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Loss of silent reading in frontotemporal dementia: unmasking the inner speech

Presenting signs of frontotemporal dementia usually include social disinhibition, loss of initiative, compulsive features, cognitive decline, and motor symptoms. Behavioural features have recently been detailed, in an attempt to distinguish patients with frontotemporal dementia from patients with Alzheimer's disease.1 2 We report a new feature inaugurating this syndrome which could be a strong illustration of a prefrontal inhibitory role in the control of inner speech, through an early loss of silent reading as an inaugural sign of frontotemporal dementia.

A 69 year old man, a retired baker, with no family history of neurological disease, was admitted to the neurological department for evaluation and diagnosis of a progressive dementia with movement disorders. Since the beginning of 1998 (when he was 67), his wife had noticed that he had slight head movements with small amplitude, occurring only …