Plasma metabolomic patterns in patients with exhaustion disorder

Abstract

Exhaustion disorder (ED) is a stress-related disorder that often implies a great burden on the individual patient as well as on society. Previous studies have shown that ED is associated with metabolic deviations, such as lowered fasting glucose. Several mechanisms have been discussed as a plausible explanation of the lack of energy described by these patients. Metabolic processes and reduced ability to mobilize energy have been suggested as important factors. This study investigated metabolomics in 20 patients diagnosed with ED and compared them with 21 healthy controls. Plasma metabolic profiles were examined in both fasting and nonfasting (postprandial) conditions. Blood plasma samples were analyzed for metabolite content using gas chromatography mass spectrometry. A total of 62 different metabolites were simultaneously detected in each of the samples. Multivariate models indicated systematic differences between patients with ED and healthy controls in both their fasting and nonfasting plasma metabolite levels. Lysine and octadecenoic acid were more abundant and glutamine, glycine, serine and gluconic acid were less abundant in the patients across both conditions. In the present study, we comprehensively and simultaneously screen for changes in a large number of metabolites. Our results show a difference in systemic metabolites between patients with exhaustion disorder and healthy controls both in the fasting and in the postprandial states. Here, we present new potential biomarkers mirroring exhaustion disorder metabolism. LAY SUMMARYExhaustion disorder (ED) patients suffer from stress-related symptoms including a reduced energy level. This study investigates the body's metabolism in patients with ED, both fasting and after a meal. New potential markers that may help future investigations on ED were identified. ARTICLE HISTORY

Metabolomic Characterization of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

“…In recent years, Trp metabolism has been increasingly recognized as central to the pathogenesis of many neuropsychiatric disorders. In particular, a decrease in Trp level was found in major depressive disorder (Moreno et al, 2010;Liu et al, 2015), schizophrenia (Yao et al, 2010;Xuan et al, 2011) and exhaustion disorder (Hadrévi et al, 2019). Our findings are in line with these reports, suggesting that Trp metabolism may be common to several neuropsychiatric conditions that share several clinical features with PANS, such as irritability, anxiety, emotional lability and thought disturbances.…”

Exhaustion disorder: scoping review of research on a recently introduced stress-related diagnosis

“…Twenty-four studies had a primary aim of investigating biological aspects of exhaustion disorder, including the hypothalamus–pituitary–adrenal (HPA) axis ( n = 5), 47 , 49 , 56 , 59 , 61 the adrenal hormone dehydroepiandrosterone sulfate (DHEA-s) ( n = 3), 48 , 50 , 51 growth factors and related molecules in plasma ( n = 6), 45 , 46 , 62 , 65 – 67 structural and functional brain imaging measures ( n = 5) 54 , 55 , 57 , 58 , 63 and various other biological measures ( n = 5). 44 , 52 , 53 , 60 , 64 In addition to the 24 studies in this synthesis, 2 studies that primarily aimed to investigate cognitive functioning in exhaustion disorder participants 41 , 42 and 1 RCT of treatment effect 90 also reported HPA-axis measures.…”

Long-term follow-up of residual symptoms in patients treated for stress-related exhaustion

“…There is currently no objective diagnostic marker available for stress-related exhaustion. We and others have previously published several interesting findings indicating that the fatigue described by these patients can partly be explained with different biological correlates, [25][26][27][28] and ongoing studies are being conducted including long-term follow-up.…”