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How do you know unless you look?

SPECT looks at blood flow and activity patterns. It looks at how your brain works. We typically obtain two scans on patients - one at rest and the other during concentration. The images below are examples of the various SPECT patterns associated with different disorders and brain types.

ATTENTION DEFICIT DISORDER ADD/ADHD

the most common psychiatric disorder in children and adults

Using advanced EEG in the 1980s, Joel Lubar, PhD introduced the first evidence demonstrating that the brains of children and teenagers with ADD had decreased activity during a concentration task. He found that there were more slow brain waves in their frontal lobes, instead of the usual fast brain wave activity with concentration that was seen in the majority of the control group.

In 1990, Alan Zametkin, MD published data from positron emission tomography (PET) studies that supported the notion of brain underactivity in the prefrontal cortex, especially in response to an intellectual challenge. Data from our own work with brain SPECT imaging drew the same conclusions:

At rest, most ADD people have normal activity in their brains but when they perform a concentration task, they have a decrease of activity in the prefrontal cortex, rather than the expected increase that is seen in a normal control group.

Research indicates that ADD has a large genetic influence involving dopamine availability in the brain. A significant amount of dopamine is produced in the basal ganglia (large, structures deep within the brain). Studies have demonstrated that the basal ganglia are smaller in people with ADD. The basal ganglia have a significant number of nerve tracks that go through the limbic system to the prefrontal cortex. It appears that when there is not enough dopamine available in the basal ganglia then there is not enough “fuel” to drive the frontal lobes when they need to activate with concentration.

In addition to genetics, maternal alcohol or drug use, birth trauma, jaundice, brain infections and head trauma (sometimes even minor ones, especially to the left prefrontal cortex) can play a causative role in ADD. Furthermore, there are numerous other factors in our society now that contribute to the rise of ADD in the population. These include an increase in processed foods and lower fat in the diet, excessive television and computer (including phone and tablet) time, video games and decreased exercise.

It is essential to note that ADD is not just a single disorder. The symptoms can present themselves in a variety of ways. From the nearly 100,000 brain SPECT scans in our Amen Clinics database, we have observed 7 clinical subtypes of ADD to date:

  • Type 1: Classic ADD
  • Type 2: Inattentive ADD
  • Type 3: Overfocused ADD
  • Type 4: Temporal Lobe ADD
  • Type 5: Limbic ADD
  • Type 6: Ring of Fire ADD
  • Type 7: Anxious ADD

Type 1: Classic ADD

SPECT findings: A generally healthy brain at rest, but during concentration there tends to be decreased blood flow in the underside of the prefrontal cortex, the cerebellum and bilateral basal ganglia.

Primary Symptoms:

  • Inattentive
  • Easily distracted
  • Disorganized
  • Impulsive
  • Restless
  • Hyperactive

Type 2: Inattentive ADD

SPECT findings: A generally healthy brain at rest, but during concentration there tends to be decreased blood flow in the underside of the prefrontal cortex, the cerebellum and bilateral basal ganglia.

Primary Symptoms:

  • Inattentive
  • Easily distracted
  • Disorganized

Type 3: Overfocused ADD

SPECT findings: At rest and during concentration, there is increased activity in the anterior cingulate gyrus. During concentration, there is also decreased activity in the underside of the prefrontal cortex, the cerebellum and bilateral basal ganglia.

Primary Symptoms:

  • Inattentive
  • Trouble shifting attention
  • Getting stuck in loops of negative thoughts or behaviors
  • Obsessive
  • Excessive worrying
  • Inflexible
  • Argumentative
  • Oppositional behavior

Type 4: Temporal Lobe ADD

SPECT findings: At rest and concentration, there is decreased (and infrequently increased) activity in the temporal lobes. During concentration there is also decreased activity in the underside of the prefrontal cortex, cerebellum and basal ganglia.

Primary Symptoms:

  • Inattentive
  • Easily distracted
  • Disorganized
  • Irritable
  • Short fuse
  • Dark thoughts
  • Memory issues
  • May have learning disabilities
  • May or may not be hyperactive

Type 5: Limbic ADD

SPECT findings: At rest there is increased deep limbic activity (thalamus and hypothalamus). During concentration there remains an increased deep limbic activity and now there is also decreased activity in the underside of the prefrontal cortex, cerebellum and basal ganglia.

Primary Symptoms:

  • Inattentive
  • Easily distracted
  • Disorganized
  • Chronic low-grade sadness or negativity
  • “Glass half empty syndrome”
  • Low energy
  • Tendency for self-isolation
  • Feelings of hopelessness and worthlessness
  • May or may not be hyperactive

Type 6: Ring of Fire ADD

SPECT findings: At rest and during concentration (often worse during concentration), there is patchy increased uptake across the cerebral cortex with focal areas of increased activity, especially in the bilateral parietal lobes, bilateral temporal lobes, and bilateral prefrontal cortex. In addition, there is often increased activity in the cingulate gyrus.

Primary Symptoms:

  • Inattentive
  • Easily distracted
  • Irritable
  • Overly sensitive
  • Cyclic moodiness
  • Oppositional
  • May or may not be hyperactive

Type 7: Anxious ADD

SPECT findings: At rest and during concentration there is increased activity in the basal ganglia, an area associated with anxiety. With concentration, there is decreased activity in the underside of the prefrontal cortex and cerebellum.

Primary Symptoms:

  • Inattentive
  • Easily distracted
  • Disorganized
  • Anxiety
  • Tension
  • Tendency to predict the worst
  • Freeze in test taking situations

GET HELP. NOW.

If you want to speak to someone immediately, you can call a qualified Patient Care Coordinator with Amen Clinics. We can start to answer your questions and help you book a Full Evaluation with Amen Clinics. Call Today! 888-208-0037

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