Serial Follow-up of White Matter Connectivity in a Patient with Progressive Multifocal Leukoencephalopathy Presenting Clinical Improvement

ABSTRACT

Progressive multifocal leukoencephalopathy (PML) is a fatal disease that is characterized by progressive demyelination of the cerebral white matter due to JC viral infection. We report serial magnetic resonance spectroscopy (MRS) and tractography changes in a patient with PML. After a three-cycle treatment with cidofovir and cytarabine, the patient exhibited remarkable improvements in motor and cognitive functions. Follow-up MRS and tractography revealed regeneration of the white-matter fibers. This is the first consecutive neuroimaging study showing improvements in neurological symptoms using MRS and tractography.