Pick Score [FTLD]

The Pick Score is a practical and easy diagnostic criteria for FTLD (Pick's disease). It is contrived by Dr. Kono through his outpatient consultations.
Although it is not based on severe statistical evidence, it is a practical method to diagnose FTLD as a 'rule of thumb'.

Pick Score.JPG

Phase: Attitude
Scrutinize the patient who is in front of doctor.  The patient refuses to medical examination, is displeased, or feared of collecting blood.
No greeting, crossing his/her legs or arms in front of doctor, or being immature(doing as a child).
Not sitting down easily, standing up without purpose, misunderstanding the place to sit down, getting out without permission.

Phase: Consultation
Scrutinize the patient who has semantic aphasia or not.
In this case, commonly known proverb is useful. This is called 'FTLD check set'.
1. Which is your dominant hand?
2. Tap your left shoulder with right hand.
3. What dose this proverb mean, ' Seeing is believing'?
4. What dose a word follow 'Experience is the best ・・・'?

If he/she makes one mistake, point is 1.  If more than two mistakes, point is 2.

Note: In original Japanese edition, the proverb 'Seeing is believing' is 'Even monkey falls down from a tree' which means that even veteran makes a mistake.  'Even Homer sometimes nods' is also same meaning. 

Phase: Interview
Antisocial behavior such as kleptomania, stealing food, skipping out on a restaurant bill, or quarreling with neighbors, those are added 2 points.

Abnormal feeding behavior is over-eating, quick eating (chain eating), unbalanced diet, or allotriophagy.  For instance, feeding behavior is eating same dish only, then another dish only.  This behavior can be seen by patients with FTLD.
Although feed behavior is normal, an overactive sexuality should be counted.
Saccadic is getting angry like switching, and getting calm quickly. This symptom is to be counted by 1 point.

Phase: CT(Computed Tomography)
Doctor with no CT nor MRI, should diagnose FTLD and prescribe, if the patient who has more than 4 points.
Kono method typical prescription:
 Chlorpromazine(4+6mg) + ferulic acid