As parents have the choice to participate in the study without their infant undergoing brain MRI, there will be three strata: 1) nil to mild white matter abnormality, 2) moderate to severe white matter abnormality, or 3) no-MRI group.
Our present findings equally showed that larger CTG repeat sizes were associated with more severe white matter affection in several brain regions.
All other neuropsychological parameters did not differ between patients with myotonic dystrophy types 1 and 2. Patients with myotonic dystrophy type 1 had more frequent and severe white matter lesions than controls in total white matter lesions scores assessing the whole brain (sum of bihemispheric scores/total score, P = 0.03).
31 We did not find evidence in our study that white matter lesions increase the risk of LRTI, although Binswanger's disease, which presents with severe white matter lesions, is associated with dysphagia.
Eighty-eight per cent of subjects had mild white matter involvement (modified Scheltens score 0 10), 12% showed moderate involvement (scores 11 20) and none showed severe white matter involvement.
MRI confirmed the severe white matter lesions concentrated around the periventricular, pons, external capsule and the anterior temporal pole and multiple subcortical lacunar infarcts (Figure 1D-1F).
The MR images were inspected by 2 to 3 well-trained radiologists, and images with the following findings were excluded from this study: head injuries, brain tumors, hemorrhages, major and lacunar infarctions, and moderate to severe white matter hyperintensities.
Recent neuropathologic reports of severe white matter damage (i.e. leukoencephalopathy) in patients with HIV-1 infection and on HAART with very low viral load [10], [11], [12], [13], suggest that additional patterns of primary brain disease are emerging, possibly due to as yet unexplained interactions between the virus, vulnerable populations of neural cells, and HAART [14], [15].
We observed nine rare non-synonymous SNPs, which were only present in subjects with severe white matter lesions.
More severe gray matter deficits have been reported in alcohol relapsers than those who maintained abstinence (Pfefferbaum et al. 1998).
