In 1892 Arnold Pick, who had recently been appointed as Professor of neuropsychiatry in Prague, reported a 71-year old man with progressive mental deterioration and unusually severe loss of language ability (aphasia) who at post-mortem had marked shrink- age (or atrophy) of the left temporal lobe. A few years later in 1904 he published his landmark paper On the symptomatology of left-sided temporal lobe atrophy in which he described three further cases. The first, a 58 year old woman (Josephina) had a 2 year history characterised by a striking loss of memory for names culminating in almost complete loss of speech and accompanied by changes in personality. She deteriorated rapidly and at post-mortem, two years after presentation, Pick observed shrinkage of the temporal lobes which was remarkably localised even after death and involved the left side to a much greater extent. Following these observations of patients with progressive aphasia, Pick went on to describe patients with alterations in personality and social behaviour who, after death, had degeneration of the frontal lobes of the brain. Hence, both of the major presentations of what we now call FTD (Frontotemporal dementia), that is to say progressive loss of language ability (aphasia) and progressive alterations in social behaviour were both described by Pick. His most important contribution was to realise that degenerative diseases can lead to very localised brain pathology and present with symptoms traditionally associated with stroke and other focal insults to the brain. He was not able to report on the pathological changes, as appropriate methods of staining samples of brain had not been developed.*

Professor John Hodges of Addenbrooke’s Hospital finally diagnosed Marianne Rumens' husband Tom as suffering from this rare disorder after a long fight to overcome the increasing difficulties of daily life.  Her book “No More apple for Tom” describes their life together and her loving care that was pushed to breaking point.  To those of us who knew her through these difficult times her sense of humour and her determination to ensure that Tom had a loving home through their turbulent life is and inspiration to us all.  Her book, she hopes, will give encouragment to all those carers fighting with and for the National Health and her campaign continues to raise awareness of a little known condition.

*Taken from Pick’s Disease: An introduction by Professor John R Hodges
University Department of Clinical Neurosciences, Addenbrooke’s Hospital, Cambridge from the book by Marianne Rumens  describing her life with Tom Rumens who suffered from the disease.

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