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in effect, the sensory filter disintegrates : Based on this literature and observations from our own laboratory and others on the role of astroglial cells in the fine-tuning of glutamate neurotransmission we present the hypothesis that the proinflammatory cytokines tumor necrosis factor- , IL-1 and IL-6 could be involved in the pathophysiology of mental fatigue through their ability to attenuate the astroglial clearance of extracellular glutamate, their disintegration of the blood brain barrier, and effects on astroglial metabolism and metabolic supply for the neurons, thereby attenuating glutamate transmission

eLife 7 , pii: e33710 (2018)

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Any hypothetical combination would likely require significantly lower doses of each compound than used in monotherapy

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