Corticobasal degeneration (CBD)

Corticobasal degeneration (CBD) is a neurological condition classified under the Parkinsonism spectrum, meaning it shares certain features with Parkinson’s disease but is a distinct disorder. It is more closely related to another condition called progressive supranuclear palsy (PSP). Both CBD and PSP are known as tauopathies, a group of disorders in which an abnormal build‑up of the tau protein causes damage to specific areas of the brain. Normally, the body clears tau efficiently, but in these conditions it accumulates and leads to progressive impairment.

CBD is very rare, affecting approximately 5 in every 100,000 people. It typically develops later in life, with most individuals diagnosed in their 60s or 70s. Over the course of my career, I have encountered only two to three cases. Diagnosis is usually based on characteristic clinical features supported by MRI findings.

Common symptoms:

• Limb rigidity affecting just one side of the body
• Poor response to normal Parkinson’s medication
• Apraxia (inability to perform learned movements despite having the strength to do so)
• Some can have alien limb syndrome where the limb acts on its own without voluntary control
• Often have cognitive and speech difficulties
• Behavioural changes, often suffering from apathy and rigidity of thought

Treatment:

• There is no cure or disease modifying treatment
• Regular mobility assessments to ensure they have the correct walking aid (if required) and their risk of falls is minimised
• Environmental adaptations and removal of risks, again to improve their independence and reduce fall
• Range of movement exercises for limbs affected by severe stiffness
• Strengthening and balance work
• Medications to manage the stiffness can be tried but often aren’t effective
• Due to cognitive changes, exercises and advice need to be really clearly documented for them and it is useful to get family involved