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When cytoplasmic catecholamine concentrations rise to levels that threaten to saturate both VMAT2 sequestration and mitochondrial monoamine oxidase (MAO) degradation pathways, the reversal of plasma membrane transporters provides a vital escape route (Underhill et al., 2021)

doi: 10.1111/tra.12683 179 MiyazakiK.MasamotoK.MorimotoN.KurataT.MimotoT.ObataT.et al

they cross the blood-brain barrier, altering neurotransmitter balance and contributing significantly to the sensation of "brain fog" and central nervous system fatigue

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