Pick's Disease

Pick's Disease is a neurological disease in which the brain cells slowly shrink due to excess protein buildup. It is sometimes misdiagnosed as Alzheimer's or other dementia-related diseases. Like many dementias, it can only be truly diagnosed through autopsy, although the symptoms that the victim displays usually allow the physician to diagnose Pick's Disease.

History

• Arnold Pick first recognized this neurological disease in 1892. Today, we know that Pick's Disease affects the function of the frontal and temporal lobes of the brain, which control speech, emotional response and personality.

Symptoms

• The common symptoms of Pick's Disease include: poor judgment, impulsive or compulsive behaviors (such as eating just one food or overeating), lack of attention to hygiene, withdrawal or seclusion, inability to function socially, excessive behaviors, such as drinking too much when it was not an issue previously or promiscuity, or excessive rudeness and impatience. Emotional changes could include depressive behaviors (lack of interest in things that were of previous interest), lack of warmth and compassion, indifference to others and abrupt mood swings. Changes in the use of language--reading, writing and talking--would be quite dramatic. The vocabulary would shrink gradually and eventually there could be a total loss of the ability to speak.

Five Characteristics

• There are five distinguishing characteristics of Pick's Disease, and a patient must show three of these behaviors to support a diagnosis of the disease: The onset is before age 65; initial personality changes; loss of normal controls (overeating, hyper-sexuality); lack of inhibition; and roaming behavior.

Management

• While there is no cure for Pick's Disease, there are medications and alternative therapies to manage it. First, don't count the patient out. Studies have shown that although patients lose the ability to communicate through speech, they can develop new abilities in the areas of music and art. Be patient with the patient; positive behavior therapy allows dignity and self-esteem to stay intact. Medications can be prescribed to control unwanted or dangerous behaviors. Antidepressants can offer some help in making the patient feel more positive, control overeating or compulsive behaviors.

The Future

• There are clinical trials in process to study patients with Pick's Disease through the National Institute of Neurological Disorders and Stroke (NINDS). This organization is researching ways to manage, treat and prevent Pick's Disease.