{
  "abstract": "A 33-year-old man with genetically confirmed X-linked adrenoleukodystrophy developed progressive irritability, emotional lability, anger outbursts, repetitive reassurance-seeking, and insomnia alongside worsening spastic paraparesis and urinary symptoms. Difficulty recalling familiar names and remembering and completing assigned tasks subsequently impaired occupational functioning. Collateral history established a departure from his calm and socially appropriate premorbid personality. Behavioral examination revealed overfamiliarity, disinhibited language, emotional lability, impaired judgment, and perseverative illness-related preoccupation. Cognitive examination demonstrated impaired attention, set-shifting, verbal fluency, inhibitory control, new learning, and recent recall, while neurological examination revealed pyramidal signs and a spastic gait. Brain magnetic resonance imaging showed symmetrical posterior cerebral white-matter hyperintensities, and genetic testing identified an ABCD1 c.323C>A variant. The temporal association with neurological progression, acquired behavioral change, cognitive impairment, and characteristic imaging abnormalities supported secondary mood syndrome with accompanying behavioral and cognitive manifestations rather than a primary depressive episode or adjustment disorder. Irritability, sleep, and anger outbursts improved during approximately one week of inpatient treatment with supportive intervention, low-dose quetiapine, and sodium valproate, although post-discharge follow-up was unavailable. This case emphasizes that new affective, behavioral, or cognitive symptoms in cerebral white-matter disease should prompt collateral history-taking, cognitive and neurological examination, and reassessment for disease progression.",
  "abstract_shown": true,
  "affiliations": [
    "Psychiatry, Armed Forces Medical College, Pune, IND",
    "Psychiatry, Command Hospital (Southern Command), Pune, IND"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Rohan Ram Setlur"
    },
    {
      "affs": [
        1
      ],
      "name": "Ranveer Singh"
    },
    {
      "affs": [
        1
      ],
      "name": "Manisha Jindal"
    },
    {
      "affs": [
        0
      ],
      "name": "Arpit Sharma"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1tv05yymv1a9z.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.117273",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13722919/?tool=EBI",
  "id": "1tv05yymv1a9z",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13722919",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Neurology"
    ],
    [
      "heading",
      "Psychiatry"
    ],
    [
      "openalex",
      "1308|Metabolism and Genetic Disorders"
    ]
  ],
  "openalex": "W7215113973",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13722919/pdf/?tool=EBI",
  "pmcid": "PMC13722919",
  "pmid": "42966968",
  "published": "2026-09-30",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/1tv05yymv1a9z.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T03:21:51Z",
      "native_id": "PMC:PMC13722919",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13722919"
    },
    {
      "first_seen": "2026-11-04T12:21:37Z",
      "native_id": "PMC13722919",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.117273"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Neurology",
      "subfield": "neurology"
    },
    {
      "field": "medicine",
      "origin": "heading:Psychiatry",
      "subfield": "psychiatry"
    }
  ],
  "title": "Mood and Behavioral Changes in Adult Cerebral X-linked Adrenoleukodystrophy",
  "title_text": "Mood and Behavioral Changes in Adult Cerebral X-linked Adrenoleukodystrophy",
  "type": "peer-reviewed",
  "updated_at": "2026-11-04T12:21:37Z",
  "url": "https://research.draconitic.com/paper/1tv05yymv1a9z",
  "venue": "Cureus",
  "versions": []
}