What Is Pick's Disease?

Pick's disease is a kind of dementia similar to Alzheimer's but far less common. It affects parts of the brain that control emotions, behavior, personality, and language. It's also a type of disorder known as frontotemporal dementia (FTD) or frontotemporal lobar degeneration (FTLD).

Your brain uses a transport system to help move around the nutrients it needs. This system is made of proteins that like railroad tracks guiding trains guide nutrients where they need to go. The proteins that keep the tracks straight are called tau proteins.

When you have Pick's disease, the tau proteins don't work the way they should. You may also have more of them in your brain than other people.

These abnormal clumps of tau proteins are called Pick bodies. Pick bodies "derail" your transport system. The track is no longer straight, and nutrients in the brain can't get where they need to go. This causes brain damage that can't be reversed.

Around 50,000 to 60,000 people in the U.S. have Pick's disease. It's usually diagnosed between the ages of 40 and 75, but it can happen in people as young as 20. It affects more men than women. People of Scandinavian descent are at a slightly higher risk of getting it than others.

Causes

Up to 25% of people with Pick's disease received a gene that causes it from a parent. Experts aren't sure why it happens in other cases.

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Symptoms

Pick bodies typically form in the frontal and temporal lobes of the brain. These sections control your behavior, personality, and speech. Symptoms usually show up in those areas.

You may:

  • Act aggressively toward others
  • Be uninterested in everyday activities
  • Be very aware of everything you do all the time
  • Feel irritable or agitated
  • Have drastic and quick mood swings
  • Have trouble feeling warmth, sympathy, or concern for others
  • Have trouble with unplanned activities
  • Make rash decisions
  • Repeat actions over and over
  • Say and do inappropriate things

Some people become hungry all the time, and some develop an unhealthy "sweet tooth" and eat much more sugar than they should.

Problems with language usually happen early in the disease. Pick bodies in the speech section of your brain can cause problems with:

  • Recalling names of common objects
  • Copying simple shapes with pencil and paper
  • Understanding written words
  • Speaking because of halted or stilted speech

Occasionally, people with Pick's disease might also have:

  • Memory loss
  • Problems moving
  • Stiff or weak muscles
  • Trouble peeing
  • Trouble with coordination

Pick's Disease vs. Alzheimer's Disease

Pick's disease has many of the same causes and symptoms that Alzheimer's does. But there are key differences.

Unlike people with Alzheimer's disease, people with Pick's disease:

  • Are diagnosed earlier in life
  • Don't have hallucinations or delusions
  • Don't tend to get lost in familiar places
  • Have a harder time making sense of their words or the words of others
  • Have behavior problems early on (behavior problems usually come late in Alzheimer's)
  • Don't have as many memory loss problems

Diagnosis

To find out if you have Pick's disease, your doctor will ask about your symptoms and go over your medical history. Then you'll have special tests that check your memory, behavior, language, and other mental functions. These are usually pencil and paper tests. You'll answer questions in writing and may be asked to draw certain objects.

The doctor may also recommend a blood test that looks at your DNA to see if you have the gene that causes Pick's disease.

To get a better picture of what's happening in your brain, your doctor may order imaging tests, such as:

  • Magnetic resonance imaging (MRI): Powerful magnets and radio waves are used to make detailed images of your brain.
  • Single-photon emission computed tomography (SPECT) or a positron emission tomography (PET) scan: A radioactive substance and a special camera create 3-dimensional pictures that show what areas of your brain are more or less active.

You may also have a lumbar puncture. Your doctor will use a long needle to take a small amount of fluid from an area near your spine for screening. In rare cases, your doctor might want to take a small amount of your brain tissue to test. This is called a biopsy.

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Treatment

There's no cure for Pick's disease, and medications can't slow it down. It can progress slowly, but usually it steadily gets worse over time. Some people live as long as 10 years with the disease.

Your doctor can recommend treatment to help you deal with many of your symptoms. He may suggest behavioral therapy to help control any dangerous behavior and antidepressants to help with agitation or aggression.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on September 19, 2016

Sources

SOURCES:

Alzheimer's Association: "Brain Tour," "Frontotemporal Dementia (FTD)."

The Association for Frontotemporal Degeneration: "Pick's Disease."

National Institute of Neurological Disorders and Stroke: "Frontotemporal Dementia." 

National Organization for Rare Disorders: "Frontotemporal Degeneration."

Medscape: "Pick Disease."

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