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Frontotemporal dementia (FTD) is a group of disorders caused by damage in the brain’s frontal and temporal lobes. The damage happens gradually over time. It is also known as frontotemporal disorder or frontotemporal degeneration.

FTD tends to occur earlier than other forms of dementia, with most cases in people ages 45 to 64. It is the most common form of dementia for people under age 60, according to the Association for Frontotemporal Degeneration.

Learn more about FTD, including types, causes, and symptoms.

Types of Frontotemporal Dementia (FTD)

There are three types of FTD: behavioral variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA), and movement disorders.

Behavioral variant frontotemporal dementia (bvFTD)

Behavioral variant frontotemporal dementia (bvFTD) is the most common type of FTD. It makes up about half of all FTD cases.

BvFTD causes changes in behavior, emotions, judgment, and personality. It can affect a person’s self-control and cause them to behave differently than they did before.

They also may lose empathy or become apathetic. In some cases, bvFTD can affect cognition.

Primary progressive aphasia (PPA)

Primary progressive aphasia (PPA) is a type of frontotemporal dementia that affects a person’s ability to communicate. It can affect their ability to speak, read, write, and/or understand other people. Symptoms get worse over time.

There are three types of PPA:

• Nonfluent/agrammatic PPA. People with nonfluent/agrammatic PPA may find speaking more difficult over time. They often find their grammar affected. They may forget to use small linking words like “the” or “to,” use incorrect verb tenses, or mix up the order of a sentence. In some cases, people with this form of PPA may lose the ability to speak altogether.
• Logopenic PPA. In logopenic PPA, people can still talk, but they struggle to find the right words as they’re talking. Their speech may become slow and halting as they try to find the right words. However, it doesn’t affect their understanding of words.
• Semantic PPA. In semantic PPA, a person begins to lose the meaning of words. They can still speak but often have trouble finding the right word. They also may struggle to understand the meanings of words. In some cases, they may also have trouble recognizing people or objects.

Movement disorders

Movement disorders are a type of frontotemporal dementia that affects the parts of the brain that control movement. This may also affect language and behavior.

Movement disorders associated with FTD include:

• Corticobasal syndrome. This can cause loss of coordination or stiffness in the hands, arms, or legs. Symptoms often begin on one side of the body and progress to the other side. They may also include trouble swallowing.
• Frontotemporal dementia with amyotrophic lateral sclerosis (FTD-ALS). This combines behavioral frontotemporal dementia and amyotrophic lateral sclerosis (ALS). People with FTD-ALS have the behavioral and emotional symptoms of bvFTD along with the physical symptoms of ALS. These symptoms include muscle weakness, atrophy, contraction, or twitching; slowed or slurred speech; and swallowing problems.
• Progressive supranuclear palsy. Symptoms of progressive supranuclear palsy may look similar to those of Parkinson’s disease. Many symptoms involve the eyes. People may have trouble with horizontal and vertical eye movement or with opening or closing their eyes. They may struggle to blink or have excessive blinking. Other symptoms include a loss of balance, which can lead to increased falls.

What Causes Frontotemporal Dementia (FTD)?

The specific cause of a person’s FTD is often unknown. But FTD happens when neurons (nerve cells) in specific parts of the brain become damaged.

This damage is often associated with abnormal amounts or forms of the proteins tau and TDP-43 inside the neurons. These proteins build up over time, causing damage to the neurons.

Genetics may play a role in some FTD cases. People with a family history of FTD are at a higher risk of developing it themselves. In these cases, a faulty gene may cause FTD.

Scientists are still learning more about FTD, including how it can occur.

Symptoms of Frontotemporal Dementia (FTD)

The symptoms of FTD depend on the affected area of the brain. Deterioration of the frontal lobe often leads to symptoms involving movement or behavior. Deterioration of the temporal lobe often leads to symptoms involving communication or emotion. The symptoms also often depend on the specific type of FTD.

FTD is a progressive disease, meaning symptoms get worse over time. As the disease progresses, a person with one type of FTD may experience symptoms associated with other types.

Common symptoms associated with bvFTD include:

• Apathy.
• Changes in routines such as eating and hygiene.
• Compulsive or repetitive behaviors and/or speech.
• Lack of self-control, judgment, or inhibition.
• Loss of empathy, awareness, or concern for others.
• Mood changes.
• Trouble with planning, decision-making, or other cognitive skills.

Common symptoms of PPA include:

• Inability to speak (going mute).
• Loss of grammar in speech.
• Physical problems in producing speech.
• Slow, hesitant speech.
• Slurred speech.
• Speech errors.
• Swallowing problems.
• Trouble finding the right word.
• Trouble understanding common words or phrases.
• Trouble understanding complex sentences.

Symptoms of FTD-associated movement disorders include:

• Balance problems/increased falls.
• Eye-movement disorders.
• Loss of coordination.
• Muscle stiffness.
• Muscle weakness or loss.
• Shaky hands.
• Trouble with common actions (for example, buttoning a shirt, closing a door, or using a fork).
• Twitching or wiggling in muscles.
• Walking problems.

Diagnosing Frontotemporal Dementia (FTD)

FTD is often difficult to diagnose because its symptoms often look like symptoms of other conditions. Also, because FTD is rare, doctors may not have much familiarity with its various symptoms, according to the National Institute on Aging.

To diagnose FTD, a doctor may ask about your symptoms and family history. They can also perform neurological tests, order tests to rule out other conditions, order genetic testing, and/or order brain scans.

Is There a Cure or Treatment for Frontotemporal Dementia (FTD)?

There is no cure for FTD. There is also no specific treatment for FTD itself. Treatment usually consists of managing FTD’s various symptoms. That may include:

• Managing behavioral changes.
• Medication.
• Physical, occupational, and/or speech therapy.

Scientists are continuing to study FTD in search of potential treatments that will improve outcomes.

Frontotemporal Dementia (FTD) Prognosis

The specific prognosis of FTD depends on each individual case. But FTD is a progressive disease, and symptoms get worse over time.

FTD’s progression can take anywhere from two to 20 years, according to the Association for Frontotemporal Degeneration. The average life expectancy is seven to 13 years after symptoms begin to appear.

Eventually, people with FTD may develop physical complications like:

• Lung, skin, or urinary tract infections.
• Physical injuries.
• Pneumonia.

These conditions often are the cause of death in people with FTD. The UPMC Department of Neurology provides world-class care for a wide range of brain and nervous system disorders. To find care near you, visit our website.