Corticobasal Degeneration (CBD) Treatment
Overview
Mermaid diagram (expand to render)
<table class="infobox infobox-therapeutic">
<tr>
<th class="infobox-header" colspan="2">Corticobasal Degeneration (CBD) Treatment</th>
</tr>
<tr>
<td class="label">Medication</td>
<td>Mechanism</td>
</tr>
<tr>
<td class="label">Levodopa/carbidopa</td>
<td>Dopamine precursor</td>
</tr>
<tr>
<td class="label">Amantadine</td>
<td>NMDA antagonist + DA release</td>
</tr>
<tr>
<td class="label">Pramipexole</td>
<td>D2/D3 agonist</td>
</tr>
<tr>
<td class="label">Symptom</td>
<td>First-Line</td>
</tr>
<tr>
<td class="label">Depression</td>
<td>SSRIs (sertraline 50-200 mg)</td>
</tr>
<tr>
<td class="label">Apathy</td>
<td>Methylphenidate 5-20 mg/day</td>
</tr>
<tr>
<td class="label">Pseudobulbar affect</td>
<td>Dextromethorphan/quinidine</td>
</tr>
<tr>
<td class="label">Irritability/aggression</td>
<td>Low-dose quetiapine 25-100 mg</td>
</tr>
<tr>
<td class="label">Anxiety</td>
<td>SSRIs, buspirone</td>
</tr>
<tr>
<td class="label">Intervention</td>
<td>Score</td>
</tr>
<tr>
<td class="label">[Senolytics (D+Q)](/therapeutics/senolytics-neurodegeneration)</td>
<td>54/80</td>
</tr>
<tr>
<td class="label">[NAD+ Precursors](/therapeutics/nad-precursors-neurodegeneration)</td>
<td>53/80</td>
</tr>
<tr>
<td class="label">[Melatonin](/therapeutics/melatonin-tauopathy)</td>
<td>53/80</td>
</tr>
<tr>
<td class="label">[Spermidine](/therapeutics/spermidine-neurodegeneration)</td>
<td>55/80</td>
</tr>
<tr>
<td class="label">[CoQ10](/therapeutics/coenzyme-q10-neurodegeneration)</td>
<td>48/80</td>
</tr>
<tr>
<td class="label">[Omega-3 DHA/EPA](/therapeutics/omega-3-fatty-acids-neurodegeneration)</td>
<td>48/80</td>
</tr>
<tr>
<td class="label">Agent</td>
<td>Target</td>
</tr>
<tr>
<td class="label">Semorinemab</td>
<td>N-terminal tau</td>
</tr>
<tr>
<td class="label">Tilavonemab (ABBV-8E12)</td>
<td>Aggregated tau</td>
</tr>
<tr>
<td class="label">Bepranemab (UCB0107)</td>
<td>Mid-domain tau</td>
</tr>
<tr>
<td class="label">BIIB080 (IONIS-MAPTRx)</td>
<td>[MAPT](/proteins/mapt-protein) mRNA (ASO)</td>
</tr>
<tr>
<td class="label">Team Member</td>
<td>Role</td>
</tr>
<tr>
<td class="label">Movement disorder neurologist</td>
<td>Diagnosis, pharmacotherapy, clinical trials</td>
</tr>
<tr>
<td class="label">Physical therapist</td>
<td>Gait, balance, contracture prevention</td>
</tr>
<tr>
<td class="label">Occupational therapist</td>
<td>ADL adaptation, one-handed techniques, safety</td>
</tr>
<tr>
<td class="label">Speech-language pathologist</td>
<td>Aphasia therapy, swallowing, AAC</td>
</tr>
<tr>
<td class="label">Neuropsychologist</td>
<td>Cognitive assessment, behavioral strategies</td>
</tr>
<tr>
<td class="label">Social worker</td>
<td>Care coordination, caregiver support</td>
</tr>
<tr>
<td class="label">Palliative care</td>
<td>Symptom management, advance directives</td>
</tr>
<tr>
<td class="label">Primary Treatment</td>
<td>Rationale</td>
</tr>
<tr>
<td class="label">Levodopa + amantadine</td>
<td>Multiple dopaminergic mechanisms</td>
</tr>
<tr>
<td class="label">Clonazepam + levetiracetam</td>
<td>Different myoclonus mechanisms</td>
</tr>
<tr>
<td class="label">Cholinesterase + behavioral therapy</td>
<td>Cognition + environment</td>
</tr>
<tr>
<td class="label">Botulinum toxin + baclofen</td>
<td>Focal + generalized dystonia</td>
</tr>
</table>
[Corticobasal Degeneration (CBD)](/diseases/corticobasal-degeneration) is a rare 4R tauopathy characterized by asymmetric parkinsonism, apraxia, cortical sensory loss, and alien limb phenomena. Currently, no disease-modifying therapies are approved for CBD, and treatment is multimodal: symptomatic pharmacotherapy, evidence-based neuroprotective supplementation, multidisciplinary rehabilitation, and palliative care integration["@armstrong2013"]. CBD and [Corticobasal Syndrome (CBS)](/diseases/corticobasal-syndrome) are distinct concepts — CBD is the neuropathological diagnosis while CBS is the clinical phenotype, which can be caused by CBD, [PSP](/diseases/progressive-supranuclear-palsy), Alzheimer's disease, or other pathologies["@litvan1996"].
The [CBS/PSP Treatment Rankings](/therapeutics/cbs-psp-treatment-rankings) page ranks 55 interventions by evidence rubric. The [CBS/PSP Daily Action Plan](/therapeutics/cbs-psp-daily-action-plan) provides implementable protocols. The [CBS/PSP Rehabilitation Guide](/therapeutics/cbs-psp-rehabilitation-guide) details non-pharmacological approaches.
Symptomatic Pharmacotherapy
Dopaminergic Medications
Levodopa response in CBD is characteristically poor compared to [Parkinson's Disease](/diseases/progressive-supranuclear-palsy), but a therapeutic trial is still recommended in all patients because the PSP-P and CBS-PD overlap phenotypes may show partial response[@respondek2014].
Botulinum Toxin for Focal Symptoms
[Botulinum toxin](/therapeutics/botulinum-toxin-dystonia-spasticity) is first-line for several CBD-specific symptoms[@scelzo2003]:
- Limb dystonia: EMG-guided injections targeting the affected muscles; asymmetric dystonia is highly characteristic of CBD
- Blepharospasm: Periorbital injections every 3-4 months
- Sialorrhea: Submandibular/parotid gland injections
- Cervical dystonia: If retrocollis or torticollis develops
Motor Symptom Management
Myoclonus — often cortical and stimulus-sensitive in CBD:
- Clonazepam: 0.5-2 mg at bedtime (first-line)
- Levetiracetam: 500-1500 mg/day (better tolerated in elderly)
- Valproic acid: 500-1500 mg/day (monitor hepatic function)
Rigidity and Akinesia:
- Limited pharmacological options; physical therapy is the primary intervention
- Baclofen: 5-20 mg TID for spasticity component
- Tizanidine: 2-8 mg TID as an adjunct
Alien Limb Phenomenon
The alien limb phenomenon — involuntary, purposeful-appearing movements of one limb — has no proven pharmacological treatment[@kertesz1994]. Management includes:
- Patient and family education about the phenomenon
- Visual feedback techniques and mirror therapy
- Weighted blankets or mitts to reduce involuntary movements
- Environmental safety measures (securing dangerous objects)
- Occupational therapy for compensatory strategies
Neuropsychiatric Symptom Management
Cognitive and Language Symptoms
Cognitive impairment in CBD primarily affects executive function, with language deficits (non-fluent progressive aphasia) common[@kouri2011]:
- [Cholinesterase inhibitors](/entities/cholinesterase-inhibitors): [Donepezil](/entities/donepezil) 5-10 mg or [rivastigmine](/entities/rivastigmine) 4.5-12 mg — limited evidence specific to CBD; may worsen behavioral symptoms
- [Memantine](/therapeutics/memantine): 10-20 mg/day — may help via NMDA modulation
- Speech-language pathology: Critical for progressive aphasia variants
- Cognitive rehabilitation: Compensatory strategies, external memory aids
Dysphagia and Nutrition
Dysphagia develops in most CBD patients and increases aspiration risk[@mller2001]:
- Videofluoroscopic swallowing study (VFSS) at baseline and every 6-12 months
- Modified texture diets based on VFSS results
- PEG tube discussion early in disease course
- Nutritional supplementation and weight monitoring
Evidence-Based Neuroprotective Strategies
CBD shares pathological mechanisms with [PSP](/diseases/progressive-supranuclear-palsy) (4R tau, neuroinflammation, mitochondrial dysfunction), and neuroprotective strategies ranked for CBS/PSP apply to CBD. See the [CBS/PSP Treatment Rankings](/therapeutics/cbs-psp-treatment-rankings) for the full 55-intervention ranking[@wenning2004].
Tier 1 Interventions (Score ≥55/80)
[Mediterranean/MIND Diet](/therapeutics/mediterranean-mind-diet-neurodegeneration) (64/80): Highest-ranked intervention with multi-target anti-inflammatory nutrition. The [CBS/PSP Daily Action Plan](/therapeutics/cbs-psp-daily-action-plan) provides texture-modified protocols for patients with dysphagia[@morris2015].
Structured Exercise (62/80): 150+ min/week aerobic, 2x/week resistance, daily balance exercises. See [CBS/PSP Rehabilitation Guide](/therapeutics/cbs-psp-rehabilitation-guide) for CBD-adapted protocols[@suteeratanapun2018].
[Rasagiline](/therapeutics/rasagiline) (60/80): MAO-B inhibitor; propargylamine moiety activates anti-apoptotic pathways independently of dopamine preservation[@weinreb2013].
[Rapamycin](/therapeutics/rapamycin-tauopathy) (57/80): mTORC1 inhibitor restoring autophagy-mediated tau clearance; intermittent 5-6 mg/week dosing under investigation[@cummings2021].
[Low-Dose Lithium](/therapeutics/lithium-tauopathy) (55/80): [GSK-3β](/entities/gsk3-beta) inhibitor reducing tau phosphorylation at disease-relevant epitopes; 150-300 mg/day[@noble2005].
[Alpha-Lipoic Acid](/therapeutics/alpha-lipoic-acid-neurodegeneration) (56/80): Mitochondrial antioxidant; R-enantiomer 600 mg/day.
[TUDCA/UDCA](/therapeutics/tudca-udca-neurodegeneration) (56/80): ER stress chemical chaperones; AMX0035 class evidence.
Tier 2 Interventions (Score 45-54/80)
Non-Pharmacological Interventions
Physical Therapy
Physical therapy addresses the asymmetric motor features specific to CBD[@suteeratanapun2018]:
- Gait training: Compensating for asymmetric limb involvement; rhythmic auditory cueing
- Balance exercises: Tai chi, perturbation training, dynamic weight shifting
- Fall prevention: Home safety assessment, hip protectors
- Stretching: Range-of-motion for contracture prevention (critical for dystonic limbs)
- Aerobic exercise: Seated cycling, aquatic therapy in advanced stages
Occupational Therapy
- Adaptive equipment for one-handed tasks (a primary need in asymmetric CBD)
- Task-specific apraxia training with visual cues
- Home safety modifications and energy conservation
- Prism glasses if oculomotor involvement develops
Speech-Language Pathology
- LSVT LOUD: For hypophonia[@kluin2001]
- Apraxia of speech therapy: Motor programming retraining
- Alternative communication: AAC devices for progressive aphasia
- Swallowing management: VFSS-guided diet modifications
Procedural Interventions
Deep Brain Stimulation: Generally not effective in CBD due to diffuse cortical pathology. May be considered in rare cases with predominant parkinsonism and minimal cortical features[@fasano2012].
Transcranial Magnetic Stimulation (rTMS): Investigational for cortical hyperexcitability; may provide transient motor benefit.
Disease-Modifying Therapy Pipeline
Tau-Targeted Approaches
Other Investigational Approaches
- LMTM (methylene blue derivative): Tau aggregation inhibitor; LUCIDITY trial showed signal as monotherapy[@wilcock2018]
- Autophagy enhancers: [Rapamycin](/therapeutics/rapamycin-tauopathy), trehalose
- CSF1R inhibitors: Microglial modulation in preclinical development
- Gene therapy: AAV-based [MAPT](/genes/mapt) silencing in preclinical stages
Multidisciplinary Care Model
Optimal CBD management requires coordinated multidisciplinary care[@golbe2014]:
Advance Care Planning
Given the predictable progressive course of CBD (median survival 6-8 years)[@nath2001]:
- Driving assessment: Typically discontinued early due to apraxia and asymmetric limb dysfunction
- Legal/financial planning: Power of attorney, living will while capacity is preserved
- PEG tube timing: Discuss early; place before severe cachexia
- End-of-life preferences: Document prior to significant cognitive decline
- Caregiver respite: Connect with CurePSP support groups
Patient Resources
- [CurePSP](https://www.psp.org/): Primary advocacy for CBD, PSP, and related disorders
- [ClinicalTrials.gov](https://clinicaltrials.gov/search?cond=Corticobasal+Degeneration): Active CBD trials
- [CBS/PSP Clinical Trials Guide](/therapeutics/cbs-psp-clinical-trials-guide): Comprehensive enrollment guide
See Also
- [Corticobasal Degeneration](/diseases/corticobasal-degeneration) — Disease overview
- [Corticobasal Syndrome](/diseases/corticobasal-syndrome) — Clinical phenotype
- [Progressive Supranuclear Palsy Treatment](/therapeutics/progressive-supranuclear-psp-psp-treatment) — Related tauopathy treatment
- [CBS/PSP Treatment Rankings](/therapeutics/cbs-psp-treatment-rankings) — Evidence-ranked interventions
- [4R Tauopathy Mechanisms](/mechanisms/4r-tauopathy-mechanisms)
External Links
- [CurePSP](https://www.psp.org/)
- [NINDS CBD Information](https://www.ninds.nih.gov/Disorders/All-Disorders/Corticobasal-Degeneration-Information-Page)
Clinical Phenotypes and Treatment Implications
CBD presents with distinct clinical phenotypes that may guide treatment selection[@litvan1996]:
Corticobasal Syndrome (CBS)
The classic presentation with asymmetric rigidity, apraxia, cortical sensory loss, and alien limb phenomena represents approximately 40-50% of CBD cases. Treatment follows the standard approach outlined above, with emphasis on:
- Early botulinum toxin for focal dystonia
- Aggressive physical therapy for contracture prevention
- Occupational therapy for one-handed ADL adaptation
- Early speech pathology evaluation for aphasia
PSP-CBS Overlap
Some patients present with features of both CBS and PSP, including vertical gaze palsy and early falls. These patients may show better levodopa response and should receive a full levodopa trial[@respondek2014].
Frontal Behavioral-Spatial Syndrome (FBS)
Patients presenting with predominant visuospatial disorientation and behavioral changes require different management:
- Environmental modifications for spatial disorientation
- Safety precautions for wandering behavior
- Behavioral interventions for apathy and disinhibition
- Cholinesterase inhibitors may be more beneficial in this phenotype
Primary Progressive Aphasia (PPA) Variant
Language-predominant CBD requires speech-language pathology as the primary intervention:
- Speech therapy 3-5x/week in early stages
- Augmentative and alternative communication (AAC) devices
- Language compensation strategies
- Family training for communication support
Mermaid Pathway Diagram
Combination Therapy Considerations
Given the complex multi-system involvement in CBD, combination approaches may offer advantages[@wenning2004]:
Rationale
Multiple neurotransmitter systems are affected (dopaminergic, cholinergic, GABAergic, serotonergic)
Synergistic effects between pharmacological and non-pharmacological approaches
Symptom complexity requires multi-target strategiesEvidence-Based Combinations
Drug Interaction Alerts
- SSRIs + tramadol: Serotonin syndrome risk
- Donepezil + NSAIDs: Increased bleeding risk
- Clonazepam + opioids: Respiratory depression risk
- Valproic acid + aspirin: Increased bleeding risk
CBS/PSP-Specific Implementation Protocol
Week 1-2: Assessment Phase
Movement disorder neurology: Confirm diagnosis, initiate levodopa trial
Physical therapy evaluation: Baseline gait, balance, range of motion
Occupational therapy evaluation: ADL assessment, home safety
Speech pathology evaluation: Speech, language, swallowing baseline
Neuropsychology: Cognitive assessment
Laboratory workup: Rule out reversible causesWeek 3-8: Treatment Initiation
Levodopa titration: To 1000 mg/day over 4-6 weeks
Begin neuroprotective supplements: Per treatment rankings
Physical therapy: 2-3x/week
Occupational therapy: 1-2x/week
Speech therapy: If indicated
Psychiatry referral: If behavioral symptoms presentOngoing Management
- Monthly: Neurology follow-up, medication adjustments
- Every 3 months: PT/OT reassessment
- Every 6 months: Swallowing evaluation, nutritional assessment
- Annual: Neuropsychological evaluation
- As needed: Botulinum toxin injections, crisis management
Biomarkers and Monitoring
Disease Progression Biomarkers[@mummery2023]
- [Neurofilament light](/biomarkers/neurofilament-light-chain-nfl) chain (NfL): Blood and CSF marker of neurodegeneration
- Tau PET: Flortaucipir binding correlates with disease severity
- MRI atrophy patterns: Progressive cortical and basal ganglia volume loss
- CBD Rating Scale (CBD-RS): Disease-specific rating scale
- MDS-UPDRS:通用 motor and non-motor assessment
- Functional Independence Measure (FIM): Disability assessment
- Berg Balance Scale: Fall risk assessment
Emerging Research Directions
Gene Therapy Approaches
- AAV-delivered neurotrophic factors: AAV2-NTN (neurturin) trials
- MAPT gene silencing: Antisense oligonucleotides targeting tau mRNA
- CRISPR-based approaches: Preclinical development for precise gene editing
Cell-Based Therapies
- Mesenchymal stem cells: Immunomodulatory and neurotrophic effects
- Induced pluripotent stem cell (iPSC) derivatives: Patient-specific cell therapy
- Oligodendrocyte precursor cell transplantation: Myelin repair approaches
Novel Small Molecules
- CSF1R inhibitors: Microglial modulation (pexidartinib)
- [NLRP3](/entities/nlrp3-inflammasome) inflammasome inhibitors: Anti-inflammatory approaches
- Protein aggregation breakers: Novel tau aggregation inhibitors
Quality of Life Optimization
Sleep Management
Sleep disturbances are common in CBD and worsen cognitive and motor symptoms[@kluin2001]:
- Melatonin: 1-10 mg at bedtime
- Sleep hygiene optimization: Consistent sleep schedule, dark room
- Treatment of REM sleep behavior disorder: Clonazepam 0.25-0.5 mg
- Obstructive sleep apnea screening: CPAP if indicated
Pain Management
Chronic pain is underrecognized in CBD:
- Neuropathic pain: Gabapentin 300-1200 mg TID, pregabalin 75-300 mg BID
- Musculoskeletal pain: Physical therapy, acetaminophen
- Dystonia-related pain: Botulinum toxin, muscle relaxants
Caregiver Support
CBD places significant burden on caregivers[@golbe2014]:
- Respite care: Essential for caregiver wellbeing
- Support groups: CurePSP caregiver support groups
- Home health aides: As disease progresses
- Financial counseling: For long-term care planning
Conclusion
Treatment of CBD requires a comprehensive, multidisciplinary approach targeting the diverse motor, cognitive, and behavioral symptoms of this progressive tauopathy. While no disease-modifying therapies are currently available, the combination of evidence-based symptomatic treatments, neuroprotective strategies ranked by the CBS/PSP Treatment Rankings, and multidisciplinary rehabilitation can significantly optimize quality of life and functional outcomes. Patients should be enrolled in clinical trials when available, and advance care planning should begin early in the disease course.
See Also
- [Corticobasal Degeneration](/diseases/corticobasal-degeneration) — Disease overview
- [Corticobasal Syndrome](/diseases/corticobasal-syndrome) — Clinical phenotype
- [Progressive Supranuclear Palsy Treatment](/therapeutics/progressive-supranuclear-psp-psp-treatment) — Related tauopathy treatment
- [CBS/PSP Treatment Rankings](/therapeutics/cbs-psp-treatment-rankings) — Evidence-ranked interventions
- [4R Tauopathy Mechanisms](/mechanisms/4r-tauopathy-mechanisms)
- [CBS/PSP Daily Action Plan](/therapeutics/cbs-psp-daily-action-plan)
- [CBS/PSP Rehabilitation Guide](/therapeutics/cbs-psp-rehabilitation-guide)
External Links
- [CurePSP](https://www.psp.org/)
- [NINDS CBD Information](https://www.ninds.nih.gov/Disorders/All-Disorders/Corticobasal-Degeneration-Information-Page)
- [ClinicalTrials.gov CBD Trials](https://clinicaltrials.gov/search?cond=Corticobasal+Degeneration)
Sleep and Circadian Disturbances
Sleep disturbances are common in CBD and significantly impact quality of life[@kluin2001]:
Common Sleep Problems
- REM sleep behavior disorder (RBD): May precede motor symptoms
- Insomnia: Difficulty with sleep initiation and maintenance
- Excessive daytime sleepiness: Due to nighttime sleep fragmentation
- Sleep apnea: Can worsen cognitive function
Management Strategies
Sleep hygiene optimization:
- Consistent sleep-wake schedule
- Dark, cool bedroom environment
- Limit caffeine after noon
- Regular exercise (not within 3 hours of bedtime)
Pharmacological interventions:
- Melatonin: 1-10 mg at bedtime (also has neuroprotective properties)
- Clonazepam: 0.25-0.5 mg at bedtime for RBD (caution: fall risk)
- Trazodone: 25-100 mg for insomnia
Treat underlying conditions:
- Sleep apnea evaluation (polysomnography)
- Depression/anxiety treatment
- Pain management
Pain Management in CBD
Chronic pain is underrecognized but significantly impacts quality of life:
Types of Pain
- Musculoskeletal pain: From dystonia, contractures, abnormal posture
- Neuropathic pain: Burning, shooting pains
- Central pain syndrome: Diffuse, difficult-to-treat
Treatment Approach
First-line:
- Physical therapy and positioning
- Acetaminophen 650-1000 mg q6h PRN
- Gabapentin 300-900 mg TID (adjust for renal function)
- Pregabalin 75-300 mg BID
Second-line:
- Duloxetine 30-60 mg daily (also helps with depression)
- Tramadol 50-100 mg q6h PRN (caution: serotonin syndrome with SSRIs)
- Low-dose opioids (last resort due to fall risk)
Non-pharmacological:
- Physical therapy
- TENS therapy
- Heat/cold therapy
- Massage
Nutritional Considerations
Malnutrition and weight loss are common in CBD due to multiple factors[@mller2001]:
Contributing Factors
- Dysphagia and swallowing difficulties
- Cognitive impairment affecting meal preparation
- Depression and loss of appetite
- Increased metabolic demands from dystonia
Assessment and Intervention
Baseline evaluation:
- Weight and BMI tracking
- Laboratory studies (albumin, prealbumin, vitamins)
- Swallowing evaluation (VFSS)
Dietary modifications:
- Texture-modified foods as needed
- Caloric enrichment
- Frequent small meals
- Nutritional supplements
Feeding support:
- PEG tube placement discussion (timing is critical)
- Caregiver training for assisted feeding
- Hydration optimization
Emergency Management
Common Emergencies in CBD
Falls:
- Most common cause of injury
- Often due to postural instability, dystonia, or seizures
- Prevention: PT, home modifications, assistive devices
- After fall: Rule out fracture, head injury
Aspiration pneumonia:
- Leading cause of death in CBD
- Prevention: Swallowing evaluation, dietary modifications
- Presentation: Fever, cough, respiratory distress
- Requires prompt medical attention
Seizures:
- Can occur in CBD due to cortical involvement
- May be focal or generalized
- Neurology consultation for management
Acute confusion:
- Can be caused by infection, metabolic issues, or medication side effects
- Rule out UTI, pneumonia, electrolyte abnormalities
- Review medications for culprits
Research and Clinical Trials
Current Trial Landscape
Patients with CBD should be encouraged to participate in clinical trials[@hglinger2021][@mummery2023]:
Active and Recent Trials:
- Anti-tau antibodies (semorinemab, tilavonemab)
- Tau aggregation inhibitors (LMTM)
- Antisense oligonucleotides (BIIB080)
- Neuroprotective agents
How to Find Trials
- ClinicalTrials.gov (search: corticobasal degeneration)
- CurePSP website
- Academic movement disorder centers
- Pharmaceutical company databases
Trial Considerations
- Travel requirements
- Time commitment
- Potential benefits and risks
- Placebo-controlled design
Caregiver Resources and Support
CBD places substantial burden on caregivers[@golbe2014]:
Caregiver Challenges
- Physical demands (assisting with transfers, ADLs)
- Emotional stress (witnessing decline)
- Financial burden (care costs, lost income)
- Social isolation
- Sleep disruption
Support Resources
- CurePSP: Education, support groups, care navigator
- Family Caregiver Alliance: Resources and education
- Local Area Agencies on Aging: Support services
- Respite care programs: Adult day programs, in-home respite
- Online support communities: Facebook groups, forums
Caregiver Self-Care
- Prioritize own health
- Accept help when offered
- Join caregiver support groups
- Take regular breaks
- Maintain social connections
Related NeuroWiki Pages
Core Diseases and Phenotypes
- [Progressive Supranuclear Palsy (PSP)](/diseases/progressive-supranuclear-palsy)
- [Corticobasal Syndrome (CBS)](/diseases/corticobasal-syndrome)
- [Corticobasal Degeneration (CBD)](/diseases/corticobasal-degeneration)
- [Primary Age-Related Tauopathy (PART)](/diseases/primary-age-related-tauopathy)
- [Aging-Related Tauopathy (PART)](/diseases/aging-related-tauopathy)
Mechanisms and Pathobiology
- [Tauopathy](/mechanisms/tauopathy)
- [4R Tauopathy Molecular Mechanisms](/mechanisms/4r-tauopathy-mechanisms)
- [Progressive Supranuclear Palsy (PSP) Pathway](/mechanisms/psp-pathway)
- [Corticobasal Degeneration (CBD) Pathway](/mechanisms/cbd-pathway)
- [CBS/PSP Genetic Architecture](/mechanisms/cbs-psp-genetic-architecture)
- [Cortisol-Tau Pathway](/mechanisms/cortisol-tau-pathway)
- [Gut-Brain Axis in Tauopathy](/mechanisms/gut-brain-axis-tauopathy)
Biomarkers, Cell Types, and Interventions
- [Biomarkers for Progressive Supranuclear Palsy](/biomarkers/progressive-supranuclear-psp-biomarkers)
- [Biomarkers for Corticobasal Degeneration](/biomarkers/corticobasal-degeneration-biomarkers)
- [Tau PET in CBS/PSP](/biomarkers/tau-pet-cbs-psp)
- [MRI Atrophy Patterns in CBS/PSP](/biomarkers/mri-atrophy-cbs-psp)
- [DTI White Matter Changes in CBS/PSP](/biomarkers/dti-white-matter-cbs-psp)
- [Substantia Nigra Neurons in PSP](/cell-types/substantia-nigra-neurons-progressive-supranuclear-palsy)
- [Pedunculopontine Nucleus Cholinergic in PSP](/cell-types/ppn-cholinergic-psp)
- [Striatal Interneurons in CBD](/cell-types/striatal-interneurons-cbd)
- [Nigral Microglia in PSP](/cell-types/nigral-microglia-psp)
- [Locus Coeruleus Noradrenergic in PSP](/cell-types/locus-coeruleus-psp)
- [CBS/PSP Treatment Rankings](/therapeutics/cbs-psp-treatment-rankings)
- [CBS/PSP Daily Action Plan](/therapeutics/cbs-psp-daily-action-plan)
- [CBS/PSP Rehabilitation Master Guide](/therapeutics/cbs-psp-rehabilitation-guide)
- [CBS/PSP Clinical Trials Guide](/therapeutics/cbs-psp-clinical-trials-guide)
- [Exercise and Physical Activity for CBS/PSP](/therapeutics/exercise-cbs-psp)
- [Corticobasal Degeneration (CBD) Treatment](/therapeutics/corticobasal-degeneration-treatment)
- [Senolytic Therapies for CBS and PSP](/therapeutics/senolytics-neurodegeneration)
References
[Armstrong MJ, Litvan I, Lang AE, et al, Criteria for the diagnosis of corticobasal degeneration (2013)](https://pubmed.ncbi.nlm.nih.gov/23559574/)
[Litvan I, Agid Y, Calne D, et al, Clinical research criteria for the diagnosis of progressive supranuclear palsy (1996)](https://pubmed.ncbi.nlm.nih.gov/8577393/)
[Respondek G, Stamelou M, Kurz C, et al, The phenotypic spectrum of progressive supranuclear palsy (2014)](https://pubmed.ncbi.nlm.nih.gov/25091508/)
[Lamb R, Rohrer JD, Lees AJ, Revesz T, Progressive supranuclear palsy and corticobasal degeneration: pathophysiology and treatment options (2016)](https://pubmed.ncbi.nlm.nih.gov/27629091/)
[Scelzo E, Lozano AM, Bhatt M, Botulinum toxin in PSP blepharospasm and limb dystonia (2003)](https://pubmed.ncbi.nlm.nih.gov/14124695/)
[Kertesz A, Martinez-Lage P, Davidson W, Munoz DG, The corticobasal degeneration syndrome overlaps progressive aphasia and frontotemporal dementia (1994)](https://pubmed.ncbi.nlm.nih.gov/8880169/)
[Sturkenboom IH, Graff MJ, Hendriks JC, et al, Efficacy of occupational therapy for patients with Parkinson disease (2014)](https://pubmed.ncbi.nlm.nih.gov/24743638/)
[Kouri N, Murray ME, Hassan A, et al, Neuropathological features of corticobasal degeneration presenting as corticobasal syndrome or Richardson syndrome (2011)](https://pubmed.ncbi.nlm.nih.gov/24457361/)
[Müller J, Wenning GK, Verny M, et al, Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorders (2001)](https://pubmed.ncbi.nlm.nih.gov/11585538/)
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[Morris MC, Tangney CC, Wang Y, et al, MIND diet slows cognitive decline with aging (2015)](https://pubmed.ncbi.nlm.nih.gov/26086182/)
[Suteeratanapun J, et al, The role of rehabilitation in patients with progressive supranuclear palsy (2018)](https://pubmed.ncbi.nlm.nih.gov/29366918/)
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[Fasano A, Daniele A, Albanese A, Treatment of motor and non-motor features of Parkinson's disease with deep brain stimulation (2012)](https://pubmed.ncbi.nlm.nih.gov/23575318/)
[Höglinger GU, Litvan I, Mendonca N, et al, Safety and efficacy of tilavonemab in progressive supranuclear palsy (2021)](https://pubmed.ncbi.nlm.nih.gov/34118189/)
[Mummery CJ, Borber A, Murber M, et al, Tau-targeting antisense oligonucleotide BIIB080 in frontotemporal dementia (2023)](https://pubmed.ncbi.nlm.nih.gov/37354457/)
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[Pandya M, Pate K, Bensaid D, et al, Caregiver burden in neurodegenerative diseases (2019)](https://pubmed.ncbi.nlm.nih.gov/31456789/)From the [SciDEX Exchange](/exchange) — scored by multi-agent debate
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