Corticobasal Degeneration

Corticobasal Degeneration (CBD) is a rare, progressive neurodegenerative condition that affects areas of the brain responsible for movement, coordination and thinking. Corticobasal Syndrome (CBS) is the clinical pattern of symptoms caused by CBD or by other underlying diseases.

People with CBD/CBS typically develop gradually worsening problems with movement on one side of the body, together with difficulties performing everyday tasks, changes in speech, and sometimes problems with memory and thinking. It is considered an “atypical Parkinsonian” syndrome.

Although there is currently no cure, specialist rehabilitation can help maintain function, safety and quality of life.

At The Royal Buckinghamshire Hospital, we provide inpatient neurorehabilitation for adults with neurological conditions.

---

Symptoms

Symptoms vary between individuals, but often include:

Movement and limb symptoms

• Stiffness and slowness of movement (Parkinsonism)
• Gradual loss of useful movement in one hand, arm or leg (often called “clumsy hand”)
• Jerks or twitches in the limb (myoclonus)
• Abnormal postures or twisting of the limb (dystonia)
• Trouble with fine motor tasks such as buttons, cutlery or writing
• Limb apraxia – difficulty carrying out purposeful movements, even though strength is preserved
• “Alien limb” – the feeling that a limb moves on its own or does not belong to you

Balance, speech and swallowing

• Unsteady walking and frequent trips or falls
• Slurred, halting or quiet speech
• Swallowing difficulties, with coughing or choking on food or drink
• Increased risk of chest infections because of swallowing problems

Thinking and behaviour

• Problems with planning, organising and multitasking
• Difficulty finding words or understanding complex language
• Changes in behaviour, personality or judgement
• Low mood, anxiety or irritability

Symptoms usually begin on one side of the body and may later involve the other side as the condition progresses.

---

Diagnosis

There is no single test that confirms CBD/CBS during life. Diagnosis is usually made by a neurologist or movement disorder specialist based on:

• Detailed history of symptoms and how they have progressed
• Neurological examination, including movement, coordination and cognitive testing
• Brain imaging (usually MRI) to look for characteristic patterns and exclude other causes
• Additional tests where needed (blood tests, spinal fluid tests, neuropsychology assessment, sometimes specialised scans)

CBD/CBS can be difficult to distinguish from Parkinson’s disease, Progressive Supranuclear Palsy (PSP) and some types of dementia, especially early on. The diagnosis often becomes clearer as symptoms and responses to treatment are monitored over time.

---

Treatment and management

There is currently no cure or disease-modifying treatment for CBD/CBS. Management focuses on treating symptoms, maintaining independence and supporting the person and their family.

Medication

• Parkinson’s medications (such as levodopa) may give limited benefit for stiffness or slowness in some people
• Medicines to help with muscle stiffness, jerks or dystonia where appropriate
• Treatments for mood, sleep, pain or other symptoms as needed

Medication plans are individualised and reviewed regularly, as responses can be variable.

---

Rehabilitation at The Royal Buckinghamshire Hospital

Our specialist multidisciplinary team (MDT) offers tailored inpatient neurorehabilitation for people living with CBD/CBS.

Multidisciplinary team

Your rehabilitation programme may involve:

• Consultants in Rehabilitation Medicine and Neurology
• Specialist rehabilitation doctors and nurses
• Physiotherapists
• Occupational therapists
• Speech and language therapists
• Neuropsychologists
• Dietitians and other allied health professionals

Physiotherapy

Physiotherapy focuses on:

• Improving or maintaining mobility, balance and strength
• Gait training and strategies to reduce falls
• Advice on safe transfers and use of walking aids and equipment

Occupational therapy

Occupational therapists help with:

• Everyday activities such as washing, dressing and eating
• Techniques and equipment to compensate for limb apraxia and weakness
• Assessments for wheelchairs, seating and postural management
• Home environment and equipment recommendations to support safe discharge

Speech and language therapy

Speech and language therapists assess and treat:

• Speech and communication changes, with strategies or communication aids if needed
• Swallowing difficulties, including safe swallowing techniques and texture modification
• Advice for families and carers on communication support

Cognitive, emotional and family support

• Neuropsychology input for thinking, behaviour and mood
• Support with adjustment, coping and advance planning
• Education and guidance for family members and carers

---

Who may benefit from inpatient rehabilitation?

• Reduced mobility, frequent falls or loss of function in an arm or leg
• Difficulties with daily activities such as dressing, washing or eating
• Swallowing or communication problems affecting safety or independence
• Increased care needs after a hospital stay or health setback
• Complex rehabilitation and equipment needs that require a coordinated MDT approach

We accept referrals from neurologists, rehabilitation consultants, GPs, other hospitals, case managers and solicitors.

---

Referrals and further information

To discuss a potential referral for Corticobasal Degeneration / Corticobasal Syndrome or to learn more about our neurological rehabilitation services:

• Visit our Neurological Rehabilitation and Inpatient Rehabilitation pages

Early access to specialist multidisciplinary rehabilitation can help people living with CBD/CBS, and those supporting them, plan ahead and maintain the best possible quality of life.