<qa>  What is the primary cause of early cortical atrophy?Conventional MRI 1.5 Tesla shows extensive involvement of the cerebral white matter hypo-T1, hyper- T2 and FLAIR signals indicative of rapidly progressing leukodystrophy. Early cortical atrophy reflects associated neuronal involvement. Proton MR spectroscopy demonstrates abnormalities of choline and N-acetyl-aspartate demyelination, neuronal loss, which are non-specific but can serve as indicators to monitor the effects of any therapeutic intervention. 