Materiały źródłowe

• #1

  https://www.nhs.uk/conditions/corticobasal-degeneration/treatment/

  There’s currently no cure for corticobasal degeneration (CBD) and no treatment to slow it down, but there are lots of things that can be done to help manage the symptoms. […] A care plan will be drawn up in discussion with your team. This will outline the treatments you need to help with the symptoms of CBD, as well as the support and advice you require to make your life easier. […] There are currently no medicines that treat CBD specifically. […] Cognitive stimulation is a type of therapy used to treat dementia, and it may be helpful if a person with CBD has dementia symptoms. […] A physiotherapist can give advice about how to remain safely mobile. […] An occupational therapist can give you advice about the best ways to increase your safety and prevent trips and falls during your day-to-day activities.

• #1 Diagnosis and treatment of corticobasal degeneration – PubMed

  https://pubmed.ncbi.nlm.nih.gov/24469408/

  Corticobasal degeneration is a pathologic entity. […] Treatment of CBD is symptomatic, particularly given recently negative neuroprotective studies. […] In patients with CBS and PSPS, parkinsonism is treated with levodopa/carbidopa. This generally has modest and transient benefits at best and often results in no improvement. […] Botulinum toxin injections are the treatment of choice for limb dystonia. […] Clonazepam and levetiracetam are commonly used for myoclonus. […] Physical therapy is an important part of motor treatment, particularly for fall prevention strategies and assist device assessment. […] Whether medications such as cholinesterase inhibitors or memantine have any role in CBD is unclear given the various responses described in related phenotypes and diseases. […] Treating the behavioral symptoms associated with CBD is critical in an attempt to treat symptoms for which we have good pharmacologic interventions and to hopefully improve quality of life.

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7500816/

  A study using levodopa reported some improvement in 24% of patients. […] Other dopaminergic drugs, such as dopamine agonists and selegiline, tend to produce less clinical improvement and more side effects than levodopa. […] The suggested use of serotonin reuptake inhibitors for depression treatment in CBD is based only on the clinical experiences of a few authors, as is also the case with symptoms of obsessiveness and anxiety. […] AChEIs have been used for CBD, based on the anecdotal experience, but their therapeutic potential for this condition remains unknown. […] Despite the lack of formal clinical trials aimed at psychiatric symptoms, such as depression and anxiety, in patients with CBD, treating associated behavioral manifestations is essential for alleviating symptoms that have effective pharmacological interventions and thus improve the quality of life of patients.

• #1 Corticobasal syndrome: a practical guide | Practical Neurology

  https://pn.bmj.com/content/21/4/276

  Corticobasal syndrome is a disorder of movement, cognition and behaviour with several possible underlying pathologies, including corticobasal degeneration. […] Its treatment is largely symptomatic and is best undertaken within a multidisciplinary setting, including a neurologist, physiotherapist, occupational therapist, speech language therapist, psychiatrist and, ultimately, a palliative care clinician. […] There are currently no proven treatments for corticobasal syndrome. Recent advances in the treatment of tauopathies with immunotherapies and gene expression show promise, but for the moment we emphasise the importance of making a diagnosis that can explain a puzzling array of problems for a patient and their family. […] Although parkinsonism in corticobasal syndrome does not generally respond well to levodopa, most patients will try it as part of their initial assessments (often when the diagnosis is less clear), and it is reasonable to push the dose up towards at least 1000mg/day before classifying a patient as a non-responder.

• #1 Corticobasal Syndrome and Corticobasal Degeneration Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/1150039-treatment

  Consider treating bothersome myoclonus with levetiracetam and/or clonazepam. […] Refer early and continuously to occupational therapy (for upper extremity functional evaluation and management), physical therapy (gait and safety evaluation and training), and speech-language pathology (speech evaluation/cognitive training, swallow evaluation using modified barium with video), consider assistive devices for ambulation, ADLs and communication, and an exercise program to maintain endurance and strength. […] Deep brain stimulation surgery is not recommended for corticobasal syndrome (CBS) or other phenotypes associated with corticobasal degeneration (CBD) pathology.

• #1 SciELO Brazil – Pharmacological interventions in corticobasal degeneration: a review Pharmacological interventions in corticobasal degeneration: a review

  https://www.scielo.br/j/dn/a/H9QPjg9FZdks9zWLsphZdHj/

  A study using levodopa reported some improvement in 24% of patients. […] Other dopaminergic drugs, such as dopamine agonists and selegiline, tend to produce less clinical improvement and more side effects than levodopa. […] Ninety-two percent of patients received dopaminergic drugs, which resulted in a beneficial effect for only 24%. […] Baclofen, isolated or combined with an anticholinergic, reduced rigidity, but produced side effects. […] Clonazepam was beneficial for myoclonus and tremor. […] The suggested use of serotonin reuptake inhibitors for depression treatment in CBD is based only on the clinical experiences of a few authors. […] AChEIs have been used for CBD, based on the anecdotal experience, but their therapeutic potential for this condition remains unknown. […] The authors concluded that CBD patients could benefit from this multidisciplinary therapeutic approach using low-frequency rTMS.

• #1 Treatment Options for Corticobasal Degeneration | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/brain-and-nerves/corticobasal-degeneration/treatments.html

  There are no specific treatments available for Corticobasal Degeneration (CBD). Drugs such as clonazepam may help with myoclonus, however, and occupational, physical, and speech therapy can help in managing the disabilities associated with this disease. […] Sometimes Botox can be helpful for dystonia. The symptoms of the disease often do not respond to Parkinson’s medications or other drugs, but may be used if there is a modest benefit.

• #1

  https://www.brain.northwestern.edu/dementia/cbs/treatment.html

  There are a number of non-pharmacologic ways to support those with Corticobasal Syndrome (CBS). […] Speech therapy can improve language and communication. […] Occupational therapy can help provide strategies and techniques to compensate for the cognitive and motor changes associated with CBS. […] Physical therapy can also improve aspects of motor function. […] There are presently no cures for Corticobasal Syndrome, but medications can be prescribed with to treat some of the symptoms. […] Though levodopa, a dopamine replacement, (Sinemet) can be given to address the motor symptoms of CBS, symptom response is uncommon and limited. […] When CBS symptoms are determined to stem from Alzheimers disease, a class of medications known as cholinesterase inhibitors might be available. […] Donepezil (Aricept), Rivastigmine (Exelon) and Galantamine (Razydyne) are examples of cholinesterase inhibitors.

• #1 Corticobasal Syndrome and Corticobasal Degeneration: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1150039-overview

  There is no disease-modifying therapy for CBD to date, but a number of symptomatic treatments can be useful, particularly botulinum toxin injections for dystonia and several other indications. Lifelong rehabilitation of these patients with physical, occupational, speech, and swallow therapy focused on maximizing daily function is crucial to limit deconditioning and potentially slow decline. […] Treatment includes approach considerations, medical care, consultations, diet, activity, surgical care, complications, prevention, and long-term monitoring. […] Medication options include benzodiazepines, neuromuscular blocking agents, cholinesterase inhibitors, antidepressants, NMDA antagonists, antiparkinson agents, dopamine agonists, decarboxylase inhibitors, and anticonvulsants.

• #1

  https://www.psp.org/iwanttolearn/corticobasal-degeneration

  A speech-language pathologist (SLP) works with people who are having issues with speech, swallowing and language. Their goals are to improve and prolong communication skills, assess and help adapt to swallowing changes. […] A feeding tube can be a safe and helpful option for people with CBD who are experiencing difficulties with swallowing. A feeding tube can be considered when someone is no longer able to take in necessary amounts of nutrition and calories by eating or drinking. […] Possible medications for depression and anxiety for people with CBD include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). […] Non-drug methods for improving mood include mental health therapy, cognitive behavioral therapy (CBT), exercise, a balanced diet, socialization, good sleeping habits, music, and meditation.

• #1

  https://www.brain.northwestern.edu/dementia/cbs/treatment.html

  Additionally, medications can be prescribed to address mood and anxiety symptoms associated with CBS. […] Antidepressants can be given to treat depression, anxiety, or irritability. […] Low doses of antipsychotics may also be considered to help address delusional thinking (believing things that have no real foundation) or aggression.

• #1 Corticobasal Degeneration | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/157387

  Constipation may respond to increased physical activity, adequate hydration, fiber supplementation, and pharmacologic therapy with stool softeners or osmotic laxatives. […] Urinary dysfunction may be targeted with the use of alpha-receptor antagonists, 5-alpha reductase inhibitors, beta-3 adrenoceptor agonists, and selective M3 antimuscarinic anticholinergics; however, nonselective antimuscarinic agents should be avoided. […] Melatonin can manage sleep disturbances like insomnia and rapid eye movement sleep behavior disorder; however, low-dose clonazepam may be necessary if melatonin fails. […] Botulinum toxin is the first-line therapy for sialorrhea. […] Apraxia of speech and nonfluent aphasia are best managed by intense, repetitive exercises and using gestures, nonspeech modalities, and pacing methods with the help of a trained speech pathologist.

• #1 Corticobasal Degeneration – EyeWiki

  https://eyewiki.org/Corticobasal_Degeneration

  Corticobasal degeneration (CBD) is a rare, progressive neurodegenerative disease characterized by nerve cell loss and atrophy of multiple areas of the brain. […] There are currently no effective disease-altering treatments for CBD. […] Thus, the management of CBD focuses on symptomatic management and supportive treatment. […] For symptomatic management, these symptoms can be the target of possible pharmacologic management: Parkinsonism – Levodopa has been observed to offer limited improvement for some patients. […] Myoclonus – Valproic acid, clonazepam, piracetam, leveiritcam, and gabapentin have shown to provide effective improvement of myoclonus. […] Limb dystonia – Chemodenervation with botulinum toxin may improve pain and abnormal posture. […] Eyelid opening apraxia and dry eyes – botulinum toxin injections into pretarsal orbicularis occuli have been shown to alleviate apraxia of the eyelid. Artificial tears, acetylcysteine, carbomers, and 0.9% sodium chloride ophthalmic drops are effective for dry eyes due to eyelid dysmotility.

• #1 Corticobasal syndrome: a practical guide | Practical Neurology

  https://pn.bmj.com/content/21/4/276

  Options for treating troublesome myoclonus include levetiracetam and clonazepam. […] Specific options to consider for the alien limb syndrome are summarised above. Management to mitigate the effects of apraxia is best coordinated by an occupational therapist with knowledge of the condition. […] Speech therapists can teach patients techniques to overcome some of their language deficits and it is worth seeking their input when speech difficulties are a prominent feature. […] We often refer patients for physiotherapy aimed at strength and balance training as well as gait assessment. […] Although there are no proven treatments for cognitive deficits such as memory and attentional impairment in corticobasal syndrome, many clinicians consider trialling cholinesterase inhibitors if there is a strong suggestion from the history (memory impairment), examination (predominate cortical signs) and cognitive assessment (visuospatial or memory deficits) to suggest an underlying Alzheimers disease pathology.

• #1 Corticobasal Degeneration | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/corticobasal-degeneration

  Currently, there are no treatments to slow the progress of corticobasal degeneration (CBD). Instead, individual symptoms are targeted with specific medications or therapy. For example, rigidity and difficulty walking may partially respond to treatments for Parkinson’s disease. […] Muscle contractions and twitching may respond to muscle relaxants or anti-seizure medications. […] Memory and behavior problems may respond to treatments for Alzheimer’s disease or depression. […] Occupational therapy may be used to design equipment that supports the activities of daily living and maintains functional independence. […] Physical therapy is important for maintaining a patient’s range of motion. This may prevent pain and contraction or the shortening of muscles as well as help maintain mobility. […] Speech therapy may be recommended to improve articulation and volume of the voice. […] The UCSF Memory and Aging Center is involved in research to better understand the cause and course of the disease, which has led to counseling, support and medications to treat symptoms.

• #1 Corticobasal Syndrome | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/corticobasal-syndrome

  For most, the progression of CBS is relatively slow, over years, but more rapid compared to typical Parkinson Disease and more rapid than all would like. […] Although there is no one pill or cure for CBS, we can and do try to treat the symptoms one faces, whether this be trouble with slowness or stiffness in movement, or other troubles such as falls or pain in the affected limb. […] In most, a trial of carbidopa-levodopa (Sinemet) is warranted to treat symptoms of slowness and stiffness but in contrast to Parkinson Disease, the effect of Sinemet in CBS for these symptoms may be minimal. […] Many patients living with CBS will need frequent evaluations and support services from physical, occupational, and speech-swallow therapists, whether at an outpatient rehab center or in the home. […] In general, physical therapy is crucial to help with gait, balance, fall prevention, and mobility while occupational therapy helps with activities of daily living like getting dressed, going to the bathroom, and eating. […] As speech and swallowing are often affected in CBS, speech-swallow therapy is frequently prescribed and can be very helpful to improve speech and prevent aspirating foods-liquids. […] Staying active is critical and any exercise you like to do and tolerate is highly recommended.

• #1 Corticobasal degeneration | Monash Health

  https://monashhealth.org/services/movement-disorders-program/understanding-movement-disorders/corticobasal-degeneration/

  Myoclonus may be helped with tranquilizers. […] Depression can be managed effectively with a range of antidepressants. […] There are currently no medications that can reverse or slow down the cognitive changes that occur with CBD. […] Apraxia or the inability to perform purposeful movements is the key symptom of CBD. There is no treatment to reverse this phenomenon. […] A physiotherapist specialised in movement disorders such as CBD can assess walking and balance problems and recommend ways to improve mobility and safety. […] An occupational therapist specialised in movement disorders such as CBD can assess the person at home and suggest ways to improve safety, both inside and outside the home. […] A speech pathologist specialised in movement disorders such as CBD can assess the persons speech and teach strategies to improve them.

• #1 Mayo Clinic Health Library – Corticobasal degeneration (corticobasal syndrome) | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20209448

  There are no treatments that help slow the progression of corticobasal degeneration (corticobasal syndrome). But if your symptoms are due to Alzheimer’s disease, new medicines may be available. Your healthcare professional may recommend medicines to try to manage your symptoms. […] Occupational and physical therapy may help you manage the disabilities caused by corticobasal degeneration. Walking devices may help with mobility and prevent falls. Speech therapy can help with communication and swallowing. A dietitian may help you ensure you get proper nutrition and lower the risk of inhaling food into the lungs, known as aspiration.

• #1

  https://www.nhs.uk/conditions/corticobasal-degeneration/treatment/

  A speech and language therapist can help assess and treat speech and swallowing problems. […] You may be referred to a dietitian, who will advise you about making changes to your diet, such as including food and liquids that are easier to swallow, while ensuring that you eat a balanced diet. […] Palliative care aims to relieve pain and other distressing symptoms while providing psychological, social and spiritual support. […] Many people with CBD make plans for the future that outline their wishes about medical care and other decisions. […] If someone you know develops CBD, you may need information and advice about caring for them.

• #1 Therapy Approaches for Corticobasal Degeneration – Ask the Experts 829

  https://www.speechpathology.com/ask-the-experts/therapy-approaches-for-corticobasal-degeneration-829

  With this in mind, a speech therapy program should be simple and target functional communication as quickly and efficiently as possible. […] It may be more beneficial to spend therapy time teaching the patient ways to compensate for speech deficits, as well as repair strategies to use when intelligibility breaks down, as well as working with family members to assure maximum communicative effectiveness. […] All patients with dysarthria, regardless of etiology, can benefit from these communication-centered approaches to therapy to improve their quality of life. […] Patients who receive speech therapy in early stages of the disease progression may be able to continue to communicate verbally for a longer period of time. […] Augmentative communication will likely be necessary in later stages.

• #1 Therapy Approaches for Corticobasal Degeneration – Ask the Experts 829

  https://www.speechpathology.com/ask-the-experts/therapy-approaches-for-corticobasal-degeneration-829

  Corticobasal degeneration (also known as corticobasal ganglionic degeneration) is one of the parkinsonism-plus syndromes (PPS) which also include progressive supranuclear palsy (PSP), Shy-Drager syndrome, multiple system atrophy (MSA) and olivopontocerebellar degeneration. […] With regard to treatment, there is very little research investigating the effectiveness of behavioral therapy with patients with this specific diagnosis. […] For example, speaking rate control techniques or other prosodic therapies for patients with predominately ataxic symptoms. […] Countryman, et al (1994) did provide some evidence that Lee Silverman Voice Therapy LSVT is effective in improving voice and intelligibility in patients with parkinsonism-plus syndromes, but caution that it should only be used in patients who have voice symptoms typical of PD.

• #1 Corticobasal degeneration | Monash Health

  https://monashhealth.org/services/movement-disorders-program/understanding-movement-disorders/corticobasal-degeneration/

  A dietitian specialised in movement disorders such as CBD can assess the persons diet and provide them with suggested menus to improve any dietary problems they may have. […] A social worker specialised in movement disorders such as CBD can assist the person with CBD, their caregiver and family negotiate the challenges faced across the life time of the persons condition. […] Depression and anxiety are common clinical symptoms of CBD. Depression and anxiety can benefit from a variety of interventions and approaches. […] Though there is no evidence to support the benefits of any medication to improve cognition or prevent its deterioration, a neuropsychologist and occupational therapist can advise on ways to manage the challenges caused by changes to the persons cognition and behaviour.

• #1

  https://zana.com/a/corticobasal-degeneration-treatment-corticobasal-degeneration.970

  Feeding tubes may be recommended for severe swallowing problems, where the risk of malnutrition, weight loss, fatigue and dehydration is increased. […] Palliative care can be received: […] Your care team can provide you with more information and advice about these decisions and how best to record them.

• #1 What to Do About… Corticobasal Syndrome | AFTD

  https://www.theaftd.org/posts/uncategorized/what-to-do-about-corticobasal-syndrome/

  While often misdiagnosed as Parkinson’s disease based on their similar pathological symptoms, corticobasal degeneration (CBD) is a distinct condition that can cause muscle rigidity, spasms, and contractions, often on just one side of the body. (Corticobasal syndrome, or CBS, is its most common presentation.) Its largely movement-based symptoms can make for an especially frustrating experience for persons diagnosed, who lose the ability to perform movements that once came naturally to them. Below are strategies for persons diagnosed, care partners, and health professionals to use when facing CBD. […] Include physical, occupational, and speech therapies to help manage CBS symptoms and improve quality of life. […] Encourage referrals to physical, speech, and occupational therapy to design care strategies to maintain independence in activities of daily living, assess the need for assistive devices for gait and balance, and monitor for problems with swallowing. […] Consider referring the person diagnosed for a palliative care consultation. Initiating hospice services early can ease the transition and provide support in the home.

• #1 Corticobasal syndrome: a practical guide | Practical Neurology

  https://pn.bmj.com/content/21/4/276

  There are several available pharmacological options for neuropsychiatric manifestations. […] Many mild behavioural issues may be better managed non-pharmacologically (caregiver education, environment changes, etc) but undoubtedly medications can help with more severe disruptions. […] Other practical issues to address include driving safety and checking whether driving licensing agencies need to be informed, the importance of updating a persons will, and establishing an enduring power of attorney early in the disease course, as these can be problematic later if significant cognitive impairment develops. […] Lastly, putting patients in touch with local charities can greatly help patients and families.

• #1 Corticobasal degeneration (corticobasal syndrome) – Doctors and departments – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/corticobasal-degeneration/doctors-departments/ddc-20354769

  Mayo Clinic staff actively conducts research in corticobasal degeneration (corticobasal syndrome) and related conditions. Researchers study causes, diagnostic techniques and treatment options for corticobasal degeneration. […] You may have the opportunity to participate in trials at the center. […] Corticobasal degeneration (corticobasal syndrome) care at Mayo Clinic.

• #1 Corticobasal Degeneration | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/157387

  If focal, botulinum toxin is the best treatment for dystonia. […] Pharmacologic management of cognitive impairment with cholinesterase inhibitors should be reserved for amnestic deficits. […] Targeted tau therapy has become more pertinent than ever to develop disease-specific biomarkers to help predict the pathology in the antemortem diagnosis of neurodegenerative diseases with increased sensitivity and specificity and monitor the quantitative effect of the treatment over time. […] Clinical trials in developing a disease-modifying therapy for 4R-tauopathies either focus on reducing the toxic gain of function caused by pathologic tau aggregates or restoring a loss of normal tau function.

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7500816/

  After rationally compiling data from the cited literature, pharmacological interventions must be adjusted for the specific symptoms of each patient, and decisions about the time of treatment must be based on its efficacy for each individual according to their tolerances. […] Symptomatic treatment of CBD patients could be useful for improving motor symptoms (parkinsonism, dystonia, myoclonus), but the effects are generally unsatisfactory.

• #2 Mayo Clinic Health Library – Corticobasal degeneration (corticobasal syndrome) | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20209448

  There are no treatments that help slow the progression of corticobasal degeneration (corticobasal syndrome). But if your symptoms are due to Alzheimer’s disease, new medicines may be available. Your healthcare professional may recommend medicines to try to manage your symptoms. […] Occupational and physical therapy may help you manage the disabilities caused by corticobasal degeneration. Walking devices may help with mobility and prevent falls. Speech therapy can help with communication and swallowing. A dietitian may help you ensure you get proper nutrition and lower the risk of inhaling food into the lungs, known as aspiration.

• #2 Corticobasal syndrome: a practical guide | Practical Neurology

  https://pn.bmj.com/content/21/4/276

  Corticobasal syndrome is a disorder of movement, cognition and behaviour with several possible underlying pathologies, including corticobasal degeneration. […] Its treatment is largely symptomatic and is best undertaken within a multidisciplinary setting, including a neurologist, physiotherapist, occupational therapist, speech language therapist, psychiatrist and, ultimately, a palliative care clinician. […] There are currently no proven treatments for corticobasal syndrome. Recent advances in the treatment of tauopathies with immunotherapies and gene expression show promise, but for the moment we emphasise the importance of making a diagnosis that can explain a puzzling array of problems for a patient and their family. […] Although parkinsonism in corticobasal syndrome does not generally respond well to levodopa, most patients will try it as part of their initial assessments (often when the diagnosis is less clear), and it is reasonable to push the dose up towards at least 1000mg/day before classifying a patient as a non-responder.

• #2 SciELO Brazil – Pharmacological interventions in corticobasal degeneration: a review Pharmacological interventions in corticobasal degeneration: a review

  https://www.scielo.br/j/dn/a/H9QPjg9FZdks9zWLsphZdHj/

  A study using levodopa reported some improvement in 24% of patients. […] Other dopaminergic drugs, such as dopamine agonists and selegiline, tend to produce less clinical improvement and more side effects than levodopa. […] Ninety-two percent of patients received dopaminergic drugs, which resulted in a beneficial effect for only 24%. […] Baclofen, isolated or combined with an anticholinergic, reduced rigidity, but produced side effects. […] Clonazepam was beneficial for myoclonus and tremor. […] The suggested use of serotonin reuptake inhibitors for depression treatment in CBD is based only on the clinical experiences of a few authors. […] AChEIs have been used for CBD, based on the anecdotal experience, but their therapeutic potential for this condition remains unknown. […] The authors concluded that CBD patients could benefit from this multidisciplinary therapeutic approach using low-frequency rTMS.

• #2 Corticobasal syndrome: a practical guide | Practical Neurology

  https://pn.bmj.com/content/21/4/276

  Options for treating troublesome myoclonus include levetiracetam and clonazepam. […] Specific options to consider for the alien limb syndrome are summarised above. Management to mitigate the effects of apraxia is best coordinated by an occupational therapist with knowledge of the condition. […] Speech therapists can teach patients techniques to overcome some of their language deficits and it is worth seeking their input when speech difficulties are a prominent feature. […] We often refer patients for physiotherapy aimed at strength and balance training as well as gait assessment. […] Although there are no proven treatments for cognitive deficits such as memory and attentional impairment in corticobasal syndrome, many clinicians consider trialling cholinesterase inhibitors if there is a strong suggestion from the history (memory impairment), examination (predominate cortical signs) and cognitive assessment (visuospatial or memory deficits) to suggest an underlying Alzheimers disease pathology.

• #2 Corticobasal degeneration | MedLink Neurology

  https://www.medlink.com/articles/corticobasal-degeneration

  In a retrospective study on pathologically proven cases of corticobasal degeneration, levodopa had resulted in mild-to-moderate improvement. […] For myoclonus, levetiracetam and clonazepam have been reported to be beneficial. […] For the symptomatic treatment of dystonia, botulinum toxin may be helpful. […] Several therapeutic approaches targeting the potential underlying biological processes are in clinical trials to reduce the progression of the pathology.

• #2 Corticobasal Degeneration

  https://www.brainfacts.org/diseases-and-disorders/neurological-disorders-az/diseases-a-to-z-from-ninds/corticobasal-degeneration

  There is no treatment available to slow the course of corticobasal degeneration, and the symptoms of the disease are generally resistant to therapy. […] Drugs used to treat Parkinson disease-type symptoms do not produce any significant or sustained improvement. […] Clonazepam may help the myoclonus. […] Occupational, physical, and speech therapy can help in managing disability.

• #2 Corticobasal Syndrome and Corticobasal Degeneration Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/1150039-treatment

  Consider treating bothersome myoclonus with levetiracetam and/or clonazepam. […] Refer early and continuously to occupational therapy (for upper extremity functional evaluation and management), physical therapy (gait and safety evaluation and training), and speech-language pathology (speech evaluation/cognitive training, swallow evaluation using modified barium with video), consider assistive devices for ambulation, ADLs and communication, and an exercise program to maintain endurance and strength. […] Deep brain stimulation surgery is not recommended for corticobasal syndrome (CBS) or other phenotypes associated with corticobasal degeneration (CBD) pathology.

• #2 Corticobasal Degeneration | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/157387

  If focal, botulinum toxin is the best treatment for dystonia. […] Pharmacologic management of cognitive impairment with cholinesterase inhibitors should be reserved for amnestic deficits. […] Targeted tau therapy has become more pertinent than ever to develop disease-specific biomarkers to help predict the pathology in the antemortem diagnosis of neurodegenerative diseases with increased sensitivity and specificity and monitor the quantitative effect of the treatment over time. […] Clinical trials in developing a disease-modifying therapy for 4R-tauopathies either focus on reducing the toxic gain of function caused by pathologic tau aggregates or restoring a loss of normal tau function.

• #2 Corticobasal Syndrome | Memory and Aging Center

  https://memory.ucsf.edu/dementia/corticobasal-syndrome

  Are There Medicines to Treat CBS? […] Though there is no cure for CBS yet, there are medications that help manage the symptoms. These medications are called cholinesterase inhibitors, and they can help if a person with CBS is having memory problems, especially with CBS symptoms that look like Alzheimers disease. Some examples of these medicines are donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne). If a person with CBS has movement symptoms they may be treated with medications used for Parkinsons disease, such as levodopa or carbidopa, although the effect of these medications is questionable. […] What Other Things Help? […] There are various ways to help a person with CBS. Speech therapy may help improve communication between people with CBS and others. Physical therapy and stretching exercises may improve some movement difficulties.

• #2 Corticobasal syndrome: a practical guide | Practical Neurology

  https://pn.bmj.com/content/21/4/276

  There are several available pharmacological options for neuropsychiatric manifestations. […] Many mild behavioural issues may be better managed non-pharmacologically (caregiver education, environment changes, etc) but undoubtedly medications can help with more severe disruptions. […] Other practical issues to address include driving safety and checking whether driving licensing agencies need to be informed, the importance of updating a persons will, and establishing an enduring power of attorney early in the disease course, as these can be problematic later if significant cognitive impairment develops. […] Lastly, putting patients in touch with local charities can greatly help patients and families.

• #2

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7500816/

  A study using levodopa reported some improvement in 24% of patients. […] Other dopaminergic drugs, such as dopamine agonists and selegiline, tend to produce less clinical improvement and more side effects than levodopa. […] The suggested use of serotonin reuptake inhibitors for depression treatment in CBD is based only on the clinical experiences of a few authors, as is also the case with symptoms of obsessiveness and anxiety. […] AChEIs have been used for CBD, based on the anecdotal experience, but their therapeutic potential for this condition remains unknown. […] Despite the lack of formal clinical trials aimed at psychiatric symptoms, such as depression and anxiety, in patients with CBD, treating associated behavioral manifestations is essential for alleviating symptoms that have effective pharmacological interventions and thus improve the quality of life of patients.

• #2 Diagnosis and treatment of corticobasal degeneration – PubMed

  https://pubmed.ncbi.nlm.nih.gov/24469408/

  Corticobasal degeneration is a pathologic entity. […] Treatment of CBD is symptomatic, particularly given recently negative neuroprotective studies. […] In patients with CBS and PSPS, parkinsonism is treated with levodopa/carbidopa. This generally has modest and transient benefits at best and often results in no improvement. […] Botulinum toxin injections are the treatment of choice for limb dystonia. […] Clonazepam and levetiracetam are commonly used for myoclonus. […] Physical therapy is an important part of motor treatment, particularly for fall prevention strategies and assist device assessment. […] Whether medications such as cholinesterase inhibitors or memantine have any role in CBD is unclear given the various responses described in related phenotypes and diseases. […] Treating the behavioral symptoms associated with CBD is critical in an attempt to treat symptoms for which we have good pharmacologic interventions and to hopefully improve quality of life.

• #2 Corticobasal Syndrome | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/corticobasal-syndrome

  For most, the progression of CBS is relatively slow, over years, but more rapid compared to typical Parkinson Disease and more rapid than all would like. […] Although there is no one pill or cure for CBS, we can and do try to treat the symptoms one faces, whether this be trouble with slowness or stiffness in movement, or other troubles such as falls or pain in the affected limb. […] In most, a trial of carbidopa-levodopa (Sinemet) is warranted to treat symptoms of slowness and stiffness but in contrast to Parkinson Disease, the effect of Sinemet in CBS for these symptoms may be minimal. […] Many patients living with CBS will need frequent evaluations and support services from physical, occupational, and speech-swallow therapists, whether at an outpatient rehab center or in the home. […] In general, physical therapy is crucial to help with gait, balance, fall prevention, and mobility while occupational therapy helps with activities of daily living like getting dressed, going to the bathroom, and eating. […] As speech and swallowing are often affected in CBS, speech-swallow therapy is frequently prescribed and can be very helpful to improve speech and prevent aspirating foods-liquids. […] Staying active is critical and any exercise you like to do and tolerate is highly recommended.

• #2 Corticobasal Syndrome | Baylor Medicine

  https://www.bcm.edu/healthcare/specialties/neurology/parkinsons-disease-and-movement-disorders/corticobasal-syndrome

  In contrast to other parkinsonian syndromes, levodopa almost never provides any meaningful improvement in the symptoms. Dystonia, painful muscle spasms and rigidity be reduced with muscle relaxants, such as clonazepam, and with botulinum toxin injections into affected parts of the body. Medications for memory loss, depression and anxiety may be useful in patients with these problems. […] Other treatments for CBS include physical therapy and stretching exercises designed to maintain range of motion, relieve rigidity and to prevent contractures and deformities as well as to maintain good strength and condition of muscles. Devices which make walking safer, such as a cane or walker, can be helpful. Speech, physical, and occupational therapy may be beneficial. Because of swallowing problems, some patients require placement of a feeding tube (PEG) directly into the stomach to maintain adequate nutrition and prevent aspiration pneumonia. If general health and nutrition can be maintained, some corticobasal syndrome patients live for several years after the onset of symptoms, although their quality of life in the advanced stages of the disease is usually significantly impaired.

• #2 Corticobasal Degeneration (Corticobasal Syndrome): What It Is

  https://my.clevelandclinic.org/health/diseases/22522-corticobasal-degeneration

  Corticobasal degeneration (corticobasal syndrome) is a rare brain condition that causes you to lose your ability to speak, move and remember. Symptoms are progressive, so they slowly get worse over time. While there aren’t any treatments to slow or stop changes to your brain, therapies are available to help manage the condition. […] Your healthcare provider may recommend different medications for different corticobasal degeneration symptoms. […] There isn’t an available treatment option to slow the progression of symptoms or cure the condition. […] The following therapies may help you manage symptoms of corticobasal syndrome: Occupational therapy can help you learn new ways to complete daily tasks and maintain independence. You may learn how to use assistive mobility devices if necessary. Physical therapy can help you maintain mobility and ease muscle symptoms. Speech therapy can help with communication and swallowing. […] Your provider will offer treatment options to help you cope and manage symptoms. Treatment options may reduce the severity of symptoms, but it won’t stop them from progressing.

• #2

  https://www.psp.org/iwanttolearn/corticobasal-degeneration

  A speech-language pathologist (SLP) works with people who are having issues with speech, swallowing and language. Their goals are to improve and prolong communication skills, assess and help adapt to swallowing changes. […] A feeding tube can be a safe and helpful option for people with CBD who are experiencing difficulties with swallowing. A feeding tube can be considered when someone is no longer able to take in necessary amounts of nutrition and calories by eating or drinking. […] Possible medications for depression and anxiety for people with CBD include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). […] Non-drug methods for improving mood include mental health therapy, cognitive behavioral therapy (CBT), exercise, a balanced diet, socialization, good sleeping habits, music, and meditation.

• #2 Therapy Approaches for Corticobasal Degeneration – Ask the Experts 829

  https://www.speechpathology.com/ask-the-experts/therapy-approaches-for-corticobasal-degeneration-829

  Corticobasal degeneration (also known as corticobasal ganglionic degeneration) is one of the parkinsonism-plus syndromes (PPS) which also include progressive supranuclear palsy (PSP), Shy-Drager syndrome, multiple system atrophy (MSA) and olivopontocerebellar degeneration. […] With regard to treatment, there is very little research investigating the effectiveness of behavioral therapy with patients with this specific diagnosis. […] For example, speaking rate control techniques or other prosodic therapies for patients with predominately ataxic symptoms. […] Countryman, et al (1994) did provide some evidence that Lee Silverman Voice Therapy LSVT is effective in improving voice and intelligibility in patients with parkinsonism-plus syndromes, but caution that it should only be used in patients who have voice symptoms typical of PD.

• #2

  https://zana.com/a/corticobasal-degeneration-treatment-corticobasal-degeneration.970

  There’s currently no cure for corticobasal degeneration (CBD) and no treatment to slow it down, but there are lots of things that can be done to help manage the symptoms. […] A care plan will be drawn up in discussion with your team. This will outline the treatments you need to help with the symptoms of CBD, as well as the support and advice you require to make your life easier. […] There are currently no medications that treat CBD specifically. Depending on the person’s symptoms or complications, the following may be used: […] Cognitive stimulation is a type of therapy used to treat dementia, and it may be helpful if a person with CBD has dementia symptoms. […] A speech and language therapist can help assess and treat speech and swallowing problems. […] You may be referred to a dietitian, who will advise you about making changes to your diet, such as including food and liquids that are easier to swallow, while ensuring that you have a healthy, balanced diet.

• #2

  https://www.aurorahealthcare.org/services/neuroscience/neurology/neurological-conditions/corticobasal-degeneration

  Right now, there aren’t any treatments that can stop it, but therapies such as speech therapy, physical therapy and occupational therapy can help you manage the symptoms better. […] There is no cure for corticobasal degeneration or treatment to slow its progression. The focus of treatment is managing the difficulties with speech and motor skills thats caused by corticobasal degeneration. […] Physical therapy, occupational therapy and speech therapy are often utilized to help improve daily life and help maintain independence. These therapies help with mobility, muscle weakness, communication and swallowing. […] Palliative care may be utilized to help manage symptoms and provide relief. Palliative care can be administered in hospitals, clinics, nursing facilities or at home after diagnosis and at the same time as treatment.

• #2 Diagnosis and treatment of corticobasal degeneration – PubMed

  https://pubmed.ncbi.nlm.nih.gov/24469408/

  General supportive care is important, including assessing for sores related to dystonia or immobility, monitoring dysphagia, and identifying needs for support services. […] Finally, as with other relentlessly progressive neurodegenerative diseases, it is critical to provide family and caregiver support and to assess for when palliative care services will serve the patient best.

• #2 Corticobasal Degeneration – EyeWiki

  https://eyewiki.org/Corticobasal_Degeneration

  In addition to symptomatic management, supportive treatment should be initiated at the time of diagnosis. […] Physical and occupational therapy may help patients retain some mobility; speech therapy aids with potential swallowing difficulty to prevent possible aspiration; dietary guidance can help maintain sufficient nutrition. […] Clinical trials of potential tau-lowering therapies are being conducted, and it is expected that these treatments can apply to CBD to at least slow the progression of the disease. […] However, more research must be done in diagnosis and treatment for this to have appropriate benefit.

• #2 Studies: Corticobasal Degeneration

  https://neurosciences.ucsd.edu/centers-programs/movement-disorders/research/corticobasal-degeneration.html

  This is a 5-year longitudinal investigating the best method of analysis to track patients with corticobasal syndrome, corticobasal degeneration, progressive supranuclear palsy, behavioral variant of frontotemporal degeneration, primary progressive aphasia, and other forms of frontotemporal lobar degeneration with the overall goal to prepare for treatment trials. The study will track familial FTD, sporadic FTD as well as asymptomatic participants with a strong history of familial FTD. The results will provide information about the value of novel imaging techniques for diagnosis and value of novel imaging techniques in comparison to biofluid biomarkers. […] This study is investigating the best method of analysis to track patients with corticobasal syndrome, corticobasal degeneration, progressive supranuclear palsy, and oligo- or variant-progressive supranuclear palsy. The results will provide information about the value of novel imaging techniques for diagnosis and value of novel imaging techniques in comparison to biofluid biomarkers. […] The study will collect detailed clinical information, biofluids, and imaging data from individuals with corticobasal degeneration and progressive supranuclear palsy.

• #2 Corticobasal Syndrome and Corticobasal Degeneration: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1150039-overview

  There is no disease-modifying therapy for CBD to date, but a number of symptomatic treatments can be useful, particularly botulinum toxin injections for dystonia and several other indications. Lifelong rehabilitation of these patients with physical, occupational, speech, and swallow therapy focused on maximizing daily function is crucial to limit deconditioning and potentially slow decline. […] Treatment includes approach considerations, medical care, consultations, diet, activity, surgical care, complications, prevention, and long-term monitoring. […] Medication options include benzodiazepines, neuromuscular blocking agents, cholinesterase inhibitors, antidepressants, NMDA antagonists, antiparkinson agents, dopamine agonists, decarboxylase inhibitors, and anticonvulsants.

• #3 Corticobasal Degeneration (Corticobasal Syndrome): What It Is

  https://my.clevelandclinic.org/health/diseases/22522-corticobasal-degeneration

  Corticobasal degeneration (corticobasal syndrome) is a rare brain condition that causes you to lose your ability to speak, move and remember. Symptoms are progressive, so they slowly get worse over time. While there aren’t any treatments to slow or stop changes to your brain, therapies are available to help manage the condition. […] Your healthcare provider may recommend different medications for different corticobasal degeneration symptoms. […] There isn’t an available treatment option to slow the progression of symptoms or cure the condition. […] The following therapies may help you manage symptoms of corticobasal syndrome: Occupational therapy can help you learn new ways to complete daily tasks and maintain independence. You may learn how to use assistive mobility devices if necessary. Physical therapy can help you maintain mobility and ease muscle symptoms. Speech therapy can help with communication and swallowing. […] Your provider will offer treatment options to help you cope and manage symptoms. Treatment options may reduce the severity of symptoms, but it won’t stop them from progressing.

• #3 Mayo Clinic Health Library – Corticobasal degeneration (corticobasal syndrome) | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20209448

  There are no treatments that help slow the progression of corticobasal degeneration (corticobasal syndrome). But if your symptoms are due to Alzheimer’s disease, new medicines may be available. Your healthcare professional may recommend medicines to try to manage your symptoms. […] Occupational and physical therapy may help you manage the disabilities caused by corticobasal degeneration. Walking devices may help with mobility and prevent falls. Speech therapy can help with communication and swallowing. A dietitian may help you ensure you get proper nutrition and lower the risk of inhaling food into the lungs, known as aspiration.

• #3 Corticobasal Syndrome and Corticobasal Degeneration: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1150039-overview

  There is no disease-modifying therapy for CBD to date, but a number of symptomatic treatments can be useful, particularly botulinum toxin injections for dystonia and several other indications. Lifelong rehabilitation of these patients with physical, occupational, speech, and swallow therapy focused on maximizing daily function is crucial to limit deconditioning and potentially slow decline. […] Treatment includes approach considerations, medical care, consultations, diet, activity, surgical care, complications, prevention, and long-term monitoring. […] Medication options include benzodiazepines, neuromuscular blocking agents, cholinesterase inhibitors, antidepressants, NMDA antagonists, antiparkinson agents, dopamine agonists, decarboxylase inhibitors, and anticonvulsants.

• #3 Corticobasal Degeneration – EyeWiki

  https://eyewiki.org/Corticobasal_Degeneration

  Corticobasal degeneration (CBD) is a rare, progressive neurodegenerative disease characterized by nerve cell loss and atrophy of multiple areas of the brain. […] There are currently no effective disease-altering treatments for CBD. […] Thus, the management of CBD focuses on symptomatic management and supportive treatment. […] For symptomatic management, these symptoms can be the target of possible pharmacologic management: Parkinsonism – Levodopa has been observed to offer limited improvement for some patients. […] Myoclonus – Valproic acid, clonazepam, piracetam, leveiritcam, and gabapentin have shown to provide effective improvement of myoclonus. […] Limb dystonia – Chemodenervation with botulinum toxin may improve pain and abnormal posture. […] Eyelid opening apraxia and dry eyes – botulinum toxin injections into pretarsal orbicularis occuli have been shown to alleviate apraxia of the eyelid. Artificial tears, acetylcysteine, carbomers, and 0.9% sodium chloride ophthalmic drops are effective for dry eyes due to eyelid dysmotility.

• #3 Diagnosis and treatment of corticobasal degeneration – PubMed

  https://pubmed.ncbi.nlm.nih.gov/24469408/

  Corticobasal degeneration is a pathologic entity. […] Treatment of CBD is symptomatic, particularly given recently negative neuroprotective studies. […] In patients with CBS and PSPS, parkinsonism is treated with levodopa/carbidopa. This generally has modest and transient benefits at best and often results in no improvement. […] Botulinum toxin injections are the treatment of choice for limb dystonia. […] Clonazepam and levetiracetam are commonly used for myoclonus. […] Physical therapy is an important part of motor treatment, particularly for fall prevention strategies and assist device assessment. […] Whether medications such as cholinesterase inhibitors or memantine have any role in CBD is unclear given the various responses described in related phenotypes and diseases. […] Treating the behavioral symptoms associated with CBD is critical in an attempt to treat symptoms for which we have good pharmacologic interventions and to hopefully improve quality of life.

• #3 Corticobasal Syndrome | Baylor Medicine

  https://www.bcm.edu/healthcare/specialties/neurology/parkinsons-disease-and-movement-disorders/corticobasal-syndrome

  In contrast to other parkinsonian syndromes, levodopa almost never provides any meaningful improvement in the symptoms. Dystonia, painful muscle spasms and rigidity be reduced with muscle relaxants, such as clonazepam, and with botulinum toxin injections into affected parts of the body. Medications for memory loss, depression and anxiety may be useful in patients with these problems. […] Other treatments for CBS include physical therapy and stretching exercises designed to maintain range of motion, relieve rigidity and to prevent contractures and deformities as well as to maintain good strength and condition of muscles. Devices which make walking safer, such as a cane or walker, can be helpful. Speech, physical, and occupational therapy may be beneficial. Because of swallowing problems, some patients require placement of a feeding tube (PEG) directly into the stomach to maintain adequate nutrition and prevent aspiration pneumonia. If general health and nutrition can be maintained, some corticobasal syndrome patients live for several years after the onset of symptoms, although their quality of life in the advanced stages of the disease is usually significantly impaired.

• #3 Understanding Corticobasal Degeneration (CBD) | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/understanding-corticobasal-degeneration-cbd

  There is no treatment to slow down the loss of brain cells. But types of treatment may help with some symptoms. These include: […] Occupational therapy (OT). This can help you keep up with daily activities such as bathing, grooming, eating, and other self-care. […] Physical therapy (PT). This can help improve mobility and range of motion. It may help prevent pain and help muscle tone. […] Speech therapy. This can help you speak more clearly. […] Medicines. Some medicines may help treat stiff muscles, pain, behavioral symptoms, and movement. […] Adaptive medical tools. Tools such as a walker can help with balance and movement. Reachers, grabbers, and other tools can help with daily actions. […] There is ongoing research about this disease. Talk with your healthcare team if you want to be part of a clinical trial for a new treatment.

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