frontaltemporal

Frontaltemporal refers to the frontal and temporal lobes of the brain, regions at the front and sides of the cerebral cortex. These areas are involved in executive function, social behavior, language, and emotion. The term is commonly used in neurology and neuropsychology to describe conditions that primarily affect this network, most notably frontotemporal dementia.

Frontotemporal dementia (FTD) is a group of neurodegenerative disorders characterized by progressive atrophy of the frontal and/or temporal lobes. It typically presents in middle adulthood, earlier than Alzheimer's disease, and leads to changes in personality, behavior, language, or movement depending on the regions affected. The main clinical variants are behavioral variant FTD (bvFTD), which features disinhibition, apathy, or compulsive behaviors, and primary progressive aphasia (PPA), which impairs language and has subtypes such as nonfluent/agrammatic and semantic variants.

Pathology in FTD often involves abnormal accumulations of proteins such as tau, TDP-43, or, less commonly, FUS. Genetic forms account for a minority of cases and can involve mutations in MAPT, GRN, or expansions in C9orf72. The pattern of brain atrophy typically begins in the frontal and/or anterior temporal regions and may spread as the disease progresses.

Diagnosis relies on clinical history, neurologic examination, and neuroimaging showing frontal and temporal atrophy or hypometabolism, supported by neuropsychological testing. There is no cure for FTD, and treatment focuses on symptom management and supportive care. Pharmacologic options are used cautiously to address behavioral symptoms, while speech and language therapy, occupational therapy, and caregiver support are central. Prognosis varies by subtype and individual, with progression occurring over several years.

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