The pathological findings of subacute combined degeneration consist of patchy losses of myelin in the dorsal and lateral columns.

HIV-associated vacuolar myelopathy can present with a similar pattern of dorsal column and corticospinal tract demyelination.

However, the basis for this has been challenged, although due to ethical considerations it is no longer able to be tested if "neuropathy is made more severe as a result of giving folic acid to vitamin B12- deficient individuals".

[11] Vitamin E deficiency, which is associated with malabsorption disorders such as cystic fibrosis and Bassen-Kornzweig syndrome,[12] can cause a similar presentation due to the degeneration of the dorsal columns.

[13] MRI-T2 images may reveal increased signal within the white matter of the spinal cord, predominantly in the posterior columns and possibly in the spinothalamic tracts.