Ukuwohloka komqondo kwangaphambili

I-Frontotemporal dementia (FTD) yindlela engavamile yokuwohloka komqondo efana nesifo i-Alzheimer, ngaphandle kokuthi ithinta izindawo ezithile zobuchopho kuphela.

Abantu abane-FTD banezinto ezingajwayelekile (ezibizwa ngothanga, imizimba yakwa-Pick, namaseli we-Pick, namaprotheni we-tau) ngaphakathi kwamangqamuzana ezinzwa ezindaweni ezilimele zobuchopho.

Imbangela ngqo yalezi zinto ezingajwayelekile ayikaziwa. Kutholakale izakhi zofuzo eziningi ezejwayelekile ezingadala i-FTD. Amanye amacala we-FTD adluliselwa emindenini.

I-FTD ayivamile. Kungenzeka kubantu abaneminyaka yobudala engama-20. Kodwa kuvame ukuqala phakathi kweminyaka engama-40 nengama-60. Isilinganiso seminyaka esiqala ngaso singama-54.

Lesi sifo sihamba kancane kancane. Izicubu ezingxenyeni zobuchopho ziyancipha ngokuhamba kwesikhathi. Izimpawu ezinjengokushintsha kokuziphatha, ubunzima bokukhuluma, nezinkinga zokucabanga zenzeka kancane kancane futhi ziba zimbi kakhulu.

Izinguquko zobuntu zakuqala zingasiza odokotela ukuthi batshele i-FTD ngaphandle kwesifo i-Alzheimer. (Ukulahleka kwememori kuvamise ukuba yisifo esiyinhloko, futhi sokuqala, sesifo i-Alzheimer.)

Abantu abane-FTD bathambekele ekuziphatheni ngendlela engafanele kuzilungiselelo zomphakathi ezahlukahlukene. Izinguquko ekuziphatheni ziyaqhubeka nokuba zimbi futhi zivame ukuba ngesinye sezimpawu eziphazamisa kakhulu zalesi sifo. Abanye abantu banobunzima obukhulu ekwenzeni izinqumo, imisebenzi enzima, noma ulimi (ukuthola kanzima noma ukuqonda amagama noma ukubhala).

Izimpawu ezijwayelekile zifaka:

IZINGUQUKO ZOKUZIPHATHA:

• Ayikwazi ukugcina umsebenzi
• Ukuziphatha okuphoqelekile
• Ukuziphatha ngokuxhamazela noma okungafanele
• Ukwehluleka ukusebenza noma ukuhlanganyela ezimeni zenhlalo noma zomuntu siqu
• Izinkinga zokuhlanzeka komuntu siqu
• Ukuziphatha okuphindaphindwayo
• Ukuhoxa ekuxhumaneni nomphakathi

IZINGUQUKO ZOMUZWA

• Ukushintsha kwemizwelo ngokungazelelwe
• Ukwehla kwesithakazelo emisebenzini yokuphila yansuku zonke
• Ukwehluleka ukubona izinguquko ekuziphatheni
• Ukwehluleka ukukhombisa imfudumalo engokomzwelo, ukukhathazeka, uzwela, uzwela
• Isimo esingafanele
• Ukungakhathaleli izehlakalo noma imvelo

UKUGUQULWA KOLIMI

• Ayikwazi ukukhuluma (mutism)
• Ukwehla kwekhono lokufunda noma ukubhala
• Kunzima ukuthola igama
• Kunzima ukukhuluma noma ukuqonda inkulumo (aphasia)
• Ukuphinda noma yini ekhulunywe kubo (echolalia)
• Ukuncipha kwesilulumagama
• Imisindo ebuthakathaka, engaqondaniswanga

IZINKINGA ZESIKHATHI ESIKHONA

• Ukukhuphuka kwethoni yemisipha (ukuqina)
• Ukulahleka kwememori okuya ngokuya kuba kubi
• Ubunzima bokuhamba / bokuxhumanisa (i-apraxia)
• Ubuthakathaka

EZINYE IZINKINGA

• Ukungakwazi ukubamba umchamo

Umhlinzeki wezokunakekelwa kwempilo uzobuza ngomlando nezimpawu zezokwelapha.

Izivivinyo zingahle zilawulwe ukuthi zisize ukukhipha ezinye izimbangela zokuwohloka komqondo, kufaka phakathi ukuwohloka komqondo ngenxa yezimbangela zomzimba. I-FTD itholakala ngokuya ngezimpawu nemiphumela yezivivinyo, kufaka phakathi:

• Ukuhlolwa kwengqondo nokuziphatha (ukuhlolwa kwe-neuropsychological)
• I-Brain MRI
• I-Electroencephalogram (EEG)
• Ukuhlolwa kobuchopho nesistimu yezinzwa (ukuhlolwa kwemizwa)
• Ukuhlolwa koketshezi oluzungeze uhlelo oluphakathi lwezinzwa (i-cerebrospinal fluid) ngemuva kokuhlatshwa ngomlenze
• Iskena sekhanda le-CT
• Ukuhlolwa kwemizwa, ukucabanga nokucabanga (ukusebenza kwengqondo), nokusebenza kwemoto
• Izindlela ezintsha ezivivinya umzimba we-metabolism noma ama-protein deposits angavumela kangcono ukuxilongwa okunembile ngokuzayo
• Ukuskena kobuchopho kwePositron emission tomography (PET)

I-biopsy yobuchopho ukuphela kwesivivinyo esingaqinisekisa ukuxilongwa.

Akukho ukwelashwa okuqondile kwe-FTD. Imithi ingasiza ukuphatha ukuguquguquka kwemizwelo.

Kwesinye isikhathi, abantu abane-FTD bathatha imithi efanayo esetshenziselwa ukwelapha ezinye izinhlobo zokuwohloka komqondo.

Kwezinye izimo, ukumisa noma ukushintsha imithi eyenza ukudideka kube kubi kakhulu noma okungadingeki kungathuthukisa ukucabanga neminye imisebenzi yengqondo. Imithi ifaka:

• Ama-analgesics
• Ama-anticholinergics
• Ukucindezeleka kwesistimu yezinzwa eziphakathi
• I-Cimetidine
• I-Lidocaine

Kubalulekile ukwelapha noma yikuphi ukuphazamiseka okungadala ukudideka. Lokhu kufaka phakathi:

• Ukushoda kwegazi
• Ukwehla kwezinga le-oxygen (hypoxia)
• Ukwehluleka kwenhliziyo
• Izinga eliphezulu lesikhutha
• Izifo
• Ukuhluleka kwezinso
• Ukuhluleka kwesibindi
• Ukuphazamiseka kokudla okunempilo
• Izinkinga ze-thyroid
• Ukuphazamiseka kwemizwelo, njengokucindezeleka

Imithi ingadingeka ukulawula isimilo esinolaka, esiyingozi, noma esikhungathekile.

Ukuguqulwa kokuziphatha kungasiza abanye abantu ukuthi balawule isimilo esingamukeleki noma esiyingozi. Lokhu kubandakanya izindlela zokuziphatha ezifanelekile noma ezivumayo nokungazinaki izindlela zokuziphatha ezingafanele (uma kuphephile ukwenza njalo).

I-Talk therapy (i-psychotherapy) ayisebenzi ngaso sonke isikhathi. Lokhu kungenxa yokuthi kungadala ukuqhubeka kokudideka noma ukudideka.

Ukuma kweqiniso, okuqinisa ezemvelo nokunye, kungasiza ekunciphiseni ukudideka.

Ngokuya ngezimpawu nobucayi besifo, ukuqapha nokusiza ngenhlanzeko yomuntu nokuzinakekela kungadingeka. Ekugcineni, kungahle kube nesidingo sokunakekelwa nokuqashwa kwamahora angama-24 ekhaya noma esikhungweni esikhethekile. Ukwelulekwa ngokomndeni kungasiza umuntu ukuthi abhekane nezinguquko ezidingekayo ekunakekelweni kwasekhaya.

Ukunakekelwa kungafaka:

• Izinsizakalo zokuvikela abantu abadala
• Izinsiza zomphakathi
• Abenzi bezindlu
• Abahlengikazi abavakashelayo noma abasizi
• Izinsizakalo zokuzithandela

Abantu abane-FTD kanye nemindeni yabo bangadinga ukufuna izeluleko zomthetho ekuqaleni kwesifo. Isiqondisi sangaphambi kokunakekelwa, amandla abameli, nezinye izinyathelo zomthetho kungenza kube lula ukwenza izinqumo maqondana nokunakekelwa komuntu one-FTD.

Unganciphisa ukucindezeleka kwe-FTD ngokujoyina iqembu lokusekela. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa. Imininingwane engaphezulu nokusekelwa kwabantu abane-FTD nemindeni yabo kungatholakala ku:

I-Association for Frontotemporal Degeneration - www.theaftd.org/get-involve/in-your-region/

Lesi sifo ngokushesha futhi kancane kancane siba sibi kakhulu. Umuntu ukhubazeka ngokuphelele ekuqaleni kwesifo.

I-FTD ivame ukudala ukufa kungakapheli iminyaka eyi-8 kuye kwayi-10, imvamisa kusuka ekuthelelekeni, noma kwesinye isikhathi ngoba izinhlelo zomzimba ziyahluleka.

Shayela umhlinzeki wakho noma uye egumbini lezimo eziphuthumayo uma ukusebenza kwengqondo kuba kubi kakhulu.

Akukho ukuvimbela okwaziwayo.

Ukuwohloka kwengqondo; Ukuwohloka komqondo - isemantic; Ukuwohloka komqondo kwangaphambili; FTD; Isifo se-Arnold Pick; Khetha isifo; I-3R tauopathy

• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo
• Ubuchopho
• Ubuchopho nesistimu yezinzwa

UBang J, uSpina S, uMiller BL. Ukuwohloka komqondo kwangaphambili. I-Lancet. 2015; 386 (10004): 1672-1682. I-PMID: 26595641 pubmed.ncbi.nlm.nih.gov/26595641/.

Peterson R, Graff-Radford J. Isifo i-Alzheimer nezinye izifo zomqondo. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 95.