the Frontal Lobe Type (DFLT) more recently described. The pathology of these two conditions is different although the clinical manifestations are similar.

The frontal lobe is involved in many aspects of mental function. These include motivation and drive, classifying and categorizing, emotion and personality. Social behaviour is also influenced as is appetite.

Frontal dysfunction may therefore lead to apathy or conversely disinhibition, disordered high level thinking- perseveration, and personality change. The manifestation will depend on which part of the lobe is affected — dorso-lateral or orbitomedial. Many routine dementia assessments do not test the frontal lobe.

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