Dementias 2017

This is a quick one.

I usually write on Saturday or Sunday mornings…

Currently, I am in a hotel somewhere in London. I am attending the ‘Dementias 2017’ conference, at the Royal College of General Practitioners.

Alistair Burns chaired this morning in his inimitable West Coast style. It was great.

One of the lecturers, Professor Michael Hornberger from the University of East Anglia talked about radiological techniques to diagnose dementia, specifically comparing Alzheimer’s with Fronto-Temporal Dementia (FTD).

I am sure that most of you have heard of Alzheimer’s; FTD is a much rarer form of the disease that can develop in younger people and is characterised by changes in the frontal lobes – those parts of the brain that control abstract thought, emotion, planning and self-control. (Yes, like our current US President; Not).

One of the fascinating differences was within Alzheimer’s, which characteristically affects first the hippocampus – the part of our brains controlling memory; it then moves-on to the Amygdala, the namesake of this blog, which controls emotions.

In FTD, the Amygdala is often affected first then the hippocampus; resulting in blunting of mood, emotion and empathy before memory. The former leading to a persistence of spacial-orientation (not getting lost), with those living with Alzheimer’s characteristically losing track of time and space earlier.

Michael has used an app – ‘Sea Quest Hero’ to investigate this.

It is incredible the extent to which physical changes in your brain can be translated into alterations in behaviour, personality or mood. I know this should be obvious, but seeing the shadowy images, projected onto the screen somehow made it more real more…

I remember a recent patient, G. who became lost after a couple of seconds of redirection, ‘Where am I?’ He had Alzheimer’s.

Some of my patients struggle.

The battle between overwhelming neurological deficits, added to the constraints of hospitalisation can be too much. ‘I want to go home,’ is one of the most painful phrases I hear. Especially when repeated again, and again and again.

We are the subjects of our brains and neuropathology.

Let us one day understand better who we are.