The core features of frontotemporal dementia (FTD) typically involve cognitive and behavioral changes that emerge from degeneration of the frontal and temporal lobes of the brain. Although the initial presentation and course can be quite variable, three main subtypes of FTD generally are recognized:
- Behavioral variant – Deterioration of social decorum and self-regulation, often characterized by impaired judgment, insight, disinhibition, apathy, and other personality changes.
- Semantic dementia – Impaired knowledge of word meaning, deficits in word-finding (particularly for nouns)
- Progressive non-fluent aphasia – Demonstrating pronounced impairments in speech production, including decreased output for words, shortened phrases, and/or deficits in articulation.
Given the variability in presentation seen in FTD and the fact that many of the initial clinical symptoms and behaviors overlap with other neurological and psychiatric syndromes, referrals for neuropsychological evaluation are commonly requested to clarify (or corroborate) an initial diagnosis, make recommendations for treatment planning, and provide a baseline assessment to monitor the course of progression.