Frontotemporal dementia in psychiatric practice: diagnostic and therapeutic aspects

Abstract

Frontotemporal dementia (FTD) is a progressive neurodegenerative disorder. It begins usually in the presenile age and affects predominantly the frontal lobes and anterior temporal lobes of the brain. Currently, there are three main clinical variant of FTD: behavioral variant frontotemporal dementia (bvFTD), which manifests early with behavioral and executive impairments; primary progressive aphasia (PPA), in which progressive speech disorders, grammatical, and verbal production; semantic variant primary progressive aphasia (svPPA). In psychiatric practice, patients with FTD occur not so rarely that requires a differential diagnosis with an endogenous mental disease and presenile dementia, especially with Alzheimer’s disease (AD). Te importance of correct diagnosis is determined by differences in the treatment of patients with dementia. In FTD, in contrast to patients with AD, the appointment of acetylcholinesterase inhibitors does not lead to a benefcial therapeutic effect and, therefore, is not appropriate. Te use of memantine, especially in the moderatesevere stages of FTD, can be useful to treat noncognitive symptoms. In the standard therapy of patients with bvFTD, should be included recommendations for the antipsychotic or the use of SSRI antidepressants, for correction of affective and behavioral disorders.