Articles in Category: Images By Category

Alcohol and Drug Abuse

  • Effects of Smoking Marijuana

    In our experience, the effects of smoking marijuana use typically cause decreased activity in the posterior temporal lobes bilaterally.

    The damage can be mild or severe, depending on how long a person used, how much use occurred, what other substances were used (nicotine is a powerful vasoconstrictor) and how vulnerable a particular brain is.

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  • Long Term Effects of Heroin & Methadone

    SPECT can be helpful in evaluating the effects of drugs and alcohol on the brain.

    On 3D surface brain images, several substances of abuse appear to show consistent patterns. For example, cocaine and methamphetamine abuse appear as multiple small holes across the cortical surface;

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  • Side Effects of Marijuana Off and On

    This 57-year-old physician had abused marijuana for 30 years. We performed this SPECT series because he had been unable to stop using without feeling very angry, irritable, agitated and anxious.

    The first study was performed after he came to the clinic intoxicated from 3 straight days of heavy usage.

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  • Increased basal ganglia activity

    Increased basal ganglia activity is often a finding we have seen with anxiety disorders. When there is increased activity on the left side it is often associated with anxiety and irritability (expressed anxiety) and when there is increased activity on the right side there is often anxiety,

    social withdrawal and conflict avoidance. Increased activity in the temporal lobes has also been associated with anxiety.

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  • A Case Of Post Traumatic Stress Disorder

    Mark, a 50-year-old business executive, was admitted to the hospital shortly after he tried to kill himself. His wife had just started divorce proceedings against him, and he felt as though his life was falling apart.

    He was angry, hostile, frustrated, distrusting and chronically anxious. His co-workers felt that he was "mad all the time." He also complained of a constant headache. Mark was also a decorated Vietnam Veteran, an infantry soldier with over 100 kills.

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  • increased right basal ganglia

    note increased right basal ganglia 28 year old woman with chronic anxiety, conflict avoidance

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  • increased right and left basal ganglia

    note increased right and left basal ganglia 48 year old man with panic disorder

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Attention Deficit Disorder ADD/ADHD

  • AD/HD, combined type

    With both symptoms of inattention and hyperactivity-impulsivity. SPECT Brain imaging typically shows decreased activity in the basal ganglia and prefrontal cortex during a concentration task.

    This subtype of ADD typically responds best to psychostimulant medication.

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  • AD/HD, primarily inattentive ADD subtype

    With symptoms of inattention and also chronic boredom, decreased motivation, internal preoccupation and low energy.

    Brain SPECT imaging typically shows decreased activity in the basal ganglia and dorsal lateral prefrontal cortex during a concentration task. This subtype of Inattentive ADD also typically responds best to psychostimulant medication.

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  • Overfocused ADD

    with symptoms of trouble shifting attention, cognitive inflexibility, difficulty with transitions, excessive worrying, and oppositional and argumentative behavior.

    There are often also symptoms of inattention and hyperactivity-impulsivity. Brain SPECT imaging typically shows increased activity in the anterior cingulate gyrus and decreased prefrontal cortex activity.

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  • Temporal lobe ADD

    with symptoms of inattention and/or hyperactivity-impulsivity and mood instability, aggression, mild paranoia, anxiety with little provocation, atypical headaches or abdominal pain, visual or auditory illusions, and learning problems (especially reading and auditory processing).

    Brain SPECT imaging typically shows decreased or increased activity in the temporal lobes with decreased prefrontal cortex activity.

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Bipolar Disorder and Schizophrenia

  • Bipolar Disorder

    Sarah was fifty-three years old when she was admitted to the hospital under my care. Just the month before her family had her committed to another psychiatric hospital for delusional thinking and bizarre behavior

    She had actually ripped out all the electrical wiring in her home because she heard voices coming from the walls. In addition to the above symptoms, she was barely getting any sleep,

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  • Schizophrenia

    A 35-year-old man who had been living on the street was brought for evaluation by his mother. He had previously been diagnosed on many occassions with paranoid schizophrenia, but refused medication.

    His SPECT study revealed marked overall decreased activity throughout the cerebral cortex. Being able to see his own brain activity, represented by the 3D surface SPECT study, was helpful for him.

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Brain Trauma

  • Brain Trauma Case Study

    Tim, age 15, was a high school sophomore at a high school in Connecticut. From the time he was young he exhibited severe conduct problems.

    He had already been arrested for shoplifting, he frequently cut school and was defiant and abusive toward his parents. He did not get along with other teens at school and seemed to "never fit in." He smoked a pack of cigarettes a day and frequently used both marijuana and cocaine.

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  • Brain Trauma Case Study

    Zachary, age 10, was a fun loving, active boy who was loving, sweet and liked to please. He did well in kindergarten and was liked by the other children.

    HOne summer, between kindergarten and first grade, at dusk Zachary was riding in the front seat of a car with his mother on a trip to his grandparents house.All of a sudden a drunk driver swerved into their lane causing the mother to quickly jerk the car to the side of the road.

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  • Brain Trauma Case Study

    56 y/o male, fell off porch into pile of bricks age 6 significant problems with temper, illusions and depression decreased left pfc and left temporal lobe, increased deep left temporal lobe activity

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Dementia versus Pseudodementia

  • Dementia Overview

    As the population ages, the incidence of dementia in the U.S. will become an even more common problem and take up an even larger percentage of the health care budget.

    With the advent of new medications that slow the course of some dementing processes, diagnostic tools that help in the early differential diagnosis of dementia is essential.

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  • Alzheimer’s Disease

    When Frank, a wealthy, well-educated man, entered his seventies, he began to grow forgetful.

    At first it was over small things, but as time went on the lapses of memory progressed to the point where he often forgot essential facts of his life: where he lived, his wife’s name and even his own name.

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  • Alzheimer’s Disease

    Here is a scan of a 92 year old man with Alzheimer’s Disease who had become forgetful, frequently lost away from home,

    forgot how to do simple things such as dress himself and began getting aggressive with his wife. Notice the extensive frontal lobe involvement.

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  • Alzheimer’s Disease

    While at first glance it may have appeared that Margaret was suffering from Alzheimer’s Disease, the results of her SPECT study showed full activity in her frontal, parietal and temporal lobes.

    If she had Alzheimer’s Disease, there should have been evidence of decreased blood flow

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  • Decreased prefrontal cortex

    Decreased prefrontal cortex activity at rest, especially on the left side is a consistent SPECT finding in depression.

    The severity of depression is often related to the degree of frontal hypometabolism. Several studies have indicated that the hypometabolism normalizes after treatment if the patient’s mood improved.

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  • Deep limbic dysfunction

    Here is an example of deep limbic dysfunction. Leigh Anne came to see me fifteen months after the birth of her first child. Several weeks after her child was born she began experiencing symptoms of nausea, social withdrawal, crying spells and depression.

    Three months later she sought help through psychotherapy. But her condition did not improve.

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  • Increased anterior cingulate

    It has been my experience as well as that of many other psychiatrists that a patient does not necessarily have to stay on medication forever just because they have started it.

    However, with certain medications, like Prozac, a minimum period of treatment is necessary before it can successfully be terminated.

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  • Marked decreased prefrontal and temporal lobe activity

    Cindy is a 17 year old who presented with symptoms of depression, suicidal thoughts and severe irritability. Serotonergic medications increased her irritability, depression and suicidal thoughts.

    Her SPECT study showed marked decreased activity in the left temporal lobe and prefrontal cortex.

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Obsessive Compulsive Spectrum Disorders

  • OCD, Obsessive Compulsive Disorder

    On the outside, Gail was normal. She went to work every day, she was married to her high school sweetheart, and she had two small children.

    On the inside, Gail felt like a mess. Her husband was ready to leave her and her children were often withdrawn and upset.

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  • Road Rage

    37 year old male attorney who, on several occasions, chased other drivers who had cut him off and on two occasions got out of the car and bashed their windows in with a baseball bat he kept in the car.

    After the second incident, he came to see me. He said, "If I don’t get help for this I’m sure I’ll end up in jail."

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  • Pathological Gambling

    Adam came to our office when his wife left him. His gambling had gotten out of control. In the past few years he began neglecting his business spending more of his time at the racetrack and driving back and forth to the casinos in Reno and Lake Tahoe.

    "I feel compelled to gamble. I know it is ruining my life, but it seems I have to place a bet or the tension just builds and builds. It is all I think about!"

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  • Chronic Pain

    Stewart, a 40-year-old roofer, hurt his back ten years ago when he fell off a roof. He underwent six back operations but remained in constant pain.

    He was essentially bedridden and about to lose his family because all he could think about was the pain. The threat of losing his family catalyzed him to get a psychiatric evaluation.

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  • Haley

    Haley is a 12-year-old girl who presented to the clinic with violent mood swings, aggressive behavior, prolonged tantrums, depression and oppositional behavior.

    Her symptoms primarily occur several days before and after the onset of her menstrual cycle. By the first week after the start

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  • Andrea

    Andrea is a 25-year-old female who has been diagnosed with severe PMS and ADD. Seven to ten days before the onset of her menstrual cycle she experiences moodiness, irritability, hypersensitivity to others, anxiety and increased alcohol consumption.

    These symptoms decrease significantly several days after the onset of her menstrual period

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  • Michelle

    On three separate occasions Michelle, a 35-year-old nurse, left her husband. Each time she left him it happened within the ten days before the onset of her menstrual period.

    The last time she left him, her irritability, anger and irrational behavior escalated to the point where she attacked him with a knife over a minor disagreement.

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  • Chris

    hris was a thirty-eight-year-old married female referred for evaluation of suicidal thoughts, depression and temper flares. She also experienced problems with anxiety, excessive tension and overeating.

    On three separate occassions she left her husband within the 10 days prior to the onset of her period, on one occasion, she attacked him physically.

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  • Left Frontal Stroke

    Ellen, 63, was suddenly paralyzed on the right side of her body. Unable to even speak, she was in a panic and her family was extremely concerned.

    As drastic as these symptoms were, two hours after the event, her CAT scan was still normal.

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  • Right Side Stroke

    Nancy was a 59-year-old woman suffering from severe depression that had been nonresponsive to treatment.

    Upon admission to a psychiatric hospital a SPECT study was done to evaluate her condition. Since she had not experienced any symptoms that would point to this, I was surprised to see that she had had two

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  • John

    John, a right-handed 79-year-old contractor, had a longstanding history of alcohol abuse and violent behavior.

    He had frequently physically abused his wife over 40 years of marriage and had been abusive to the children when they were living at home. Almost all of the abuse occurred when he was intoxicated.

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  • Rusty

    Twenty-eight-year-old Rusty had a severe methamphetamine problem. He was unable to keep steady work, he was involved in a physically abusive relationship with his girlfriend

    arrested four times for assault and battery, he was mean to his parents even though they tried to help him. He failed five drug treatment programs.

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  • Jose

    Jose, a 16-year-old gang member, was arrested after he and another gang member beat another teenager nearly to death. They were charged with attempted murder.

    Their gang claimed the color red. One evening, when they were in an intoxicated state (from both alcohol and heavy marijuana usage), they approached a boy who was wearing a red sweater walking his dog across the street.

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  • Steven

    Steven, a 39-year-old radio station engineer, was admitted to the hospital for suicidal thoughts. He was recently separated from his wife of eight years.

    During their relationship there had been mutual physical spousal abuse for which he had spent some time in jail. Steven also complained of having a very "short fuse"

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