Intervenções farmacológicas na degeneração corticobasal: uma revisão

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

doi:10.1590/1980-57642020dn14-030006

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Dementia & Neuropsychologia

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

Intervenções farmacológicas na degeneração corticobasal: uma revisão

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO.

A degeneração corticobasal (DCB) é uma tauopatia esporádica que se apresenta com uma combinação variada de características motoras, cognitivas e comportamentais, dificultando seu diagnóstico. O CBD tem alta morbidade e mau prognóstico, sem terapia efetiva no momento. Pesquisamos o banco de dados PubMed / MEDLINE para artigos publicados de 1990 a 2019, usando as palavras-chave "degeneração corticobasal" e "tratamento". O método PRISMA foi adotado. Os artigos recuperados foram caracterizados como tendo uma de duas abordagens metodológicas: (1) estudos voltados para o tratamento da tauopatia primária e (2) manejo sintomático. Artigos de revisão (baseados em grupos de especialistas em CBD), relatos de casos, séries de casos e ensaios clínicos piloto foram selecionados. Poucas tentativas foram feitas para estudar as opções de drogas e eficácia de drogas no CBD de forma sistemática, e um tratamento eficaz ainda não está disponível. O tratamento é sintomático e baseado na semelhança com outras doenças devido à escassez de estudos que abordem especificamente o CBD. O CBD parece não despertar o interesse em mais ensaios clínicos por sua baixa prevalência e confiabilidade no diagnóstico clínico.

Palavras-chave:
degeneração corticobasal; síndrome corticobasal; terapia dopaminérgica; tratamento

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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E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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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