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Frontotemporal Dementia

Frontotemporal Dementia. Thomas G. Bowers, Ph.D. Frontal Lobes. Executive functions Include attention, problem solving, hypothesis testing, social cognition and judgment Relatively recent evolutionary development Last structure to mature and develop (~25 years old). Pineas Gage.

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Frontotemporal Dementia

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  1. Frontotemporal Dementia Thomas G. Bowers, Ph.D.

  2. Frontal Lobes • Executive functions • Include attention, problem solving, hypothesis testing, social cognition and judgment • Relatively recent evolutionary development • Last structure to mature and develop (~25 years old)

  3. Pineas Gage

  4. Other Views of Gage

  5. Gages Actual Skull

  6. Impact of Frontal Lesion • Gage’s behavior became socially very inappropriate • Displayed consistently poor social judgment

  7. Basic Gross Anatomy • Motor, Premotor and Prefrontal regions • Many projections to premotor from other cortical regions • Extensive limbic projections to the premotor region

  8. Frontal Organization • From anterior • 1. Prefrontal • 2. Premotor • 3. Motor

  9. Frontal Organization • Prefrontal • Does not receive any primary sensory input except olfactory stimuli • Extensive projections from other cortical regions • Extensive projections from the limbic system • Reciprocating projections

  10. Frontal Organization • Premotor • Broca’s Area • Critical convergence zone

  11. Frontal Organization • Motor • Linked with the premotor cortex, sensory cortex, and the basal ganglia • Gives rise to pyramidal tacts that descend subcortically

  12. Frontal Organization • Prefrontal – Limbic Links • Includes amygdala, hippocampus, thalamus, temporal lobe pole • Involves social processing as empathy, moral emotions, interpersonal judgment

  13. Frontal Organization • Prefrontal – Subcortical Links • Thalamofrontal • Frontial-striatal • Difficulties here can include disinhibition, perserveration, loss of motivation, attentional disorders, hemispatial neglect

  14. Vulnerable to Impairment • Traumatic brain injury • Axonal shearing, contusions, laceration, hemorrhage • Stroke • ACA, rostral aspects of MCA • Aneurysm • Neurodegenerative disease • Pick’s • Frontotemporal dementia

  15. Vulnerable to Impairment • Psychiatric disorders • Hydroencephalus • Brain tumors • Orbitofrontal meningioma

  16. Frontal Region is Vulnerable • Frontal pole and anterior horn of the temporal lobe in particular are sensitive to lesions • Coup injury • Contrecoup • Shearing injuries • Small petechial hemorrhage

  17. Degenerative Disorders • Pick’s Disease • Atrophy has an affinity for the frontotemporal region • Development of Pick’s bodies • Frontotemporal dementia • Not frequent, but 10% of degenerative dementias

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