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Abstract Purpose To detect the Marchiafava Bignami Disease (MBD) using a distinct deep learning technique. Background Advanced deep learning methods are becoming more crucial in contemporary medical diagnostics, particularly for detecting intricate and uncommon neurological illnesses such as MBD. This rare neurodegenerative disorder, sometimes associated with persistent alcoholism, is characterized by the loss of myelin or tissue death in the corpus callosum. It poses significant diagnostic difficulties owing to its infrequency and the subtle signs it exhibits in its first stages, both clinically and on radiological scans. Methods The novel method of Variational Autoencoders (VAEs) in conjunction with attention mechanisms is used to identify MBD peculiar diseases accurately. VAEs are well-known for their proficiency in unsupervised learning and anomaly detection. They excel at analyzing extensive brain imaging datasets to uncover subtle patterns and abnormalities that traditional diagnostic approaches may overlook, especially those related to specific diseases. The use of attention mechanisms enhances this technique, enabling the model to concentrate on the most crucial elements of the imaging data, similar to the discerning observation of a skilled radiologist. Thus, we utilized the VAE with attention mechanisms in this study to detect MBD. Such a combination enables the prompt identification of MBD and assists in formulating more customized and efficient treatment strategies. Results A significant breakthrough in this field is the creation of a VAE equipped with attention mechanisms, which has shown outstanding performance by achieving accuracy rates of over 90% in accurately differentiating MBD from other neurodegenerative disorders. Conclusion This model, which underwent training using a diverse range of MRI images, has shown a notable level of sensitivity and specificity, significantly minimizing the frequency of false positive results and strengthening the confidence and dependability of these sophisticated automated diagnostic tools.

AbstractMarchiafava-Bignami disease (MBD) is an uncommon neurological disorder characterized by corpus callosum demyelination and necrosis, primarily associated with alcohol use disorder and vitamin deficiencies, notably thiamine. We present the case of a 27-year-old female who was diagnosed by MRI after developing stroke-like symptoms, and was found to have undetectable serum thiamine concentrations, likely due to alcohol use disorder and noncompliance with prescribed vitamin supplements after Roux-en-Y gastric bypass surgery. She was prescribed thiamine supplementation, and upon follow-up one month later, she had no residual neurological deficits. MBD is a rare cause of stroke-like symptoms, and thorough medical and surgical history is needed in patients who may not be in the typical age range for development of the disease.

Purpose: To detect the Marchiafava Bignami Disease (MBD) using a distinct deep learning technique. Background: Advanced deep learning methods are becoming more crucial in contemporary medical diagnostics, particularly for detecting intricate and uncommon neurological illnesses such as MBD. This rare neurodegenerative disorder, sometimes associated with persistent alcoholism, is characterized by the loss of myelin or tissue death in the corpus callosum. It poses significant diagnostic difficulties owing to its infrequency and the subtle signs it exhibits in its first stages, both clinically and on radiological scans. Methods: The novel method of Variational Autoencoders (VAEs) in conjunction with attention mechanisms is used to identify MBD peculiar diseases accurately. VAEs are well-known for their proficiency in unsupervised learning and anomaly detection. They excel at analyzing extensive brain imaging datasets to uncover subtle patterns and abnormalities that traditional diagnostic approaches may overlook, especially those related to specific diseases. The use of attention mechanisms enhances this technique, enabling the model to concentrate on the most crucial elements of the imaging data, similar to the discerning observation of a skilled radiologist. Thus, we utilized the VAE with attention mechanisms in this study to detect MBD. Such a combination enables the prompt identification of MBD and assists in formulating more customized and efficient treatment strategies. Results: A significant breakthrough in this field is the creation of a VAE equipped with attention mechanisms, which has shown outstanding performance by achieving accuracy rates of over 90% in accurately differentiating MBD from other neurodegenerative disorders. Conclusion: This model, which underwent training using a diverse range of MRI images, has shown a notable level of sensitivity and specificity, significantly minimizing the frequency of false positive results and strengthening the confidence and dependability of these sophisticated automated diagnostic tools. [ABSTRACT FROM AUTHOR]

Abstract Marchiafava–Bignami disease (MBD) is an uncommon alcoholism‐related neuropsychiatric disorder, featured with symmetrical demyelination of part or whole corpus callosum (CC). Previous studies reported follow‐up neuroimaging changes with necrosis, cystic degeneration, and atrophy of the CC after the diagnosis of MBD, but it is unclear whether the white matter is damaged before MBD. We report a case of alcoholic MBD whose magnetic resonance imaging revealed structural lesions in the white matter before the typical demyelination of CC during MBD, which support the prior hypothesis that chronic hazardous drinking may initially lead to microstructure abnormalities of the white matter and CC through some possible mechanisms, then microstructure lesions in the CC, and white matter deterioration into extensive demyelination, that is MBD. In future clinical practice, when patients with chronic alcoholism seek treatment for neuropsychiatric disorders, they may need to undergo repeated MRI scans to reveal progressive neuroimaging features before and after MBD.

Marchiafava-Bignami disease (MBD) is a metabolic disease of the nervous system. It mainly involves the Corpus callosum, but the handknob area is rarely involved. This article reports a MBD case involving the bilateral handknob area. The involvement of the bilateral handknob area contributes to the clinical presentation of convulsions of both hands. Through this case, more clinicians realize the bilateral handknob area involvement in MBD, which is helpful for the identification and diagnosis of MBD. To our knowledge, this is the first report on MBD involving the bilateral handknob area. [ABSTRACT FROM AUTHOR]

Key Clinical Message Marchiafava‐Bignami disease, a rare condition often associated with alcoholism, shows myelin degeneration with tissue necrosis specifically in the corpus callosum. Urgent application of magnetic resonance imaging could lead to prompt diagnosis. Abstract A 66‐year‐old male with habitual alcohol drink complained acute deterioration of left‐side muscle weakness as initial presentation. On the arrival, the patient was confused, with stable vital sign and unremarkable pyramidal sign. Although several potential diagnoses could be considered, brain computed tomography did not provide diagnostic information, and subsequently‐performed magnetic resonance imaging revealed hyperintense lesions on T2‐flair images in corpus callosum, suggesting MBD as clinical diagnosis. Prompt diagnosis enabled us to introduce thiamine administration with subsequent favorable neurological outcome.

Abstract Marchiafava–Bignami disease (MBD) is a very rare disorder characterized by demyelination and necrosis of the corpus callosum. A 53‐year‐old male was transported to the emergency room with impaired consciousness. On his arrival, he was quite emaciated. CT examination revealed no hemorrhagic lesions whereas MR images showed hyperintense areas throughout the corpus callosum, leading to a diagnosis of MBD. His impaired consciousness improved with treatment, including parenteral thiamine administration. When examining patients with impaired consciousness because of malnutrition, MBD should be taken in consideration and the incorporation of head MR imaging into the examination protocol enables early diagnosis and treatment, and may improve the prognosis.

Corpus callosum (CC) is the largest brain commissure interconnecting the left and right cerebral hemisphere. It consists of fibers projecting mainly to homotopical cortical regions and is well visualized on the conventional MR scans. The main types of callosal abnormalities are congenital defects, signal changes and atrophy, where the first two are rarely unnoticed and unreported - contrary to atrophy, which is frequently attributed to the old age only. Aside from age-related involution, callosal atrophy may be caused by a broad spectrum of pathological conditions damaging either white or gray matter. Demyelinating conditions lead to CC atrophy by primary damage of white matter. Loss of cortical neurons and subsequent wallerian degeneration lead to loss of axons projecting through CC and its secondary atrophy. Because fibers in CC are topographically arranged, loss of neurons in certain cortical regions corresponds to loss of fibers (and thus loss of volume) in certain segments of CC, resulting in regional callosal atrophy. The aim of this article is to provide a broader view on the atrophy of corpus callosum, present its differential diagnosis and potential practical use. [ABSTRACT FROM AUTHOR]

Marchiafava–Bignami disease (MBD) is a very rare disorder characterized by demyelination and necrosis of the corpus callosum. A 53‐year‐old male was transported to the emergency room with impaired consciousness. On his arrival, he was quite emaciated. CT examination revealed no hemorrhagic lesions whereas MR images showed hyperintense areas throughout the corpus callosum, leading to a diagnosis of MBD. His impaired consciousness improved with treatment, including parenteral thiamine administration. When examining patients with impaired consciousness because of malnutrition, MBD should be taken in consideration and the incorporation of head MR imaging into the examination protocol enables early diagnosis and treatment, and may improve the prognosis. [ABSTRACT FROM AUTHOR]

Mild encephalitis/encephalopathy with a reversible lesion in the splenium (MERS) is a clinico-radiological syndrome with mild central nervous system symptoms and a reversible lesion in the splenium of the corpus callosum. It is mainly associated with a number of viral and bacterial infections, including Coronavirus disease 2019 (COVID-19). In this paper, we report four MERS patients. One had a mumps infection, the second had aseptic meningitis, the third had Marchiafava-Bignami disease, and the fourth had atypical pneumonia associated with COVID-19 infection. [ABSTRACT FROM AUTHOR]

Marchiafava-Bignami disease is a rare neurological condition characterized by necrosis and demyelination of the corpus callosum, typically associated with chronic alcoholism and/or malnutrition. The clinical manifestations of Marchiafava-Bignami disease are diverse and often nonspecific. Diagnosis of Marchiafava-Bignami disease relies on magnetic resonance imaging findings, which reveal significant and symmetrical involvement of the corpus callosum. We report the case of a 48-year-old man with chronic alcoholism who has been experiencing symptoms of confusion, stupor, difficulties in using and manipulating objects, and balance disorders for the past 10 days. Brain magnetic resonance imaging revealed diffuse and complete involvement of the corpus callosum, characteristic of a severe form of Marchiafava-Bignami disease., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Competing Interests: Both authors have disclosed no conflicts of interest.

Key Clinical Message: Marchiafava‐Bignami disease, a rare condition often associated with alcoholism, shows myelin degeneration with tissue necrosis specifically in the corpus callosum. Urgent application of magnetic resonance imaging could lead to prompt diagnosis. A 66‐year‐old male with habitual alcohol drink complained acute deterioration of left‐side muscle weakness as initial presentation. On the arrival, the patient was confused, with stable vital sign and unremarkable pyramidal sign. Although several potential diagnoses could be considered, brain computed tomography did not provide diagnostic information, and subsequently‐performed magnetic resonance imaging revealed hyperintense lesions on T2‐flair images in corpus callosum, suggesting MBD as clinical diagnosis. Prompt diagnosis enabled us to introduce thiamine administration with subsequent favorable neurological outcome. [ABSTRACT FROM AUTHOR]

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Rationale: Clinicians encounter multiple alcohol-related illnesses in practice, and Marchiafava-Bignami disease is a rare and devastating entity among them. It is a toxic-demyelinating disease and seen in chronic alcoholics, although it may be occasionally observed in chronically malnourished teetotalers. The clinical presentations are diverse. The symptoms and signs are non-specific, and the onset can be acute or chronic. Patient’s concerns: A 45-year-old right-handed patient suffered from alcohol use disorder with multiple non-specific neuropsychiatric manifestations. Diagnosis: Marchiafava-Bignami disease. Interventions: Thiamine, folate, vitamin B12, and steroid therapy. Outcome: The patient’s behaviour was significantly improved but dysarthria and pyramidal signs persisted. He was left with permanent cognitive impairment. Lessons: Though prompt therapy may halt the demyelinating process in this disease, the treatment remains a challenge in clinical practice. The recognition of the neuro-radiologic features is crucial to establish an early diagnosis.

Introduction: Alcohol is the most consumed substance in Western culture and its use is a causal factor in more than 200 diseases and disorders. Our objective was to determine the relationship between alcohol consumption and cognitive impairment in people aged ≥60, and identify which cognitive functions are most affected by prolonged alcohol consumption., Methods: Search in MEDLINE, PsycInfo, Psicodoc, Cochrane and Web of Science databases. The search was limited to articles published from 2010 to 2020. A total of 8716 articles were obtained. Those repeated and unrelated to the topic were eliminated, leaving a total of seven articles: five longitudinal studies, covering the relationship between alcohol and cognitive impairment; and two cross-sectional studies, which helped identify which cognitive functions are more affected. This systematic review was carried out in accordance with the criteria of the PRISMA statement., Results: Most of the studies found conclude that no or excessive alcohol consumption is associated with a higher risk of cognitive impairment, compared to moderate consumption. In addition, excessive and prolonged alcohol consumption can evolve into secondary alcoholic dementia such as Marchiafava-Bignami disease, Wernicke-Korsakoff syndrome or pellagra. In people with alcohol use disorder, the cognitive functions that are most affected are executive functions, visuospatial skills, attention and memory., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Marchiafava-Bignami disease (MBD) is uncommon and typically linked with persistent alcohol consumption; nevertheless, instances have been reported in non-alcoholic individuals with nutritional deficiencies. Depending on the severity, this condition may manifest as acute, subacute, or chronic neurological signs and symptoms, ranging from moderate dysarthria or mild disorientation to coma and death. We report a case of a 30-year-old, 14-week pregnant female who presented with complaints of persistent vomiting and loss of appetite. She was found to have achalasia cardia on upper GI endoscopy. Later, she developed confusion, irrelevant talks and her speech was incomprehensible. An MRI of the brain was done which showed features likely that of MBD. She was started high dose intravenous thiamine to which she responded brilliantly., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kadam et al.)

Introduction. Substance-related disorders are the most frequent comorbidity in schizophrenia. Concretely, alcohol is the most commonly consumed substance after tobacco. Patients with schizophrenia with this comorbidity have a worse clinical course and can develop serious neuropsychiatric complications. One of them, Marchiafava-Bignami disease (MBD) can be incorrectly diagnosed as a decompensation of their mental disorder. Methods. A case of a 51-year-old man, diagnosed with schizophrenia and alcohol use disorder is presented. He experienced acute neuropsychiatric symptoms for which schizophrenia decompensation was suspected. Based on his atypical symptoms and medical history, a brain imaging test was performed and MBD was diagnosed. Conclusions. MBD is an infrequent clinical entity that should be part of differential diagnosis in patients with alcohol abuse disorder experiencing atypical neuropsychiatric symptoms. [ABSTRACT FROM AUTHOR]

Marchiafava-Bignami disease (MBD) is a rare complication associated with chronic heavy alcohol use, with case reports documenting a range of cognitive outcomes. Given the variability in MBD presentation and outcomes, milder cases may remain undiagnosed and few studies or case reports have presented a comprehensive neuropsychological profile of these patients. The objective of this case study was to describe the neuropsychological presentation and findings of a case of likely MBD. The patient was a 46-year-old, African American female with a complex history of malnutrition and alcohol abuse presenting for outpatient neuropsychological evaluation. She was administered a comprehensive battery of neuropsychological tests as part of routine clinical care. Neuropsychological data demonstrated severe deficits in executive functions, complex visuoconstruction, and motor dexterity, as well as an amnestic verbal and visual memory pattern. Overall, data and the patient's initial presentation of acute behavioral change were consistent with some reports of cognitive and behavioral sequela of MBD. Additionally, the patient's history of chronic poor nutritional intake with exacerbation from chronic heavy alcohol use, and imaging findings of severe cerebral/corpus callosum white matter loss and bilateral frontoparietal atrophy, were highly suggestive of MBD. [ABSTRACT FROM AUTHOR]

Marchiafava-Bignami disease (MBD) is a rare neurological disease often associated with a chronic consumption of alcohol and malnutrition, which is characterized by a demyelination and necrosis of the corpus callosum. We present a case of a 21-yearold male with chronic alcoholism who presented with an acute altered sensorium and seizure, which were initially treated as meningoencephalitis. His persistent poor Glasgow coma scale score and ideomotor recovery with encephalitic changes on his electroencephalogram prompted urgent magnetic resonance imaging (MRI) of his brain, which revealed extensive symmetrical hyperintensities in the corpus callosum. The diagnosis of MBD was made because of the typical MRI findings and after the exclusion of other possible diagnosis. The patient was promptly treated with a parenteral thiamine and showed a good recovery at 3 months follow-up. This case highlights the importance of diagnosing and recognizing MBD in a patient with chronic alcoholism as prompt treatment could prevent irreversible damage, which could carry high morbidity. [ABSTRACT FROM AUTHOR]

Marchiafava-Bignami disease (MBD) is a rare demyelinating disease associated with chronic alcohol use and/or malnutrition leading to vitamin deficiency. Clinical presentation is diverse and can range from mild neurological deficits of dysarthria and confusion to severe symptoms such as coma or even death. Diagnosis is made using imaging modalities including magnetic resonance imaging (MRI) and computed tomography (CT) with the rise in technological advances placing MRI as the most sensitive and specific imaging technology for diagnosis. Classic MBD imaging demonstrates demyelination and necrotic damage of the corpus callosum. While MBD is a well-documented neurologic complication of chronic alcoholism, its occurrence and presentation in the context of concurrent polysubstance abuse remain underexplored. We outline the case of a 27-year-old male with polysubstance use disorder presenting with subacute neurological deterioration and demyelination of the splenium of the corpus callosum., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Chalupczak et al.)

Among the various manifestations of COVID-19, the neurological implications of SARS-CoV-2 infection are of significant concern. Marchiafava-Bignami disease (MBD), a neurodegenerative disorder, exhibits a clinical spectrum ranging from mild progressive dementia in its chronic form to states of acute coma and varied mortality rates. Acute MBD primarily occurs in chronic alcoholics and malnourished individuals and is characterized by sudden loss of consciousness, seizures, confusion, and psychosis. We herein report a case of MBD presenting as acute loss of consciousness after the development of COVID-19. The patient presented with a history of fever and upper respiratory infection and was diagnosed with SARS-CoV-2 infection. He developed a neurological syndrome characterized by altered consciousness and convulsions, and brain magnetic resonance imaging revealed abnormal signals in the corpus callosum and frontoparietal lobes. Considering his alcohol intake history and the absence of other differential diagnoses, we diagnosed him with acute MBD triggered by COVID-19. After high-dose vitamin B1 and corticosteroid therapy, his clinical symptoms improved. In this case, we observed a temporal sequence between the development of COVID-19 and acute exacerbation of MBD. This case adds to the mounting evidence suggesting the potential effect of SARS-CoV-2 on the neurological system., Competing Interests: Declaration of conflicting interestsThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

We report a 68-year-old right-handed female who was admitted to our hospital complaining chiefly of incontinence and decreased activity. Her brain images showed characteristics of Marchiafava-Bignami disease, such as symmetrical abnormal signals localized in the corpus callosum. The patient had no drinking habits. Her past medical history included total gastric resection to treat gastric cancer. On hospital admission she was markedly underweight. This appeared to be a rare case of Marchiafava-Bignami disease not attributable to heavy drinking and occurring in a state of malnutrition. Evaluation of callosal dissociation symptoms produced findings indicative of such symptoms. She showed a marked difficulty in writing dictated single words and short sentences in Japanese alphabetic characters, especially with her left hand. In contrast, writing dictated words in Chinese characters (also used in written Japanese) was affected in both hands, with different types of dysgraphia seen in the right and left hands. The agraphia in the left hand seen in this patient appears to have occurred as a result of the language faculty of the left hemisphere failing to be transmitted to the right brain, while agraphia in the right hand may have occurred as a result of spatial processing information in the right hemisphere failing to be transmitted to the left hemisphere.

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Marchiafava–Bignami disease (MBD) is a rare condition characterized by demyelination, necrosis and atrophy of the corpus callosum (CC), and mainly associated with alcoholism. MBD may present with various clinical manifestations. Brain magnetic resonance imaging (MRI) scan is important in prompt diagnosis and treatment of MBD. Here we reported a case of MBD and reviewed literature about the usage of gadolinium-enhanced MRI in MBD. Gadolinium enhancement may indicate a condition at risk of developing necrosis. We therefore recommend a contrast-enhanced MRI study in severe alcoholics with suspected diagnosis of MBD.

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Marchiafava–Bignami disease (MBD) is a rare condition characterized by demyelination, necrosis and atrophy of the corpus callosum (CC), and mainly associated with alcoholism. MBD may present with various clinical manifestations. Brain magnetic resonance imaging (MRI) scan is important in prompt diagnosis and treatment of MBD. Here we reported a case of MBD and reviewed literature about the usage of gadolinium-enhanced MRI in MBD. Gadolinium enhancement may indicate a condition at risk of developing necrosis. We therefore recommend a contrast-enhanced MRI study in severe alcoholics with suspected diagnosis of MBD. [ABSTRACT FROM AUTHOR]

Marchiafava–Bignami disease is a rare toxic encephalopathy seen mostly in chronic alcoholics due to progressive demyelination and necrosis of the corpus callosum. It may involve adjacent white matter and subcortical regions. We present here the magnetic resonance imaging findings of Machiafava–Bignami disease in a chronic alcoholic patient. In 1903, Italian pathologists Marchiafava and Bignami described 3 alcoholic men who died after having seizures and coma. All 3 patients were chronic alcoholics and had consumed considerable amounts of red wine.

• Marchiafava-Bignami disease is a rare disorder associated with chronic alcohol consumption. • Clinicians should keep a high level of suspicion since clinical presentation is highly variable. • Diagnosis relies on MRI findings correlated with a context of alcohol abuse and malnutrition. • Brain MRI usually shows cytotoxic lesions of the corpus callosum. • Early treatment with intravenous thiamine is associated with a better prognosis. [ABSTRACT FROM AUTHOR]

Background: Marchiafava-Bignami disease (MBD) is a rare disorder characterized by acute demyelination of the corpus callosum in people with chronic alcoholism. Early thiamine treatment can reduce neurological complications of MBD. However, the outcome of MBD is usually unfavorable. Here we report a case of MBD responded to intravenous corticosteroid administration. Case Report: 46-year-old woman with chronic alcoholism presented to our emergency department with two days of dysarthria, dysphagia, extremity weakness, and decreased consciousness. Diffusion-weighted image and fluid attenuated inversion recovery revealed high signal intensities of the left frontal cortex and the entire corpus callosum. After receiving high dose intravenous thiamine and multivitamin, she did not improve. At the third day of admission, intravenous steroid was started. Her mental status and weakness were rapidly improved. At 2 weeks later, she could walk independently. Follow-up MRI revealed only a small lesion in the splenium of corpus callosum. Conclusion: The MBD in our case is associated with thiamine deficiency with main pathology of edema and demyelination of corpus callosum. Corticosteroid stabilized blood brain barrier and reduced inflammation and edema. Therefore, corticosteroid therapy might have beneficial effects as an alternative therapy for MBD.

Objective: Most patients with Marchiafava-Bignami disease (MBD) had unfavorable prognosis, with disability or death. We aimed to determine the risk factors of early unfavorable prognosis of MBD, and to develop a predictive nomogram for early unfavorable prognosis of MBD., Methods: MBD patients admitted to our hospital between 1 January 2013 and 31 December 2021 were included. Unfavorable prognosis was defined as mRS score ≥3, the independent risk factors for unfavorable prognosis of MBD with the odds ratio (OR) and 95% confidential interval (CI) acquired by multiple logistic regression were included in development of the predictive nomogram for early unfavorable prognosis of MBD, and the area under curve (AUC) of the receiver operating characteristic curve was calculated. The published case reports of MBD were used as the external validation group to verify the predictive ability of the nomogram., Results: Independent risk factors for early unfavorable prognosis of MBD included Glasgow Coma Scale score (OR = 0.636, 95% CI = 0.506-0.800, p = 0.004) and pneumonia (OR = 2.317, 95% CI = 1.003-5.352, p = 0.049). The AUC of the nomogram was 0.852. Ninety-four case reports, a total of 100 cases of MBD were included as the external validation group, its AUC was 0.840. The online dynamic nomogram for early unfavorable prognosis of MBD was constructed., Interpretation: It is confirmed by external validation that the nomogram has a preferable predictive ability and clinical efficacy, and the dynamic online predictive nomogram is helpful for physicians to quickly assess the prognosis of MBD., (© 2023 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.)

Background: Marchiafava-Bignami disease (MBD) is a neurological degenerative disorder with a pathognomonic hallmark of symmetric demyelination in the corpus callosum (CC). Most reported cases were chronic alcoholics and some showed cortical lesions related to poor clinical prognosis. Herein we report a case of a chronic alcoholic who presented with confusion and generalized weakness. Methods: Nerve fiber integrity and metabolic changes were evaluated with Magnetic resonance imaging (MRI) sequences including diffusion tensor imaging (DTI) and MRS. Results: MRI revealed the typical callosal lesions of MBD with bilateral frontoparietal cortical lesions. DTI and MRS showed both impaired myelin integrity and axonal density in the CC. The cortical lesions partly disappeared after intravenous administration of high-dose multivitamins and corticosteroids. The patient regained consciousness 3 months later while dysarthria and quadriplegia persisted. Three years later, the patient can interact occasionally with people and the functional activities of both upper and lower limbs have no improvement. Conclusions: To our knowledge, this is the first report of DTI together with MRS assisting in evaluating the prognosis of MBD. [ABSTRACT FROM AUTHOR]