These are some very odd, ritualistic, repetitive behaviors that we see. In Alzheimer's, the first symptom in close to 80 percent of people is memory loss. With FTD memory loss is unusual as a first symptom, more likely you're going to see loss of speech or language or these behavioral changes. But I think in the earlier stages we have a much better chance of differentiating them. So this suggests that there is a vulnerability of the frontal neurons and the lower motor neurons for reasons we don't quite understand yet.
Diagnosis is a combination of history, neuroimaging and neuropsychological testing.
Often, the history suggests early onset changes in personality, weight gain, and the repetitive compulsive behaviors. Neuropsychologically, we see the loss of frontal executive function or imaging atrophy in frontal regions. Neuropsychological testing tends to show sparing of memory, sparing of visual spatial skills, which you know are the first deficits in Alzheimer's, and quite marked problems with frontal and executive type tasks. We have treatments for the behaviors but nothing at the moment to slow down the illness or improve the psychological function. So, a lot of these patients benefit from selective serotonin reuptake inhibitors.