from Section 8 - Pediatrics
Published online by Cambridge University Press: 05 March 2013
Introduction
Magnetic resonance spectroscopy (MRS) provides in vivo information into the metabolic alterations occurring during the different stages of white matter (WM) diseases. Inborn metabolic/genetic disorders are considered here, while the acquired, mainly inflammatory or hypoxic–ischemic conditions, are addressed in Chs. 28, 30, and 48.
This chapter describes metabolic characteristics as shown by MRS of WM caused primarily by hereditary conditions (leukodystrophies; Table 52.1). The classification of leukoencephalopathies used here is based on the concept of hypomyelination and demyelination (Table 52.2). Some of these disorders are discussed in Chs. 30 and 53.
Several comprehensive reviews on this topic are available. Most publications deal with individual disease entities and will be referred to in the respective sections.
Lysosomal disorders
Metachromatic leukodystrophy
Metachromatic leukodystrophy (MLD, MIM #250100) is an autosomal recessive lysosomal storage disorder caused by mutations in the gene ARSA on chromosome 22q13.31-qter. A deficiency of arylsulfatase A leads to accumulation of cerebroside sulfates in cerebral WM and peripheral nerves.
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