American Board of Psychiatry and Neurology (ABPN) Practice Exam

What type of dementia is indicated by the imaging showing atrophy of the frontal and temporal lobes?

1. Pick's disease

2. Lewy body dementia

3. Alzheimer's dementia

4. Medication-induced psychosis

The correct answer is: Pick's disease

The indication of frontal and temporal lobe atrophy on imaging is closely associated with frontotemporal dementia (FTD), of which Pick's disease is a specific subtype. Pick's disease is characterized by atrophy of the frontal and temporal regions of the brain, leading to significant changes in behavior, personality, and social functioning. In Pick's disease, patients may exhibit symptoms such as apathy, disinhibition, and changes in mood, which stem from the degeneration of neurons in these critical regions. As a result, the imaging findings are directly correlating with the clinical presentation of the disease. Other types of dementia, such as Lewy body dementia and Alzheimer's dementia, would show different patterns of brain atrophy and changes. Lewy body dementia typically involves both frontal and occipital lobe atrophy along with significant parkinsonian features. Alzheimer's dementia commonly shows atrophy of the temporoparietal lobes, particularly affecting memory-related functions. Medication-induced psychosis is not classified as a type of dementia and would not be associated with structural brain changes visible on imaging like atrophy of specific lobes. Therefore, the findings on imaging clearly point toward Pick's disease as the correct answer.