Behavioral or cognitive neurology is a specialty that sees some of the most difficult and, put simply, unusual conditions of the brain. UCLA sees patients who develop personality changes, strange behaviors, or alterations in mental abilities unexpectedly and in middle life. Without obvious cause, they may become disinhibited and say or do inappropriate things, violate social norms, get into trouble with the law, become repetitively compulsive in their actions, or develop perplexing problems in seeing or speaking. These patients are difficult to diagnose. They often go from one doctor to another, sometimes for years and are told that they are experiencing, stress, depression, a midlife crisis, and a number of other psychological explanations, until someone suspects a brain disorder and they are referred to the Behavioral Neurology Program in the Department of Neurology, under the leadership of Dr. Mario Mendez.Dr. Mendez’s work has established a truly unique program at UCLA. In this program, clinicians specialize in brain disorders that cause these behavioral and cognitive changes in previously normal people. Many, if not most, of these patients have an unusual or atypical dementia. Most people think of dementia, a decline in multiple mental abilities, as due to Alzheimer’s disease in elderly individuals with memory difficulty. People are less aware that dementia may also result from non-Alzheimer’s disorders or unusual variations of Alzheimer’s disease. These unusual or atypical dementias are particularly devastating, not only because they are frequently misdiagnosed, but also because they tend to occur in people in their 40s to early 60s, when these patients may be in the prime of their lives. It is important to accurately diagnose these conditions because the therapies differ from those of other dementias, the genetics may differ, and the required care and outcomes are distinct.
UCLA investigators study these unusual or atypical dementias, particularly frontotemporal dementia and variations in early-onset Alzheimer’s disease. First, researchers use psychophysiology, virtual reality, and state-of-the-art brain imaging to investigate how frontotemporal dementia results in personality changes. This research links patients to drug trials at UCLA to impact these socio-emotional changes and helps patients and families understand the disorder. Second, Dr. Mendez and his team are studying early-onset variations of Alzheimer’s disease. Many of these patients do not develop early memory difficulty; rather, they complain of not being able to see or not being able to find words. On a larger scale, understanding these patients and the different brain networks involved helps researchers understand what causes all types of Alzheimer’s disease.
In sum, this program is unique in its focus, research, understanding of brain function, and clinical trial opportunities. It not only provides accurate information to those patients who develop unusual behavioral and cognitive changes in midlife, but it also clarifies two of the main disorders that cause these changes: frontotemporal dementia and the several categories associated with it, and early-onset Alzheimer’s disease. These are essential first steps in understanding these disorders. Ultimately, this research is a special and relatively unexplored window into learning how to prevent, treat, and eventually conquer all dementias.
Join the conversation…Dr. Mendez will answer questions about this piece and his work in Behavioral Neurology on Twitter, Friday December 8th, 9-4pm (Pacific Time) @UCLANeurology. Please note: Dr. Mendez can not answer patient-specific questions.