Summary model showing ATP-generating pathways likely to influence the vulnerability status of MNs in SMA.

<p>Efficient ATP generation through different processes maintains levels in energy demanding MNs, critical for their function and survival during disease. Certain motor neuron pools possess inherently higher bioenergetic capacities that provide protection during cellular insult both at the cell body and at the NMJ. Efficient ATP generated from mitochondria allows cellular homeostasis to be maintained. During hypoxia, glycolytic pathways are employed to meet acute ATP demand, particularly at the NMJ, critical for vesicular recycling and synaptic transmission. Mitochondrial transport along the axon provides local ATP to maintain axonal integrity. Glycolytic machinery present along the axon allows for fast vesicular transport down to the NMJ to deliver packaged proteins for pre-synaptic function.