Leakage of astrocyte-derived extracellular vesicles in stress-induced exhaustion disorder, 2021, Wallensten et al

[mango]

Leakage of astrocyte-derived extracellular vesicles in stress-induced exhaustion disorder: a cross-sectional study

Johanna Wallensten, Anna Nager, Marie Åsberg, Kristian Borg, Aniella Beser, Alexander Wilczek & Fariborz Mobarrez

"Abstract

Patients with stress-induced exhaustion disorder (SED) demonstrate cognitive dysfunction similar to patients with minor traumatic brain injury (TBI).

We have previously detected elevated concentrations of astrocyte-derived extracellular vesicles (EVs) in patients with TBI. As such, we hypothesized that astrocyte-derived EVs could be higher in patients with SED than in patients with major depressive disorder (MDD) and healthy controls.

Patients with SED (n = 31), MDD (n = 31), and healthy matched controls (n = 61) were included.

Astrocyte-derived EVs (previously known as microparticles) were measured in plasma with flow cytometry and labeled against glial fibrillary acidic protein (GFAP) and aquaporin 4 (AQP4). In addition, platelet EVs and their CD40 ligand expression were measured.

Patients with SED had significantly higher concentrations of AQP4 and GFAP-positive EVs and EVs co-expressing AQP4/GFAP than patients with MDD and healthy controls.

Patients with MDD had significantly higher concentrations of GFAP-positive EVs and EVs co-expressing AQP4/GFAP than healthy controls.

Platelet EVs did not differ between groups.

CD40 ligand expression was significantly higher in patients with SED and MDD than in controls.

In conclusion, the present study suggests that patients with SED, and to some extent, patients with MDD, have increased leakage of astrocyte-derived EVs through the blood–brain barrier."

https://www.nature.com/articles/s41598-021-81453-8

 

[mango]

The Swedish website forskning.se recently published an article about biomedical research into various mental health conditions, including the diagnosis that in Sweden is known as exhaustion disorder (utmattningssyndrom, formerly utbrändhet or utmattningsdepression). This study was mentioned, along a couple of others from the same research group.

Psykisk ohälsa syns i blodet
https://www.forskning.se/2022/04/20/psykisk-ohalsa-blodprov

Exhaustion disorder, or "burnout" is a separate diagnosis to ME/CFS/PVFS in Sweden, and is usually defined as "a stress related psychiatric disorder caused by long-term psychological stress that is often, but not exclusively, work related", which involves both physical and psychological/behavioural symptoms. I believe this group of patients is usually lumped in under the CFS umbrella in many other countries?

The official Swedish Healthcare guide 1177 is a good place to start if you want to learn more about the differences between the definitions, diagnostic processes and recommended treatments:
Utmattningssyndrom
ME/CFS

Exhaustion syndrome shows up in blood tests

Marie Åsberg is Professor Emerita of Psychiatry at Karolinska Institutet. Her research team has shown that patients with exhaustion syndrome have fragments of astrocytes in their blood, a type of support cell found only in the brain. They also have elevated levels of the protein aquaporin4, which is linked to the brain.

- That's very interesting, because it suggests brain involvement. These two biomarkers clearly distinguish the exhausted from the depressed and healthy. They could be used clinically, but they cost money and you have to know about them and think they are better than a clinical assessment.

The team's latest study shows that the MapCog neuropsychological test, which measures the ability to maintain and rapidly shift attention, also very clearly distinguishes between fatigue sufferers and healthy controls. The test is administered on a tablet and could be carried out by a nurse in a health centre.

Forum thread on the tablet study:
https://www.s4me.info/threads/impai...et-based-assessment-2021-bartfei-et-al.22495/

Forum thread on another study about leakage of astrocyte-derived extracellular vesicles, by the same research group:
https://www.s4me.info/threads/isofo...mental-disorders-2021-wallensten-et-al.27107/

forskning.se is backed by a number of government agencies and foundations that fund research, as well as the country's universities. The editorial office is located at the Swedish Research Council. The news on forskning.se comes from universities, higher education institutions, research funders, research agencies, research institutes and academies.

ETA: Marie Åsberg has been involved in ME/CFS research and other projects over the years as well, including a systematic review of ME/CFS research for SBU (Swedish Agency for Health Technology Assessment and Assessment of Social Services).

 

[Creekside]

I can't judge the value of the research, but this is the sort of abnormality I expect they'll find in PWME: something that doesn't show up on the 'standard' testing, yet does interfere with normal brain function.