Figure 4. Two-year neurocognitive outcomes following hematopoietic stem cell transplantation at a stage of relatively low MRI severity.

(A–F) The relationship of pretransplant MRI severity score plotted with 2-year transplant outcomes revealed that neurocognitive skill areas were differentially impacted. While domains such as processing speed and fine motor dexterity showed greater susceptibility to poor outcomes when the MRI severity was higher, verbal reasoning skills and working memory generally remained intact across this low severity spectrum. The resilience of verbal reasoning skills in particular can inflate the perception of a child's functioning, as a child with intact communication and motor coordination generally appears unaffected by disease, but these perceptions of intact functioning likely obscure cerebral adrenoleukodystrophy–related neurocognitive changes that can occur and were quantified in this study. HSCT = hematopoietic stem cell transplantation.