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Adult-onset metachromatic leukodystrophy (MRI)

T2-weighted MRI scans from 2 brothers with adult-onset metachromatic leukodystrophy, demonstrating predominantly frontal white matter signal abnormalities. (A) MRI from the older, more severely affected brother at 24 years of age. The arrow points to severe frontal white matter signal increase. (B) MRI from the less severely affected brother at 21 years of age. The arrow points to frontal and anterior corpus callosum abnormalities that are less severe. (Contributed by Dr. James Garbern.)