People with early-onset dementia are often mistaken for having depression.
In a new study from the University of Sydney, researchers discovered the cause: a profound loss of ability to experience pleasure — for example a delicious meal or beautiful sunset — related to degeneration of ‘hedonic hotspots’ in the brain where pleasure mechanisms are concentrated.
They found marked degeneration, or atrophy, in frontal and striatal areas of the brain related to diminished reward-seeking, in patients with frontotemporal dementia (FTD).
The researchers believe it is the first study to demonstrate profound anhedonia — the clinical definition for a loss of ability to experience pleasure — in people with FTD.
Anhedonia is also common in people with depression, bipolar disorder and obsessive-compulsive disorder and can be particularly disabling for the patient
In the study, patients with FTD — which generally affects people aged 40-65 — displayed a dramatic decline from the pre-disease onset, in contrast to patients with Alzheimer’s disease, who were not found to show strong anhedonia.
The results point to the importance of considering anhedonia as a primary presenting feature of FTD, where researchers found neural drivers in areas that are distinct from apathy or depression.
The team says despite increasing evidence of motivational disturbances, no study had previously explored the capacity to experience pleasure in people with FTD.
Much of human experience is motivated by the drive to experience pleasure but people often take this capacity for granted.
But consider what it might be like to lose the capacity to enjoy the simple pleasures of life — this has stark implications for the wellbeing of people affected by these neurodegenerative disorders.
The findings also reflect the workings of a complex network of regions in the brain, signaling potential treatments.
The team says future studies will be essential to address the impact of anhedonia on everyday activities and to inform the development of targeted interventions to improve the quality of life in patients and their families.
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The study is published in Brain. One author of the study is Professor Muireann Irish.
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