Cited by 414Hereditary Neurological DisordersMetabolism and Genetic DisordersCerebrovascular and genetic disorders

Leukodystrophies: a proposed classification system based on pathological changes and pathogenetic mechanisms

Open access
van der Knaap, Marjo S., Bugiani, Marianna·2017·Acta Neuropathologica

Abstract

Leukodystrophies are genetically determined disorders characterized by the selective involvement of the central nervous system white matter. Onset may be at any age, from prenatal life to senescence. Many leukodystrophies are degenerative in nature, but some only impair white matter function. The clinical course is mostly progressive, but may also be static or even improving with time. Progressive leukodystrophies are often fatal, and no curative treatment is known. The last decade has witnessed a tremendous increase in the number of defined leukodystrophies also owing to a diagnostic approach combining magnetic resonance imaging pattern recognition and next generation sequencing. Knowledge on white matter physiology and pathology has also dramatically built up. This led to the recognition that only few leukodystrophies are due to mutations in myelin- or oligodendrocyte-specific genes, and many are rather caused by defects in other white matter structural components, including astrocytes, microglia, axons and blood vessels. We here propose a novel classification of leukodystrophies that takes into account the primary involvement of any white matter component. Categories in this classification are the myelin disorders due to a primary defect in oligodendrocytes or myelin (hypomyelinating and demyelinating leukodystrophies, leukodystrophies with myelin vacuolization); astrocytopathies; leuko-axonopathies; microgliopathies; and leuko-vasculopathies. Following this classification, we illustrate the neuropathology and disease mechanisms of some leukodystrophies taken as example for each category. Some leukodystrophies fall into more than one category. Given the complex molecular and cellular interplay underlying white matter pathology, recognition of the cellular pathology behind a disease becomes crucial in addressing possible treatment strategies.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1007/s00401-017-1739-1

Cites

276 of 277 references verified1 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The astrocytic contribution of the TSPO signal could complicate differentiation of multiple sclerosis from leukodystrophies that have significant astrocytic but not microglial involvement.

    “The astrocytic contribution of the TSPO signal could also complicate differentiation of multiple sclerosis from leukodystrophies that have significant astrocytic but not microglial involvement (van der Knaap and Bugiani, 2017).”

    From A quantitative neuropathological assessment of translocator protein expression in multiple sclerosis (2019) · cites this paper as van der Knaap and Bugiani, 2017

    In “Astrocytopathies” (page not provided), the paper reports fibrillary astrogliosis with little, if any, microglial activation in one leukodystrophy, MLC. It does not address TSPO signals or whether an astrocytic signal complicates differentiation from multiple sclerosis. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. [146]Nahhas N, Conant A, Hamilton E, Curiel J, Simons C, van der Knaap M, Vanderver A (1993) TUBB4A-Related Leukodystrophy. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, Bird TD, Ledbetter N, Mefford HC, Smith RJH et al (eds) GeneReviews(R). University of Washington, Seattle. GeneReviews is a registered trademark of the University of Washington, Seattle, City 27809427
  2. [173]Powers JM Pathology & genetics 2004 Developmental neuropathology ISN Neuropath Press, City
  3. [213]Suzuki K, Suzuki K (1996) The gangliosidoses. In: handbook of clinical neurology, RJ Vinken and GW Bruyn, Revised series Vol 22 (66) Neurodystrophies and neurolipidoses, HW Moser (ed) Elsevier Science B.V., Amsterdam, pp.247-280.
  4. [214]Suzuki KV, Vanier M.T. (2004) Sphingolipidoses. In: Pathology & genetics. Developmental neuropathology. JA Golden, BN Arding (eds). ISN Neuropath, Basel. pp.235-236.

Cited by

Sorted by citations

Authors
van der Knaap, M. S., & Bugiani, M.
Affiliations
Amsterdam Neuroscience (NL)
Corresponding author
Bugiani, Marianna
Venue
Acta Neuropathologica
Published
2017-06-21
Volume
134
Issue
3
Pages
351-382
ISSN
  • 0001-6322 (ISSN-L)
  • 1432-0533
OpenAlex
W2653495475
Cited by
403
References
276
Citations by year
2026: 32 · 2025: 49 · 2024: 79 · 2023: 52 · 2022: 36 · 2021: 51 · 2020: 39 · 2019: 45 · 2018: 13 · 2017: 5
FWCI
3.44
Type
journal article
Language
en
Open access
Locations
  • Acta Neuropathologica (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • VU Research Portal (publishedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • Vrije Universiteit Amsterdam
  • Fonds NutsOhra
Topics
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Hereditary Neurological Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
  • Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
Keywords
leukodystrophy, white matter pathology, hypomyelinating leukodystrophy, astrocytopathy, oligodendrocytes, myelin disorders, neuropathology, disease mechanisms
MeSH terms
Axons, Demyelinating Diseases, Humans, Myelin Sheath, Neuroglia, White Matter

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review