Magnetic resonance with spectroscopy, ME/CFS and ADHD? Help please!

[Hubris]

Hello everyone,

MR with spectroscopy is available where i live. Having proof of neuroinflammation would be very useful to be taken more seriously by doctors.

Unfortunately they don't measure the whole brain, only an area that is 8x8x1 cm, so i have to choose where i want the metabolites to be measured.

I would go for: 1. Left anterior cingulate (shows the most inflammation in Younger's study) and 2. The area above the right lateral ventricle in the frontal region (studies have shown increased lactate in the lateral ventricles in ME/CFS, my EEG shows abnormal slow wave activity in the right side of the brain and another ME/CFS patient i know had the metabolites elevated here).

If i can get a third prescription i want to measure the part of the brain most associated with ADHD since i have extreme ADHD (developed after infection, so it's not actually ADHD and stimulants don't work - it sometimes gets better for a brief moment after flu like episodes) which gets worse every day, i'm at the point where i basically have no free will anymore, like i have 0 dopamine left. Even writing this was absolute torture. I am very desperate about this symptom if you can tell. I'm fine with fatigue, POTS and everything else but this is the absolute worst.

So my question is: What 8x8x1 area of the brain malfunctioning is most associated with ADHD?

Thank you!

 

[Pyrrhus]

So my question is: What 8x8x1 area of the brain malfunctioning is most associated with ADHD?

Every ADHD case is different, so you may get many different answers.

In ME, neuroinflammation has been reported in the thalamus, basal ganglia, brainstem, cerebellum, frontal cortex, and anterior cingulate cortex. But the research is still in the very early stages.

I would choose the right thalamus and the right basal ganglia.
They are very very close together, so you could choose a small region that covers both of them.
If they ask “what part of the basal ganglia”, you can say “the putamen”.

Why the thalamus and basal ganglia? Because they are the regions that control attention, sensory gating, and alertness. Furthermore, the abnormal EEG slow-wave activity refers to the thalamo-cortical oscillations, indicating a possible dysfunction in your right thalamus.

I hope they measure more metabolites than just lactate. Lactate doesn’t tell the whole story. And remember that there is no way to ‘prove’ neuroinflammation from MR Spectroscopy, it just gives ‘hints’ of neuroinflammation.

I hope this helps.

 

[percyval577]

I would choose the right thalamus and the right basal ganglia.
They are very very close together, so you could choose a small region that covers both of them.
If they ask “what part of the basal ganglia”, you can say “the putamen”.

cf: Müller, Lin 2019 From the abstract:
"Metabolite ratios in seven regions were correlated with fatigue (p < 0.05). ME/CFS patients had increased temperature in the right insula, putamen, frontal cortex, thalamus, and the cerebellum (all p < 0.05), which was not attributable to increased body temperature or differences in cerebral perfusion."

Why the thalamus and basal ganglia? Because they are the regions that control attention, sensory gating, and alertness. Furthermore, the abnormal EEG slow-wave activity refers to the thalamo-cortical oscillations, indicating a possible dysfunction in your right thalamus.

If I am remembering right:
The EEG measured waves originate (deep inside the brain) in the nucleus reticularis half around the rest of thalamus.
In his nucleus reticularis three different types of cells have been found. Nobody knows what that means.
I think it´s even a good candiate for our most significant pem including delayed one,
probably along with other "nonspecific" structures like the nucleus caudatus which hasn´t been studied much.

Interesting might also be that there is a pronounced connection between the caudatus and the putamen
(though both of which are visibly split to some degree almost only in primates),
the nucleus accumbens, important for drug addiction and (if I am remembering right) for concentration.

 

[Pyrrhus]

The EEG measured waves originate (deep inside the brain) in the nucleus reticularis half around the rest of thalamus.
In his nucleus reticularis three different types of cells have been found. Nobody knows what that means.
I think it´s even a good candiate for our most significant pem including delayed one,
probably along with other "nonspecific" structures like the nucleus caudatus which hasn´t been studied much.

Interesting might also be that there is a pronounced connection between the caudatus and the putamen
(though both of which are visibly split to some degree almost only in primates),
the nucleus accumbens, important for drug addiction and (if I am remembering right) for concentration.

Thank you @percyval577 for your insights!

Another fascinating thing about the neurons in the thalamus that control slow-wave activity is that these neurons rely heavily on T-type calcium channels, unlike most other neurons which depend on other types of calcium channels. T-type calcium channels, unlike other calcium channels, are very very sensitive to changes in the intracellular calcium concentration. This hypersensitivity allows the neurons to develop spontaneous firing, leading to the rhythmic firings found in slow-wave frequencies.