Pick's disease

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at September 26, 2016
StartPick's disease

A rare type of neurodegenerative disease, Pick’s disease (also known as Pick disease or PiD) is a kind of frontotemporal dementia that is caused by the destruction of specific nerve cells in the brain. It typically presents among patients as language problems, difficulty with social functioning, and cognitive impairment.

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Definition & Facts

Pick’s disease is characterized by a buildup of tau proteins in the neurons of the brain. The buildup of these proteins creates silver clusters that are referred to a pick bodies. While the term Pick’s disease is sometimes used in a general sense to describe any condition relating to frontotemporal lobar degeneration, Pick's disease more specifically refers to a condition of localized dementia caused by pick bodies.

Pick’s disease affects less than 200,000 people in the United States. Worldwide, the incidences of Pick's disease tend to be higher in Northern European and specifically in Scandinavian countries, where its statistical frequency ranges between 7 and 43 cases out of every 100,000 people in the population.

Similar to other forms of dementia, Pick's disease progresses slowly. Those diagnosed with Pick's live on average for about six years following diagnosis.

Symptoms & Complaints

Pick’s disease is often misdiagnosed or not recognized in early stages. Speech and language problems tend to present early on and worsen rapidly. Behavioral changes such as apathy, irritability, and agitation are also typical symptoms associated with the early stages of Pick's disease.

Though similar to Alzheimer’s disease, Pick's disease is typically identified differently due to changes in the patient’s personality and social interactions. Disturbing symptoms arise which pertain to social conduct. Symptoms typically include the following:

Causes

Pick's disease is caused by the buildup of tau proteins in the neurons of the brain. This buildup inside the cells results in inflammation and destruction of the cells as a result of the response of the immune system. The tau protein buildup is related to a variety of genetic mutations. Statistics indicate that 50% of persons who are diagnosed with Pick's disease have a family history of frontotemporal dementia. Additionally, some linkage has been found between Pick's disease and the mutation or degeneration of three particular chromosomes, but the role they play in causing the disease is not yet identified.

Diagnosis & Tests

The doctor will inquire about family history and medical history. As with the diagnosis of most medical conditions, Pick’s is identified by a battery of tests, which rule out other types of dementia and zero in on the specific portion of the brain that is being affected. The following tests are typically ordered in the process of identifying the proper diagnosis of the disease:

Once Pick's disease is identified as a possible cause, a brain biopsy, which will be examined for the presence of pick bodies, may be ordered to confirm the diagnosis. 

Treatment & Therapy

There is no cure for Pick's disease, and treatments and therapies for patients with Pick’s are directed at alleviating or lessening the effects of the symptoms. Occupational therapy and speech therapy may be helpful in addressing a patient's problems with everyday functioning and with verbal and written communication, respectively.

Since many of the symptoms are related to behavioral disorders, talk therapy (psychotherapy) is often mistaken as the sole means of treating patients with Pick's disease. However, it can still be a valuable tool in helping a patient cope with the challenges of their disorder. Behavior modification approaches, which reward good behavior, are sometimes but not always effective.

Reality orientation therapy, which makes use of environment cues, is sometimes effective in helping to alleviate disorientation among those with dementia. Regular exercise, regular sleep, and healthy diet may promote cognitive functioning. Medications that can be utilized in the treatment of Pick's disease include:

Depending upon how the patient responds, some of these medications can worsen confusion; therefore, it is important to find a regimen that works. Additional treatments may include:

It is often critical for patients with Pick's disease to be closely monitored and assisted in hygiene and dietary functions. As the disease progresses, care facilities and home health care services are often needed.

Prevention & Prophylaxis

There is no known prevention for Pick's disease or any other type of dementia; however, studies suggest that prolonging the onset or preventing it might be related to implementing certain behaviors as a person ages, including:

Though there is no guarantee that these factors will help prevent Pick’s disease, these healthy habits will certainly help a person's overall well-being.