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- Title
Pick's disease: clinicopathologic characterization of 21 cases.
- Authors
Choudhury, Parichita; Scharf, Eugene L.; Paolini II, Michael A.; Graff-Radford, Jonathan; Alden, Eva C.; Machulda, Mary M.; Jones, David T.; Fields, Julie A.; Murray, Melissa E.; Graff-Radford, Neill R.; Constantopoulos, Eleni; Reichard, Ross R.; Knopman, David S.; Duffy, Joseph R.; Dickson, Dennis W.; Parisi, Joseph E.; Josephs, Keith A.; Petersen, Ronald C.; Boeve, Bradley F.
- Abstract
Background: Pick's disease (PiD) is a unique subtype of frontotemporal lobar degeneration characterized pathologically by aggregates of 3-Repeat tau. Few studies have examined the clinical variability and disease progression in PiD. We describe the clinical features, neuropsychological profiles and coexistent pathologies in 21 cases of autopsy-confirmed PiD. Methods: This study was a retrospective analysis of patients with Pick's disease evaluated at Mayo Clinic, Rochester or Jacksonville (1995–2018), and identified through an existing database. Results: Twenty-one cases with sufficient clinical data were identified. Behavioral variant FTD (bvFTD; 12/21) was the most common phenotype, followed by primary progressive aphasia (PPA; 7/21), corticobasal syndrome (CBS; 1/21) and amnestic dementia (1/21). Median age at disease onset was 54 years, with PPA cases (median = 52 years) presenting earlier than bvFTD (median = 59). Median disease duration (onset–death) overall was 10 years and did not differ significantly between bvFTD (median = 9.5 years) and PPA (median = 13). Age at death was not significantly different in PPA (median = 66) compared to bvFTD (median = 68.5). A third of the cases (n = 7/21) demonstrated pure PiD pathology, while the remainder showed co-existent other pathologies including Alzheimer's type (n = 6), cerebral amyloid angiopathy (n = 3), combined Alzheimer's and amyloid angiopathy (n = 4), and Lewy body disease (n = 1). Conclusions: Our study shows that bvFTD and PPA are the most common clinical phenotypes associated with PiD, although rare presentations such as CBS were also seen. Coexisting non-Pick's pathology was also present in many cases. Our study highlights the clinical and pathologic heterogeneity in PiD.
- Subjects
JACKSONVILLE (Fla.); ROCHESTER (N.Y.); MAYO Clinic; FRONTOTEMPORAL lobar degeneration; CEREBRAL amyloid angiopathy; DISEASE duration; DISEASE progression; DISEASES; AGE of onset
- Publication
Journal of Neurology, 2020, Vol 267, Issue 9, p2697
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-020-09927-9