“…Cortical gray matter pathology, including demyelination, axonal degeneration, and brain atrophy, is recognized as a major factor contributing to disability in MS (Inglese et al, 2004;Bö et al, 2006;Fisher et al, 2008). Previous studies suggest that mitochondrial defects, including reductions in neuronal expression of nuclear encoded mitochondrial electron transport chain genes, decreased synthesis of the neuronal mitochondrial metabolite N-acetylaspartate (NAA), and inhibition of mitochondrial respiration contribute to cortical pathology in MS (Dutta et al, 2006;Pandit et al, 2009;Broadwater et al, 2011;Campbell et al, 2011;Li et al, 2013;Witte et al, 2013); however, the mechanisms involved in these mitochondrial changes are not clear.…”