“…Here, the significant decrease in the NAA/Cr ratio in the frontal NAWM may in part account for the phenomenon of cognitive deficits that occurs in most MS patients, and this has been demonstrated by previous studies. [ 36 – 39 ] For example, a global memory disorder involving indices for short-term memory, long-term memory, and working memory was found in MS patients in Staffen et al's study, [ 40 ] and deficits in decision-making under risk conditions, which might be related to deficits in processing speed or visuospatial learning, were found in MS patients in a study by Rovaris M and colleagues [ 41 ] Regarding NAA/Cr abnormalities in the parietal-occipital NAWM, Kotov et al's [ 42 ] work showed that they may be associated with vision impairment caused by MS.…”