A Rare Disease Called Pick's
A rare and permanent form of dementia similar to that of Alzheimer’s, Pick’s disease tends to affect only certain areas of the brain.
Pick’s disease patients have abnormal substances called Pick bodies and Pick cells inside their nerve cells in certain areas of the brain. These bodies and cells have an abnormal form of a protein called “tau”. Tau is found in all nerve cells, but some people with Pick’s have an abnormal amount or type of this protein.
The cause of the abnormal form of protein is unknown. Most cases of Pick’s are not hereditary. A gene for the disease has not been found.
This disease is rare, showing up in more women than men. It can occur in people as young as 20 years of age, but normally begins between ages forty and sixty. Fifty-four is the average age.
The disease worsens slowly. Frontal lobe tissues of the brain begin to shrink and continue shrinking over time. Behavioral changes, speech difficulty, and impaired thinking occur slowly, but can continue to get worse.
Early personality changes help doctors discern between Pick’s and Alzheimer’s. Memory loss is often the earliest symptom of Alzheimer’s.
Behavioral changes continue to get worse and are often one of the most disturbing symptoms of the disease. Often times, people with Pick’s tend to misbehave in social settings. Patients will have difficulty in language arts, either trouble finding, or understanding and writing words.
Some of the symptoms are not being able to keep a job, or having compulsive or inappropriate behavior. The inability to function or interact in personal or social situations. Personal hygiene may become an issue. Repetitive behavior and withdrawal from social interaction could play a part in symptomatic details.
Emotional changes found in most Pick patients are abrupt mood changes, decreased interest in daily living activities and failure to recognize the changes of the behavior. Emotions such as warmth, concern, empathy, or sympathy tend to be absent.
Patients may also lose the ability to speak or have a decreased ability to write or read. It may become difficult for most to speak or to understand speech. Losing the ability to repeat anything spoken to them can be another factor. Weak and uncoordinated speech sounds and a shrinking vocabulary tend to be a symptom as well.
Neurological problems appear in patients with Pick’s, in the way of increased muscle tone, leaving the muscles rigid. Of course, it affects the brain in the way that memory loss, getting worse as time goes by, appears in the patient. Movement and coordination becomes apparent, along with weakness. Urinary incontinence is another problem of this disease.
When visiting a doctor concerning these symptoms, you can expect an assessment of the mind and behavior (neuropsychological assessment), along with a brain MRI. An EEG or electroencephalogram should also be conducted.
Examination of the brain and nervous system or neurological exam should be expected, along with an exam of the fluid around the central nervous system. A head CT scan, psychological studies and tests of sensation, thinking and reasoning can and should be expected. While all these tests will probably be performed, a brain biopsy is the only test that can confirm the diagnosis.
There is no specific treatment for Pick’s disease. Antidepressants may help manage some of the mood swings that can be related to the disease, but at this time no other medication or treatment has been found.
Patients with Pick’s will sometimes be prescribed the same medications as dementia. In some cases, stopping or changing medications that worsen confusion or that are not necessary can improve thinking and other cognitive functions