Talk:Corticobasal syndrome

Ping
User:Looie496, User:Mark viking, User:Brainist, Paul Wicks, User:Tryptofish, User:Seppi333 – are any of you around and able to add a sentence or three to this new page? Or maybe explain what it is a little more clearly? (It's five sentences long, and if it got about another 10 this week, then it might qualify for WP:DYK.) WhatamIdoing (talk) 00:59, 30 March 2018 (UTC)
 * Thanks for the ping. I've put this page on my watchlist. I've been involved with a lot of DYKs lately, and I'm currently kind of tired of them, plus I'm not familiar with this disorder, so I'm not likely to do very much with it. It's really more of a medical, neurological subject than a basic neuroscience one, so I would suggest posting about it at WT:MED. --Tryptofish (talk) 20:45, 30 March 2018 (UTC)

I changed this, but it needs to be checked. The source says "dementia with Lewy bodies", but it is a 2011 source, and the distinction between dementia with Lewy bodies (DLB) and the Lewy body dementias (LBD) isn't always made in older sources. I don't have access to the sources cited by Hassan where they say "dementia with Lewy bodies", and checking them may reveal whether they meant DLB or LBD. Sandy Georgia (Talk)  10:39, 31 March 2018 (UTC)

Harv referencing - RfC
Due to rarity of sources, I am planning to change to [Wikipedia:Harvard_citation_template_examples Harvard referencing] then we can clearly see which source is used within the text. Comments? Amousey (talk) 12:54, 1 June 2020 (UTC)
 * , I am sorry I failed to follow closely after creating this article, and multiple issues have been introduced, which I will correct next. No, please do NOT change to Harv referencing, which is dreadful.  This article should match the suite of other related articles in WP:CITEVAR (eg dementia with Lewy bodies).  Sandy Georgia  (Talk)  13:26, 1 June 2020 (UTC)
 * I will state the source in the text when it's significant instead then. Amousey (talk) 13:27, 1 June 2020 (UTC)
 * The bigger issue here is that you are using very old sources when there are plenty of new secondary reviews available. Have you researched PubMed for the latest secondary reviews?  Sandy Georgia  (Talk)  13:44, 1 June 2020 (UTC)

I have completed some basic repairs now to get back to square one; there are numerous recent secondary reviews available, so we don't need to use a 2005 book. Sandy Georgia (Talk)  14:25, 1 June 2020 (UTC)
 * The book was for the history section only, which had only just been started. I did a search for recent reviews as a place to start, yes, although I think it would have been better to not restrict by title since some of the reviews that cover several related syndromes are likely to be useful.
 * Pubmed is just one of several places to look. Differential diagnosis of cerebrotendinous xanthomatosis has several sources mentioning corticobasal syndrome. It does seem like the one specific article you mentioned might be getting undue weight since one main piece of research is being cited by multiple later reviews Stamelou 2013 is one. Atypical parkinsonism reviews brings up more. Stelten 2019. It's probably better to do the main diagnostic first though. Do you have particular sources in mind?  Amousey (talk) 15:23, 1 June 2020 (UTC).
 * Not necessarily-- just the most recent. For example, Palmera 2016 covered the same area as the 2005 Boeve book covered, and is freely available. If you are planning a lot of expansion here, I would just suggest using the most recent available.  Best, Sandy Georgia  (Talk)  15:37, 1 June 2020 (UTC)
 * Thanks for the suggestion. Do you have any preference over sources for diagnostic criteria. There's some on NORD but more recent criteria elsewhere. Amousey (talk) 20:29, 1 June 2020 (UTC)
 * Parmera says it’s a conundrum, so we have to describe the conundrum as sources do. Here is a recent explanation: https://www.sciencedirect.com/science/article/pii/S2590112519300167 Here are othre recent reviews:
 * mentions Armstrong′s criteria
 * Considering that there seems to be some contentiousness, I would suggest using the underlying literature before an org like NORD—especially since there is plenty of underlying literature. Sandy Georgia (Talk)  23:42, 1 June 2020 (UTC)
 * Many thanks Amousey (they/then pronouns) (talk) 19:57, 5 June 2020 (UTC)
 * Considering that there seems to be some contentiousness, I would suggest using the underlying literature before an org like NORD—especially since there is plenty of underlying literature. Sandy Georgia (Talk)  23:42, 1 June 2020 (UTC)
 * Many thanks Amousey (they/then pronouns) (talk) 19:57, 5 June 2020 (UTC)

Moved for discussion: CTX
I have moved this text here for discussion as it relies on an eight-year-old source, which is the only mention I can find of any association between CTX and CBC. I am unable to access the full text of the recent review at, which might be more useful in sorting this. Sandy Georgia (Talk)  14:00, 1 June 2020 (UTC)
 * Cerebrotendinous xanthomatosis can cause early parkinsonism, although rare, clinical findings of tendon xanthomata, early‐onset cataracts, and radiological findings of cerebellar atrophy with lesions of the dentate nuclei can help diagnosis.

Diagnostic criteria
Adding it here to help work out the formatting {{collapse bottom|Amousey (they/then pronouns) (talk) 00:25, 6 June 2020 (UTC) {{cot}}

Possible CBD

 * Insidious onset and gradual progression
 * Lasts 1 year or more
 * Meets one of the four subtypes:
 * Possible CBS
 * FBS or NAV
 * PSPS plus at least one CBS feature other than limb rigidity or akinesia
 * No exclusion criteria present
 * More likely if onset is after age 50
 * More likely if no family history (2 or more relatives)
 * More likely if no genetic mutation affecting T (e.g., MAPT)

Possible CBS
Symptoms may be symmetric or asymmetric. One or more of: More likely (probable sporadic CBS) if:
 * 1) limb rigidity or akinesia
 * 2) limb dystonia
 * 3) limb myoclonus, plus one of:
 * 4) orobuccal or limb apraxia
 * 5) cortical sensory deficit
 * 6) alien limb phenomena (more than simple levitation)
 * Asymmetric presentation
 * Onset after age 50
 * No family history (2 or more relatives)
 * No genetic mutation affecting T (e.g. MAPT)
 * plus two of:
 * 1) limb rigidity or akinesia
 * 2) limb dystonia
 * 3) limb myoclonus
 * plus two of:
 * 1) orobuccal or limb apraxia,
 * 2) cortical sensory deficit
 * 3) alien limb phenomena (more than simple levitation)

Frontal behavioural-spatial syndrome (FBS)
Two of:
 * 1) executive dysfunction
 * 2) behavioural or personality changes
 * 3) visuospatial deficits

NAV of primary progressive aphasia
Effortful, agrammatic speech plus at least one of:
 * 1) impaired grammar/sentence comprehension with relatively preserved single word comprehension or
 * 2) groping, distorted speech production (apraxia of speech)

Progressive supranuclear palsy syndrome (PSPS)
Three of:
 * 1) axial or symmetric limb rigidity or akinesia
 * 2) postural instability or falls
 * 3) urinary incontinence
 * 4) behavioural changes
 * 5) supranuclear vertical gaze palsy or decreased vertical saccade velocity

Exclusion criteria:
 * Evidence of Lewy body disease
 * multiple system atrophy
 * Alzheimer's disease
 * ALS
 * semantic or logopenic variant primary progressive aphasia
 * structural lesion suggestive of focal cause
 * granulin mutation or reduced plasma progranulin levels
 * TDP-43 or fused in sarcoma (FUS) mutations

Amousey (they/then pronouns) (talk) 00:25, 6 June 2020 (UTC)

Criteria added and page expanded
Feedback appreciated. Found it hard to present such complex info on the criteria in a way that's readable and clear. I know some terms need explaining. User:Looie496, User:Mark viking, User:Brainist, Paul Wicks, User:Tryptofish, User:Seppi333, User:SandyGeorgia Amousey (they/then pronouns) (talk) 16:12, 6 June 2020 (UTC)
 * My suggestions are better wikilinking, WP:MOSNUM adjustments (two not 2, fifty not 50, etc), and I would prosify the text rather than put it in a list, but that is up to you. I am also keen on citation consistency, and set up the article with the Boghog/Diberrri style.  If you are planning to expand further, perhaps you would rather use your own citation style.  If you are not planning further work, I eventually may add more, so would stick with the established style that I used when creating the article-- let me know please. Also, it is unclear why something is more likely when there is no family history, so again, prosifying the text to add more explanation-- rather than just listing criteria-- might help.  Sandy Georgia  (Talk)  16:56, 6 June 2020 (UTC)

Next, there is already an article at Corticobasal degeneration, and yet someone altered the lead here to combine the two articles? A whole lot of this text belongs not here, but at corticobasal degeneration; shall I move it? This is the CBS article, but all of the criteria apply to CBD. Sandy Georgia (Talk)  17:44, 6 June 2020 (UTC)
 * Most of what was written belonged at CBD, so I have moved it-- that is the article that needs repair and expansion now :) Sandy Georgia  (Talk)  18:14, 6 June 2020 (UTC)
 * I hadn't realized there was a separate CBD article - I thought this was the CBD article but confused it with CBS so ended up covering both. Criteria for the other subtypes of CBD should probably be moved or removed from the CBS page. According to WP:MOSNUM 50 / fifty are equally accepted. I'm going to leave the rest of this to you since I don't follow what needs clarifying. Almost all the papers are available in full online. Possible CBD also has exclusions in Armstrong (see Table 5 notes under table), and 1 year duration is a criteria (currently reads more like a description). De Stasi ref is broken. Amousey (they/then pronouns) (talk) 21:40, 6 June 2020 (UTC)
 * , I am not watching CBD ... only this article, that I created. It would be grand if you would continue to expand CBD!  Sandy Georgia  (Talk)  14:47, 7 June 2020 (UTC)

Infobox
Can I just check why Infobox Medical Condition was removed? The edit tag was "Consensus not established", but asking for others opinions on whether to add an infobox seems overly-bureaucratic. Little pob (talk) 14:16, 7 June 2020 (UTC)
 * I do not support infoboxes in general on medical content (because they always advance misinformation and cannot convey nuance), but I am particularly opposed to them on underdeveloped topics, where they add even more of nothing. Arbitration/Requests/Case/Infoboxes. Featured article dementia with Lewy bodies is promoting marginal information in its lead via an infobox; the utility of them should be established article by article, and they should not be an assumed addition. Just as we have some guidelines being widely interpreted as policy in medical editing, we have editors automatically adding infoboxes, without always considering if the information advanced in them is helpful.  Sandy Georgia  (Talk)  14:45, 7 June 2020 (UTC)
 * Thanks, I don't recall seeing that before. I've added it to the template's documentation so other editors are aware. Little pob (talk) 16:42, 7 June 2020 (UTC)

Syndrome needs better clarification from disease here
I think this article might benefit from clarification, it's hard for the average reader to understand that CBS is a presentation of a neurological disease rather than a disease per se.

I suggest

CBS comprises of a group of symptoms (a syndrome) that represents a common presentation of CBD.

PSPS shouldn't link to PSP as PSP and CBD are distinct clinical aetiologies with a different neuropathology. Maybe this section could be expanded.

PainProf (talk) 18:27, 21 June 2020 (UTC)
 * We can do that if you have a recent secondary review that supports the proposed text. Regards, Sandy Georgia  (Talk)  18:42, 21 June 2020 (UTC)


 * I think this is supported by the existing sources. Per source 1: "The term CBS denotes the clinical phenotype and is associated with a heterogeneous spectrum of pathologies. "

PSP is distinct and described here: PMC5516529 PainProf (talk) 20:09, 21 June 2020 (UTC)