New Delhi: Aphasia and frontotemporal dementia (FTD) are conditions that affect the brain in ways that impact how a person speaks and behaves. Aphasia specifically makes it difficult for someone to communicate. It can affect their speaking, understanding of what others say, reading, and writing skills. On the other hand, FTD is a type of brain disorder where parts of the brain called the frontal and temporal lobes gradually get worse over time. This worsening can change a person’s personality and behaviour, and it can also make it difficult for them to use language properly. These changes happen because these brain areas are crucial for controlling how we act and how we use language.
Dr. Sadique Pathan, Neurologist, Sahyadri Super Speciality Hospital, Hadapsar, Pune, decoded the link.
Relationship between Aphasia and FTD
In frontotemporal dementia (FTD), some types of speech and language problems are unique because they are caused by specific parts of the brain getting worse. This condition is known as primary progressive aphasia (PPA). PPA shows up in three main forms:
- Semantic Variant PPA: People with this type have trouble understanding the meanings of words. It’s like knowing the word but not being able to connect it to its meaning.
- Nonfluent/Agrammatic Variant PPA: This type impacts how fluently people can speak and how well they can put words into sentences. They may speak in short, broken phrases and often have a hard time constructing sentences correctly.
- Logopenic Variant PPA: Those with this condition struggle with finding the right words and putting them together in sentences. It’s not that they don’t know the words; they just have difficulty pulling them out and using them in conversation.
These issues are linked to the shrinking (atrophy) of different parts of the brain, especially in the left hemisphere, which is the side of the brain mainly responsible for language. This means the parts of the brain that usually help us talk and understand language are slowly getting smaller and less effective.
Causes and Pathophysiology
Frontotemporal dementia (FTD) happens when the frontal and temporal parts of the brain start to deteriorate. This damage is often caused by the build-up of abnormal proteins, named tau and TDP-43. These proteins interfere with how brain cells work, which eventually leads to the death of these cells, a process called neuronal death. In FTD cases that also involve aphasia, the loss of brain cells mainly happens in the parts of the brain that handle language. This makes it even more difficult for people to communicate because the specific brain areas that control speaking, understanding, reading, and writing are affected. This compound effect makes communication even more challenging for those with both FTD and aphasia.
Symptoms and Clinical Presentation
People with aphasia that is linked to frontotemporal dementia (FTD) can show several different symptoms. They might find it difficult to name objects, a problem known as anomia. Their ability to talk and hold conversations can be weak, and they might struggle to understand complicated sentences. Additionally, they may experience noticeable changes in how they behave and their personality traits. These symptoms mainly impact cognitive functions, which are the mental processes related to thinking, knowing, remembering, and judging. This significant effect on language and behaviour makes FTD different from other types of dementia.
Diagnosis and Management
Diagnosing frontotemporal dementia (FTD) with aphasia requires a thorough evaluation process. This includes MRI scans, which help doctors see if there are any areas of brain shrinkage (atrophy), a common sign of FTD. Neuropsychological testing is also used, which tests different brain functions to see what areas are affected. The main goal of treatment is to improve the quality of life and help patients communicate better. Treatment usually involves several approaches:
- Speech and Language Therapy: This helps patients improve their ability to speak and understand others, enhancing their communication skills.
- Behavioral Management: This approach addresses changes in personality and behavior that often occur with FTD, helping patients manage their emotions and actions better.
- Pharmacological Interventions: These are medications prescribed to relieve specific symptoms related to mood, such as irritability or aggression, helping patients feel more stable.
Each of these treatments is tailored to meet the individual needs of the patient, aiming to help them function as well as possible in daily life. The progression of FTD with aphasia varies among individuals but generally leads to a gradual decline in cognitive and functional abilities. Early diagnosis and proactive management are crucial to mitigate symptoms and plan for future care needs.
Frontotemporal dementia (FTD) happens when the frontal and temporal parts of the brain start to deteriorate. This damage is often caused by the build-up of abnormal proteins, named tau and TDP-43. These proteins interfere with how brain cells work, which eventually leads to the death of these cells, a process called neuronal death. Mental Health Health News: Latest News from Health Care, Mental Health, Weight Loss, Disease, Nutrition, Healthcare
