Consistent with results from the high-throughput data, we confirmed that muscle expressions of 4 ncRNAs (miR-6089, miR-27b-3p, miR-214-3p and LINC01405) were significantly down-regulated, and 7 ncRNAs (miR-150-5p, let-7e-5p, miR-145-5p, SNHG12, RP11-403P17.4, CTC-260E6.6 and RP11-357D18.1l) significantly up-regulated in MELAS muscle biopsies vs. controls, indicating that they might be acting as suppressors or accelerator in occurrence or progression of MELAS pathogenesis. Here, VHRT is linked to MELAS.