Corticobasal Degeneration: Difference between revisions
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== Introduction == | == Introduction == | ||
Corticobasal degeneration (CBD), sometimes called corticobasal ganglionic degeneration (CBDG) is a form of [[Parkinsonism]], more specifically a Parkinson-Plus Syndrome. Parkinson-Plus Syndromes are a group of neurodegenerative disorders that present with symptoms typical of [[Parkinson's Disease|Parkinson's Disease (PD)]] (bradykinesia, apraxia, resting tremor, rigidity, etc.), | Corticobasal degeneration (CBD), sometimes called corticobasal ganglionic degeneration (CBDG) is a form of [[Parkinsonism]], more specifically a Parkinson-Plus Syndrome. Parkinson-Plus Syndromes are a group of neurodegenerative disorders that present with symptoms typical of [[Parkinson's Disease|Parkinson's Disease (PD)]] (bradykinesia, apraxia, resting tremor, rigidity, etc.); however, they do not typically respond well to PD pharmacological management and have additional symptoms such as cognitive deficits, dementia, cranial nerve involvement.<ref>Mark MH. [https://pubmed.ncbi.nlm.nih.gov/11532646/ Lumping and splitting the Parkinson Plus syndromes: dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, and cortical-basal ganglionic degeneration.] Neurol Clin. 2001;19(3):607-27</ref> <ref>Miyasaki JM. [https://pubmed.ncbi.nlm.nih.gov/27495200/ Treatment of Advanced Parkinson Disease and Related Disorders.] Continuum (Minneap Minn). 2016;22(4):1104-16</ref> | ||
== Clinically Relevant Anatomy == | == Clinically Relevant Anatomy and Pathophysiology == | ||
Corticobasal degeneration is a type of [[tauopathy]] affecting regions throughout the [[Cerebral Cortex|cerebral cortex]] (with greater impacts to the frontoparietal cortex) and [[Basal Ganglia|basal ganglia]] (specifically the striatum and [[Substantia Nigra|substantia nigra]]). <br> | |||
== Pathophysiology == | == Pathophysiology == | ||
add text here relating to the mechanism of injury and/or pathology of the condition<br> | add text here relating to the mechanism of injury and/or pathology of the condition<br> | ||
== Epidemiology == | |||
Due to the difficulty of antemortem diagnosis, the proposed numbers are likely to be underestimates. | |||
* Annual incidence rate: 0.62 to 0.92 cases per 100,000 people | |||
* Prevalence: 5 to 7 per 100,000 | |||
== Clinical Presentation == | == Clinical Presentation == | ||
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== Diagnostic Procedures == | == Diagnostic Procedures == | ||
Part of the difficulty in managing CBD is that it is referred to in a group of disorders referred to as "corticobasal syndrome," of which many of its differential diagnoses are also a part of.<br> | |||
== Outcome Measures == | == Outcome Measures == | ||
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add links to outcome measures here (see [[Outcome Measures|Outcome Measures Database]]) | add links to outcome measures here (see [[Outcome Measures|Outcome Measures Database]]) | ||
== Management | == Medical Management == | ||
Presently, there is no cure for CBD; all medical interventions at this time are directed at symptom management, rather than disease management. | |||
'''Pharmacological management:''' due to the resemblance to [[Parkinson's|Parkinson's Disease]], dopaminergic agonists such as levodopa or rotigotine are used to treat the motor effects of atypical parkinsonism. Although transdermal rotigotine may be effective in reducing these symptoms, it does not specify subtype efficacy; additionally, only 24% of patients with CBD demonstrated improvements with levodopa intervention. Dopaminergic interventions are also used sparingly due to the high likelihood of inducing adverse psychotic events. Benzodiazepams such as clonazepam, appear to be effective in combatting symptoms of [[myoclonus]] and [[dystonia]]. Ultimately, most effects of these drugs are considered unsatisfactory for the population as a whole. <ref>Caixeta L,Caizeta VM, Nogueira YL, Aversi-Ferreira TA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500816/ Pharmacological interventions in corticobasal degeneration: a review.] Dement Neuropsychol. 2020;14(3):243-247</ref> | |||
== Physical Therapy Management == | |||
== Differential Diagnosis<br> == | == Differential Diagnosis<br> == | ||
The differential diagnosis list of CBD includes: | |||
* [[Progressive Supranuclear Palsy]] | |||
* [[Multiple System Atrophy]] | |||
* [[Parkinson's|Parkinson's Disease]] | |||
* [[Pick's Disease]] | |||
== Resources <br> == | == Resources <br> == | ||
Revision as of 05:45, 24 January 2024
Introduction[edit | edit source]
Corticobasal degeneration (CBD), sometimes called corticobasal ganglionic degeneration (CBDG) is a form of Parkinsonism, more specifically a Parkinson-Plus Syndrome. Parkinson-Plus Syndromes are a group of neurodegenerative disorders that present with symptoms typical of Parkinson's Disease (PD) (bradykinesia, apraxia, resting tremor, rigidity, etc.); however, they do not typically respond well to PD pharmacological management and have additional symptoms such as cognitive deficits, dementia, cranial nerve involvement.[1] [2]
Clinically Relevant Anatomy and Pathophysiology[edit | edit source]
Corticobasal degeneration is a type of tauopathy affecting regions throughout the cerebral cortex (with greater impacts to the frontoparietal cortex) and basal ganglia (specifically the striatum and substantia nigra).
Pathophysiology[edit | edit source]
add text here relating to the mechanism of injury and/or pathology of the condition
Epidemiology[edit | edit source]
Due to the difficulty of antemortem diagnosis, the proposed numbers are likely to be underestimates.
- Annual incidence rate: 0.62 to 0.92 cases per 100,000 people
- Prevalence: 5 to 7 per 100,000
Clinical Presentation[edit | edit source]
add text here relating to the clinical presentation of the condition
Diagnostic Procedures[edit | edit source]
Part of the difficulty in managing CBD is that it is referred to in a group of disorders referred to as "corticobasal syndrome," of which many of its differential diagnoses are also a part of.
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Medical Management[edit | edit source]
Presently, there is no cure for CBD; all medical interventions at this time are directed at symptom management, rather than disease management.
Pharmacological management: due to the resemblance to Parkinson's Disease, dopaminergic agonists such as levodopa or rotigotine are used to treat the motor effects of atypical parkinsonism. Although transdermal rotigotine may be effective in reducing these symptoms, it does not specify subtype efficacy; additionally, only 24% of patients with CBD demonstrated improvements with levodopa intervention. Dopaminergic interventions are also used sparingly due to the high likelihood of inducing adverse psychotic events. Benzodiazepams such as clonazepam, appear to be effective in combatting symptoms of myoclonus and dystonia. Ultimately, most effects of these drugs are considered unsatisfactory for the population as a whole. [3]
Physical Therapy Management[edit | edit source]
Differential Diagnosis
[edit | edit source]
The differential diagnosis list of CBD includes:
Resources
[edit | edit source]
add appropriate resources here
References[edit | edit source]
- ↑ Mark MH. Lumping and splitting the Parkinson Plus syndromes: dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, and cortical-basal ganglionic degeneration. Neurol Clin. 2001;19(3):607-27
- ↑ Miyasaki JM. Treatment of Advanced Parkinson Disease and Related Disorders. Continuum (Minneap Minn). 2016;22(4):1104-16
- ↑ Caixeta L,Caizeta VM, Nogueira YL, Aversi-Ferreira TA. Pharmacological interventions in corticobasal degeneration: a review. Dement Neuropsychol. 2020;14(3):243-247
