#bvftd

[letsspeechtherapylogopedia]

Fascinating talk! 

Some notes about the talk:

Emotions biology is complex but knowable.  Neural systems support emotions.

Emotions shape our responses to Salient Cues: 

threat→fear, loss→sadness, contamination→disgust, unfairness →anger, play→amusement, kindship bond →nurturant love,  faux pas →embarassement, achievement →pride.

Each emotion has distinct autonomic and facial behavior profiles, ex:

 Embarrassment - emerges after violation of social convention, encourages reparation of disrupted social bonds.

Disgust: Is a highly visceral emotion, promotes distance from contaminated objects.

Change scores quantify emotional reactivity. But emotions are brief!

Autonomic Activity is dynamic

Positive emotions serve interpersonal functions

Parasympathetic Activity fosters compassion and prosocial behavior - high rate variability associated with: social engagement, emotion regulation, optimism and agreeableness, empathy, compassion, prosocial behavior.

In bvFTD, negative emotions and baseline autonomic activity are impaire while certain positive emotions are elevated. Empathic concern is impaired in bvFTD.

Empathy takes different forms (graph)

In AD, emotional empathy is enhanced

In dyslexia, differences in emotion relate to socioemotional strenghts

Emotions and empathy change in neurodegenerative disease

Emotions in neurodevelopmental disorders such as dyslexia

More info: https://calendar.ucsf.edu/event/memory_and_aging_center_grand_rounds_9047

[windcarvedlyre]

Somewhat related to your Komaeda autism post, but did you know that FTD can often be mistaken for mental disorders like depression, bipolar, OCD, autism, etc.? And vice versa? I always thought it was interesting and I like playing with the idea that Komaeda got misdiagnosed with FTD because of that overlap. Idk it's just fun to think about (also because a lot of typical FTD symptoms really don't match with him imo so it could be a fun explanation idk)

Disclaimer: I have zero expertise in this.

I was actually just discussing that with someone! I'm not sure that's possible, though? Because of his age I feel like it would have taken a lot of red flags (or a lucky coincidence) for doctors to consider dementia at all, and there's no way they wouldn't have confirmed it with brain scans. @cry-stars recently told me about a case in Japan where a guy in his 20s had dementia mistaken for depression for aaageees, so I could see him being the same.

So I could see him being misdiagnosed as something else- or correctly diagnosed with something he has on top of the FTD, attributing FTD symptoms to that- for years before having it corrected to FTD, or luck leading to brain scans/cognitive tests getting him diagnosed out of nowhere, but not the reverse of the former.

I still really love reading meta on potential comorbidities, though! On top of the post-traumatic stress there's no way he doesn't have. I've read some neat perspectives on him from people with OCD and BPD, but I don't have them myself so I can't add anything to those discussions.

[cry-stars]

Komaeda and Dementia: Part 1 of 5: Introduction and Overview of FTD

Hi everyone!

I’m an aspiring Komaedologist with an interest in dementia. I often see people doubting Komaeda’s stated diagnosis of frontotemporal dementia, since it presents differently in him than in the common portrayal of dementia in the media. While his portrayal may not be completely accurate, there is a lot of truth to it, and there are many symptoms visible in-game. I wanted to share a few posts about dementia symptoms that we do see canonically in Komaeda’s portrayals in SDR2 and DR:AE, and share some information regarding his specific diagnosis as opposed to Alzheimers, for example.

I work with people living with dementia as a recreation worker. This means that I see them living their daily lives, and know about difficulties they might have with recreational or day to day activities. There are a lot of observations that I might make that can’t be backed up scientifically yet, but do make sense in a practical way. Everyone with dementia is different, and since I work with seniors for the most part, some observations won’t transfer onto Komaeda. However, I’ll do my best to back up whatever I can with sources.

This post is just for fun and to give people ideas. It means a lot to me to see a fascinating and endearing character like Komaeda portrayed with dementia, since it is a sad and terminal disease, and I usually see it end badly in my job, so I hope to give people ideas on how to portray it, or just to notice things in a different way they might not have before!

My main sources for this post and the following ones include “Dementia Diaries,” which is a really cool project where people with dementia talk about their experiences, National Institute on Aging, Alzheimer’s Association, Alzheimer’s Society, and my own work experience. I plan on doing more posts about specific symptoms that we see in Komaeda later, but I would be happy to hear from other people who have dementia knowledge, or to answer any questions that I can.

For the most part, I'm only going to be talking about SDR2 and a little bit of DR:AE. I haven't finished watching the anime yet and have not read any of the manga. If anyone has ideas from any of those sources, I would love to hear about them!

Overview of FTD: Which Variant does Komaeda Have?

There are two major forms of frontotemporal dementia. The first, which Komaeda likely has, is the behavioural variant (BvFTD), which is also the most likely for young people to develop. This variant of FTD mainly affects behaviour, empathy, judgement, and planning.

Komaeda is less likely to have the other variant of FTD, primary progressive aphasia. This form of FTD mainly affects language skills, including speech and comprehension.

Komaeda doesn’t seem to have very much trouble with understanding the concrete content of what people say to him, but he does occasionally seem to have trouble fully comprehending hidden meanings behind statements (for example, taking statements literally rather than as sarcastic). To me though, this is less connected to him not being able to understand the words or content of statements, and more not picking up on the emotions hidden in the statements (which I’ll address more in the behavior post). He does seem to have some trouble with word-finding in the Japanese version of the game, but again, it doesn't inhibit his ability to express himself given enough time to speak.

Another thing to note about FTD is that, in its early stages, it mainly affects behaviour and language processing, as stated above, rather than memory. In later stages, memory does start to be affected as well, but it’s different from Alzheimers (probably the most well-known form of dementia) in that memory loss isn’t the main symptom.

FTD’s prognosis is about 6-8 years. Komaeda states in his fifth free time event that his life expectancy is between half a year and one year. However, he is also referring to his lymphoma diagnosis, meaning he expected to die from a combination of both illnesses within that time frame. In SDR2, Komaeda is probably in the early to middle stages of FTD, since he was diagnosed right before entering Hope’s Peak, and was a Remnant of Despair for some time without treatment, so while we can see evidence of memory issues (which I will address in another post), it’s something he’s able to cope with and isn’t a debilitating symptom yet.

One more observation: while dementia as a whole is usually seen in elderly people, Komaeda’s specific frontotemporal dementia diagnosis has an earlier age of onset, usually between ages 40-65, and is rarely seen in elderly people. Even though being diagnosed in high school seems unlikely, it is not impossible. According to Alzheimer Society Canada, early-onset or young-onset dementia (between ages 18 and 65) accounts for 2-8% of all dementia cases.

Thank you for reading! I plan on making five posts total. The other post topics will be Outward Behaviour, Judgement/Thought Processes, Other Symptoms, and Writing Ideas.

[woobifykamukura]

ghdsfkjghdsf is that a common thing?

I don't really get how he'd be misdiagnosed anyway; it would need brain scans, especially since it's so rare at his age, and if anything it would have been misdiagnosed as other conditions for a while. Only going off cry-stars here- I have no expertise myself- but she's said that can happen and there was a recent case in Japan where a young guy's dementia was mistaken for depression for ages.

If we doubt Komaeda's FTD it can only be via doubting his honesty imo (but I still think he's telling the truth). I also love seeing analyses of him through the lenses of other disorders as comorbid instead of alternative diagnoses- especially autism, but I've seen interesting takes wrt OCD and BPD too- but canonically I feel like bvFTD, extreme post-traumatic stress and political radicalisation adequately explain his issues.

TO BE FAIR it probably isnt As common as i think it is, i just saw one reddit post thst explicitly claimed the FTD was a misdiagnosis and that it totally makes way more sense for komaeda to have autism and bpd, and a surprisung number of people... agreed? for some reason??

which i need to state for the record a) i am autistic myself and b) have absolutely zero problems with headcanons, even if they arent ones i ascribe to personally

what i DO have a problem with is people erasing canon neurodivergencies and/or erasing traits CENTRAL to a character in order to square-peg-round-hole the headcanon THEY have as the most correct one

"nagito has ftd and was autistic before that?" cool! neat! seeing how those two disorders being comorbid with each other could be really interesting!

"nagito does NOT have ftd, the devs were wrong, they actually wrote an autistic character and didnt realize it" stop talking.

this is very like, misanthropic i guess but after SO MUCH SHIT ive seen it just speaks to an unwillingness to empathize with or relate to anyone that isnt exactly like you. and you cant just headcanon real people around you with Misdiagnosed Autistic (most.... times....) so this pops up in fiction

like. i am autistic! i also have two (2) personality disorders, and neither is bpd. this has led to a non negligible amount of autistic people completely stereotyping my other disorders as evil in order to prop themselves up ("i thought i was a narcissist/sociopath, which wouldve been awful, but really i was just autistic! phew!!" with implicit, sometimes EXPLICIT value judgements being made)

i have had a friend i had in real life, to my face, say he didn't believe i had either personality disorder and really i was secretly just autistic

...if we had been better friends, maybe he would've known me well enough to know that that's almost... comically untrue. lol

so in my opinion there do exist a certain minority of autistic people who see autism as the only neurodivergency that Matters, or at least the one that matters the most. and the only way they can feel any sympathy for anyone else is if they are also autistic

and i know this is a minority! and i just see it a lot because i am an autist in fandom and a lot of other autistic people are also in fandom! AND that this is a mindset prone to ANY minority- most people think their Problem is the Worst Problem, it just... happens. however i am just as irrational and prone to biases as anyone else and ive chosen this as my completely irrelevant hill to die on

that one reddit post made me so goddamn mad bc of All This PLUS its double insulting when someone says "i have a special interest in psychology!" as a way to say theyre extremely knowledgable, and doing genuine analysis with the lens of "i am looking at the text and trying to make an objective diagnosis" and then STILL DO THIS!!! because they have this veneer of "im just a guy asking questions" before diving right into a weirdly consspiratory subset of "everyones an idiot about mental health except for ME"

...which tbf i dont think that about myself. i am very good at writing a wide variety of mental illness due to a combination of research and life experience BUT i could really only tell you like. actual non-surface level FACTS about aspd and to a lesser extent, npd. because thats what i chose to focus on. there are far and away lots more people that know more about me about other things, and im fine wit that

i am however also aware of this extremely hyperspecific social phenominon. and thus it is my burden to bear. my mountainous molehill.

also r/danganronpa just fucking sucks like in general. every time i see a kokichi opinion there i get a little closer to pulling the trigger. i think the real moral here is reddit is garbage and should not be used for anything other than product reviews

(also fwiw i agree w ur personal take at the end, with a lil bit of ocd tendencies that like, started off manageable and nowhere near diagnostic level badness, since things he might do to manage his cycle and even the constant thinking about it are very much reminiscent of obsessions and compulsions. but ftd in of itself can cause ocd symptoms so after that it got... worse. thats my personal take on it ^^)

[ultfan]

sigh. was watching a let’s player go through komaeda’s FTEs and they said he was using his diagnosis as an excuse for his actions. “oh, i’m dying and insane so everything i do is justified” like — agH stfu!!! i’ll never claim komaeda’s actions to be good, and yeah i joke about his “insane”ness a lot, but at the end of the day you genuinely can’t hold him accountable. he is not in control of his facilities — FTD specifically targets your personality/behaviors — he is not in a right state of mind and is completely unaware he is in the wrong. he CANNOT COMPREHEND that. he’s just genuinely unable to!!! i’ll never claim he isn’t a bad person, or that he isn’t an antagonist, but at the end of the day he is someone who needs not help necessarily, but to be taken care of/looked after. he doesn’t belong in a prison, he belongs in a mental facility. where he can have trained professionals who can keep watch over him and actually work with him and keep him in check. — in any canon related verse he’ll never actually get that, esp given the state of the world, but it’s true that’s what he needs more than anything else.

and people really do tend to overlook just how much bvFTD truly fits komaeda as a diagnosis. especially in ways that aren’t touched upon by the vaaaaast majority of people. a while back i read a research paper about hyper-religiousity in patients with FTD; which could very easily be applied to the way he views hope. first clinging to it as a coping mechanism and that being exaggerated through the deterioration to become a blind faith that he is obsessed over which leads every action he takes.

anyway i just think it’s ridiculous to call a disease like FTD an “excuse.” there are people who use their mental illness as excuses for their actions to justify themselves, yes. but this isn’t a mental illness — it’s a degenerative brain disease. it’s an entirely different category. this isn’t a case of an illness making it difficult to control his actions and act reasonably, it’s a case of a disease making it IMPOSSIBLE to control his actions and act reasonably. it just really upsets me to see people brush that off because that is one of the main things that makes komaeda actually sympathetic.

[covenawhite66]

Cerebrospinal fluid (CSF) circulates in and around the brain and spinal cord to help cushion them from injury. When this fluid leaks into the body, the brain can sag, causing dementia symptoms.

Chiari brain malformation, a condition in which brain tissue extends into the spinal canal. Brain sagging, Schievink said, is often mistaken for a Chiari malformation.

The reversible impairment of behavioral variant frontotemporal brain sagging syndrome: Challenges and opportunities.

Alzheimer's & Dementia: Translational Research & Clinical InterventionsVolume 8, Issue 1 e12367 published: 18 December 2022

https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/trc2.12367

Due to loss of brain buoyancy, spontaneous spinal cerebrospinal fluid (CSF) leaks cause orthostatic headaches but also can cause symptoms indistinguishable from behavioral variant frontotemporal dementia (bvFTD) due to severe brain sagging (including the frontal and temporal lobes), as visualized on brain magnetic resonance imaging. However, the detection of these CSF leaks may require specialized spinal imaging techniques, such as digital subtraction myelography (DSM).

[neurodiscoveryai]

6 Debilitating Neurological Disorders and the Search for Potential Cures

This article discusses six neurological disorders which presently have no definite cure. Also, how AI is being used to find new treatments for these diseases. These disorders are Multiple Sclerosis (MS), Parkinson’s Disease (PD), Alzheimer’s Disease (AD), Frontotemporal Dementia (FTD), Migraine and Autism Spectrum Disorders (ASD).

Multiple sclerosis (MS) is a neurological disorder which affects the central nervous system (CNS). For a patient suffering from MS, their immune system attacks myelin (protective cover of nerve fibers) by mistake. It causes cognitive impairment, paralysis, numbness, blurred vision, coordination problems and fatigue. There is a serious need for new drug discovery approaches as there is no complete cure available. NeuroDiscovery AI is using artificial intelligence to make advances in helping to find cures for MS.

The company uses real world data (RWD) like EHRs (electronic health records) and treatment outcomes to analyze disease progression and treatment efficiency. Their AI platform analyzes huge medical datasets to help in patient recruitment and designing effective clinical trials. This assists biotech researchers and pharmaceutical companies to identify potential drug candidates. The platform collaborates with neurological care providers, academic institutions and life sciences companies to provide large patient datasets. It is leading to a complete transformation of the MS drug discovery process as artificial intelligence is continuously evolving.

Parkinson's disease (PD) is a progressive CNS disorder which largely affects movement. This occurs with the degeneration of nerve cells in substantia nigra (a part of the brain). These nerve cells create dopamine which is a neurotransmitter crucial for coordinated and smooth muscle movement. Patients go through symptoms like balance issues, slowness of movement, stiffness, tremors, sleep disturbances, cognitive decline, changes in speech and depression. 

PD is supposed to be caused by trauma, environmental and genetic factors. The treatments for PD are limited to managing symptoms and improving the quality of life as there is no cure available for PD. NeuroDiscovery AI is on a mission to help in finding cures for PD with its extensive patient data and use of its AI platform.

Alzheimer’s disease (AD) is a neurodegenerative disease which impacts behavior, thinking and memory. AD is the most prevalent reason for dementia. AD starts with moderate memory loss which becomes worse gradually. This leads to cognitive impairment and decreases the patient's ability in carrying out day-to-day activities.

AD begins with symptoms like difficulties in learning new things, remembering recent events, confusion and memory loss. With its progression, patients experience mood swings, impaired judgment, trouble in speaking and disorientation. The patient loses the ability for basic communication, daily tasks and recognizing close ones. AD is supposed to be caused by lifestyle, environmental, genetic and age factors. At present, treatments for AD focus on managing symptoms, improving quality of life for patients and slowing disease progression. NeuroDiscovery AI envisions a world where AD can be stopped and even reversed.

Frontotemporal dementia (FTD) is a category of CNS disorders which affects the frontal and temporal lobes in the brain. This leads to changes in motor skills, personality and overall behavior in patients. There are three primary types of FTD, Behavioral variant FTD (bvFTD), Primary progressive aphasia (PPA) and FTD with movement disorders.

bvFTD is the degeneration in the frontal lobe which results in personality changes. PPA mainly affects a patient's language skills. PPA patients lose fluency in speaking, have problems in sentence forming and have difficulties in finding the correct words. FTD with movement disorders have motor symptoms like movement issues, tremors and stiffness which are similar to symptoms found in ALS (amyotrophic lateral sclerosis) and PD. We at NDAI are assisting life sciences companies in neuro research to find a cure for FTD.

Migraine is the most common CNS disorder which can be described by repeated headaches of different intensities. It impacts a patient's quality of life and daily activities. The other symptoms which follow migraine are auras (visual disturbances), nausea (urge to vomit), phonophobia (sensitivity to sound) and photophobia (sensitivity to light). Generally, a migraine attack advances in four phases, Prodrome, Aura, Headache and Postdrome. All patients may not experience all four phases.

Prodrome is the first phase occurring hours/days before headache which has symptoms like neck stiffness, mood swings, fatigue and food cravings. Aura has symptoms like flashing lights, blurred vision, tingling sensations and blind spots. Aura usually lasts for less than an hour. The headache phase has intense pain mostly on one side of the head which lasts between 4 hours to 3 days. This phase is also followed by symptoms like sensitivity to sound/light, nausea and vomiting. Postdrome is the last phase which lasts up to 2 days. The symptoms include fatigue, weakness, confusion and exhaustion. NDAI is working towards finding innovative cures for Migraine.

Autism Spectrum Disorder (ASD) is a neurological condition which impacts social interaction, behavior, communication ability, forming relationships and maintaining eye contact. Most often, ASD occurs by the early age of 2-3. ASD is believed to be caused by a combination of environmental and genetic factors. People with mild ASD symptoms lead independent lives. While others with major symptoms need support in daily tasks.

ASD is usually followed by symptoms like sensitivities to sound and light. This affects a person's daily life in a significant way. ASD treatment includes medical treatment, nutritional therapy, social skills training, school based therapies, occupational therapy, sensory integration therapy, behavioral therapy and cognitive therapy.

NeuroDiscovery AI is partnering with top healthcare providers, educational institutions, patient advocacy groups and life sciences companies to transform neurology with AI driven insights.

[despair-to-future-arcs]

At this point, anything can be sexualized. Why do ya think Rule 34 is a thing?

Uh, wh-what...? Sorry but I don't think I look up those, it's really odd to me! I mostly watch horror and mystery anime!

But the doctors did tell me that hypersexual behavior might be apart of behavioral variant frontotemporal dementia and given my love for Ultimates, maybe that's why I love and idolize them?

Indeed and looking over your behavior I think we can safely assume that you get turn on by hope and talent then but they also indicate an increasing awareness of heightened sexual activity as a source of personal distress and functional impairment, and clarification of hypersexuality in bvFTD could contribute to understanding the neurobiology of this behavior.

Ah so that's why...

Well, thank you for explaining that then!

[lovingkimmyy]

Unraveling Frontotemporal Dementia: Understanding, Challenges, and Coping Strategies

Frontotemporal Dementia (FTD) is a less common yet significant form of dementia that predominantly affects the frontal and temporal lobes of the brain. Unlike more widely recognized forms of dementia, FTD often manifests in distinct behavioral and personality changes rather than memory loss. In this article, we will delve into the complexities of Frontotemporal Dementia, exploring its characteristics, challenges, and strategies for coping with its unique impact on individuals and their families.

Understanding Frontotemporal Dementia:

Distinctive Brain Regions Affected:

FTD primarily targets the frontal and temporal lobes of the brain, responsible for personality, behavior, language, and social functioning.

Unlike Alzheimer's disease, which affects memory initially, FTD's early symptoms are often related to changes in personality, decision-making, and social interactions.

Behavioral and Cognitive Changes:

Early signs may include alterations in social conduct, such as disinhibition, apathy, or increased impulsivity.

Language difficulties, including speaking, writing, or understanding speech, can emerge as the disease progresses.

Subtypes of FTD:

FTD is categorized into subtypes based on the predominant symptoms:

Behavioral Variant Frontotemporal Dementia (bvFTD): Characterized by behavioral changes and personality disturbances.

Primary Progressive Aphasia (PPA): Primarily affecting language skills, including speaking, understanding, reading, and writing.

Challenges and Impact on Daily Life:

Social and Relationship Challenges:

Individuals with FTD may exhibit socially inappropriate behaviors, impacting relationships with family, friends, and colleagues.

Difficulty in understanding social cues can lead to isolation and strained interpersonal interactions.

Occupational and Functional Impairments:

Occupational challenges arise as cognitive decline affects decision-making and problem-solving abilities.

Daily tasks, such as managing finances or organizing activities, become increasingly challenging.

Caregiver Strain:

Caregivers face unique challenges as they navigate the behavioral and cognitive changes associated with FTD.

The progressive nature of the disease can lead to caregiver burnout, emotional strain, and the need for comprehensive support systems.

Coping Strategies and Support:

Early Diagnosis and Intervention:

Timely diagnosis is crucial for managing FTD. Early intervention allows for the implementation of strategies to address specific symptoms and plan for future care.

Behavioral Interventions:

Behavioral therapies can help manage challenging behaviors. Strategies may include establishing routines, creating a supportive environment, and using positive reinforcement.

Communication Strategies:

Tailoring communication approaches is essential, especially for individuals with language-related symptoms. Simplifying language, using visual aids, and employing alternative communication methods can enhance understanding.

Support Groups and Counseling:

Both individuals with FTD and their caregivers can benefit from joining support groups or seeking counseling. Sharing experiences, gaining insights, and receiving emotional support contribute to a more resilient coping mechanism.

Legal and Financial Planning:

As FTD progresses, individuals may lose the ability to make sound financial and legal decisions. Planning in advance, including creating power of attorney and discussing end-of-life preferences, is essential.

[dementiasocietyofamerica]

Exploring Behavioral Variant Frontotemporal Dementia: Insights & Understanding

Behavioral Variant Frontotemporal Dementia (bvFTD) is a neurodegenerative disorder affecting behavior and cognition, primarily involving the frontal and temporal brain lobes. It leads to changes in personality, social behavior, and cognitive functions like decision-making and language. Unlike Alzheimer's, bvFTD more prominently affects behavior than memory in early stages.

[windcarvedlyre]

Rewatched part of ch1's trial and found something else that's really interesting in hindsight!

We're all familiar with Komaeda's FTE; over a decade later, there's still some room for debate wrt whether he was telling the truth about his diagnoses or not. My stance was already that he was telling the truth, instantly regretted it, and lied that he was lying, and I will die on that hill. I think the above lines reinforce my stance further.

Hear me out. I might as well make this a comprehensive 'Komaeda wasn't lying' post while I'm at it.

For reference, here's the entire final FTE.

The reasons I already had to believe him are as follows, ordered from strongest to weakest:

Komaeda almost died from despair disease; he was much more severely affected than Owari and Mioda. Lymphoma can weaken your immune system, leaving you more vulnerable to infections. While Komaeda's degree of illness could also have been due to bad luck, this could easily be an intentional hint about him.

He claims he's wanted someone's love all along. Again in chapter 3, after the trial, Tsumiki targets his lack of loved ones and seems to genuinely perturb him, indicating this is a real insecurity:

Behavioural variant frontotemporal dementia, or bvFTD, can have symptoms that align with a lot of his social and behavioural issues in the game. bvFTD symptoms can include saying socially inappropriate things/being rude and insensitive, rash/impulsive behaviour, empathy issues, and rigid thinking, among other things. Do I even need to cite examples of these? He can still hide things and manipulate people sometimes, but his ch4 investigation segment proves he's genuinely socially impaired. He sometimes fails to understand the emotional nuances of other people and the impact his words will have. For example:

(Though he still has moments of self-awareness and introspection; he acknowledges he's pessimistic in his introduction and worries he'll make Hinata hate him by saying weird things in Island Mode.)

Issues with memory, cognition in general, etc, are more of a thing in later stages of the disease, so Komaeda having significant social impairments but still being extremely sharp and lacking noticeable lapses in memory makes sense.

Physically Komaeda just doesn't seem healthy in general. He's pale, skinny, his hair is white (possibly fading into a pinkish brown that I could see being his hair colour in the past), and- at least in Japanese- he sounds really breathy and wheezy. I once laughed in a way uncannily similar to his ch1 breakdown when I had a chest infection. With asthma. Stage 3 lymphoma symptoms can include chest pain, shortness of breath, weight loss, loss of appetite and fatigue. If it's still stage 3 it's present in lymph nodes above and below the diaphragm but hasn't metastasized outside of the lymphatic system yet, but if it's advanced to stage 4 since his diagnosis then it may have spread to his lungs as well- having further potential to cause respiratory issues.

In his second-last FTE he starts to tell Hinata about something before he entered Hope's Peak but stops himself, not wanting to 'burden' Hinata. And leaves immediately to end the conversation. He'd just told Hinata how his parents died in front of him, showing zero awareness of how bad it was or how it would affect Hinata, so it must have been real bad for him to do this. And makes it less plausible he was impulsively repeating something from a book later, imo.

Iirc at least one spinoff manga runs with it being true, depicting him in a doctor's office during a nightmare. I'm too tired to hunt this down now; maybe I'll edit it in later.

On a meta level I just find it less compelling for the final reward for spending so much time with him to be 'Here's some actual vulnerability- lol psyche, remember he's manipulative? He might still want sympathy, you be the judge'. It would make the aborted confession at the end the only thing we can't infer from elsewhere in the game already. On the other hand, the diagnoses being real, and him trying to take it back and distract Hinata with an incitement to kill him (before also trying to confess his crush and aborting that too, he's a mess there), really really adds depth to his character.

Semi-tangentially, some people with bvFTD also develop neurological problems that affect movement- eg. making them slow and stiff. There's no evidence for or against Komaeda having this in canon afaik, and I've read it's more of a thing in later stages of the disease, but in the ch1 trial he talks about the threatening letter as if it's in his actual handwriting, and if so... it looks pretty stiff, doesn't it? Either it was angular on purpose or the writer has trouble with fluid hand movements. Let me know if he displays fine motor skills anywhere else, I guess.

The only real counterargument is that he's outlived the 6-12 months he was expected to, but:

The estimate is presumably from the cancer, which is treatable. FTD can take years and years, even 10+, to reach the later stages.

That's an estimate, not set in stone, and real people have survived after being told they have X months to live without supernatural luck.

In either case, it doesn't matter how dire the prognosis is if Komaeda's involved. If the chance of him surviving something isn't zero it will probably happen. When he finally managed to kill himself it wasn't even real.

Anyway, the thing I started the post with! Compare the lines below.

In both cases he's said something that could make others feel bad for him, immediately takes it back, and claims he did that on purpose.

But he wasn't actually lying in the first line, albeit hamming it up a little. He wanted someone to kill him. This happened while he was still pretending to be the killer, after Saionji asked him why he sent the letter. He dropped a hint about the truth and then deflected away from it, likely intentionally antagonising people to distract them from thinking too hard about what he just implied and make them more averse to empathising with him.

So what could that imply about the lines from his FTE?

TL;DR: He told the truth about having cancer and dementia, your honour. There's not only strong evidence for this but precedent for the sort of deflection he made afterwards.

[misguided-adventures-of-floppy]

Party at my moms camp tomorrow. We were around the table just bullshitting and maria told the story to Shelly about when my mom had sandy follow her to my house for kaykays birthday.

Fucking bitch didn't even stop in. I was excited about tomorrow now I am just pissed. I told Maria that I don't want to go now. I am so pissed that I didn't remember it. Maria says there is alot of stuff like this I don't remember.

This is such a horrible disease.

#memoryloss #bvftd #memory

[hrsychannel]

the Neurodegenerative Disease

A Comprehensive Guide to the Neurodegenerative Disease that Affects Behavior, Personality, and Language

Frontotemporal Dementia // Pixabay

READ :The Health Benefits of Drinking Tea: A Comprehensive Guide

Frontotemporal dementia (FTD) 

is a neurodegenerative disease that affects the frontal and temporal lobes of the brain. It is a progressive condition that gradually impairs a person's cognitive and language function, as well as their behavior and personality. FTD is a relatively rare form of dementia, accounting for only about 5-10% of all dementia cases, but it can have a significant impact on individuals and their families.

FTD is actually a group of diseases that share similar clinical features, including changes in personality and behavior, loss of empathy, and language difficulties. There are three main subtypes of FTD, which are distinguished by their symptoms and the parts of the brain that are most affected.

There are three main subtypes of FTD, which are distinguished by their symptoms and the parts of the brain that are most affected:

The first subtype is behavioral variant FTD (bvFTD), which is characterized by changes in behavior and personality. People with bvFTD may experience apathy, loss of empathy, impulsivity, and inappropriate social behavior. They may also exhibit a lack of inhibition, including making inappropriate comments or gestures, or acting in socially unacceptable ways. Changes in eating habits, including overeating, food cravings, and a preference for sweet foods, are also common. Difficulty with planning, organization, and decision-making are also hallmark features of bvFTD.

READ :Best Eating Habits

The second subtype is semantic variant primary progressive aphasia (svPPA), which is characterized by progressive difficulty in understanding and using language. People with svPPA may have difficulty recognizing familiar objects and faces, loss of knowledge of common facts and concepts, and may exhibit changes in behavior and personality, including apathy and social withdrawal.

The third subtype is nonfluent variant primary progressive aphasia (nfvPPA), which is characterized by difficulty with speech production. People with nfvPPA may experience stuttering, word-finding difficulty, and halting speech. They may also have difficulty understanding complex sentences and following conversations, and they may experience a loss of ability to write or read fluently. Like svPPA, people with nfvPPA may also exhibit changes in behavior and personality, including apathy and social withdrawal.

FTD typically affects people between the ages of 40 and 65, and it is more common in men than women. Unfortunately, there is currently no cure for FTD, and treatment is focused on managing symptoms and improving quality of life. Medications such as antidepressants, antipsychotics, and mood stabilizers may be used to manage behavioral symptoms such as agitation and aggression. Speech therapy and occupational therapy may be used to help maintain communication skills and improve functional abilities.

FTD can be challenging for both the person with the disease and their family members. The changes in behavior and personality can be particularly difficult to deal with, and it can be hard to adjust to the loss of language and communication skills. However, there are many resources available to help people cope with FTD, including support groups, counseling, and respite care.

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In conclusion, frontotemporal dementia is a complex and challenging disease that affects cognitive, behavioral, and language function. It is important to be aware of the symptoms of FTD and to seek a proper diagnosis if you or a loved one is experiencing any of them. While there is currently no cure for FTD, there are treatments available to manage symptoms and improve quality of life. With the right support and care, people with FTD can maintain a good quality of life for many years.

[myfeeds]

Potential hidden cause of dementia detected

Researchers say these findings, published in the peer-reviewed journal Alzheimer’s & Dementia: Translational Research and Clinical Interventions, may point the way to a cure. “Many of these patients experience cognitive, behavioral and personality changes so severe that they are arrested or placed in nursing homes,” said Wouter Schievink, MD, director of the Cerebrospinal Fluid Leak and Microvascular Neurosurgery Program and professor of Neurosurgery at Cedars-Sinai. “If they have behavioral-variant frontotemporal dementia with an unknown cause, then no treatment is available. But our study shows that patients with cerebrospinal fluid leaks can be cured if we can find the source of the leak.” Cerebrospinal fluid (CSF) circulates in and around the brain and spinal cord to help cushion them from injury. When this fluid leaks into the body, the brain can sag, causing dementia symptoms. Schievink said many patients with brain sagging — which can be detected through MRI — go undiagnosed, and he advises clinicians to take a second look at patients with telltale symptoms. “A knowledgeable radiologist, neurosurgeon or neurologist should check the patient’s MRI again to make sure there is no evidence for brain sagging,” Schievink said. Clinicians can also ask about a history of severe headaches that improve when the patient lies down, significant sleepiness even after adequate nighttime sleep, and whether the patient has ever been diagnosed with a Chiari brain malformation, a condition in which brain tissue extends into the spinal canal. Brain sagging, Schievink said, is often mistaken for a Chiari malformation. Even when brain sagging is detected, the source of a CSF leak can be difficult to locate. When the fluid leaks through a tear or cyst in the surrounding membrane, it is visible on CT myelogram imaging with the aid of contrast medium. Schievink and his team recently discovered an additional cause of CSF leak: the CSF-venous fistula. In these cases, the fluid leaks into a vein, making it difficult to see on a routine CT myelogram. To detect these leaks, technicians must use a specialized CT scan and observe the contrast medium in motion as it flows through the cerebrospinal fluid. In this study, investigators used this imaging technique on 21 patients with brain sagging and symptoms of bvFTD, and they discovered CSF-venous fistulas in nine of those patients. All nine patients had their fistulas surgically closed, and their brain sagging and accompanying symptoms were completely reversed. “This is a rapidly evolving field of study, and advances in imaging technology have greatly improved our ability to detect sources of CSF leak, especially CSF-venous fistula,” said Keith L. Black, MD, chair of the department of Neurosurgery and the Ruth and Lawrence Harvey Chair in Neuroscience at Cedars-Sinai. “This specialized imaging is not widely available, and this study suggests the need for further research to improve detection and cure rates for patients.” The remaining 12 study participants, whose leaks could not be identified, were treated with nontargeted therapies designed to relieve brain sagging, such as implantable systems for infusing the patient with CSF. However, only three of these patients experienced relief from their symptoms. “Great efforts need to be made to improve the detection rate of CSF leak in these patients,” Schievink said. “We have developed nontargeted treatments for patients where no leak can be detected, but as our study shows, these treatments are much less effective than targeted, surgical correction of the leak.”

[kibokill]

i’ve been reading up on ftd again (specifically bvftd) and it’s time for symptom talk. take this as a warning and ask to tag

- loss of inhibition. very hard for him to tell what’s appropriate and what’s not, so he can sway from thinking something absolutely harmless is very disrespectful, to thinking something very inappropriate is normal. takes social cues, but might interpret them weirdly. jumps to conclusions on top of that, so it’s basically a constant that person is lying, this person is hiding something, that person wants me to leave immediately, etc.

- oversharing. might do so about trauma to acquaintances or strangers, in the form of, um, lighthearted jokes. or at least, they’re supposed to be taken that way... but jesus christ, they can get dark.

- impulsivity. i mean, he did kind of try to blow up the school because of a test. he’s stubborn and rigid on what he finds morally right, and is quick to defend it. is not afraid to take action or participate in risky behavior, as seen in the killing game. his set of beliefs can contradict, and his reaction to someone poking a hole in them is to double down. mind can be changed, but not easily. he’ll fight back with all he’s got.

- apathy. is a bit numb to trauma, claiming it’s far overshadowed by the good things that happen to him. came to terms with the fact that he can’t achieve anything in life, and is adamant about it. gets pretty bad after the simulation, when he’s not exactly so cheerful about it. sees the destruction his pursuit of the greater good brings as a means to an end.

- loss of empathy. sacrifices must be made for the greater good. the weak must sacrifice themselves to save the strong, the ones who will actually persevere and achieve great things. far from the level of psychopathy, though. he can empathize with people.

- delusions. thinks of himself and his talent as a liability and worships it in a way, it’s a love-hate relationship. the only form of control he ever gained over his life is when he worked with it, not against it. so, it’s a source of power, in a sense. idealizes the talented, the ones who were born to improve the world, and is adamant he could never become one of them.

- compulsions. will think every single thing that happens to him is a result of the cycle. will engage in compulsive behavior, anything that he thinks might soften the negative outcome of his bad luck. sort of like superstition, except not that harmless.

- no hallucinations, mostly no memory problems. no overeating or hyperorality, but there is one interesting thing. it’s common for people who have ftd to go through food fads, where they only eat one specific type of food. that might just be one of the reasons for the scene at the beginning of chapter two, when he refused to eat whatever breakfast he was given at the lodge and asked for toast. i don’t know... might be a reach?

two main sources, if you want to read more on it. this was written very quickly, so i definitely missed some things.