Mitochondrial Mutation & Increased State 4 Respiration

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The discussion revolves around a patient with a mitochondrial mutation leading to lethargy, characterized by increased state 4 respiration and normal state 3 respiration in mitochondrial tests. The initial hypothesis suggested that the mutation might cause increased leakiness of the inner mitochondrial membrane, which would disrupt the proton motive force (PMF) and activate the respiratory chain. However, the provided answer, which is not fully detailed in the discussion, seems to contradict this explanation. There is a request for clarification on the answer and an understanding of the ADP addition experiment, indicating that the original question and context are necessary for a complete understanding. The focus is on the relationship between mitochondrial function, respiration states, and the implications of the mutation.
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i was undertaking a question regarding a patient who had a mutation in their mitochondria, and hence experienced lethargy. A subsequent test of his mitochondria found his mitochondria to have an increased state 4 respiration, but a normal state 3 respiration.

In order to explain this, I would have thought that perhaps some mutation has results in increased leak across the inner mitochondrial membrane, dissipating the PMF and thus electric field across the membrane, in turn activating the respiratory chain. However, the answer for the question was:

http://img94.imageshack.us/img94/9099/screenshot20100411at184.png

Can someone explain this answer to me; i am unable to understand it; and what is wrong with my explanation?

Thank you!
 
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It would help if you copied the entire question. I don't understand the ADP addition experiment from what you copied alone.
 
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