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Pick's Complex

This is a less common form of dementia, more prominent in those under the age 65. Frequently misdiagnosed as Alzheimer's disease, Pick's patients initially exhibit marked personality and behavioral changes. And gradually the ability to speak coherently declines.


Although there is no cure for Pick's complex presently, it can however be managed well and the quality of life improved. According to Arnold Pick, who first described the disease in 1892, Pick's disease causes an irreversible decline in a person's functioning for several years. Pick's affects adults between the ages of 40 and 60 and is more common in women than men.


Causes

The frontal and temporal lobes of the brain control a person's speech and personality. Excess protein build-up in these parts causes slow atrophy in these regions. The cause for this build-up of protein is unknown. Other than causing speech and behavioral changes, Pick's disease can also cause memory loss quite like those with Alzheimer's as well as socially inappropriate behavior, poor decision making, progressing to severe impairment in intellect, speech and memory. Some opine that Pick's disease may have a genetic or heredity component although not all family members are affected.


Symptoms of Pick's disease

The first sign of Pick's complex is personality changes and decline of basic functioning. Pick's can occur in an age earlier than Alzheimer's and memory loss need not be a predominant early sign of Pick's disease. Although there could be reports of Pick's occurring as young as 20 years of age, the progression is slower in Pick's disease. However, there are cases where symptoms could worsen over time and brain cells degenerate. More severe symptoms appear at later stages of Pick's. Some noticeable behavioral symptoms of Pick's disease are poor judgment, extreme restlessness especially in the early stages, overeating or drinking, lack of personal hygiene, sexual exhibitionism, decreased interest in daily activities and obsessive behavior.

Mood swings, lack of empathy, apathy, rudeness, impatience and aggression, easy distraction and being unaware of strange behavior and memory loss are some of the prominent emotional symptoms of Pick's disease. Loss of vocabulary, difficulty in speaking and understanding, uncoordinated speech and decrease in the ability to speak and write are some serious signs of Pick's.


Diagnosis of Pick's Complex

Other than careful symptomatic evaluation, brain scans and EEG, three of the following five characteristics are found to be present in the early stages. They include:


    Onset before age 65
    Personality changes
    Lack of normal behavior / Loss of control
    Lack of inhibition
    Roaming behavior
    When compared to Alzheimer's, memory loss and mental impairment occur later in Pick's.

Diet and activity

There should be a restriction on foods with high sugar content. There could be carbohydrate cravings in some. While in Alzheimer's and Parkinsons, a diet relatively high in fat and protein and low in carbohydrates is necessary, it is unclear if the same is recommended for Pick's complex. It is better to get a doctor's opinion on an appropriate heart-healthy diet. A regimen of therapeutic exercises such as brisk walking can help to regulate the patient's mood and benefit on cognitive function.


Treatment

Pick's disease, like any other dementia progresses rapidly and life gets shortened about six to eight years, although some do live for as long as twenty years. As currently there is no cure for Pick's like Alzheimer's, the aim is to maximize quality of life by way of medications to manage particular symptoms, regular supervision, and assistance.

Emotional and substantive support is an important aspect of the treatment. The family of the affected may help with the following control symptoms:


  • Eyeglasses and hearing aids to bolster the failing senses.
  • Positive behavior when symptoms set in by creating a calm and soothing atmosphere so that the patient feels safe and less anxious.
  • Speech therapy or any other physical therapy that can improve communication and movement.
  • Selective antidepressants that can provide some relief from apathy and depression and help reduce food cravings, impulse control and compulsive activity.
  • Treatment for other disorders such as anemia, thyroid disorders and kidney or liver diseases.
  • Stopping medications like paracetamol, NSAIDS, anti-cholergenics or changing them under medical guidance.

Tips for coping with Pick's complex

Being diagnosed with Pick's complex can be overwhelming especially when it involves any form of dementia. It is good to learn more about Pick's disease and frontotemporal dementia. In this way, more control can be exhibited and they will be better prepared to manage symptoms.


  • Music therapy, meditation, deep breathing exercises can help control stress and anxiety.
  • Pet therapy and visits from specially trained animals can help relieve stress and improve mood.
  • Treating depression can make it easier to handle other challenges of the disease.
  • Reaching out to family and friends for emotional support can help avoid isolation. A support group of similar patients can help overcome feelings of depression and isolation and provide a wealth of coping tips. Staying socially active will lighten the load and increase patient comfort.
  • Playing cards and word games such as scrabble, crossword and Sudoku puzzles can exercise the brain and help slow cognitive decline.
  • It would be wise for a Pick's patient to avoid medical, financial and legal confusion and instead create a design plan and discuss and document end-of-life preferences with doctors and family members.

Biofeedback Training

Biofeedback training is a process wherein the patient is trained to improve his/her health by using signals from his/her own body. It helps a person control physiological processes such as blood pressure, heart rate and muscle tension. These processes actually are involuntary but can be manipulated and controlled at will. Biofeedback therapy is used to treat conditions such as migraine headache, tension headache, urinary incontinence, high blood pressure, chronic pain, etc.


The concept behind biofeedback training is very interesting. It utilizes the power of the mind to become aware of what is happening within the body. This awareness helps a person to gain more control over bodily functions, involuntary ones too. This therapy works wonders on people experiencing stress. Stress can cause fluctuations in blood pressure and biofeedback therapy aids in relaxation.


Electrodes are attached to the patient's skin, which sends information to the monitor. Based on the monitor reading, the therapist understands the mental activities of the patient. The parameters that are monitored include blood pressure, sweating, breathing rate, and muscle activity. If a patient is experiencing stress at a particular moment the above mentioned parameters may alter. Understanding this alteration can help understand which part of the body needs to relax.


Depending on the severity of the issue, the number of sessions may vary. A session may typically last from 30 minutes to one hour. Biofeedback therapy does not have any side effects or pose any risk and is a non-invasive procedure. To undertake a session in biofeedback therapy, it is advisable to work with a health care professional trained in biofeedback.


Biofeedback therapy uses

Biofeedback therapy can be used to treat:

Chronic pain: Helps in identifying tight muscles and relaxing them, relieves lower back pain, abdominal pain, etc. This therapy benefits people across all age groups.

Anxiety: Anxiety relief is one huge area wherein biofeedback therapy can be very helpful. The therapy helps understand the body's responses when a person is stressed and anxious. By understanding this, one can control body response using biofeedback therapy.

Urinary incontinence: People may have trouble in controlling the urge to urinate. This therapy, particularly in women helps in tightening the pelvic floor muscles that control the urge/feeling to urinate. It is helpful in treating kids who bed wet.

Headache: Stress and muscle tension can cause headaches like migraine and other types of headache. This therapy can help relax the muscles and reduce frequency as well as severity of the headache.


Other conditions that can be cured using biofeedback therapy include ADHD (Attention Deficit Hyperactivity Disorder), asthma, constipation, rheumatoid arthritis, COPD (Chronic Obstructive Pulmonary Disease), high blood pressure, etc. Different relaxation exercises used in biofeedback therapy:


  • Deep breathing

  • Guided imagery: Concentrating on a specific image and focusing on the image to make the person feel relaxed.

  • Progressive muscle relaxation: Alternately tightening and relaxing various muscle groups.

  • Mindfulness meditation: Focusing thoughts to let go of negative emotions.

Biofeedback therapy types

Neuro feedback: Used to measure brain wave feedback. Used to treat epilepsy and other seizure disorders.

Thermal biofeedback: Used to measure skin temperature. Used to treat headache and Raynaud's disease.

Electromyography: Used to measure muscle activity and tension. Used to treat conditions such as headaches, back pain, anxiety disorder, incontinence, muscle retraining after injury.

Electrodermal activity: Used to measure sweating and can be used in pain and anxiety.



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Collection of Pages - Last revised Date: November 11, 2019