With chronic fatigue, the brain removes toxins worse

The glymphatic system acts as a figurative drainage system in the brain, removing toxic metabolic waste that accumulates in the nervous tissue. Its activity increases significantly during sleep and decreases significantly during wakefulness. When this system malfunctions, harmful substances can accumulate in the tissues, leading to neuroinflammation, which can result in cognitive impairments, persistent fatigue, and other characteristic symptoms.

In a study led by Dr. Kiran Tapalya of the National Centre for Neuroimmunology and Emerging Diseases (NCNED) at Griffith University, magnetic resonance imaging and a special index, the DTI-ALPS index, were used. This index indirectly assessed the effectiveness of glymphatic drainage by analyzing the movement of fluid along perivascular spaces and along neural pathways, particularly in the projection and association tracts of the brain, which are areas where fluid flow is normally active. This was the first study to demonstrate a disruption of the glialphatic function in ME/CFS using non-invasive imaging.

The study also highlighted the important relationship between sleep quality and the brain’s cleaning system. Participants with more severe sleep disturbances also had more significant impairments in the removal of metabolic waste. This study further emphasizes the critical role of sleep in maintaining brain health, as it is during sleep that the brain’s cleaning process occurs, and its disruption can have a significant impact on a person’s well-being and cognitive abilities.

According to Professor Sonia Marshall-Gradisnik, director of the NCNED, the reduction of glial function may be a key factor in both the brain fog and sleep disturbances in patients with ME/CFS. The discovery is significant in several ways.

Firstly, it provides a clearer neurophysiological basis for the syndrome, moving the description of the condition from subjective complaints to objectively measurable processes. Secondly, since the DTI-ALPS index can be determined using standard MRI, it has the potential to become a reliable biomarker for the diagnosis of ME/CFS, which is currently based primarily on symptoms and lacks objective laboratory or instrumental criteria. Thirdly, understanding the role of glial dysfunction opens up new avenues for the development of therapies. If we can find ways to improve brain drainage, such as through optimizing sleep, changing body position during rest, or using specific medications, it could significantly alleviate the symptoms experienced by patients.

Dr. Tapalia notes that

Профессор Маршалл‑Градисник добавляет, что команда надеется на то, что результаты работы помогут внедрить в клиническую практику неинвазивные методы диагностики и в конечном счете разработать более эффективные варианты лечения для людей, страдающих этим тяжелым и пока недостаточно изученным заболеванием.