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Pick’s disease

Definition:

A disorder which produces deterioration in mental function caused by loss of brain tissue in discrete areas (focal lesions). Pick's disease is marked by the presence of abnormalities in brain cells (Pick's bodies) which can be found in the affected areas and elsewhere in the brain.



Alternative Names:
Lobar sclerosis; Circumscribed brain atrophy; Fronto-temporal dementia; Arnold Pick's disease; Focal cerebral atrophy

Causes, incidence, and risk factors:
Pick's disease is a rare disorder similar to senile dementia/Alzheimer's type. What differentiates it from Alzheimer's disease is that it seems to affect predominantly circumscribed areas of the brain, not all regions. Alzheimer's disease is a more diffuse process that can affect any part of the brain as it progresses. Pick's disease affects about 1 out of 100,000 people. It affects both sexes, but it is more common in women than men. It may occur as early as 20 years old, but usually begins between ages 40 to 60. The average age of onset is 54 years.

The onset is usually slow and insidious. The disorder involves shrinking of the tissues (atrophy) of the frontal and temporal lobes of the brain, "fronto-temporal dementia". The neurons (nerve cells) in the affected areas contain abnormal material (Pick's bodies). These are tangles made of tau protein. The exact cause is unknown.

The symptoms may be similar to senile dementia/Alzheimer's type, with aphasia (loss of language abilities), agnosia (loss of ability to recognize objects or people), and apraxia (loss of skilled movement abilities). Behavioral changes are prominent with loss of inhibition and change in personality as opposed to Alzheimer's Disease where memory loss is often the primary feature.

Risk factors may include a having a personal or family history of Pick's disease or senile dementia, though the genetic basis of the disease has not yet been determined.

Review Date: 5/7/2002
Reviewed By: Alberto Espay, M.D., Department of Neurology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. Review provided by VeriMed Healthcare Network.

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