Mitochondrial complex I deficiency can cause insufficient ATP generation, increased reactive oxygen species, and neuroinflammation.

“one could be you just can't generate enough atp and and neurons or a subset of neurons are particularly sensitive right another could be that you're generating high levels of reactive oxygen species we know subsets of neurons are are especially sensitive to that right um uh and you could come up there's also an inflammatory component to this disease where we see a lot of neural inflammation in the brain regions where the lesions occur”