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Little-known brain disease rips apart lives of victim, loved ones

When Stu Bryant began acting rude and impulsive, his family was baffled. Then they learned he had frontotemporal disease, which strips away self-restraint and the ability to decipher social situations.

February 10, 2012|By Thomas Curwen, Los Angeles Times

More than a year after the diagnosis, Maureen Bryant had grown accustomed to making excuses for her husband.

When Stu stood behind a tattooed woman in line at Panda Express, and said loudly, "Wow, that's a lot of tattoos," Moe stepped between him and the woman and apologized.

When he repeatedly wandered into the house that was being built down the street — despite the "No Trespassing" sign and the fence — she explained to the owner that he was just curious.

Possibly the most embarrassing episode occurred when they were coming home from dinner, and she dashed into a mini-mart at a marina in Oxnard to buy milk.

"Do you know that man?" the owner said, seeing Stu in the car. "He's been stealing from me."

Moe remembers being baffled.

Muffins and cheesecake, the owner said, showing her photos from the store's video camera. "But I can't catch him. He drives away in the golf cart too fast."

Moe offered to pay for what Stu had taken. "He has no control over what he does," she said to police when they arrived.

Sometimes she will say that he has a brain tumor. It's easier than saying frontotemporal dementia and having to describe how the disease has stripped away his self-restraint. Stu is no longer aware of how to behave in the company of others, and like an unknowing child, will blurt out the first thing that comes to mind or will act without considering the consequences.

Moe realizes that this is difficult to understand. Being rude or disrespectful seems like a deliberate choice, and Stu, 60, has a quick smile and an easy laugh. It's easy for people to write him off as inconsiderate and self-centered.

This is what Moe and her daughters, Katy and Jessica, did before they discovered how sick he was.

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Once called Pick's disease and now FTD, frontotemporal dementia hides its symptoms well. Like Alzheimer's, it is the result of the degeneration of neurons caused by an abnormal accumulation of proteins in the brain.

In early stages, Alzheimer's affects predominantly the hippocampus in the inner part of the brain, where memories are formed, and FTD affects the frontal and temporal lobes, above and behind the eyes, where social emotions are formed. Alzheimer's patients sense a fuzziness in their thinking — a word misplaced, a confusion between the past and present — and realize their errors. Most patients with FTD have no such insight into their disease.

Jessica, 22, first noticed her father becoming more selfish and temperamental when they lived in Sacramento. He doted upon his daughters and would do anything for them, but then that seemed to stop. Where once he let Jessica choose what to watch on TV, now he held on to the remote and got angry if she changed the channel.

The tragedy of FTD, according to Mario Mendez, the UCLA neurologist treating Stu, is its elusive diagnosis. The presence of the disease can be confirmed only through an autopsy, and Mendez reached his conclusion about Stu based on specific behaviors and brain scans.

The disease begins with a change in personality that's often seen as volitional. Introverts become extroverts. Once-agreeable employees act rude. Formerly faithful spouses have affairs, and while they acknowledge their transgressions, they are unable to appreciate the implications.

Some end up institutionalized because their behavior looks like mental illness. Some are incarcerated when they break the law. A diagnosis of FTD led to reduced charges against a New York City physician who cut his initials into the stomach of a patient, and what could have been as many as 25 years in prison ended up as five years' probation.

Researchers believe that between 30,000 and 50,000 people in the United States have FTD. There is no cure, and the disease leads to death, often within eight years, either from accidents or secondary infections.

When Stu began acting differently in 2007, bickering with Jessica, Moe didn't think anything of it. She and Stu had been married more than 25 years. She figured relationships change.

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He was the dreamer, she the pragmatic one. She was a consultant for a healthcare company, and he was a private golf coach and a car salesman. But his real passion was coaching baseball. According to Jerry Weinstein — who was head coach in the early 1980s at Sacramento City College, where Stu worked — Stu was known for his caustic wit and demanding practices. The players trusted him, Weinstein said.

Moe and Stu had moved to Sacramento from Los Angeles in 1992. His father had just died, and he thought he should be near his mother. But a decade later, when she was in her 80s, he suddenly stopped wanting to see her.

When Moe asked why, he couldn't say, and after his mother died, he became more withdrawn and stubborn. They saw a counselor and decided that leaving Sacramento might help them get over their problems.

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