Corticobasal degeneration: clinical characteristics and multidisciplinary therapeutic approach in 26 patients
Neurological Sciences - 2015
Tóm tắt
Corticobasal syndrome (CBS) is a sporadic tauopathy that manifests by a various combination of motor and cognitive deficits, which makes its diagnosis challenging. Treatment of CBS is symptomatic and based on evidence from other similar disorders due to the lack of studies on CBS. The aim of the study was to investigate low-frequency repetitive transcranial magnetic stimulation (rTMS) as a therapeutic tool in CBS. Twenty-six patients with clinically evident CBS according to Cambridge criteria were followed for 12–18 months while receiving low-frequency rTMS combined with pharmacological, rehabilitation treatment and botulinum toxin injection. The majority of patients are manifested with akinetic-rigid syndrome and cognitive dysfunction. There was improvement of the UPDRS and quality of life after 3 months of therapeutic interventions (P < 0.001 and <0.05, respectively). No significant deterioration in cognitive functions was detected over the study period. There was a significant reduction of caregiver burden after 3 months of interventions (P < 0.01); this improvement was maintained up to 18 months. Cognitive dysfunction is a frequent manifestation of CBS. CBS patients can benefit from multidisciplinary therapeutic approach employing low-frequency rTMS.
Từ khóa
Tài liệu tham khảo
Mizusawa H (1997) Corticobasal degeneration. Rinsho Shinkeigaku 37:1131–1133
Boeve BF, Maraganore DM, Parisi JE, Ahlskog JE, Graff-Radford N, Caselli RJ, Dickson DW, Kokmen E, Petersen RC (1999) Pathologic heterogeneity in clinically diagnosed corticobasal degeneration. Neurology 53:795–800
Boeve BF (2011) The multiple phenotypes of corticobasal syndrome and corticobasal degeneration: implications for further study. J Mol Neurosci 45:350–353
Doran M, Du Plessis DG, Enevoldson TP, Fletcher NA, Ghadiali E, Larner AJ (2003) Pathological heterogeneity of clinically diagnosed corticobasal degeneration. J Neurol Sci 216:127–134
Wenning GK, Litvan I, Jankovic J, Granata R, Mangone CA, McKee A, Poewe W, Jellinger K, Ray K, Chaudhuri L, D’Olhaberriague, Pearce RK (1998) “Natural history and survival of 14 patients with corticobasal degeneration confirmed at postmortem examination”. J Neurol Neurosurg Psychiatry 64:184–189
Armstrong MJ (2014) Diagnosis and treatment of corticobasal degeneration. Curr Treat Options Neurol 16(3):282
Armstrong MJ, Lang AE (2011) Handbook of Atypical Parkinsonism. In: Carlo Colosimo GKW, David Riley E (ed) Cambridge University Press, pp 75–98
Pascual-Leone A, Rubio B, Pallardó F, Catalá MD (1996) Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression. Lancet 348:233–237
Chen R (2000) Studies of human motor physiology with transcranial magnetic stimulation. Muscle Nerve Suppl 9:S26–S32
Hallett M (2007) Transcranial magnetic stimulation: a primer. Neuron 55:187–199
Goetz CC (2003) The unified Parkinson’s disease rating scale (UPDRS): status and recommendations. Mov Disord 18:738–750
Mioshi E, Dawson K, Mitchell J, Arnold R, Hodges JR (2006) The Addenbrooke’s Cognitive Examination revised (ACE-R): a brief cognitive test battery for dementia screening. Int J Geriatr Psychiatry 21:1078–1085
Comella CL, Leurgans S, Wuu J, Stebbins GT, Chmura T (2003) Rating scales for dystonia: a multicenter assessment. Mov Disord 18:303–312
Peto V, Jenkinson C, Fitzpatrick R, Greenhall R (1995) The development and validation of a short measure of functioning and well being for individuals with Parkinson’s disease. Qual Life Res 4:241–248
Zarit SH, Reever KE, Bach-Peterson J (1980) Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 20:649–655
Rinne JO, Lee MS, Thompson PD, Marsden CD (1994) Corticobasal degeneration. A clinical study of 36 cases. Brain 117(Pt 5):1183–1196
Riley DE, Lang AE, Lewis A, Resch L, Ashby P, Hornykiewicz O, Black S (1990) Cortical-basal ganglionic degeneration 40:1203–1212
Gibb WR, Luthert PJ, Marsden CD (1989) Corticobasal degeneration. Brain 112:1171–1192
Mathew R, Bak TH, Hodges JR (2012) Diagnostic criteria for corticobasal syndrome: a comparative study. J Neurol Neurosurg Psychiatry 83:405–410
Kompoliti K, Goetz CG, Boeve BF, Maraganore DM, Ahlskog JE, Marsden CD, Bhatia KP, Greene PE, Przedborski S, Seal EC, Burns RS, Hauser RA, Gauger LL, Factor SA, Molho ES, Riley DE (1998) Clinical presentation and pharmacological therapy in corticobasal degeneration
Chang KH, Chuang CC, Lyu RK, Chen CM, Ro LS, Chen ST, Wu YR (2007) Clinical characteristics of corticobasal syndrome amongst Chinese in Taiwan. Park Relat Disord 13:219–223
Kawahira K, Noma T, Iiyama J, Etoh S, Ogata A, Shimodozono M (2009) Improvements in limb kinetic apraxia by repetition of a newly designed facilitation exercise in a patient with corticobasal degeneration. Int J Rehabil Res 32:2
Steffen TM, Boeve BF, Mollinger-Riemann LA, Petersen CM (2007) Long-term locomotor training for gait and balance in a patient with mixed progressive supranuclear palsy and corticobasal degeneration. 87:1078–1087
Arias P, Vivas J, Grieve KL, Cudeiro J (2010) Controlled trial on the effect of 10 days low-frequency repetitive transcranial magnetic stimulation (rTMS) on motor signs in Parkinson’s disease. Mov Disord 25:1830–1838
Kimura H, Kurimura M, Kurokawa K, Nagaoka U, Arawaka S, Wada M, Kawanami T, Kurita K, Kato T (2011) A comprehensive study of repetitive transcranial magnetic stimulation in Parkinson’s disease. ISRN Neurol 2011:1–7
Shirota Y, Ohtsu H, Hamada M, Enomoto H, Ugawa Y (2013) Supplementary motor area stimulation for Parkinson disease: a randomized controlled study. Neurology 80:1400–1405
Potrebic A, Dragasevic N, Svetel M, Kostic VS (2001) Effect of slow repetitive transcranial magnetic stimulation on depression in patients with Parkinson disease. Srp Arh Celok Lek 129:1–4
Furukawa T, Izumi S-I, Toyokura M, Masakado Y (2009) Effects of low-frequency repetitive transcranial magnetic stimulation in Parkinson’s disease. Tokai J Exp Clin Med 34:63–71
Brusa L, Agrò EF, Petta F, Sciobica F, Torriero S, Lo Gerfo E, Iani C, Stanzione P, Koch G (2009) “Effects of inhibitory rTMS on bladder function in Parkinson’s disease Patients”. Mov Disord 24:445–448
Siebner HR, Mentschel C, Auer C (1999) Repetitive transcranial magnetic stimulation has a bene ® cial effect on bradykinesia in Parkinson’s disease. NeuroReport 10:589–594
Santens P, Sieben A, De Letter M (2009) Repetitive transcranial magnetic stimulation in patients with progressive supranuclear palsy: a pilot study
Berardelli A, Inghilleri M, Rothwell JC, Romeo S, Currà A, Gilio F, Modugno N, Manfredi M (1998) Facilitation of muscle evoked responses after repetitive cortical stimulation in man. Exp Brain Res 122(1):79–84
Chen R, Classen J, Gerloff C, Celnik P, Wassermann EM, Hallett M, Cohen LG (1997) Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation. Neurol 48(5):1398–1403
Wassermann EM (1998) Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines. Clin Neurophysiol Potentials Sect
Reis J, Swayne OB, Vandermeeren Y, Camus M, Dimyan MA, Harris-Love M, Perez MA, Ragert P, Rothwell JC, Cohen LG (2008) Contribution of transcranial magnetic stimulation to the understanding of cortical mechanisms involved in motor control. J Physiol 586(2):325–351
Valls-Solé J, Tolosa E, Marti MJ, Valldeoriola F, Revilla M, Pastor P, Blesa R (2001) Examination of motor output pathways in patients with corticobasal ganglionic degeneration using transcranial magnetic stimulation. Brain 124:1131–1137
Wolters A, Classen J, Kunesch E, Grossmann A, Benecke R (2004) Measurements of transcallosally mediated cortical inhibition for differentiating Parkinsonian syndromes. Mov Disord 19(5):518–528
Kühn AA, Grosse P, Holtz K, Brown P, Meyer BU, Kupsch A (2004) Patterns of abnormal motor cortex excitability in atypical parkinsonian syndromes. Clin Neurophysiol 115(8):1786–1795
Pal PK, Gunraj CA, Li J-Y, Lang AE, Chen R (2008) Reduced intracortical and interhemispheric inhibitions in corticobasal syndrome. J Clin Neurophysiol 25(5):304–312
Pascual-Leone A, Valls-Solé J, Brasil-Neto JP, Cammarota A, Grafman J, Hallett M (1994) Akinesia in Parkinson’s disease. II. Effects of subthreshold repetitive transcranial motor cortex stimulation. Neurology 44(5):892–898
Lomarev MP, Kanchana S, Bara-Jimenez W, Iyer M, Wassermann EM, Hallett M (2006) Placebo-controlled study of rTMS for the treatment of Parkinson’s disease. Mov Disord 21(3):325–331
Cooke SF, Bliss TVP (2006) Plasticity in the human central nervous system. Brain 129(Pt 7):1659–1673
Malenka RC, Bear MF (2004) LTP and LTD: an embarrassment of riches. Neuron 44(1):5–21
Ben-Shachar D, Belmaker RH, Grisaru N, Klein E (1997) Transcranial magnetic stimulation induces alterations in brain monoamines. J Neural Transm 104:191–197
Ben-Shachar D, Gazawi H, Riboyad-Levin J, Klein E (1999) Chronic repetitive transcranial magnetic stimulation alters beta-adrenergic and 5-HT2 receptor characteristics in rat brain. Brain Res 816:78–83