Opinions needed: Hypoechogenic substantia nigra

[Numby]

A couple of weeks ago I went to see a neurologist and he performed a number of tests on me like blood tests, an ultrasound of the brain as well as an EEG.
The results were all fine except for two points. B12 was way below average, so I’m taking supplements now. And the other thing is that the ultrasound showed a hypoechogenic substantia nigra (0,08cm2, note: not HYPERechogenic as in Parkinson’s). This is common in RLS. I don’t have any symptoms connected to RLS. However, I am wondering if there could be a connection to PSSD because the treatment that is recommended for RLS is l-dopa or Pramipexole. The neurologist said I didn’t need any treatment as long as I don’t have any RLS symptoms.

I couldn’t really find any information, that’s why I created a new topic. So here are my questions:

Has anyone had an ultrasound of the brain, too? If so, what were your results?
Any ideas as to whether there could be a connection between my sn being hypoechogenic and PSSD?
Do you think Pramipexole would be worth a try?

Thanks!

[theloneranger86]

I thought you were doing well on Wellbutrin. Has that changed ?

[AnhedonicApe]

Please watch out with supplementing b12, it's a methyl donor, able to further increase gene silencing. I crashed on a methyl donor hard, it made my PSSD 2 times worse for the past 3 months. Check this out: https://forum.propeciahelp.com/t/a-warn ... s/32044/13

[Numby]

I thought you were doing well on Wellbutrin. Has that changed ?

I am doing well on Wellbutrin. I would let you now immediately if that changed. However, Bupropion is not a cure and I would rather not take it if I could. Now that I learned that there’s something wrong with my sn, which is connected to dopamine, I’d of course like to know if there’s anything I can do. Well, and I have to admit that Pramipexole is something that I’ve had in mind for a long time.

[enriqueiglesias]

It's hard to find anything useful on this topic, which arguably seems even stranger than no PSSD research.

However, this seems slightly interesting:
Allopregnanolone and neurogenesis in the nigrostriatal tract
Full article:
https://www.frontiersin.org/articles/10 ... 00224/full

In summary, research demonstrates that the levels of APα, are reduced in the brains of subjects with AD or PD. The promising role of this APα therapy in AD and PD is supported by the recent work that peripheral administration of APα, with its ability to permeate the blood brain barrier, could improve cognitive and motor performance and increase the number of DA neurons in the SN of mice lesioned by MPTP and mice with AD mutations. These results support that APα accomplishes its role through the reestablishment of dopamine neuronal architecture, rather than blockading the neurotoxic effects of MPTP.

I don't know about allopregnanolone as a supplement, but there's pregnenolone, which I think is transformed into it (among other things).

[enriqueiglesias]

Saffron might also help:

Safranal-promoted differentiation and survival of dopaminergic neurons in an animal model of Parkinson’s disease

However they also used actual rat neural stem cells (RNS). I suppose it might still strengthen the effect of the neurosteroids of the pregnenolone-family (I think also progesterone, apparently not just allopregnanolone), which is said promote growth.

I'm personally pursuing this, since normal brain recovery things that are regularly recommended (Citicoline) didn't seem to work so much. However they are probably still good adjuncts in any case.

[Meso]

Numby82, I'll look more into this.

Meanwhile, do you have cognitive symptoms? the substantia nigra indirectly increases tonic and phasic dopamine firing in the prefrontal cortex. This is why patients suffering from PD also experience cognitive dysfunction.

SNc is also responsible for goal-directed behaviors and habit learning (i.e. driving a car, playing a musical instrument, and any muscle-memory behaviors). Are these affected in your case?

[Numby]

Hi Meso, thank you so much!

I don't have any cognitive symptoms (at least I think so ). However, I am often very tired and feel a little sick the day after I exercise. I also don't think that goal-directed behavior or habit learning is affected. For instance, I play the piano and do not have any problems.

[enriqueiglesias]

I also don't think that goal-directed behavior or habit learning is affected. For instance, I play the piano and do not have any problems.

I sugget not to get distracted by this, however, since you already have an empirical confirmation. (And as usual with psychological criteria, they can be vague and rather arbitrarily selected.)

In any case, I am also waiting for updates on this.

[Numby]

Please watch out with supplementing b12, it's a methyl donor, able to further increase gene silencing. I crashed on a methyl donor hard, it made my PSSD 2 times worse for the past 3 months. Check this out: https://forum.propeciahelp.com/t/a-warn ... s/32044/13

You were so right. My level of numbness has increased drastically since I started b12. I can only orgasm with huuuuge effort, it takes like 30 or 40 minutes if it works at all and orgasms are rather weak. So I stopped b12 supplementation today. I haven’t felt as numb as this since I started Bupropion. And I haven’t changed anything else. Maybe it’s because b12 has an effect on histamine and acetylcholine.

Is there anything I can do to reverse this? I am becoming really nervous and desperate because this feels like my 2009 baseline (which was pretty bad...).

My neurologist said he is open to low-dose dopamine medication (probably l-dopa or pramipexole) if the substantia nigra stays hypoechogenic. What do you think? Should I try this?