Over the last 30 years, Amen Clinics have built the world’s largest database of functional brain scans—over 200,000 and growing—related to how people think, feel, and behave. Our brain imaging work has completely changed the way we help our patients get well.
Your brain is involved in everything you do. How you think, how you act, and how well you get along with other people is related to the moment-by-moment functioning of your brain. When the brain works right, people tend to work right. When the brain is troubled, people tend to struggle to be their best selves.
Unfortunately, psychiatry remains the only medical field that rarely looks at the organ it treats. How can you know what’s going on inside your head if nobody ever looks? Experienced psychiatrists evaluating patients can tell if someone is likely to have ADHD, OCD, or bipolar disorder without the benefit of these tools. But without functional brain imaging tools, clinicians will never be able to know the underlying brain patterns of the patients they treat, so they are forced to throw medication-tipped darts in the dark at their patients.
Brain SPECT (single photon emission computed tomography) is a state-of-the-art brain imaging tool that can give psychiatrists more information to help their patients more effectively. SPECT is a nuclear medicine study that is proven to reliably evaluate regional cerebral perfusion (blood flow) and activity in the brain. SPECT allows physicians to look deep inside the brain to observe three things: (1) Areas of the brain that work well, (2) Areas of the brain that work too hard, and (3) Areas of the brain that do not work hard enough.
Since the 1970s, brain SPECT has been used to evaluate strokes, seizures (epileptic foci), and brain tumors. In the 1980s, scientists were also using it to study Alzheimer’s disease, head trauma, schizophrenia, depression and other mood disorders, ADHD, and substance abuse. Today, physicians around the world typically order brain SPECT scans to look at the following conditions: Alzheimer’s disease and other types of suspected dementia, seizures, cerebrovascular disease (strokes), brain injury, chemical exposure, Lyme disease, brain inflammation, and drug toxicity.
The research on brain SPECT is vast with over 14,000 scientific research articles on it listed on PubMed.com. At Amen Clinics, we have studied and used single photon emission computed tomography to help us with complex psychiatric patients and have published 70 peer-reviewed scientific studies on SPECT. In 2012, we published a study in which we asked 7 psychiatrists to evaluate 109 consecutive charts without brain SPECT scans and then with scans. In 8 times out of 10, adding the scan into the review changed the diagnosis and/or treatment. In over 1 in 5 cases, the scan revealed an unexpected brain injury, and in another 1 in 5 cases, it revealed unexpected toxicity. And 60% of the time, it changed the medications or supplements recommended.
SPECT allows physicians to look deep inside the brain to observe three things:
Our experience with more than 200,000 brain SPECT scans over more than 30 years has led us to be the best in the world for brain SPECT imaging related to behavior. We have performed scans on patients from 9 months old to 105 years old from over 155 countries. We perform outcome studies on all of our patients—we have over 7,000 outcomes on our patients. At the end of 6 months, if they are treated at Amen Clinics, 84% of our complicated patients report being improved. And quality of life scores go up in 85% of patients.
Although a brain SPECT scan is a simple procedure from the patient’s perspective, it takes considerable skill and experience to dependably generate accurate scan results and brain SPECT images suitable for psychiatric applications. Equally important is the need for consistency in imaging techniques among patients so results are quantifiable, repeatable, and consistent. There are two types of brain SPECT images: a “surface” scan and an “active” scan.
A healthy “surface” scan, looking down from the top, shows full, even symmetrical activity. The color is not important, it’s the shape that matters. Surface scans help us see areas that are healthy and those with low activity.
A healthy “active” scan shows the most active parts of the brain. Here, blue is average activity and red, or sometimes red and white, are the most active parts of the brain. In a healthy scan, the most active area is in the cerebellum, at the back/bottom part of the brain, which makes up just 10% of the brain’s volume but houses half of the brain’s neurons.
A healthy “surface” scan, looking down from the top, shows full, even symmetrical activity. The color is not important, it’s the shape that matters. Surface scans help us see areas that are healthy and those with low activity.
A healthy “active” scan shows the most active parts of the brain. Here, blue is average activity and red, or sometimes red and white, are the most active parts of the brain. In a healthy scan, the most active area is in the cerebellum, at the back/bottom part of the brain, which makes up just 10 percent of the brain’s volume but houses half of the brain’s neurons.
Watch Daniel Amen, MD explain Brain SPECT imaging in more detail in these SPECT Made Ridiculously Simple videos.
“Why are psychiatrists the only physicians who rarely look at the organ they treat?”
– Daniel G. Amen, M.D.
A SPECT scan is similar to an MRI study in that both can show 3D images of the brain. However, whereas MRI shows the physical anatomy or structure of the brain, SPECT shows the blood flow patterns, indicators of how an individual’s brain works. Positron emission tomography (PET), another nuclear imaging technique, is similar to SPECT but a PET scan is a more costly imagining technique. Both SPECT and PET scans show areas of the brain that are healthy, overactive, or underactive. MRI does not give any information on function. A newer version of MRI called functional MRI or “fMRI” is also capable of showing brain activity. It is a very expensive tool that has become popular for scientific research on the brain, but it is not commonly used in clinical settings. fMRI shows instantaneous neural activity to see how the brain responds to a specific stimulus. With SPECT we see brain activity averaged over a few minutes, which makes it better at showing the brain doing everyday activities, such concentrating, meditating, and reading. For both fMRI and PET, the images actually occur when a patient lies in the camera, which can be uncomfortable, noisy, and anxiety provoking. With SPECT, the image occurs when a patient is in the injection room, making the procedure more reliable and easier to do.
Ready to learn more? Speak to a care coordinator today!
Contact UsNeuroimaging is the future of psychiatry, and at Amen Clinics, the future is here now. However, traditional psychiatrists remain the only medical specialists who rarely look at the organ they treat. Most continue to make diagnoses based on symptom clusters and clinical observations, the same way they did over 150 years ago when Abraham Lincoln was diagnosed with depression (called “melancholia” at the time). There is a better way. SPECT imaging is a clinically reliable evaluation tool for looking at brain function to help identify the correct diagnosis and target treatment specifically for a patient’s needs. In addition, SPECT scan results help families see their loved one’s problems as medical not moral, which helps increase compassion and understanding while decreasing shame, blame, and conflict. With brain SPECT imaging, you can finally get to the core of a wide variety of mental health conditions and cognitive issues, so you can find the best solutions to get your life back.
SPECT scanning helps provide biologically based answers to mental health issues and helps clinicians ask better, more targeted questions, such as about head injuries, infections (such as Lyme disease), exposure to toxins (such as mold), past emotional traumas, and much more. See all conditions we treat using brain SPECT imaging here.
The Amen Clinics Method uses single photon emission computed tomography along with a detailed clinical history, neuropsychological testing, and diagnostic lab tests (when necessary) to help us better understand you and your brain.
The information from SPECT scans helps clinicians avoid prescribing the wrong treatments, such as unnecessarily stimulating an already overactive brain or calming one that is underactive. In addition, follow-up scans can help show if treatments are effective or if treatment needs to be adjusted. Seeing how your brain is improving on your treatment plan can provide much-needed reinforcement to stick with your program.
SPECT scans can reveal forgotten or hidden brain injuries, such as damage from past concussions, exposure to toxins or unexpected infections, which may be complicating symptoms. SPECT scans can also identify the specific areas impacted by brain injuries to better target treatment and help deal with insurance, legal, and rehabilitation issues by providing evidence of brain injury.
ADD, anxiety, depression, addiction, and obesity are not single or simple disorders. One treatment does not fit everyone. Dr. Daniel Amen has described 7 types of ADD, 7 types of anxiety and depression, 6 types of addicts, and 5 types of overeaters. SPECT imaging helps determine your subtype, so treatment can be more targeted.
Science now knows that the processes associated with Alzheimer’s disease and other forms of dementia start in the brain decades before symptoms appear. One of the great contributions of brain SPECT imaging is that it can show the abnormal patterns of suspected dementia, including Alzheimer’s disease, early in the course of the disease, and in some cases, even before symptoms develop. Detection with SPECT gives people the opportunity to get treatment in the early stages when it will be most effective. Learn more about our memory program here.
Even if you are not struggling with specific emotional or cognitive issues, SPECT scans can help check the health of your individual brain and screen for any vulnerabilities. They can also serve as baseline information if you develop problems in the future. With brain imaging, you can learn the areas of your brain that could benefit from optimization so you can reach your peak potential and achieve more of what you want out of life. With a better brain, always comes a better life.
SPECT scans help people better understand the root causes of their problems, which decreases shame, guilt, stigma ,and self-loathing.
“Your brain is the hardware of your soul. You cannot be who you really want to be unless your brain is working right.”
– Daniel G. Amen, M.D.