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Evaluation of Bioenergetic Function in Cerebral Vascular Endothelial Cells
Published on: November 19, 2016
Cerebral Manifestations of Mitochondrial Disorders
Josef Finsterer1, Elmano Henrique Torres de Carvalho2
11Krankenanstalt Rudolfstiftung,Vienna,Austria.
Abstract:
This review aims at summarizing and discussing previous and recent findings concerning the cerebral manifestations of mitochondrial disorders (MIDs). MIDs frequently present as mitochondrial multiorgan disorder syndrome (MIMODS) either already at onset or later in the course. After the muscle, the brain is the organ second most frequently affected in MIMODS. Cerebral manifestations of MIDs are variable and may present with or without a lesion on imaging or functional studies, but there can be imaging/functional lesions without clinical manifestations. The most well-known cerebral manifestations of MIDs include stroke-like episodes, epilepsy, headache, ataxia, movement disorders, hypopituitarism, muscle weakness, psychiatric abnormalities, nystagmus, white and gray matter lesions, atrophy, basal ganglia calcification, and hypometabolism on 2-deoxy-2-[fluorine-18]fluoro-D-glucose positron-emission tomography. For most MIDs, only symptomatic therapy is currently available. Symptomatic treatment should be supplemented by vitamins, cofactors, and antioxidants. In conclusion, cerebral manifestations of MIDs need to be recognized and appropriately managed because they strongly determine the outcome of MID patients.
Insights
Mitochondrial disorders (MIDs) frequently affect the brain, causing diverse neurological symptoms and imaging findings. Early recognition and management of these cerebral manifestations are crucial for patient outcomes.
Area of Science:
- Neurology
- Genetics
- Metabolic Disorders
Background:
- Mitochondrial disorders (MIDs) are a group of genetic diseases affecting cellular energy production.
- The brain is the second most commonly affected organ in MIDs, after muscle.
- Cerebral manifestations can occur with or without detectable lesions on imaging or functional studies.
Purpose of the Study:
- To review and synthesize current knowledge on the cerebral manifestations of MIDs.
- To highlight the variability and common neurological symptoms associated with MIDs.
- To discuss diagnostic and therapeutic approaches for brain involvement in MIDs.
Main Methods:
- Comprehensive literature review of previous and recent findings on MIDs and their cerebral impact.
- Analysis of reported clinical presentations, neuroimaging findings, and functional studies.
- Synthesis of information on therapeutic strategies, including symptomatic treatment and supportive care.
Main Results:
- Cerebral manifestations of MIDs are highly variable, including stroke-like episodes, epilepsy, ataxia, movement disorders, and psychiatric abnormalities.
- Common neuroimaging findings include white and gray matter lesions, atrophy, and basal ganglia calcification.
- Functional studies like FDG-PET may reveal hypometabolism in affected brain regions.
Conclusions:
- Cerebral involvement significantly impacts the prognosis of patients with MIDs.
- Prompt recognition and appropriate management of neurological symptoms are essential.
- Symptomatic treatment, supplemented with vitamins, cofactors, and antioxidants, forms the current therapeutic approach.
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