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Prominent brain axonal damage and functional reorganization in "pure" adrenomyeloneuropathy.
[adrenomyeloneuropathy]
Cerebral
involvement
is
usually
absent
in
pure
adrenomyeloneuropathy
(
AMN
)
.
Recently
,
nonconventional
MR
studies
have
reported
brain
abnormalities
in
patients
with
pure
AMN
,
providing
evidence
that
occult
cerebral
involvement
may
occur
in
this
disease
.
It
remains
unclear
,
however
,
whether
these
brain
abnormalities
reflect
centripetal
extension
of
spinal
cord
long
-tract
axonopathy
or
can
be
the
expression
of
a
pathologic
process
largely
involving
the
brain
.
Conventional
MRI
and
proton
MR
spectroscopic
imaging
(
1
H-MRSI
)
data
of
four
patients
with
pure
AMN
were
compared
to
those
of
four
men
with
spinal
cord
injury
(
SCI
)
and
10
age-matched
healthy
men
(
HM
)
.
Resonance
intensity
areas
of
N-
acetylaspartate
(
NAA
)
and
choline
were
calculated
as
ratios
to
creatine
(
Cr
)
in
voxels
located
in
white
matter
(
WM
)
regions
.
Functional
MRI
(
fMRI
)
data
during
simple
motor
task
were
obtained
in
a
separate
session
in
three
patients
with
AMN
and
three
age-matched
HM
.
Conventional
MRI
examinations
were
normal
in
all
patients
.
On
1
H-MRSI
,
NAA
/
Cr
values
were
lower
in
all
WM
regions
of
patients
with
AMN
than
in
those
of
patients
with
SCI
(
p
<
0
.
05
)
and
HM
(
p
<
0
.
01
)
.
In
contrast
,
patients
with
SCI
showed
NAA
/
Cr
values
lower
than
HM
only
in
the
periventricular
WM
(
p
=
0
.
04
)
.
At
fMRI
,
patients
with
AMN
showed
a
more
pronounced
activation
than
HM
in
all
movement-associated
cortical
regions
contralateral
to
the
hand
moved
and
an
exclusive
voxel
activation
of
the
primary
motor
,
somatosensory
,
and
posterior
parietal
cortices
ipsilateral
to
the
hand
moved
.
CNS
damage
in
pure
adrenomyeloneuropathy
is
not
confined
exclusively
to
spinal
cord
and
seems
to
primarily
involve
the
brain
.
Diseases
Validation
Diseases presenting
"white matter"
symptom
22q11.2 deletion syndrome
adrenomyeloneuropathy
alexander disease
cadasil
canavan disease
classical phenylketonuria
cushing syndrome
gm1 gangliosidosis
hereditary cerebral hemorrhage with amyloidosis
homocystinuria without methylmalonic aciduria
kabuki syndrome
kallmann syndrome
krabbe disease
neonatal adrenoleukodystrophy
proteus syndrome
pyruvate dehydrogenase deficiency
sneddon syndrome
wiskott-aldrich syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
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