The effect of white matter integrity on functional outcome in central pontine demyelination.
Kyoung Bo Lee, Bo Young Hong, Joon Sung Kim and 3 others
PMID 31528012WHAT IT FOUND
Two patients with central pontine demyelination showed preserved corticospinal tract integrity and discontinuous corticoreticular pathways on MRI.
This pattern matched their clinical recovery: hand function returned fully while lower limb ataxia persisted.
Key findings
01Diffusion tensor imaging showed preserved corticospinal tract integrity but discontinuous corticoreticular pathways in both patients.
02Clinical recovery aligned with tract findings: hand function returned fully, but lower limb ataxia remained.
03Both patients regained most functional abilities for gait and hand function one year after onset.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study included only two patients, so findings cannot be generalized. The cross-sectional design meant early-stage tensor images were not collected, so changes in diffusion tensor imaging over time were not investigated. The rarity of central pontine demyelination limits the ability to draw firm conclusions about prognosis from this small sample.
Declared interests
The authors declare no financial or other conflicts of interest.
The easy way to misread this
Do not assume that preserved corticospinal tract integrity on MRI guarantees full recovery of lower limb function. In these two patients, the corticoreticular pathway was discontinuous, and they still had persistent ataxia despite hand function returning.