[tri-med] Re: In the hospital... update

----- Original Message ----- 
From: "Janet" <
>>Preliminary info is that there is decreased white
> matter. Ok...  so what does that MEAN?????????  Anyone else been told
this?

White matter is the cortex of the brain - its white because its coated in a
myelin sheath. Myelin is made up of fats and looks white. White matter also
surrounds the spinal cord and makes up the optic nerves etc.

Grey matter lays underneath the white matter. Its grey because it doesn't
have myelin sheaths.

Very simplified - The grey matter of the brain does all the work and
calculations of the brain, the white matter connects and communicates what
the grey matter does. if you think of the brain as a computer - the grey
matter is the CPU and the white matter connects all the other parts of the
computer

When you look up white matter try using myelin or myelination of the brain,
even outer cortex rather than white matter.

Decreased white matter? My understanding is that the effect is variable. It
depends on how much it is decreased and the reason for it. From what I
understand its pretty typical for white matter to be decreased in a lot of
conditions - chromosomal, pre-term children and so on. Its been reported
frequently in children with T-18. (I havent studied the other trisomies in
as much detail)

White matter can also decrease due to certain diseases, eg alcoholism,
multiple sclerosis and also in conditions like cerebral palsy. You know she
isnt drinking, and you know she doesn't have MS!! By simple definition she
has CP - just like all of our kids. CP is simply a term that applies to any
injury to the brain before or shortly after birth (traditionally defined as
within the first 12 months). We know that the extra genetic material causes
a disruption to the development of the brain - so yes our kids technically
have CP. Just not in the most commonly accepted sense of it being caused by
hypoxia at birth.

At this stage its probably impossible for anyone to tell you with any
accuracy what it means. It can mean nothing, it can be a sign that she will
have developmental issues (not that that is news to you) or she may have
learning difficulties or nothing at all. But to what extent she has any of
these only time will tell.

Ten years ago it was the reports of decreased white matter or more
accurately poor myelination of the brain in T-18'ers that caused me to
investigate the long chain fatty acids. Long Chain Fatty Acids or the Omegas
are known to increase the myelination of the brain. Thats why the FDA has
baby formula manufacturers add them to most infant formulas. Its also why
fats should NOT be restricted in children, especially those under 5. Breast
milk is naturally high in long chain fatty acids.

Myelination of the brain continues until the late teens, though most occurs
within the first 5 years. Old age sees myelination decrease (hence why
omegas are strongly pushed in the elderly to delay the effects of aging) So
the earlier you start with omegas the better the effect, but its no reason
not to start later in life because myelination is a continual process.

One of the theories behind early intervention is that it encourages the
development of brain pathways, alternate pathways where necessary and
maximises the use of what paths are there.

The other thing that effects myelin development is oxygen. Its one of the
reasons that those in favour of HBOT are so in favour of it. There is no
hard evidence that HBOT increases white matter significantly but
theoretically it should help the brain to generate myelin and slow down any
degeneration. Michael Jackson believes it works to prevent aging - he sleeps
in his own chamber :-)) (sorry thats a bit low, but he does).

As I said the other day though I am not a huge fan of HBOT. I can see that
it MAY have some benefit for those who have suffered a brain injury, I am
just not convinced that its as promising for congenital conditions or worth
the risks. And there are risks associated with HBOT, not the least to
someone's hip pocket.

More than you wanted in response Janet? In summary though. Decreased white
matter is non specific. It probably means that she will have global delays
but to what extent I dont think anyone will be able to tell you. As far as I
know its definitely not something to get worried about.
Its been a while since I did all this formally though and things change -
please let me know what your neuro says eventually.

Love many, hate few, learn to paddle your own canoe.
  -- American Proverb

Keep Looking For Rainbows!!
   _--_|\
 /Karen \
 \ _.--._ /
          v Karen, Mum to Alex (9 years, T-18 Mosaic)
http://members.optushome.com.au/karens

                  Building ___ooOOoo__ Rainbows
                       www.trisomyonline.org
                  Families Helping Families On-line

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