A case study of corticobasal degeneration patient who's symptoms were partially ameliorated by using SSRI

DOI 15 References
  • Ishii Hiroshi
    Department of Geriatric Behavioral Neurology,Tohoku University Graduate School of Medicine Kawasaki Kokoro Hospital
  • Meguro Kenichi
    Department of Geriatric Behavioral Neurology,Tohoku University Graduate School of Medicine
  • Akanuma Kyoko
    Department of Geriatric Behavioral Neurology,Tohoku University Graduate School of Medicine
  • Yamaguchi Satoshi
    Department of Geriatric Behavioral Neurology,Tohoku University Graduate School of Medicine Oosaki-Tajiri SKIP center
  • Mori Etsuro
    Department of Behavioral Neurology and Cognitive Neuroscience,Tohoku University Graduate School of Medicine

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  • SSRI 投与により症状の一部改善を認めた大脳皮質基底核変性症の一例

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  [Background] There are few therapeutic approaches for patients with corticobasal degeneration(CBD). We report a case of CBD whose physical and cognitive symptoms were partially ameliorated by SSRI.[Case] A right-handed, 80-year-old man, with 6 years educational level was studied. He had several episodes of fall from 2001. Speech disturbance became worse at the end of 2002. He was diagnosed as pseudo-bulbar palsy caused by cerebral infarctions at a hospital. His dysarthria and dysfunction of left upper arm got worse gradually, and he was admitted to our hospital in May, 2004. Neurologically, he had dysarthria, impairment of vertical eye movement, hyper-activity of jaw jerk reflex, decreased gag reflex, paratonic rigidity, increased deep tendon reflex, and mild retropulsion. He had disorder of attention, executive function, mental speed, and construction. MRI disclosed the right central sulcus being wider than the left. There were cerebral blood flow reduction at the periphery of right central sulcus and right basal ganglia as shown by SPECT. His symptoms met the CBD criteria of the ministry of Health, Labour and Welfare of Japan, and the Boeve's criteria. When he took SSRI(Paroxetine 10mg), his walking speed and balance were improved. Cognitive functions were also improved in the 2-or-3-month follow up evaluation; MMSE from 20 to 25, digit span backward from 3 to 4, trail making test part B from ‘incomplete’ to complete(16' 29" ), Rey's complex figure copy from 22. 5 to 29, immediate recall from 9. 5 to 15, delayed recall from 8. 5 to 13. 5.[Discussion] We considered that the patient's physical and cognitive dysfunctions were ameliorated by the replacement of serotonin which decreased in the brain of CBD.

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