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Looking beyond the basal ganglia: The spectrum of MRI changes in methylmalonic acidaemia
Author(s) -
Harting I.,
Seitz A.,
Geb S.,
Zwickler T.,
Porto L.,
Lindner M.,
Kölker S.,
Hörster F.
Publication year - 2008
Publication title -
journal of inherited metabolic disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 102
eISSN - 1573-2665
pISSN - 0141-8955
DOI - 10.1007/s10545-008-0801-5
Subject(s) - basal ganglia , white matter , brainstem , cerebellum , pathology , magnetic resonance imaging , medicine , neuroimaging , methylmalonic acidemia , methylmalonic acid , neuroscience , psychology , central nervous system , audiology , pediatrics , radiology , homocysteine
Summary We report imaging abnormalities from 5 brain MR examinations in 4 children with methylmalonic acidaemia between the ages of 20 days and 31 months. In addition to bilateral basal ganglia lesions (pallidum) observed in 3 of 4 children, we found signs of delayed brain maturation (myelination delay, immature gyral pattern, incomplete opercularization) in all children and signs of a white matter disorder in the 3 older children. Unexpectedly, brainstem and cerebellar changes were present in all children. Reviewing the brain imaging changes reported for methylmalonic acidaemia, we discuss the findings and patterns observed in our patients. We postulate that delayed myelination and signs of a white matter disorder as well as brainstem and cerebellar involvement are common findings and may be due to a chronic neurotoxic effect on the developing and ageing brain.