“…Given the spectrum of the presentations for MS, it should be no surprise that a vast array of cellular mechanisms may foster the onset and progression of MS. Pathways that involve inflammatory mediators, demyelination and remyelination pathways, oxidative stress, blood-brain barrier impairment, viral antigens, and cellular metabolism, which are dependent upon nicotinamide adenine dinucleotide (NAD+), have been tied to the underlying pathology of MS [10,29,31,33,39,43,72,77,85,86,99,100,115,162,171,[179][180][181][182][183][184][185][186][187][188][189][190][191][192][193][194][195][196][197][198]. Although new treatments that address MS, known as disease modifying therapies (DMTs), can limit the rate of relapse in patients with relapsing-remitting MS, DMTs cannot prevent disease progression.…”