For the first time, differences have been found in brain activity between healthy people and people suffering from burnout. A breakthrough. Until now, this condition was not to be determined on the basis of objective data. Nijmegen researchers found a combination of EEG changes that are unique to burnout. They have thus found an objective measure for the diagnosis of burnout.
A team of researchers led by Dr. Gilles van Luijtelaar of the Donders Institute for Brain Cognition and Behavior at Radboud University Nijmegen publishes the results in the recently published Journal of Neuropsychiatry and Clinical Neurosciences, the scientific journal of the American Neuropsychiatric Association.

Difficult diagnosis

Burnout is not recognized in all countries. Diagnosis is difficult, among other things, because some characteristics resemble those of depression and chronic fatigue (CFS). The disorder also has no place of its own in the standard work for diagnosis and treatment of mental disorders, the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Strict pre-selection of burnout

With the help of EEG, the researchers recorded the brain activity of thirteen burnout patients and compared it with data from just as many healthy volunteers. A small group, but sufficiently reliable for a first study, says Van Luijtelaar. “A strict selection was made in advance. Our test subjects were without a doubt suffering from a burnout. Their problems were clearly work-related. Those with depressive symptoms and / or other psychiatric problems did not make the selection.”

EEG of burnout patients is different

The test subjects participated in various neuropsychological and EEG tests. For example, spontaneous activity was measured in a relaxed state when the subjects quietly had their eyes open and closed. A nice rhythmic and balanced wave pattern was visible in both groups in the form of alpha waves (8-12 Hz waves, which mainly occur with relaxation). However, the peak frequency of this rhythm was lower in the burnout group. This points to a lower willingness or ability to make mental efforts.

The beta rhythm, the fast little brain waves associated with a waking state, were also smaller. According to the researchers, this points to reduced activation of the cortex, the outermost layer of the large brain. In burnout patients there were – unlike those in depression – no differences in frontal EEG activity between the left and right hemisphere.

A second test, in which the participants listened to a series of tones that was occasionally interrupted by a different tone, also showed clear differences between the two groups. Deviations were found in the P300, an excited brain wave. This wave was flatter with burnout patients: they responded less strongly to the abnormal tone. Such a flattened wave also occurs with depression, but unlike burned out patients, they do not have an early peak of the P300.

Comparisons with depression and CFS

Because some symptoms of depression and chronic fatigue are similar to those of burnout, the researchers compared parts of their measurements with results such as those described for depressives and CFS patients. The combination of the EEG changes found is unique for burnout. The researchers conclude from this that they have an objective measure – a biomarker – to be able to determine this condition.

Recognition burnout patients

“An important result,” says neuroscientist Gilles van Luijtelaar. To him it’s even more important that the research is published in an American journal. “In the US, burnout is not recognized as a disease. Now that psychiatrists are aware of this objective measure, patients will be recognized and treated better. ” The authors do, however, emphasize that this is an initial study in a small group. The research – as it goes in science – needs a follow-up in a larger group.

Cooperation between practitioners and scientists

This study combines expertise from practitioners and scientists. Researchers from Donders Center for Cognition (Dr. Gilles van Luijtelaar, Dr. Martijn van den Bunt) and the Behavioral Science Institute (Dr. Ger Keijsers, Dr. Marc Verbraak) of Radboud University collaborated with the HSK Group, a national healthcare organization specialized in the diagnosis and treatment of mental disorders, including burnout (dr. Marc Verbraak) and Brainclinics Diagnostics (dr. Martijn Arns).
The patients were recruited via HSK. Clinical psychologists Dr. Ger Keijsers and Dr. Marc Verbraak know the symptoms of and the usual diagnosis for burnout and chose the most optimal selection criteria, in which patients with depression and CFS were filtered from the research group. Brainclinics Diagnostics provided the measurements and Martijn Arns, Martijn van den Bunt and Dr. Gilles van Luijtelaar drew up the experiment, edited the data and took care of the publication.

EEG Findings in Burnout Patients.
Gilles van Luijtelaar, Marc Verbraak, Martijn van den Bunt, Ger Keijsers, Martijn Arns. The Journal of Neuropsychiatry and Clinical Neurosciences, (Spring issue).