Toxic Leukoencephalopathy by liaoqinmei



   Christopher M. Filley, M.D.
B.K. Kleinschmidt-DeMasters, M.D.
      Douglas K. Novins, M.D.
      Spero M. Manson, Ph.D.
    Departments of Neurology,
     Psychiatry, and Pathology
 University of Colorado School of
• Leukoencephalopathy is a
  structural alteration of brain
  white matter
• Toxic causes include drugs of
  abuse, cranial irradiation,
  therapeutic drugs, and
  environmental toxins
• Affected individuals may
  develop white matter dementia
   Cranial Irradiation
• Radiation for brain tumors can reduce
  the tumor size but also can produce
  unwanted leukoencephalopathy
• The left MRI scan shows a malignant
  brain tumor before radiation; after
  radiation (right), the tumor is smaller
  but the white matter is damaged
    Other Toxins that Can
    Damage Brain White
• Alcohol (ethanol)
• Cocaine
• Intravenous heroin
• Hallucinogenic drugs
• Probably Ecstacy
• Even anticancer drugs doctors
  use for treatment of the tumor
  may have the unwanted (but
  currently unpreventable) side
  effect of leukoencephalopathy
• In toxic leukoencephalopathy,
  white matter damage can result
  from injury to any important part
  of the white matter including
  myelin, oligodendrocytes, axons,
  astrocytes, or blood vessels
  Toluene Abuse
• Toluene is an organic solvent
  commonly used in many
  household products, including
  spray paint, and in industry
• Heavy “glue/paint/ or gasoline
  sniffing”, a form of inhalant drug
  abuse often used by American
  Indian and urban youth, results in
         Future Aim
• Study brain damage due to toluene
  abuse in American Indian and
  urban youth, in whom the
  prevalence of this problem is high,
  by performing detailed
  neurological, neuropsychological,
  & psychiatric evaluations, in
  conjunction with advanced brain
  imaging (MRI) techniques, to
  clarify the impact of this toxin on
  brain function
• This population has NEVER been
  adequately studied, nor has the
  impact of the problem been fully
The American
Indian and
Alaska Native
 To promote the health and
 well-being of American
 Indians and Alaska Natives,
 of all ages, by pursuing
 research, training, continuing
 education, technical
 assistance, and information
 dissemination within a
 biopsychosocial framework
 that recognizes the unique
 cultural contexts of this
 special population.

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