What Is Pick's Disease?

Written by Rachel Reiff Ellis, Alicia Racelis, PhD
Medically Reviewed by Zilpah Sheikh, MD on July 03, 2025
7 min read

Pick's disease is a neurodegenerative condition that slowly breaks down your brain cells (neurons). Over time, protein buildup forms Pick bodies in the front (frontal) and side (temporal) parts of your brain. 

Also called frontotemporal dementia (FTD) or frontotemporal lobar degeneration (FTLD), your brain tissue shrinks (atrophy). And your personality, language, and behavior can change.

It's the fourth most common cause of dementia (memory loss). Around 20,000 to 30,000 people in the U.S. have this type of dementia. It often causes dementia before you turn 60, with the average age at diagnosis being around 57.

That's almost 13 years before Alzheimer's is usually diagnosed. But you can have the disease when you are as young as 20 or as old as 80. Find out the causes, symptoms, and treatments for Pick's disease.

Pick's disease results from the gradual buildup of unstable proteins called Pick bodies. They're made from proteins such as:

  • Tau protein
  • TAR DNA-binding protein 43 (TDP-43)
  • FET protein

Your brain usually has a transport system, made of proteins that move nutrients where needed — similar to a railroad track guiding a train. But in Pick's disease, these proteins don't work the way they should. 

These abnormal proteins "derail" your brain's normal transport system. Your brain's track can get crooked. That means nutrients can't move to the right place. And your brain cells (neurons) can get damaged.

What gene causes Pick's disease?

Many different genes can cause Pick's disease. But research shows you can inherit the condition with changes in your:

  • MAPT gene: This gene makes tau protein, which forms Pick bodies.
  • GRN gene: This gene is linked to the buildup of TDP-42 protein, which is also found in Pick bodies.
  • C9orf72 gene: The change in this gene causes loss of healthy proteins.

Although rare, Pick's disease can also happen with changes to your: 

  • VCP gene
  • CHMP2B gene
  • TBK1 gene

Symptoms typically show up as a change in your behavior, personality, or speech. But it depends on the type of frontotemporal dementia (FTD). Because it's a type of dementia, most people aren't aware of their symptoms.

Behavioral FTD symptoms

With behavioral FTD, your symptoms may start very slowly. Typically, someone close to you will first notice changes in your behavior. But you may not think that you've changed. This is common, but can also delay diagnosis. 

With behavioral symptoms, you may:

Behave inappropriately. You may lack respect or make rash decisions. You may say and do things that are rude or out of place.

Act aggressively toward others. You may feel irritable, agitated, or have drastic and quick mood swings.

Feel like you don't care (apathy). You have less self-care, motivation, or do not want to see people close to you.

Not feel warmth or concern for others (lose empathy). You might not laugh as much or lose your sense of humor.

Feel you must perform a task again and again (compulsion). You may repeat actions over and over.

Lose your executive skills. You might not plan, organize, or solve problems like you used to.

Not eat the same. You may feel hungry all the time or crave dirt or pebbles (pica). You may get an unhealthy "sweet tooth." 

Take up new habits like music or spirituality. You may become too wrapped up (obsessed) in new hobbies.

Have a hard time focusing. It can be harder to concentrate.

Primary progressive aphasia symptoms

This form of Pick's disease mainly affects your language. You may lose the ability to speak or others may not understand you. There are two types of primary progressive aphasia (PPA): nonfluent variant PPA and semantic variant PPA.

Nonfluent variant PPA. With this, you have problems using and forming words. You can understand the meaning of words and simple sentences, too. But you may not understand complex sentences. It can also be physically harder to talk.

You may get symptoms such as:

  • Speaking slowly or with long pauses
  • Talking differently (shorter or simpler sentences)
  • Using wrong grammar
  • Saying the opposite of what you mean
  • Trouble swallowing
  • Stopping speech completely

Semantic variant PPA. You forget what words mean. You can repeat what others say, but you may have issues reading or writing.

With semantic variant primary progressive aphasia, you may:

  • Lose your vocabulary
  • Forget what objects are used for over time
  • Not choose or understand words correctly
  • Choose words that may not make sense to others
  • Have a harder time understanding other people

Later stages

As your dementia advances, the type differences become less obvious. For example, people with behavior problems may get speech trouble. And those with language dementia eventually get behavior changes, too.

And gradually, Pick bodies also form in other parts of your brain. So, you can get new symptoms that look similar to Alzheimer's disease.

If you have later-stage Pick's disease, you may:

  • Forget things (memory loss)
  • Withdraw into your own mind
  • Become restless, irritated, or aggressive
  • Not recognize your friends or family
  • Have problems moving or swallowing
  • Get stiff or weak muscles (trouble with coordination)
  • Have trouble peeing or controlling your bowels

The type of protein and damage to certain brain areas can cause different symptoms. 

Here's how Pick's disease differs from Alzheimer's disease:

When dementia starts and how common. Pick's disease is usually diagnosed earlier between 40 and 65 years old. But Pick's disease is far less common than Alzheimer's.

Pick's bodies. Pick's disease has stuctures made of tau, TDP-43, and FET proteins. Alzheimer's tangles contain tau and beta-amyloid proteins.

Location of brain cell damage. Pick's bodies mainly break down frontal and temporal brain areas, while Alzheimer's affects the whole brain.

How your memory changes. Memory loss is usually less serious in Pick's disease.

Timing for behavioral change. Behavioral changes appear earlier in Pick's disease, while they tend to show up later in Alzheimer's.

Speech issues. Speech problems are more common in Pick's disease. and people with Pick's disease often have trouble making sense of their own or others' words.

Different symptoms for Alzheimer's. With Pick's disease, you usually don't have hallucinations or delusions . You don't tend to get lost in familiar places either. 

Pick's disease is diagnosed using clinical tests. Your doctor will ask a close family member questions. That's because, with dementia, you often don't realize your behavior has changed. Your doctor looks for personality, emotional, or behavioral changes. 

Many other medical conditions can cause these symptoms, too. Your doctor will order tests to rule out other conditions. And they'll review your medical and family history.

Neuropsychological testing

Your doctor may do special memory, behavior, language, or other mental tests. They'll test your executive functions — ability to organize, make decisions, or focus.

Some of the cognitive and memory tests will ask you to answer questions. You may need to write, draw objects, or recall words. 

Your doctor may give you:

  • Mini-Mental State Exam (MMSE): This tests your ability to reason, know where you are, and pay attention. You'll also solve simple problems.
  • Mini-Cog: This can help if you have language problems.

Genetic testing for Pick's disease

Your doctor may do a special blood test. It looks for gene changes in your DNA. The most common changes occur in the MAPT, GRN, and C9orf72 genes.

Your doctor will review your family history, too. They'll see if you have a motor syndrome with Pick's disease. Although less common, other genes can also lead to Pick's disease.

Other diagnostic testing for Pick's disease

To see your brain structure, your doctor may order imaging tests, such as:

MRI.Powerful magnets and radio waves are used to make detailed images of your brain.

CT. A type of X-ray creates detailed images of your brain to check if there is brain shrinkage (atrophy).

Fluorodeoxyglucose positron emission tracer (FDG-PET) scan. The scan uses a low amount of radioactive substance to show areas of your brain where nutrients aren't being used. These areas mean changes to your brain have occurred.

Treatments for Pick's disease can help you manage your symptoms. There is no cure for Pick's disease, and no medications can slow it down. But some therapies can help improve your quality of life.

Your doctor may prescribe:

  • Speech therapy to help you talk or use communication aids
  • Behavioral therapy to help control behavior changes
  • Antidepressants to help with agitation or aggression
  • Antipsychotic medicine to help with behavior, but it's unclear if these help

You can also live a healthy lifestyle. As your condition worsens, you can prepare for certain life changes:

  • Ask someone you trust to help with your finances.
  • Plan for transportation to your doctor's appointments and other places.
  • Get regular exercise to help lift your mood and improve thinking skills.
  • Make life easier at home by removing any rugs you can trip on or raising toilet seats.
  • Learn to skip events that trigger unwanted behaviors.
  • Practice staying calm (take a deep breath or meditate).
  • Simplify your daily routine and tasks.
  • Learn to distract yourself from inappropriate or harmful behaviors — read a book, go for a walk, or call a friend.

Write down and keep a log of your symptoms. It can help you remember what to ask your doctor. Talk to your care team about any changes or new symptoms. They can help you create a care plan for the best support.

Pick's disease (frontotemporal dementia) forms Pick bodies in some areas of your brain — front (frontal) and sides (temporal). Pick bodies damage brain cells, gradually causing changes in your personality, language, and behavior. Talk to your doctor about antidepressants, speech, and behavioral therapy to better manage symptoms and improve your quality of life.

What is Pick's disease called now?

Pick's disease is now called frontotemporal dementia (FTD) or frontotemporal lobar degeneration (FTLD). That's because brain cell damage happens in the front (frontal) and sides (temporal) of your brain.

What are the first signs of Pick's disease?

The first signs of Pick's disease usually involve changes in your behavior, speech, and personality.

Which organ of the body is affected by Pick's disease?

Pick's disease affects the front and sides of your brain — the organ that controls behavior, speech, and personality. 

What is the life expectancy of Pick's disease?

After your symptoms begin, most people live up to 10 years with the disease. It can progress slowly. Usually, it steadily worsens over time. But everyone is different, and some people live much longer with Pick's disease.