TNF and medium chain acyl-CoA dehydrogenase deficiency: This leads to the release of proinflammatorycytokines such as TNF-α, IL-1β, and IL-6 from astrocytes,contributing to neuroinflammation and demyelination., Therefore, Cer upregulation is consistent with the results foundfor SM species and may also be a risk factor for MCADD-associatedencephalopathy.