Clinical and pathological overlap between frontotemporal dementia, primaryprogressive aphasia and corticobasal degeneration: The Pick complex

A substantive overlap between the clinical syndromes of frontal lobe dement ia (FLD), frontotemporal dementia (FTD), or primary progressive aphasia (PP A), and cortico-basal degeneration syndrome (CBDS) has been demonstrated in a population of 55 patients followed for more than 3 years in a cognitive neurology clinic. Patients presenting with the personality behavior disorde r (FLD) often develop progressive aphasia (PA) and vice versa. CBDS is ofte n associated with FLD and PA, and the extrapyramidal-apractic syndrome of C BDS often appears in FLD and PPA, The histopathological variations do not p redict the clinical phenotype. The term Pick complex is suggested to indica te that these clinical and pathological variations are related and they wer e first described by Pick as clinical manifestations of fronotemporal atrop hy. This term will avoid the confusion of using FLD or FTD or for the whole complex and also for the personality behavioral presentation. The relation ship of the various clinical presentations has been strengthened by the dis covery of chromosome 17 linkage in families manifesting them.