Meditation and neurodegenerative diseases.

Neurodegenerative diseases pose a significant problem for the healthcare system, doctors, and patients. With an aging population, more and more individuals are developing neurodegenerative diseases and there are few treatment options at the present time. Meditation techniques present an interesting potential adjuvant treatment for patients with neurodegenerative diseases and have the advantage of being inexpensive, and easy to teach and perform. There is increasing research evidence to support the application of meditation techniques to help improve cognition and memory in patients with neurodegenerative diseases. This review discusses the current data on meditation, memory, and attention, and the potential applications of meditation techniques in patients with neurodegenerative diseases.

[Frontotemporal dementias]. / Frontotemporale Demenzen.

Frontotemporal dementias (FTD) account for only 5-7% of all dementia aetiologies. However, FTD is one common form of dementia in the presenile period with a symptom onset between an age of 45 and 65 years. FTD are clinically classified into a group of rare genetic variants, the behavioural variant, primary progressive aphasias and a variant including motor neuron symptoms (FTD-MNS). In recent years the pathobiological characteristics of some FTD variants was clarified, demonstrating a pathological accumulation of TAR-DNA binding protein 43 (TDP-43) as a common pathological substrate. The revised diagnostic criteria of the behavioural variant of the FTD require at least three of six clinically discriminating features (disinhibition, apathy, loss of sympathy, perseverative behaviours, hyperorality and dysexecutive neuropsychological profile). The primary progressive aphasias are classified in a nonfluent/agrammatic variant, a logopenic variant and a semantic variant according to clinical and imaging features. Movement disorders and more precisely a Parkinsonian syndrome can be part of the FTD spectrum. Some clinical features overlap the clinical diagnosis of a progressive supranuclear paralysis and the corticobasal ganglionic degeneration. A causal therapy does not exist and medical treatment is directed at the patient's key symptoms. Different agents such as serotonin reuptake inhibitors, tricyclic antidepressants, atypical neuroleptics, carbamazepine, valproate, lamotrigine and when indicated also acetylcholinesterase inhibitors are potentially helpful. All together, theses medical treatments have a low level of evidence. Non-pharmacological therapies such as physiotherapy, occupational therapy, speech therapy and disease-specific education of the patient and their relatives are important to ensure a safe residential environment and daily routine.

The journey through Pick's Disease with a loved one: a personal account.

BACKGROUND: The aim of this short communication is to share my personal experience of caring for a terminally ill family member who was afflicted with Pick's disease. I tell my story in the hope of increasing society's awareness on this little known but devastating disease and assisting those who might be facing a similar situation. Pick's disease is a rare and incurable type of dementia that is associated with atrophy of the frontal and temporal lobes of the brain over time as a result of accumulation of tau protein fibres known as Pick's bodies. The exact cause is not known, but genetic predisposition is implicated in some disease cases. Pick's disease tends to affect men and women alike. It affects thinking, language and problem solving. METHODS: Data supporting this document were obtained from a thorough review of the literature and Internet search on Pick's disease, as well as from a personal experience with Pick's disease as it was unfolding. RESULTS: Clinical features, diagnosis and treatment, and stages of the disease are presented. CONCLUSION: Very little is known about Pick's disease. Additional research is needed to inform practice about tau protein dementias.

Frontotemporal dementia, Pick's disease.

A significant expansion of knowledge in the last few years, especially in the molecular biology of frontotemporal dementia (FTD) is summarized. This condition, formerly known as Pick's disease and considered rare, is estimated to be 12-15% of all dementias and 30-50% early onset ones. The clinical picture is protean, mainly a behavioural and language impairment, but the extrapyramidal syndromes of CBD and PSP also belong. These seemingly different presentations converge, as one or other areas in the brain are affected. Less than half of the cases are tauopathies, the majority has been discovered to have a TDP-43 and most recently a FUS proteinopathy, shared with ALS, opening potential opportunities for pharmacological approaches to treatment. Tau and progranulin mutations on Ch-17 and some others, point to molecular mechanisms. A glossary is provided to navigate the complex terminology.

[Current diagnostic, clinical and therapeutic conceptions of frontotemporal dementia]. / Wspólczesne koncepcje diagnostyczne, kliniczne i terapeutyczne otepienia czolowo-skroniowego.

The authors present a review of the selected publications on frontotemporal dementia. Frontotemporal dementia (FTD) is a progressive degeneration of the central nervous system. The typical symptoms of FTD are behavioural disorders, affective symptoms and speech disorders. Neuroimaging methods reveal atrophic lesions and hypometabolism of the frontal and temporal lobes.

Pick Complex: an integrative approach to frontotemporal dementia: primary progressive aphasia, corticobasal degeneration, and progressive supranuclear palsy.

BACKGROUND: Frontotemporal dementia (FTD) is a new label for clinical Pick's disease (PiD) because the eponymic term is increasingly restricted to the pathologic finding of Pick bodies. This restriction created the impression that PiD is rare and that is it difficult to diagnose. FTD is also a term most often used for behavioral and personality alterations. Primary progressive aphasia (PPA) and corticobasal degeneration (CBD), formerly the extrapyramidal variety of PiD, are also part of the syndrome. Recently, chromosome 17 localization and tau mutations were discovered in familial forms of the disease. REVIEW SUMMARY: FTD consists of behavioral and personality changes, often beginning with apathy and disinterest, which may be mistaken for depression. Disinhibition and perseverative, compulsive behavior often appear at the same time. A quantifiable frontal behavioral inventory is useful in the diagnosis beyond a checklist. The second type of presentation is progressive language loss (PPA). A less common variety is semantic dementia: the meaning of nouns and objects is lost. As the disease progresses, all components tend to overlap. CBD and progressive supranuclear palsy (PSP), although described as distinct entities, show a great deal of clinical, pathologic, genetic, and biochemical overlap. The evidence suggests they also belong to the complex. The association of motor neuron disease (MND) with FTD and other varieties of the complex is also reviewed. CONCLUSIONS: Clinical Pick's disease or Pick Complex includes the overlapping syndromes of FTD, PPA, CBD, PSP, and FTD-MND. The neuropathological and genetic spectrum should be viewed with emphasis on the commonalities rather than the differences, allowing the recognition of the relatively high frequency of this presenile syndrome.

[Frontotemporal dementia. Results from "Frontotemporal Demential and Pick's Disease Conference"]. / Die frontotemporale Demenz. Ergebnisse der "Frontotemporal Dementia & Pick's Disease Conference"

At the Frontotemporal Dementia and Pick's Disease Conference, recent data concerning the epidemiology, diagnosis, and therapy of frontotemporal dementia were presented. Topics included clinical manifestations, differential diagnosis, pathologic and genetic bases of the disease, therapy, and specific problems facing patients and care givers. A consensus in the terminology of this condition was sought.

A story of Pick's disease: a rare form of dementia.

Pick's disease is a progressive illness that affects brain function, eventually causing loss of verbal skills and problem-solving abilities. Pick's disease accounts for 5% of all dementias. The most common symptoms involve personality, behavior, and language changes. Diagnosis can be difficult; a differential diagnosis often requires several years. Frequently, the disorder is initially diagnosed as stress, depression, or Alzheimer's disease. A magnetic resonance imaging scan will show atrophied portions of the frontal and temporal lobes. One of the most difficult aspects of care for someone with Pick's disease is communication. The communication styles of nurses can alleviate the anxiety experienced by a person with Pick's disease. Nurses should try different strategies as an approach to communicating and caring for someone with Pick's disease, remembering that each person suffering from dementia is different. Pick's disease can be emotionally devastating to the families of those who develop this disease. Working with families confronting the disability of a loved one is perhaps the greatest challenge for nurses. Nurses have the responsibility of educating the primary caregiver about nutrition, skin protection, incontinence care, safety, and end-of-life decisions.

Therapy and management of frontal lobe dementia patients.

Patients with frontal lobe dementia (FLD) include those who suffer from Pick's disease, corticobasal degeneration, FLD without specific histopathologic features, as well as the infrequent families with frontotemporal dementia and parkinsonism associated with chromosome 17. Currently there have been no systematic efforts to manage and to treat patients with FLD. Drawing on the accumulated experience of clinicians and the known therapeutic approaches for patients with other neurodegenerative disorders such as AD and PD, the author discusses possible neurotransmitter replacement and biologic therapeutic approaches for patients with FLD.

Frontotemporal dementia: a different kind of dementia.

Frontotemporal dementia (FTD) is an umbrella term for a number of uncommon illnesses, including Pick's disease, which affect the frontal and/or temporal lobes of the brain and produce a dementia syndrome that is quite characteristic but unfamiliar to most clinicians. It is the third most common cause of cortical dementia. An overview of clinical manifestations, diagnosis, and management of FTD is provided with some specific information in relation to Pick's disease and a case example. Caregivers, in particular, need the education and support that could be provided by informed nurses.