More symptom information
Learn more about specific symptoms of this leukodystrophy in these pages.
See also: Adrenoleukodystrophy
Adrenomyeloneuropathy (AMN) is a rare genetic disorder primarily affecting males and characterized by the accumulation of very long chain fatty acids (VLCFAs) due to mutations in the ABCD1 gene. AMN is a form of adrenoleukodystrophy that affects the spinal cord and body (peripheral nerves), resulting in symptoms like muscle weakness, difficulty walking, and bladder dysfunction. It may also cause adrenal gland dysfunction known as Addison’s disease. Treatment options vary based on the form and stage of the disease, and management focuses on addressing symptoms and supporting the patient’s well-being.
We have produced separate booklets for more practical information relevant to your condition.
A new diagnosis can be overwhelming as it brings unique challenges and adjustments, but it is important to remember that you are not alone.
AMN is a genetically inherited disease caused by mutations (pathogenic variants) in the ABCD1 gene. It is X-linked meaning the gene is located on the X chromosome. Unlike women, men only have one X chromosome and they are generally more severely affected than females, although females are at risk of developing AMN.
X-linked recessive: The mutant gene is located on the X chromosome. Men have one X and one Y chromosome while women have two X chromosomes. This means that a female with a mutated gene on one X chromosome, will have the effects somewhat balanced by their second X chromosome without the mutation. However, a male with a mutated gene on their X chromosome will be affected as they only have one.
Men who are diagnosed with the ALD gene often feel a sense of guilt, especially if they have passed the gene on to their daughter. It is very common to have these feelings but it is important to remember that it is not your fault. Our counsellor and support services team can help you to work through these feelings.
Genetic counselling is essential for affected families due to the inheritance pattern of the condition. This is available at hospitals and Regional Genetic Centres. Please contact your doctor if you have any questions.
Learn more about genetic testing and counselling here.
Symptoms of Adrenomyeloneuropathy (AMN) can include stiffness, weakness and pain in the legs. This starts gradually and can progress over time. The medical term for this is ‘progressive spastic paraparesis’. Damage to the peripheral nerves supplying the legs means unsteadiness and falls are common. The nerves to the bladder, bowel and sexual organs can also be affected in AMN. Mobility can gradually deteriorate to the point where the sufferer eventually loses the ability to walk and becomes wheelchair bound. But this does not necessarily happen to all sufferers. AMN affects men more severely than women. Females are sometimes called ‘carriers’, because they can pass the gene to their children but were thought to be unaffected themselves. However, we now know that the ALD gene does cause effects in many women, therefore, we refer to females as ‘females with the ALD gene’. It is thought that about 80% of women with the ALD gene will develop some symptoms of AMN during their lifetime. Symptoms usually start around the ages of 40 to 50, but can begin earlier or later.
As with ALD, in most males with AMN the adrenal glands are also affected. The adrenal glands make steroid hormones. Poor functioning of these glands is known as adrenal insufficiency, or Addison’s Disease. It is important to get tested for this alongside your ALD/AMN diagnosis. About 20% of men with AMN eventually develop some damage to nerves in the brain, known as adult-onset cerebral ALD, often the first symptoms are dementia-like symptoms including inappropriate comments, angry outbursts, memory, personality and behavioural changes. Some men affected in this way go on to experience severe physical and mental deterioration, similar to that seen in boys with cerebral ALD.
Learn more about specific symptoms of this leukodystrophy in these pages.
Currently there is no treatment for AMN but there are promising clinical studies researching options. Treatment is unique to each person but generally focuses on alleviating symptoms of the disease.
Steroid replacement therapy is available for treating adrenal insufficiency and generally improves the patient’s quality of life.
Yearly MRI scans are recommended to monitor disease progression as it is important for early signs of cerebral ALD to be picked up quickly and treatment may be given. Bone Marrow Transplants (BMT) or Haemopoietic Stem Cell Transplants (HSCT) are the most common tried and tested treatment for boys with early stage ALD, usually before any physical symptoms have appeared. Transplants in adults who are showing signs of cerebral ALD are not common, but practices are changing. BMT/HSCT is available in the UK for men with cerebral ALD, there are strict criteria and this will be discussed by your specialist doctor.
This research article discusses the successful use of HSCT in adult males with cerebral adrenoleukodystrophy. It showed that HSCT can slow or stop cerebral demyelination from progressing and prevent severe loss of neurocognition. Long-term outcomes of allogeneic haematopoietic stem cell transplantation for adult cerebral X-linked adrenoleukodystrophy
There is condition management information that may be useful for you in managing your or your loved one’s leukodystrophy.
There may be a current clinical trial, natural history study or patient registry for your condition. Check our current research page and ask your specialist doctor for more information.
Dr. Stephan Kemp is a Professor at the Amsterdam University Medical Centers (AMC), University of Amsterdam, the Netherlands. With over 20 years of experience in adrenoleukodystrophy (ALD) research and more than 80 scientific publications, Dr. Kemp is a leading expert in the field. In 1999, together with Dr. Hugo Moser, he helped create the ALD database now known as the ABCD1 Variant Registry.
The ABCD1 Variant Registry collects and records changes (variants or mutations) in the ABCD1 gene which is the gene responsible for adrenoleukodystrophy and adrenomyeloneuropathy (AMN). A genetic variant simply means a change in the DNA. Some variants are harmless (benign), while others known as pathogenic variants can cause disease. In ALD, a pathogenic variant in the ABCD1 gene alters how the body processes very long-chain fatty acids, leading to ALD and AMN. For more information, visit The ABCD1 Variant Registry.
Each variant added to the ABCD1 registry helps researchers and clinicians better understand:
The strength of this registry lies in collaboration. Diagnostic laboratories, researchers, physicians, and families all contribute information to improve understanding of how different ABCD1 variants affect people.
By sharing your or your family’s ABCD1 variant, you help strengthen this global resource by:
If you would like to add your ABCD1 variant to the registry, please contact: Professor Stephan Kemp at s.kemp@amsterdamumc.nl
We understand that research is a significant priority and source of hope for the leukodystrophy community. There is more research in leukodystrophy now than ever before. Alex TLC actively promotes and supports research in a number of ways.
Every month we update our database of research summaries with the most recent research. This includes summaries of leukodystrophy articles, clinical trials and pharmaceutical press releases. Our summaries allow our community to read about relevant recent research developments in a format that is easily understood.
Learn about the ways in which we can help in the how we support you section. When you or a family member been diagnosed with a leukodystrophy it may be difficult to know where to go for more advice – this information could help.
Our services and equipment section is here to help leukodystrophy patients and their families manage their condition. All information is based on our knowledge of UK services, however, our team are happy to receive support requests from other countries – email us.
You may be introduced to many different medical professionals which you may find confusing. View our guide to the health and care professionals you may encounter, with short descriptions about what they do.
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