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Overview – Corticobasal degeneration

Corticobasal degeneration (CBD) is a rare condition that can cause gradually worsening problems with movement, speech, memory and swallowing.

It’s often also called corticobasal syndrome (CBS).

CBD is caused by increasing numbers of brain cells becoming damaged or dying over time.

Most cases of CBD develop in adults aged between 50 and 70.

CBD symptoms

The symptoms of CBD get gradually worse over time. They are very variable and many people only have a few of them.

Symptoms can include:

  • difficulty controlling your limb on one side of the body (a “useless” hand)
  • muscle stiffness
  • shaking (tremors), jerky movements and spasms (dystonia)
  • problems with balance and co-ordination
  • slow and slurred speech
  • symptoms of dementia, such as memory and visual problems
  • slow, effortful speech
  • difficulty swallowing

One limb is usually affected at first, before spreading to the rest of the body. The rate at which the symptoms progress varies widely from person to person.

Read more about the symptoms of CBD.

What causes CBD?

CBD occurs when brain cells in certain parts of the brain are damaged as a result of a build-up of a protein called tau.

The surface of the brain (cortex) is affected, as well as a deep part of the brain called the basal ganglia.

Tau occurs naturally in the brain and is usually broken down before it reaches high levels. In people with CBD, it isn’t broken down properly and forms harmful clumps in brain cells.

CBD has been linked to changes in certain genes, but these genetic links are weak and the risk to other family members is very low.

Diagnosing CBD

There’s no single test for CBD. Instead, the diagnosis is based on the pattern of your symptoms. Your doctor will try to rule out other conditions that can cause similar symptoms, such as Parkinson’s disease or a stroke.

You may need to have a brain scan to look for other possible causes of your symptoms, as well as tests of your memory, concentration and ability to understand language.

The diagnosis must be made or confirmed by a consultant with expertise in CBD. This will usually be a neurologist (a specialist in conditions affecting the brain and nerves).

Treatments for CBD

As someone with CBD can be affected in many different ways, treatment and care is best provided by a team of health and social care professionals working together. Treatments may include:

  • medication – to improve stiffness and muscle spasms, sleep and mood, pain or memory
  • physiotherapy – to help with movement and balance difficulties
  • speech and language therapy – to help with communication and swallowing problems
  • occupational therapy – to improve the skills and abilities needed for daily activities at home
  • palliative care and advanced care planning

Outlook

There is currently no treatment that has been shown to stop CBD getting gradually worse, although treatments can reduce many of the symptoms.

Good care and assistance can help someone with CBD be more independent and enjoy a better quality of life, but the condition will eventually put them at risk of serious complications.

CBD usually changes very slowly. Many people find it helpful to plan ahead with their doctors (GP and specialist) to make decisions about what to do in later stages of the illness.

Difficulty swallowing can cause choking, or inhaling food or liquid into the airways. This can lead to pneumonia, which can be life-threatening.

As a result of these complications, the average life expectancy for someone with CBD is around 6 to 8 years from when their symptoms start. However, this is only an average and CBD is very variable.

Information about you

If you have CBD, your clinical team will pass information about you on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS).

This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time.

Page last reviewed: 20 August 2018
Next review due: 20 August 2021

Read about corticobasal degeneration (CBD), a rare condition where brain cells become damaged over time and certain sections of the brain start to shrink.

CBD consumption to rise across the treatment of neurological conditions

Research shows that CBD consumption for the treatment of neurological conditions is set to rise.

With an exponential rise in the availability of CBD products and public opinion towards it becoming more positive over the past decade, the consumption of the ingredient has exploded. Global Market Insights, Inc., forecasts that global cannabidiol market size will be worth more than $89bn by 2026.

However, the industry will need to overcome the complex regulatory landscape as well as quality and supply challenges in the near future.

Over the past few years, cannabidiol, or CBD, has caught the public’s imagination as an ingredient presenting a range of health benefits when infused in various consumables. More and more individuals worldwide are now vouching for its effectiveness in terms of alleviating certain chronic illnesses and treating several health conditions.

CBD has conquered industry after industry, from pharmaceuticals to personal care and cosmetics, food and beverages, and nutraceuticals.

Cannabidiol is the legal and non-psychoactive counterpart of tetrahydro cannabidiol (THC), the chemical compound responsible for cannabis’s psychological effects. CBD is the second most-commonly used active ingredients of cannabis. The cannabinoid is derived directly from the hemp plant, a cousin of the cannabis plant, and forms an essential component of medical cannabis.

CBD regulatory landscape in Europe

Factors such as population growth, nationalised healthcare, GDP, and cultural historic use of CBD in many European countries make the continent an attractive market for global producers of both medical and retail cannabis-based products. Hemp cultivation in the region has witnessed a massive upsurge in recent years; the European Union (EU) constitutes more than 25% of the global hemp production.

In July last year Epidiolex CBD oil received a positive recommendation for marketing approval from the European Medicines Agency (EMA) for the treatment of seizures. EMA’s Human Medicines Committee (CHMP) approved the oral solution for use with clobazam for the treatment of seizures associated with Dravet syndrome or Lennox-Gastaut syndrome in patients aged two or more.

The European Commission granted marketing approval to Epidyolex, the trade name for Epidiolex in Europe, in September 2019. Epidiolex is the only federally-approved CBD product in the U.S.

Additionally, the use of CBD in cosmetics is harmonised within the European Cosmetic Regulation 1223/2009. The regulation prohibits the use of cannabis and its derivatives in cosmetic products. Essentially, EU prohibits the use of CBD derived naturally from cannabis plants. However, the use of hemp-derived or synthetically-produced cannabidiol is approved.

Europe CBD market is poised to witness monumental growth in the forthcoming years on account of surging consumer demand for safe-strength CBD products that are easily available in their normal retail environments and cultivated, extracted, processed and labelled as per the European standards.

Growing burden of neurological diseases in Europe

Europe has witnessed a growing occurrence of various neurological conditions in recent years. These include epilepsy, migraine, stress, anxiety, and numerous sleeping disorders. An expanding geriatric population base indicates rising incidences of these conditions. Citing data from the European Brain Council, more than 220 million people in Europe suffer from at least one neurological condition, which is more than the populations of France, Germany, and the Great Britain combined.

Described below are some of the most prevalent neurological conditions in Europe and the effectiveness of CBD in their treatment.

  • Stress and anxiety – Nearly 25% of the European population suffers from stress, anxiety or depression each year. The effectiveness of CBD products as anti-anxiety nutraceuticals is backed with plenty of research, however there is still a long way to go. Several clinical trials have provided considerable evidence of cannabidiol’s usefulness for the treatment of generalised anxiety disorder (GAD), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), social anxiety disorder, and panic disorder;
  • Migraine – Migraine currently affects more than 11% of the global population. The social societal burden of migraine in Europe is an approximately €27bn per year. While pain medications are known to help temporarily alleviate the symptoms of migraine, they can have several side-effects. Research concerning the use of cannabidiol for migraine is limited however a number of laboratory studies suggest that CBD oil may help reduce all types of acute and chronic pain, including migraine; and
  • Seizures – In Europe, close to six. million people suffer from epilepsy, while 15 million people will have at least one seizure at some point during their lifetime. Numerous research studies over the years have demonstrated the benefits and effectiveness of hemp-derived CBD products in patients with epilepsy who have not responded to traditional treatment.

Surging popularity of cannabidiol among boomers along with ongoing research and development into its potential health benefits will augment CBD market forecast. More and more boomers are adding CBD to their health regimes to help reduce stress and anxiety, get better sleep, and alleviate chronic pain. Increasing awareness towards the safety and efficacy of cannabidiol products will drive future CBD industry trends.

Hrishikesh Kadam
Guest Contribution
Global Market Insights
www.gminsights.com

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Research shows that CBD consumption for the treatment of neurological conditions is set to rise.