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What Causes An Increase Of White Matter In Brain?

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Posted on Sat, 12 Mar 2016
Question: why does the brain continue to increase the white matter.
doctor
Answered by Dr. Dariush Saghafi (4 hours later)
Brief Answer:
Not sure what you're referring to...please expand your question a bit

Detailed Answer:
Good evening and thank you for the interesting question but I must admit that without a little more information I'm not sure I'm understanding what you're trying to ask. Does this relate to a clinical condition that you're interested in knowing about?

White matter itself is a common or generic term for the substance known as myelin and this is produced by a set of cells in the brain called oligodendrocytes. The myelin is protein in content and wraps around axons that transmit electrical impulses from one part of the brain to some other part of the nervous system such as the brain, spinal cord, or out to the muscles and organs...wherever the nerve goes that we're talking about.

The process of myelination is ongoing for about the first 25-30 years of an individual's life. After that the entire volume and all lobes of the brain have been myelinated and covered. Beyond that I'm not aware of anything in the literature that states that myelination CONTINUES to occur or accumulate. If there is damage to the myelin sheath covering a nerve then, there is a process of REPAIR called REMYELINATION but this is just laying down more myelin that was lost or damaged. I wouldn't consider that INCREASING myelin so much as just replacing what was already there...I don't know if that's what you're referring to.

If you'd like to clarify your question a bit more then, I may be able to help with a more direct answer otherwise, I would have to answer your question by saying that after a certain point in maturity of the person the brain DOES NOT continue to increase its white matter.....Taking that concept one step further into the aging individual and talking about the elderly we actually talk about a LOSS OF MYELIN and this probably happens just as a result of the normal aging process but if we lose too much- things start going wrong with the way people think, move, or perceive sensations in the brain. So that process of DEMYELINATION actually can start to occur but again this represents a loss of the insulation or covering and can conceivably happen just due to aging processes...or if too much...pathological processes.

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them in the context of your question.

Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.

Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

This consult request has taken a total of 40 minutes of time to read, research, and respond.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dariush Saghafi (8 hours later)
In 2006 I had an incident that caused me to drive irradically. I was stopped by the police, taken by ambulance to the nearest hospital and had exrays, CT's, and MRI's of my brain. The reports stated it appeared I had an unusual amount of white matter in my brain. Since then I receive an MRI to monitor the white matter and it has increased in sized. Now the radiologist has noticed that clusters of white matter have developed in the frontal part of the frontal lobe. I have pressure on the left optic nerve. In August 2003 I was a Naval Reservist doing my 2 weeks at Camp Pendelton in California. The second week there we had to drink water from a water XXXXXXX (a metal drum that sits in the heat). The water did not taste right and I informed my immediate supervisor, it went up the chain of command and nothing was done until at least half the camp went down with fever,uncontroled vomiting, abdominal pain and sever diarrhea. At that point they tested the water and it was VERY contaminated. But nothing was said how contaminated and what with. I informed my PCP, and Neurologist's and was dismissed as looking for something that wasn't there. In the meantime the white matter increases and keep getting told not to worry.
doctor
Answered by Dr. Dariush Saghafi (15 hours later)
Brief Answer:
Can you upload a copy of your latest MRI report?

Detailed Answer:
Thank you for the update on your original question and the clearer picture of what you mean by "increase" in white matter. I now understand that you're getting that terminology due to a radiologist's read of your MRI of the brain and that it appears that "white matter is increasing." It would be most helpful it you had the actual report to either upload to this site as a .pdf file or if you would just copy the radiologist's conclusion out as it is written. If you've gotten any imaging work done at your local VA hospital then, you can get that information from MyEvet.

Otherwise, if you got your last MRI from an outside of VA provider you would have to request a copy of the report from the facility where you had it done. Shouldn't be a problem if you simply call them and request a copy. Then, you could either upload the document or copy it out here.

Now, aside from the "finding" made by the radiologist is there anything going on from a neurological perspective? What are YOU FEELING when it comes to "pressure on the left optic nerve?" And what exactly is PRESSING on that? And how is your vision in the eyes affected? Have you had an eye exam recently? Any changes in your visual sharpness or acuity? Any losses of vision or visual field losses sometimes referred to as FIELD CUTS?

I can't really bring the other information into play that you are talking about regarding contamination of the water supply since that was 12 years ago and there's no further information to give or get (I'd imagine) regarding what they actually found in the water...correct?

Nevertheless, more importantly to me is what is going on neurologically? You mention "pressure" on the left optic nerve but is there a symptom or symptoms you can tell me about that may help me understand what these "increased clumps" of white matter might be referring to as far as your function is concerned? Or is that more a radiographic finding without there being much else going on?

There are also conditions referred to as HETEROTOPIAS described where ISLANDS of white matter and gray matter seem to be mixed in differing proportions that appear to occur as errors in migration but this tends to happen during brain development and isn't something that continues in the adult condition so if the radiologist is referring to this entity then, it may be an incidental finding that he is calling but nothing of consequence to you at the age of 59 since it should not be progressing. If that's not the case then, I believe you may need some laboratory testing done to rule out other potential causes of white matter disorders but again, it would be highly unusual and probably reportable for someone of your age group to develop inborn errors of metabolism of this nature with little else going on neurologically.

Bottom line is that I would like to see the neuroradiologist's report and see if they actually specify the process that they think is going on and whether it is truly an INCREASE in white matter volume (rare) vs. degeneration of white matter....or possibly something referred to as white matter ischemic disease (more common) or whether someone has identified some form of HETEROTOPIA (congenital migrational issue of white matter) which would've occurred during brain development and should not be "progressing" as it sounds like this may be doing according to your information.

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them in the context of your question.

Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.

Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

This consult request has taken a total of 68 minutes of time to read, research, and respond.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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What Causes An Increase Of White Matter In Brain?

Brief Answer: Not sure what you're referring to...please expand your question a bit Detailed Answer: Good evening and thank you for the interesting question but I must admit that without a little more information I'm not sure I'm understanding what you're trying to ask. Does this relate to a clinical condition that you're interested in knowing about? White matter itself is a common or generic term for the substance known as myelin and this is produced by a set of cells in the brain called oligodendrocytes. The myelin is protein in content and wraps around axons that transmit electrical impulses from one part of the brain to some other part of the nervous system such as the brain, spinal cord, or out to the muscles and organs...wherever the nerve goes that we're talking about. The process of myelination is ongoing for about the first 25-30 years of an individual's life. After that the entire volume and all lobes of the brain have been myelinated and covered. Beyond that I'm not aware of anything in the literature that states that myelination CONTINUES to occur or accumulate. If there is damage to the myelin sheath covering a nerve then, there is a process of REPAIR called REMYELINATION but this is just laying down more myelin that was lost or damaged. I wouldn't consider that INCREASING myelin so much as just replacing what was already there...I don't know if that's what you're referring to. If you'd like to clarify your question a bit more then, I may be able to help with a more direct answer otherwise, I would have to answer your question by saying that after a certain point in maturity of the person the brain DOES NOT continue to increase its white matter.....Taking that concept one step further into the aging individual and talking about the elderly we actually talk about a LOSS OF MYELIN and this probably happens just as a result of the normal aging process but if we lose too much- things start going wrong with the way people think, move, or perceive sensations in the brain. So that process of DEMYELINATION actually can start to occur but again this represents a loss of the insulation or covering and can conceivably happen just due to aging processes...or if too much...pathological processes. I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them in the context of your question. Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response. Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered. This consult request has taken a total of 40 minutes of time to read, research, and respond.