How to restore white matter deformation

White matter is the area inside the brain where nerve fibers gather. It is called white matter because its color is lighter than the surface of the brain where cell bodies gather. There are many types of lesions that can occur in the white matter of the brain, and white matter degeneration is one of them. White matter disease is a structural change of the brain, characterized by damage to the myelin sheath of central nervous cells. The lesions involve the white matter tracts that are specialized for higher brain functions. Now let’s see how to restore white matter deformation.

Symptoms and clinical classification: The most significant clinical manifestation of leukoencephalopathy is the change in mental status, that is, in the absence of aphasia, there is at least one defect in attention, memory, visual-spatial skills, executive function, and emotional state. Mild cases present with a chronic state of confusion, accompanied by inattention, memory loss and emotional dysfunction; more severe cases produce serious sequelae such as dementia, loss of consciousness, stupor and coma. Gray matter diseases, on the other hand, primarily affect language, behavior, or sensory functions. If focal necrosis of the white matter occurs, changes in mental status may be more prominent than general physical signs such as hemiparesis, sensory disturbances, and visual loss. The distribution of lesions in toxic leukoencephalopathy is usually diffuse, and its clinical grade generally parallels the severity of white matter damage.

Laboratory tests: Initial mental status examination, including tests to assess inattention, a three-word delayed recall test to identify memory impairment, clock drawing to assess visual dysfunction, and an alternating movement sequence to assess brain function. If the mental status examination results are equivocal, further neuropsychiatric testing may be performed. If the first two types of tests of the initial mental status examination reveal no deficits, then no detectable brain damage is confirmed. If the first two types of tests reveal abnormalities, brain neuroimaging may be performed. Magnetic resonance imaging is the preferred examination method and is an important means of distinguishing early or mild white matter disease from mental illness, while CT can only show severe white matter damage.

Its clinical manifestations range from inattention, forgetfulness and personality changes to dementia, coma and even death. White matter will gradually develop fully in different brain regions when humans reach around 20 years old. The timing and maturity of its growth will affect learning, self-control and mental illnesses, such as schizophrenia, autism and pathological lying. One of the reasons for adolescents' youthful recklessness is also due to the incomplete development of white matter.

The condition of most patients with leukoencephalopathy is reversible, but a small number of patients are irreversible. Therefore, if appropriate preventive measures are taken, the patient's symptoms can be significantly improved. However, the treatment methods for white matter disease have certain limitations, and there is currently no unified treatment plan. Therefore, prevention is very important. Treatment is mostly with large amounts of corticosteroids, but anticoagulants may also be used. There have been 6 cases of breast cancer patients with leukoencephalopathy caused by 5-fluorouracil chemotherapy, 5 of whom had clinical improvement after treatment with glucocorticoids in the early stage of symptoms. In addition, clinical evidence shows that the occurrence of leukoencephalopathy in these patients is unrelated to their age, gender, pathology, and breast cancer stage.