White matter disease: genetic

A leukodystrophy is a type of rare genetic disorder that affects the brain, spinal cord, and other nerves in the body.It is caused by destruction of the white matter of the brain. The white matter degrades due to defects of the myelin, which is a fatty covering that insulates nerves in the brain.Myelin is needed to protect the nerves and the nerves can't function normally without it Over the past two decades, an increasing number of novel heritable disorders affecting the white matter of the brain, or leukodystrophies, have been described, often with identification of a causative gene (Table 71-1) Advanced neuroimaging and future studies of genetic architecture of leukoaraiosis will unravel the underlying biology of white matter disease and its role in pathophysiology of stroke, dementia and the total burden of cerebrovascular dysfunction. Open in a separate window Figure 1 Severity of MRI-detected white matter hyperintensity Summary: White matter disease (WMD) covers a large group of disorders that affect the white matter, or myelin. In children these disorders are commonly genetic and often go undiagnosed

Genetic and acquired disorders of white matter comprise a diverse group of conditions, with often overlapping clinical and radiological findings. Patients present with a variable combination of cognitive impairment, ataxia, spasticity or movement disorders, among others White matter disease, or leukoaraiosis, involves the degeneration of white matter in the brain. White matter is tissue that includes nerve fibers (axons), which connect nerve cells. A fatty tissue.. White matter disease is the wearing away of tissue in the largest and deepest part of your brain that has a number of causes, including aging. This tissue contains millions of nerve fibers, or.. White matter hyperintensities (WMH) are signal changes in the white matter seen on T2-weighted magnetic resonance imaging which are frequent incidental findings in otherwise healthy middle-aged and elderly individuals. 1 - 3 WMH do not have a specific pathogenesis, but those seen in asymptomatic older individuals are likely to be ischemic in.

Leukodystrophies are a group of usually inherited disorders characterized by degeneration of the white matter in the brain. The word leukodystrophy comes from the Greek roots leuko, white, dys, abnormal and troph, growth White matter lesions (WMLs), commonly seen as hyperintensities on T2-weighted MRI scans of healthy elderly individuals, are considered to be related to small vessel disease in the brain, and are often associated with sub Leukoencephalopathy with vanishing white matter is a genetic condition caused by mutations in any of 5 genes - EIF2B1, EIF2B2, EIF2B3, EIF2B4, and EIF2B5. These genes give the body instructions to make the five parts (subunits) of a protein called eIF2B. This protein helps regulate overall production of protein in cells (protein synthesis) What is Vanishing White Matter Disease? Vanishing White Matter Disease (VWM) is a genetic disorder that affects the nervous system and causes neurologic symptoms. Although initially recognized as a disease of young children, it is now known that the disease has a highly variable course with a wide range in severity White matter disease is used to refer to a large group of illnesses that affect the white matter of the brain. In most individuals, these diseases are age-related and progressive. However, studies indicate some cases of white matter disease can be genetic. This is especially true with cases involving children

Leukodystrophy Genetic and Rare Diseases Information

Inflamed white matter is implicated in multiple sclerosis, cerebral palsy and several inherited childhood diseases such as adrenoleukodystrophy. Decoding the pathways that inflammation opens is a puzzle Pleasure is solving with genetic, immune and vascular pieces Vanishing white matter disease (VWMD) is one of the most prevalent inherited leukoencephalopathies, which generally presents in childhood as a progressive disorder while less beginning in adulthood. The present report describes the clinical, neuroimaging, and genetic findings of a female patient with adult-onset VWMD APOE-ε4 is a major genetic risk factor for late-onset Alzheimer's disease that interacts with other risk factors, but the nature of such combined effects remains poorly understood. We quantified the impact of APOE-ε4, family history (FH) of dementia, and obesity on white matter (WM) microstructure i Vanishing white matter disease (VWMD) is one of the most prevalent hereditary white matter diseases in childhood, but it is increasingly recognised in adulthood with high phenotypic variation and severity. We report a case of an adult female presenting with emotional lability and cognitive impairment, in addition to progressive dystonia, ataxia, postural instability and recurrent falls A hereditary CNS demyelinating disease is a demyelinating central nervous system disease that is primarily due to an inherited genetic condition. (This is in contrast to autoimmune demyelinating conditions, such as multiple sclerosis, or conditions such as central pontine myelinolysis that are associated with acute acquired insult.) [citation needed].

Genetic and Metabolic Disorders of the White Matter

Learning from Multiple Sclerosis Misdiagnosis: Insights Into Genetic Leukodystrophies. Some 2% to 4% of patients misdiagnosed with multiple sclerosis are eventually diagnosed with a genetic leukodystrophy. A new clinical cohort study offers much-needed guidance to help identify them Adult-onset leukodystrophies and genetic leukoencephalopathies comprise a diverse group of neurodegenerative disorders of white matter with a wide age of onset and phenotypic spectrum. Patients with white matter abnormalities detected on MRI often present a diagnostic challenge to both general and specialist neurologists. Patients typically present with a progressive syndrome including various. Vanishing white matter disease on axial and sagittal T2-weighted (g, i) as well as coronal T1-weighted (h) sequences demonstrating diffuse white matter T2-weighted hyperintensity and volume loss. Atrophy of the corpus callosum and spinal cord is also present

White matter disease as a biomarker for long-term

White matter pathology with neurobehavioral consequences can occur in a wide variety of acquired and genetic disorders affecting myelin and has also been recognized to occur in neurodegenerative disorders such as Alzheimer's disease (AD) that have long been thought to originate in cortical gray matter (4, 5) 1. Inherited white matter diseases• Primary demyelination - loss of normalformed myelin with preservation of axons. E.g-MS• Secondary demyelination - known aetiologywith preferential destruction of myelin andaxons. E.g - ADEM,PML, osmoticdemyelination,etc.• Dysmyelination- defective formation ormaintenance of myelin. 2 Genetic leukoencephalopathies are diseases in which there are abnormalities or degeneration in the white matter—deep brain tissue made up of bundles of nerve fibres that carry messages to different parts of the nervous system. The cause of genetic leukoencephalopathies are often mutations passed from generation to generation. Dr

White matter disease: Genetic mutation causing MLC

More than 100 neurologic diseases, injuries, and intoxications are known to prominently or exclusively involve the white matter of the brain.1,2 Without exception, these disorders have the potential to disrupt aspects of cognitive and emotional function and to lead to important syndromes related to white matter dysfunction R. Schiffmann and O. Elroy-Stein, Childhood ataxia with CNS hypomyelination/vanishing white matter disease—a common leukodystrophy caused by abnormal control of protein synthesis, Molecular Genetics and Metabolism, vol. 88, no. 1, pp. 7-15, 2006 Leukoencephalopathy with vanishing white matter Description Leukoencephalopathy with vanishing white matter is a progressive disorder that mainly affects the brain and spinal cord (central nervous system). This disorder causes deterioration of the central nervous system's white matter, which consists of nerve fibers covered by myelin Vanishing white matter (VWM) disease is an inherited condition caused by a faulty gene. Children with VWM disease have a defective protein that prevents the body from making enough myelin, a white, fatty substance that insulates nerve fibers, protecting them from damage. Nerve fibers covered by myelin are known as white matter.

Because white matter disorders can be mild and reversible, however, the prognosis is more optimistic than for gray matter disorders, most notably the dreaded dementia of Alzheimer's disease in which cortical cell bodies, synapses, and receptors are destroyed by the disease. In many white matter cases, such as subtle toxic. INTRODUCTION AND HISTORY. Childhood ataxia with central nervous system hypomyelination/vanishing white matter disease (CACH/VWM; MIM #603896), also known as myelinopathia centralis diffusa, leukoencephalopathy with vanishing white matter, and Cree leukoencephalopathy, is a chronic and progressive white matter disorder, often exacerbated by infection, head trauma, or other stresses

Flashcards - White Matter Diseases - Constitution of

How to diagnose difficult white matter disorders

White matter disease: Prognosis, symptoms, and treatmen

The study, Development and clinical consequences of white matter lesions in Fabry disease: a systematic review, was published in Molecular Genetics and Metabolism. Fabry disease is a rare genetic disorder caused by mutations in the GLA gene — located on the X chromosome — that provides instructions for the production of an enzyme. The genetic correlation with lacunar stroke and white matter hyperintensities, accounting for linkage disequilibrium, among the MRI-confirmed and pooled cohorts was 0.46 (SE, 0.10; P =4.6´10-6.

Leukoencephalopathy with Vanishing White Matter. Clinical Characteristics. Ocular Features: Optic atrophy is a common feature and blindness is often the result. Systemic Features: Onset of symptoms may occur at any time from 1.5 years of age to adulthood. Early psychomotor development may be normal but developmental milestones such as walking. Overview. Leukoencephalopathy with vanishing white matter is a progressive disorder that mainly affects the central nervous system (CNS). This disorder causes deterioration of white matter, which consists of nerve fibers covered by myelin (the substance that protects the nerves). Most affected people begin to have signs and symptoms during childhood, but symptoms may first become apparent. Vanishing white matter disease (VWM), also known as childhood ataxia with central hypomyelination (CACH), is a rare, genetic leukoencephalopathy due to mutations in EIF2B subunit mutations, typically appearing as extensive white matter involvement with cavitary changes Childhood Ataxia with Central Nervous System Hypomyelination/Vanishing White Matter Disease (CACH-VWM) is a progressive disorder that mainly affects the brain and spinal cord (central nervous system). This leukodystrophy disorder causes deterioration of the CNS white matter, which consists of nerve fibers covered by myelin Background. White matter hyperintensities (WMH) on magnetic resonance imaging may influence clinical presentation in patients with Parkinson's disease (PD), although their significance and pathophysiological origins remain unresolved

White Matter Disease: Causes, Symptoms, Treatmen

White Matter Hyperintensities Are Under Strong Genetic

The study, White matter lesions in treated late onset Pompe disease are not different to matched controls, was published in the journal Molecular Genetics and Metabolism. Pompe disease is characterized by genetic mutations in the GAA gene, which lead to defective production of the alpha-glucosidase enzyme and consequent toxic accumulation. Department of Neurology, Reference Center for Lysosomal Diseases, UF Neuro-Genetics and Metabolism, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France Brain and Spine Institute, CNRS UMR 7225 - Inserm U 1127 - UPMC-P6 UMR S 1127, Paris, Franc title = A practical approach to adult-onset white matter diseases, with illustrative cases, abstract = Aim. To evaluate five illustrative cases and perform a literature review to identify and describe a working approach to adult-onset white matter diseases (WMD). State of the art. Inherited WMD are a group of disorders often seen in childhood Decoding Presymptomatic White Matter Changes in Huntington Disease (Win-HD) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government With respect to morphologic changes visible on imaging, small vessel disease includes small subcortical (lacunar) infarcts (of deep gray nuclei and deep white matter), hemorrhages, perivascular spaces, and diffuse white matter changes 14,16. The latter has received much attention in particular and is the focus of this article

We diagnosed vanishing white matter disease (VWMD) based on compound heterozygosis for the EIF2B2 gene mutation and the diffuse symmetric abnor-mality in white matter Fig. 2. A 10-month follow-up examination showed a mild de-cline in intelligence (IQ decreased from 81 to 73), a slightly aggravated pyramidal tract (positive bilatera Objective To assess white matter integrity in patients with essential tremor (ET) and Parkinson disease (PD) with moderate to severe motor impairment. Methods Sedated participants with ET (n = 57) or PD (n = 99) underwent diffusion tensor imaging (DTI) and fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity values were computed The community-based Austrian stroke prevention study found that white matter lesions progressed in only 17.9% of study subjects over a 3-year period.69 In other studies, 27%,70 32%71 and 28%72 of the study population showed disease progression over a 2-, 3- and 5-year follow-up period, respectively, and more recently the multi-centre LADIS.

We read with interest the article by Lemmens et al 1 on unilateral white matter involvement in Krabbe disease. Leukodystrophies typically present with specific patterns of abnormalities on magnetic resonance imaging. 2 Whereas unilateral white matter involvement is known in unusual cases of X-linked adrenoleukodystrophy, 3 this is unheard of in Krabbe disease Canavan disease (CD) is a severe progressive inherited (genetic) disorder of the central nervous system (CNS). It is one of the most common cerebral degenerative diseases of infancy, is a gene-linked, neurological birth disorder in which the white matter of the brain degenerates into spongy tissue riddled with microscopic fluid-filled spaces for white matter disorders Multi-disciplinary Diagnostic Service for White Matter Disorders at the Leeds Teaching Hospitals NHS Trust • Multi-disciplinary diagnostic service including specialist clinical and radiological assessment, plus molecular genetic diagnosis • Phenotype-targeted analysis of up to 95 genes by next-generation sequencin

Typical histology of the white matter of a patient with

Leukodystrophy - Wikipedi

Objective To identify novel genetic associations with white matter hyperintensities (WMH). Methods We performed a genome-wide association meta-analysis of WMH volumes in 11,226 individuals, including 8,429 population-based individuals from UK Biobank and 2,797 stroke patients. Replication of novel loci was performed in an independent dataset of 1,202 individuals. In all studies, WMH were. Researchers compared the brains of people with the genetic disorder, 22q11.2 deletion syndrome, to the brains of healthy people and to the brains of people with the disease who do not have schizophrenia. The brain's white matter connects different regions of the brain and allows neurons to communicate with each other and finally genetic studies. It is essential not to miss the treatable acquired causes. In this review, we present a practical approach to investigating patients with acquired and genetic disorders of white matter, based on the experience of a large international referral centre. We present a guide for clinicians, including pitfalls of testing. White matter disease was originally considered a normal event in an aging brain. But Dr. Daniel Mandell and his research team have discovered that it might actually be caused by tiny strokes and contribute to vascular dementia. (Video: UHN) . Dementia is a term for declining mental abilities, such as memory difficulties, language problems and. White matter injury (WMI), one of the most common consequences of premature birth, can produce long-term neurodevelopmental deficits. A study by researchers at Children's National Hospital provides direct evidence that targeting specific receptors in white matter cells after brain injury promotes cellular and functional recovery.. In the United States, about 500,000 babies are born.

The Genetics of White Matter Lesion

White matter in neurological disease and mental illness Many neurological disorders result from damage or disease affecting the myelin sheath on nerve fibers, but recently, white matter defects Alexander disease is caused by a genetic defect in astrocytes and this results in severe hypomyelination, mental retardation and death at a young age A new study by researchers at the University of Washington shows that the final grades that college students received in a second-language class were predicted by a combination of genetic and brain factors. Genetic variations of the COMT gene and a measure of the strength of the brain's communications network — known as white matter.

Leukoencephalopathy with vanishing white matter Genetic

  1. These data further define the spectrum of white matter abnormalities in common epilepsy syndromes, yielding more detailed insights into pathological substrates that may explain cognitive and psychiatric comorbidities and be used to guide biomarker studies of treatment outcomes and/or genetic research. R. Edward Hogan
  2. White matter decrease, however, was pronounced and located along the entire corpus callosum and in every lobe, although the regions were less confluent than in myotonic dystrophy type 1. Further, white matter loss was present at brainstem level (pons), along middle cerebellar peduncles and in cerebellar white matter (Supplementary Table 2; Fig. 1)
  3. Sometimes, white matter disease, particularly when it is severe, can interfere with the way the brain works and the processes that it controls, including thinking and walking. This is because the nerve signals can't get through as normal. Other factors such as genetics are likely to play a role. Sometimes, white matter lesions are caused.
  4. Lesions were observed in 42% of 48 adult patients with Crohn disease and in 46% of 24 adult patients with ulcerative colitis versus an incidence of 16% in the control group. 15 Unfortunately, there are no available age-matched data concerning periventricular white-matter lesions in nonceliac children
  5. Non-genetic causes of white matter disease include ischaemia, infection and multiple sclerosis. Diagnosis of leukodystrophy The diagnosis of a specific leukodystrophy is often not easy and may involve the input of a number of specialists, including neurologists, geneticists and metabolic physicians
  6. Many different diseases, injuries, and toxins can cause changes in your white matter. Doctors point to the same blood vessel problems that lead to heart trouble or strokes, such as long term high blood pressure, ongoing blood vessel inflammation a..
  7. Childhood white matter disorders and their sequelae constitute a major clinical problem associated with considerable morbidity and mortality. The genetic forms occur in at least 1:7500 live births, while the overall incidence of acquired white matter afflictions is not known, comprising amongst others congenital infections, perinatal damage, and inflammatory disorders

Vanishing White Matter Disease United Leukodystrophy

Leukodystrophy is not a single disease or condition, but a group of diseases that affect the white (leuko) matter of the brain and often the spinal cord. The condition is caused by the inexact development of the myelin sheath that acts as the insulator for the nerve fibres. And, it causes the degeneration of the white [1] matter. The damage or. A systematic literature review was conducted, and clinical cases are provided. Given the central role of MRI pattern recognition in the diagnosis of white matter disorders, the investigators adapted an MRI algorithm that guides the interpretation of MRI findings and thus directs further investigations, such as genetic testing Think of white matter disease as changes seen in the white matter of different parts (lobes) of the brain visualized on a MRI scan of the brain. Either the white matter appears scarred or atrophic. If the white matter is examined under the microscope, degenerative (ischemic) changes are visualized in the small blood vessels hence the term. Trusted Source suggests that the endangerment of white matter disease grows with age and the existence of cardiovascular disease. Medical, lifestyle and other problematic factors that . play a vital role in this disease which includes: chronic hypertension. diabetes. genetics. high cholesterol. history of stroke. inflammation of the blood vessel Vanishing white matter disease caused by EIF2B2 mutation with the presentation of an adrenoleukodystrophy phenotype Alsalem A, Shaheen R, Alkuraya FS. Gene. 2012 Apr 1;496(2) :141-3

Common Causes Of White Matter Disease - HealthPrep

Alzheimer's disease (AD) is conceptualized as a progressive consequence of two hallmark pathological changes in grey matter: extracellular amyloid plaques and neurofibrillary tangles. However, over the past several years, neuroimaging studies have implicated micro- and macrostructural abnormalities in white matter in the risk and progression of AD, suggesting that in addition to the neuronal. A high genetic risk for multiple sclerosis (MS) is associated with structural alterations in white matter — brain regions composed mainly of nerve fibers — in childhood, findings from a large. White matter disorders may sometimes be the result of a genetic variation. Infection, stroke, and head injury may also cause white matter disease, along with age-related degeneration. Research studies suggest that the white matter of the brain may be related to mental illnesses such as bipolar disorder involvement of white matter in patients with epilepsy.5,6 The introductory text by Hatton et al7 nicely summarizes previous studies about white matter changes in epilepsy, which docu-ment white matter changes in patients with temporal lobe epi-lepsy (TLE) and genetic generalized epilepsy (GGE). White

Leukodystrophy - NORD (National Organization for Rare

  1. Koscik, T.R., van der Plas, E., Gutmann, L. et al. White matter microstructure relates to motor outcomes in myotonic dystrophy type 1 independently of disease duration and genetic burden
  2. Author summary Various hereditary diseases of the cerebral white matter occur in humans and dogs. We describe a new leukodystrophy in Standard Schnauzers. Genetic mapping and whole genome sequence analysis identified a likely candidate causative variant in the TSEN54 gene encoding tRNA splicing endonuclease 54. These results provide new information about the role of TSEN54 in cell metabolism.
  3. Large-scale GWAS reveals genetic architecture of brain white matter microstructure and genetic overlap with cognitive and mental health traits (n = 17,706). Molecular Psychiatry . Advance online publication

White matter in brain disease is the consumption of tissue in the largest and deepest parts of the brain due to aging. This tissue contains millions of nerve fibers or axons that connect other parts of the brain and spinal cord and signal the nerves to talk to each other Schizophrenia: genetics, white matter defects and dopamine. New research helps bridge an important gap in understanding schizophrenia, providing the best evidence to date that defects in the brain's white matter are a key contributor to the disease, which affects about 1 percent of people worldwide. The findings, to be published online by the. And, in focusing on five image-based microstructures in 21 white matter tracts, they were able to identify over 150 parts of the genome that exert an influence on the microstructure of white matter Diseases. White matter diseases are caused due to the inflammatory process and loss of myelin sheath. Small unnoticeable strokes in the brain may also damage the white matter and cause white matter disease. The most common symptoms of white matter disease include issues with balance, difficulty in multitasking, and mood changes. Multiple sclerosi

Leukoencephalopathy with vanishing white matter

Krabbe disease ; Hereditary white matter disorders - Unclassified; Sequence primers for new disorders 'New' white matter disorders. Vanishing white matter disease; Leukoencephalopathy with brain stem and spinal cord involvement and elevated lactate; Megalencephalic leukoencephalopathy with subcortical cysts The disease that has the Abdi family in its grasp is one of 50-plus leukodystrophies in a group of genetic disorders that affect the central nervous system, according to the United Leukodystrophy. A rare disease is defined as a condition that affects fewer than 1 in 200,000 patients in the United States or 1 in 2000 in Europe. Many rare diseases are genetic (caused by change in DNA), which change can be inherited, spontaneous, or epigenetic. Since there are many genes (~20,000), there are many possible defects R01 grant funds white matter protection study for congenital heart disease. Nobuyuki Ishibashi, M.D., is the principal investigator on a $3.2 million NIH R01 to study white matter growth and repair in utero for fetal brains affected by congenital heart disease. Many of the neurological deficits seen in children with congenital heart disease.

White matter hyperintensities (WMHs) on brain MRI may contribute to cognitive difficulties. In this cross-sectional study, researchers investigated whether disease severity, cortical thinning, and reduced cognition were associated with WMHs in 64 patients with behavioral variant frontotemporal dementia (bvFTD), 65 with Alzheimer disease (AD), and 66 controls The sub-cortical white matter is also involved, as are the internal and external capsules (arrow-heads). 31. Megalencephalic leukoencephalopathy with subcortical cysts (8-month-old boy). 32. Vanishing White Matter Disease. Vanishing White Matter Disease (VWM) is inherited in an autosomal recessive manner, meaning that it is a disease that can. Disease Focus . Institution and capitalize on mechanisms of neuronal instruction of oligodendrogliogenesis to encourage OPC population repair and white matter regeneration following chemotherapy exposure. The initial phase of the project (2.5 years) is dedicated to further validating and optimizing the experimental model systems with which.

White Matter Disease and Psychiatric Dysfunction: Clinical

Increased white matter water content occurs in several metabolic diseases, most notably Alexander disease, Canavan disease, megaloencephalic leukoencephalopathy with subcortical cysts, and vanishing white matter disease, 7-10 though the white matter is typically more extensively swollen in these disorders than in HCC, often resulting in. There are several causes of white spots on a brain MRI, including small strokes, migraines, multiple sclerosis (MS), lupus, B12 deficiency, a brain tumor such as lymphoma, or an infection such as Lyme disease or HIV. 1 . Sometimes the white matter hyperintensities can resolve, as with a treated infection or brain tumor Van der Knaap et al. (1997) identified 9 children with a 'new' leukoencephalopathy with vanishing white matter. The 9 patients included 3 affected sib pairs; the age range was 3 to 19 years. The onset of the disease was in childhood and the course was chronic, progressive, and episodic

Update on cerebral small vessel disease: a dynamic wholeStroke subtype, vascular risk factors, and total MRI brain

Vanishing white matter disease (VWM) is considered as one of the most frequent types of inherited childhood leukoencephalopathies. Various neurological and non-neurological manifestations have been reported in this type of leukodystrophy; however, seizures are rarely described in infantile type of VWM.To patient is a 12 months old boy who experienced frequent seizures at 4th month of age Research Article Synapse DOI 10.1002/syn.21959 Whole Genome Grey and White matter DNA Methylation Profiles in Dorsolateral Prefrontal cortex Jose Vicente Sanchez-Mut1, Holger Heyn2, Enrique Vidal3, Raúl Delgado-Morales4,5, 4 6 7 8 4* Sebastian Moran , Sergi Sayols , Juan Sandoval , Isidre Ferrer , Manel Esteller and 1* Johannes Gräff 1 Brain Mind Institute, Faculty of Life Sciences, Ecole. The objective of this study was to evaluate the role of silent CSVD in the progression from MCI to dementia and if confluent white matter hyperintensities (WMHs) pose a higher risk for progression in the clinical setting. Methods: Patients with MCI with baseline magnetic resonance imaging and longitudinal follow-up were evaluated. WMH were quantified using visual scoring at baseline (all. White matter hyperintensities are frequent in Alzheimer's disease and frontotemporal dementia. Source: Adobe Stock. WMH are increasingly common with age and interpreted as reflecting small. Vanishing white matter (VWM) disease is a genetic leukodystrophy leading to severe neurological disease and early death. VWM is caused by bi-allelic mutations in any of the five genes encoding the subunits of the eukaryotic translation factor 2B (EIF2B). Previous studies have attempted to investigate the molecular mechanism of VWN by constructing models for each subunit of EIF2B that causes.