ALD is an inherited metabolic storage disease associated to a defect in an enzyme that results in defective peroxisomal B-oxidation and the accumulation of very-long-chain fatty acids (VLCFA C24, C26) in tissues of the body, especially the brain and the adrenal glands. It results in demyelination associated with an intense inflammatory response in the white matter. ALD affects only boys. Female carriers can manifest with some degree of disability. Approximately 70% of boys with ALD have adrenal insufficiency. If no focality is found on the neurological exam, a brain MRI might be appropriately deferred which would result in underdiagnosis of ALD. Elevated plasma VLCFA level is highly reliable in the diagnosis of ALD, which is confirmed by mutation analysis of the ABCD1 gene. Molecular studies are essential in determining a carrier state and especially in prenatal diagnosis, which can be performed in all peroxisomal disorders. MRI findings in ALD correlate with neuropathological features of bilaterally symmetric demyelination in the parieto-occipital region with the involvement of the splenium of the corpus callosum. Although there is no definitive treatment, evidence suggests that early interventions before CNS involvement clinically and in MRI may offer a better prognosis to these patients. This information can be published in our peer-reviewed journal with impact factors and are calculated using citations not only from research articles but also review articles (which tend to receive more citations), editorials, letters, meeting abstracts, short communications, and case reports. The inclusion of these publications provides the opportunity for editors and publishers to manipulate the ratio used to calculate the impact factor and try to increase their number rapidly. Impact factor plays a major role for the particular journal. Journal with higher impact factor is considered to be more important than other ones.
