Pick disease

Last revised by Dr Daniel J Bell on 01 Mar 2018

Pick disease is a neurodegenerative disease, and one of the tauopathies characterized by the accumulation of Pick bodies.

Pick disease is sometimes used synonymously with frontotemporal lobar degeneration, although this is probably unwise, as not all cases which fit clinically into a frontotemporal dementia have the underlying pathological changes seen in Pick disease. 

Pick disease typically manifests between the ages of 40 and 60 years, with a male predilection 1

Clinical presentation depends on the particular pattern of cortical involvement, and is discussed in the frontotemporal lobar degeneration (FTLD) article. 

The characteristic features of Pick disease include 1

  • Pick bodies
  • swollen chromatolytic neurons
  • loss of large pyramidal neurons
  • astrocytic gliosis

The primary radiographic abnormality is that of cortical atrophy of the frontal and temporal lobes. These changes can be markedly asymmetric and affect one region much more than another. They are discussed further in the frontotemporal lobar degeneration (FTLD) article. 

Caudate head volumes are also often reduced 3.

On imaging, Pick disease may mimic other causes of frontal and temporal atrophy, especially:

Clinically Pick disease may overlap with other neurodegenerative diseases with prominent frontal involvement, including 1

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