Pharmacological interventions in corticobasal degeneration: a review

Caixeta, Leonardo; Caixeta, Victor de Melo; Nogueira, Yanley Lucio; Aversi-Ferreira, Tales Alexandre

doi:10.1590/1980-57642020dn14-030006

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Brasil

Dementia & Neuropsychologia

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Brasil

Español English

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Sumário

Views & Reviews • Dement. neuropsychol. 14 (03) • Jul-Sep 2020 • https://doi.org/10.1590/1980-57642020dn14-030006 copy

Pharmacological interventions in corticobasal degeneration: a review

Intervenções farmacológicas na degeneração corticobasal: uma revisão

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT.

Corticobasal degeneration (CBD) is a sporadic tauopathy that presents with a varied combination of motor, cognitive, and behavioral features, making its diagnosis difficult. CBD has high morbidity and poor prognosis, with no effective therapy at present. We searched the PubMed/MEDLINE database for articles published from 1990 to 2019, using the keywords “corticobasal degeneration” AND “treatment.” The PRISMA method was adopted. Retrieved articles were characterized as having one of two methodological approaches: (1) studies aimed at primary tauopathy treatment and (2) symptomatic management. Review articles (based on CBD expert groups), case reports, case series, and pilot clinical trials were selected. Few attempts have been made to study drug options and drug efficacy in CBD systematically, and an effective treatment is not yet available. Treatment is symptomatic and based on similarity with other diseases due to the scarcity of studies specifically addressing CBD. CBD seems not to spark interest in more clinical trials for its low prevalence and reliability in clinical diagnosis.

Keywords:
corticobasal degeneration; corticobasal syndrome; dopaminergic therapy

Drug	Actions	Side effects
Lithium	Mood stabilizer. Reduced gambling thoughts and behaviors in bipolar disorders¹⁹19. Antonini A, Cilia R. Behavioral adverse effects of dopaminergic treatments in Parkinson’s disease: incidence, neurobiological basis, management and prevention. Drug Saf. 2009;32(6):475-88. https://doi.org/10.2165/00002018-200932060-00004 https://doi.org/https://doi.org/10.2165/...	Confusion, somnolence
Serotonin reuptake inhibitors	Decreased pursuit of rewards, hypersexuality, and aggression,²⁰20. Karakaya T, Fußer F, Prvulovic D, Hampel H. Treatment options for tauopathies. Curr Treat Options Neurol. 2012;14(2):126-36. https://doi.org/10.1007/s11940-012-0168-7 https://doi.org/https://doi.org/10.1007/... improved social and occupational functioning¹⁹19. Antonini A, Cilia R. Behavioral adverse effects of dopaminergic treatments in Parkinson’s disease: incidence, neurobiological basis, management and prevention. Drug Saf. 2009;32(6):475-88. https://doi.org/10.2165/00002018-200932060-00004 https://doi.org/https://doi.org/10.2165/...	Dry mouth, diarrhea, nausea, loss of appetite, headache, somnolence, insomnia, tremor, agitation, sexual dysfunction, asthenia, dizziness, anxiety, nervousness²2. Armstrong MJ. Diagnosis and treatment of corticobasal degeneration. Curr Treat Options Neurol. 2014;16(3):282. https://doi.org/10.1007/s11940-013-0282-1 https://doi.org/https://doi.org/10.1007/... ^,²⁰20. Karakaya T, Fußer F, Prvulovic D, Hampel H. Treatment options for tauopathies. Curr Treat Options Neurol. 2012;14(2):126-36. https://doi.org/10.1007/s11940-012-0168-7 https://doi.org/https://doi.org/10.1007/...
Levodopa	Dopamine agonist¹⁹19. Antonini A, Cilia R. Behavioral adverse effects of dopaminergic treatments in Parkinson’s disease: incidence, neurobiological basis, management and prevention. Drug Saf. 2009;32(6):475-88. https://doi.org/10.2165/00002018-200932060-00004 https://doi.org/https://doi.org/10.2165/...	Dyskinesia, cardiac irregularities, orthostatic hypotensive episodes, psychotic episodes, nausea, depression, urinary retention²⁰20. Karakaya T, Fußer F, Prvulovic D, Hampel H. Treatment options for tauopathies. Curr Treat Options Neurol. 2012;14(2):126-36. https://doi.org/10.1007/s11940-012-0168-7 https://doi.org/https://doi.org/10.1007/...
Rotigotine	Non-ergot dopamine agonist⁸8. Moretti DV, Binetti G, Zanetti O, Frisoni GB. Rotigotine is safe and efficacious in Atypical Parkinsonism Syndromes induced by both α-synucleinopathy and tauopathy. Neuropsychiatr Dis Treat. 2014;10:1003-9. https://doi.org/10.2147/NDT.S64015 https://doi.org/https://doi.org/10.2147/...	Hypotension, nausea, vomiting, somnolence, tachycardia, and dystonia⁸8. Moretti DV, Binetti G, Zanetti O, Frisoni GB. Rotigotine is safe and efficacious in Atypical Parkinsonism Syndromes induced by both α-synucleinopathy and tauopathy. Neuropsychiatr Dis Treat. 2014;10:1003-9. https://doi.org/10.2147/NDT.S64015 https://doi.org/https://doi.org/10.2147/...
AChEIs	Acetylcholinesterase inhibitors¹²12. Boeve BF, Josephs KA, Drubach DA. Current and future management of the corticobasal syndrome and corticobasal degeneration. Handb Clin Neurol. 2008;89:533-48. https://doi.org/10.1016/s0072-9752(07)01249-3 https://doi.org/https://doi.org/10.1016/... ^,¹³13. Liepelt I, Maetzler W, Blaicher HP, Gasser T, Berg D. Treatment of dementia in parkinsonian syndromes with cholinesterase inhibitors. Dement Geriatr Cogn Disord. 2007;23(6):351-67. https://doi.org/10.1159/000101337 https://doi.org/https://doi.org/10.1159/...	Nausea, vomiting, diarrhea, anorexia, insomnia, fatigue, loss of appetite, weight loss, abdominal pain²2. Armstrong MJ. Diagnosis and treatment of corticobasal degeneration. Curr Treat Options Neurol. 2014;16(3):282. https://doi.org/10.1007/s11940-013-0282-1 https://doi.org/https://doi.org/10.1007/... ^,²⁰20. Karakaya T, Fußer F, Prvulovic D, Hampel H. Treatment options for tauopathies. Curr Treat Options Neurol. 2012;14(2):126-36. https://doi.org/10.1007/s11940-012-0168-7 https://doi.org/https://doi.org/10.1007/...
Clonazepam	Hypnotic and anxiolytic	Drowsiness,²2. Armstrong MJ. Diagnosis and treatment of corticobasal degeneration. Curr Treat Options Neurol. 2014;16(3):282. https://doi.org/10.1007/s11940-013-0282-1 https://doi.org/https://doi.org/10.1007/... ^,⁴4. Marsili L, Suppa A, Berardelli A, Colosimo C. Therapeutic interventions in parkinsonism: corticobasal degeneration. Parkinsonism Relat Disord. 2016;22(Suppl 1):S96-100. https://doi.org/10.1016/j.parkreldis.2015.09.023 https://doi.org/https://doi.org/10.1016/... ^,²¹21. Reich S, Stephen G. Corticobasal degeneration. Curr Treat Options Neurol. 2009;11(3):179-85. https://doi.org/10.1007/s11940-009-0021-9 https://doi.org/https://doi.org/10.1007/... behavioral changes, imbalance, incoordination, dizziness,²2. Armstrong MJ. Diagnosis and treatment of corticobasal degeneration. Curr Treat Options Neurol. 2014;16(3):282. https://doi.org/10.1007/s11940-013-0282-1 https://doi.org/https://doi.org/10.1007/... ^,²¹21. Reich S, Stephen G. Corticobasal degeneration. Curr Treat Options Neurol. 2009;11(3):179-85. https://doi.org/10.1007/s11940-009-0021-9 https://doi.org/https://doi.org/10.1007/... tiredness, confusion, memory loss,⁴4. Marsili L, Suppa A, Berardelli A, Colosimo C. Therapeutic interventions in parkinsonism: corticobasal degeneration. Parkinsonism Relat Disord. 2016;22(Suppl 1):S96-100. https://doi.org/10.1016/j.parkreldis.2015.09.023 https://doi.org/https://doi.org/10.1016/... somnolence, gastrointestinal complaints⁵5. Kompoliti K, Goetz CG, Boeve BF, Maraganore DM, Ahlskog JE, Marsden CD, et al. Clinical presentation and pharmacological therapy in corticobasal degeneration. Arch Neurol. 1998;55(7):957-61. https://doi.org/10.1001/archneur.55.7.957 https://doi.org/https://doi.org/10.1001/... , slurred speech, cognitive impairment, depression²¹21. Reich S, Stephen G. Corticobasal degeneration. Curr Treat Options Neurol. 2009;11(3):179-85. https://doi.org/10.1007/s11940-009-0021-9 https://doi.org/https://doi.org/10.1007/...
Levetiracetam	Decreased amplitude of cortical somatosensory evoked potentials⁸8. Moretti DV, Binetti G, Zanetti O, Frisoni GB. Rotigotine is safe and efficacious in Atypical Parkinsonism Syndromes induced by both α-synucleinopathy and tauopathy. Neuropsychiatr Dis Treat. 2014;10:1003-9. https://doi.org/10.2147/NDT.S64015 https://doi.org/https://doi.org/10.2147/...	Behavioral changes, irritability, fatigue, loss of appetite, dizziness, headache²2. Armstrong MJ. Diagnosis and treatment of corticobasal degeneration. Curr Treat Options Neurol. 2014;16(3):282. https://doi.org/10.1007/s11940-013-0282-1 https://doi.org/https://doi.org/10.1007/...
Botulinum toxin	Acetylcholine antagonist	Excessive weakness²2. Armstrong MJ. Diagnosis and treatment of corticobasal degeneration. Curr Treat Options Neurol. 2014;16(3):282. https://doi.org/10.1007/s11940-013-0282-1 https://doi.org/https://doi.org/10.1007/...

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[1] Leonardo Caixeta. Universidade Federal de Goiás, Faculdade de Medicina. Ringgold Standard Institution - Neurology. Avenida Cristo Rei, 626 - 74605-020 Setor Jaó, Goiânia GO - Brazil. E-mail: leonardocaixeta1@gmail.com