November 1997

Frontotemporal Degeneration, Pick Disease, and Corticobasal DegenerationOne Entity or 3? 3

Author Affiliations

From the Department of Neurology, Manchester Royal Infirmary, Manchester, England.

Arch Neurol. 1997;54(11):1425-1427. doi:10.1001/archneur.1997.00550230088023

In ad 325, the Council of Nicaea condemned the Arian heresy and proclaimed, in the Athanasian creed, that the Father and Son were not distinct beings, but along with the Holy Spirit were of 1 substance. We are now asked to consider whether frontotemporal lobar degeneration (FTLD), Pick disease, and corticobasal degeneration are 1 or 3 entities. This controversy, in common with theological debate, depends on terminological distinctions, traditionally held beliefs, and a degree of ancestor worship, not to mention proprietary politics.

It was Pick who first described circumscribed frontotemporal atrophy.1-4 His was an anatomical observation, and the histological condition of ballooned cells and inclusion bodies that now bears his name was only later described by Alzheimer.5 Moreover, Pick's cases were clinically heterogeneous. The designation Pick disease, suggesting a unique clinical and pathological entity distinct from Alzheimer disease, gained coinage in the continental literature, but in the English

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