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Brain spect imaging: Benefits for Physicians and Clinicians

A spect scan can show:

  • Areas of the brain implicated in specific problems, such as the prefrontal cortex (executive function) and the medial temporal lobes (long term memory storage).
  • Unexpected findings that may be contributing to the presenting
    problem(s), such as toxicity, potential areas of seizure activity, or
    past brain trauma.
  • Potential seizure activity, in many cases more accurately seen by
    SPECT than standard EEG, especially in the areas of the medial
    temporal lobe.
  • Targeted areas for treatment, such as overactive basal ganglia or
    anterior cingulate gyrus (seen on anxiety and OCD spectrum
    disorders), or an underactive temporal lobe (seen in seizure
    disorders and trauma).
  • Specific effects of medication on the brain to help guide us in adjusting dosages or augmenting treatment. Often patients report that SSRIs are helpful but also cause decreased motivation or memory problems, seen as decreased prefrontal or temporal lobe activity on SPECT.
  • Changes in brain function with treatment, improved or worsened. A SPECT scan captures the brain at the time of injection and outside the imaging camera, which gives SPECT several significant advantages over fMRI. Most notably, we are able to sedate people after they have been injected so that they can lie still for the scan, which is often difficult for hyperactive or autistic children or demented adults (motion artifact ruins the scan in all clinical imaging techniques).
  • Provide explanations for refractory symptoms and help clinicians ask better and more targeted questions (e.g.: about toxic exposure,
    brain injuries, anoxia, inflammation, or infections that patients may
    have denied or forgotten).
  • Help us to avoid prescribing treatments that make the problem
    worse, such as unnecessarily stimulating an already overactive
    brain or calming an underactive one.
  • Help to evaluate risk for dementia – the brain starts to change long
    before people show symptoms. There is usually a loss of 30% of
    hippocampal tissue before symptoms occur. Using autopsy data in
    54 patients Bonte4 reported that brain SPECT had a positive
    predictive value for Alzheimer’s disease of 92%.
  • Help to differentiate between types of dementia. Early in the
    disease, Alzheimer’s disease, frontal temporal lobe dementia, Lewy
    body dementia and multi-infarct dementia each have their own
  • Help clinicians understand the rationale for using certain
    medications (such as anticonvulsants to stabilize temporal lobe
    function or calm areas of marked hyperactivity, or stimulants to
    enhance decreased prefrontal perfusion, or SSRIs to calm basal
    ganglia and anterior cingulate hyperactivity).
  • Identify specific areas of the brain affected by trauma, better target
    treatment, and help deal with insurance, legal and rehabilitation
  • Identify factors contributing to relapse in those recovering from
    substance abuse, eating disorders, or sexual addiction.
  • Useful in determining if further adjustment of medication is
    needed. Scans of patients on medication will reveal areas of the
    brain still overactive or underactive. Pictures are powerful…
  • Allow patients to see a physical representation of their problems
    that is accurate and reliable and helps to increase compliance. It
    can influence a patient’s willingness and ability to accept and
    adhere to the treatment program.
  • Help to develop a deeper understanding of the problem, resulting
    in less shame, guilt, stigma, and self-loathing. This can promote
    self-forgiveness, often the first step in healing. Patients can see that
    their problems are, at least in part, medical and physical.
  • Help families understand when things such as permanent brain
    damage from an injury will not get better, so that they can better
    accept the condition and plan accordingly.
  • Show substance abusers the damage they have done to their
    brains, thus helping their denial, provide them with motivation in
    treatment, and support perseverance in their sobriety.
  • Show patients how treatments have impacted (improved or
    worsened) brain function.
  • Help motivate abusive spouses to follow medication protocols by
    showing that there are physical abnormalities contributing to their
  • Is useful for cancer patients suffering with a “chemotherapy toxic
    brain.” It gives them insight into their cognitive struggles and also
    helps their doctors see the neurophysiologic and emotional effects
    of having cancer and its treatment.
  • Help take modern psychopharmacology from mystery and
    unknown consequences to reality and more predictable outcomes.
  • Allows patients to understand why specific treatments are
    indicated, which medication are likely to be most helpful, and what
    other interventions may be indicated.

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