What is Pick’s Disease?

Pick’s disease is a rare type of age-related dementia that affects the frontal lobes of the brain and causes speech problems like aphasia, behavior difficulties and eventually death. It was first described by Czech neurologist and psychiatrist Arnold Pick in 1892. In some older medical texts, Pick’s disease is used interchangeably with “frontotemporal dementia,” but in modern medicine, Pick’s disease is understood to be one of three very specific causes of frontotemporal dementia.

Symptoms of Pick’s Disease

Differentiating between types of dementia can be difficult for physicians. Alzheimer’s disease, the most common cause of dementia, can often be distinguished from frontal lobe dementia like Pick’s disease because memory loss is one of the first notable symptoms of Alzheimer’s. Frontal lobe dementia is not usually associated with memory loss in its early stages.
Pick’s disease is known especially for the aphasia it causes. This can distinguish it from other types of frontotemporal dementia, in which behavior problems and personality changes are often a primary first symptom. That said, Pick’s disease can also be associated with behavior problems. Determining with certainty whether a patient has Pick’s disease, another type of frontal lobe dementia, or an altogether different cause of aphasia, is not always possible.

Symptoms of Pick’s disease include:

Speech Problems

* Hesitant speech
* Difficulty articulating
* Stuttering
* Ungrammatical speech
* Difficulty recalling words or names

Behavior Problems and Personality Changes

* Unusual behavior
* Disinhibition
* Passivity
* Hyperactivity
* Anxiety
* Slovenly appearance
* Delusions and paranoia
* Lack of empathy

As Pick’s disease progresses to its later stages, the range of symptoms become increasingly noticeable and more severe. Gradually, nearly every aspect of cognition and daily functioning can be severely impaired.
Pick’s Disease and the Brain

Pick’s disease is caused by a buildup of tau proteins, called “Pick bodies,” in the brain. Pick bodies cause neurological damage in areas where they are present, which includes (but is not limited to) the frontal lobes.
Tau proteins also build up in the brains of Alzheimer’s patients, though, only one form of these tau proteins is prevalent in the brains of those with Pick’s disease. This difference allows Pick’s disease to be differentiated from Alzheimer’s disease postmortem by researchers and pathologists.
Pick’s Disease Treatment and Prognosis

Like Alzheimer’s disease, Pick’s disease is currently untreatable. “As far as I know, there are no successful interventions in the treatment of frontotemporal dementia,” dementia expert Howard Crystal, professor of neurology and pathology at New York Downstate Medical College, told Psychiatric Times.
While Pick’s disease cannot be slowed or stopped, medical professionals have had mixed success addressing specific symptoms of the disease. The goal is to maximize the functioning and comfort of those with Pick’s disease as much as possible.
Care for Seniors with Pick’s Disease

Pick’s disease can be an enormous challenge for caregivers. Patients with Pick’s disease may have personality changes so severe that their loved ones do not recognize them as the people they formerly were. As Pick’s disease progresses, patients become unable to complete activities of daily living, such as dressing, grooming and toileting. The combination of personality changes and inability to function can require caregivers to place loved ones with Pick’s disease into professional dementia care at residential communities.