Pick's disease (Arnold Pick)
A rare and fatal degenerative disease of the nervous system. It is characterized by signs of severe frontal or temporal lobe dysfunction, including loss of memory, disorientation, apathy, reduced initiative, lack of insight, and, in later stages, speech disorders, prominent grasp and sucking reflexes, and terminal decerebrate rigidity, dystonia, and tremor. It usually occurs between the ages of 40 and 60, more often in women than in men. Course may take from a few months to 4 or 5 years to progress to complete loss of intellectual function. Death takes place 7-10 years after the onset of symptoms. It is due to atrophy of the frontal and temporal lobes.
Clinically there are major overlaps with Alzheimer's presenile dementia. Some experts consider these diseases as one entity, and the term Pick-Alzheimer
disease has been used. These are however two separate entities. Arnold Pick described progressive mental deterioration in a 71-year-old man. On autopsy, his brain showed unusual shrinkage of the frontal cortex. Cortex shrinkage is different from the anatomical changes in the brain associated with Alzheimer's disease.
Compared with Alzheimer's disease, which accounts for 50 to 60 percent of dementia cases, Pick's disease accounts for about 5 percent. While average age of onset for Alzheimer's disease is about 50 years, Pick's disease may appear a decade earlier. Pick's disease is apparently hereditary and autosomal dominant inheritance has been reported.
An inherited form of dementia is known as Neumann's disease. See under M. A. Neumann.
The eponymic term was introduced by A. Gans in 1925.
See also Wernicke's aphasia, under Carl Wernicke, German neurologist and psychiatrist, 1848-1905.
- A. Pick:
Über die Beziehungen der senilen Hirnatrophie zur Aphasie.
Prager medicinische Wochenschrift, Prague, 1892, 17: 165-167. Apperzeptive Blindheit der Senilen.
Arbeiten aus der Deutschen Psychiatrischen Universitäts-Klinik in Prag, Berlin, 1908: 43.
- A. Gans:
De ziekten van Pick en van Alzheimer.
Nederlandsch Tijdschrift voor Geneeskunde, Amsterdam, 1925; 2: 1953.