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ABCD1 dysfunction alters white matter microvascular perfusion.

Arne Lauer1,2, Xiao Da3, Mikkel Bo Hansen4

  • 1Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.

Brain : a Journal of Neurology
|November 15, 2017
PubMed
Summary
This summary is machine-generated.

X-linked adrenoleukodystrophy (X-ALD) involves brain microvascular dysfunction, leading to neurodegeneration. Early detection of capillary flow changes in white matter may predict disease progression and treatment response.

Keywords:
ABCD1ALDcerebral X-linked adrenoleukodystrophyinflammatory demyelinationmicrovascular perfusion

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Area of Science:

  • Neuroscience
  • Genetics
  • Vascular Biology

Background:

  • X-linked adrenoleukodystrophy (X-ALD) is a severe neurodegenerative disorder caused by ABCD1 gene mutations.
  • It leads to progressive cerebral inflammatory demyelination in males, with white matter microvascular dysfunction implicated in disease onset.

Purpose of the Study:

  • To investigate the role of ABCD1 in white matter microvascular function.
  • To identify early biomarkers for cerebral X-ALD progression and treatment response.

Main Methods:

  • Utilized a vascular model with dynamic susceptibility contrast magnetic resonance perfusion imaging.
  • Analyzed capillary flow heterogeneity and blood-brain barrier permeability in X-ALD patients and asymptomatic carriers.

Main Results:

  • Asymptomatic hemizygotes showed increased capillary flow heterogeneity in white matter, predicting disease conversion.
  • Ongoing demyelination correlated with capillary flow heterogeneity followed by blood-brain barrier changes, predicting lesion progression.
  • Hematopoietic stem cell transplantation normalized microvascular alterations within a year.

Conclusions:

  • ABCD1 deficiency impairs white matter microvascular function, contributing to X-ALD pathogenesis.
  • Microvascular alterations serve as early biomarkers for disease progression and treatment efficacy in X-ALD.