Pick’s disease is also a degenerative disorder of the cerebral cortex that produces dementia in middle and late life. It is distinguished from Alzheimer’s disease by its morbid anatomy.
In contrast to Alzheimer’s disease in which the cerebral atrophy is diffuse, in Pick’s disease the atrophy is relatively circumscribed and confined to the frontal and temporal lobes. Here the atrophy is severe. The microscopic pathology is also distinct in Pick’s disease. There is a particular degenerating neuron characterized by the accumulation close to the nucleus of a globular argyrophilic mass that distends the neuron into a swollen ballooned form. This is the Pick cell and it is usually found widespread in the atrophying areas of cortex. There are usually neurofibrillary tangles and senile plaques as well in the atrophic parts of brain.
It has proved impossible to distinguish Pick’s disease from Alzheimer’s disease on the basis of onset, progression, duration, or clinical symptoms. Patients with Pick’s disease may have less difficulty in gait than patients with Alzheimer’s disease. Otherwise, the conditions seem clinically identical. Pick’s disease is considerably less common than Alzheimer’s disease, but, as in that condition, no definite etiology has been identified. Some examples of Pick’s disease appear to be transmitted by a dominant gene in a family, but many examples are without a family history.
