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Re: Dr. Hoffman - alternative approaches

Posted by Daniel Hoffman, M.D. on March 23, 2005, at 18:59:12

In reply to Dr. Hoffman - alternative approaches, posted by Iansf on March 23, 2005, at 17:32:40

> Dr. Hoffman,
> How would you compare your approach to alternative approaches that also use brain data, such as the BrainSpect system of the Amen Clinic? There's a clinic in Walnut Creek, Calif. - whose name I can't recall - that uses some other system based on MRIs or some such. I imagine there's even more that I don't know of. All seem to focus on measures of actual brain function for either diagnosis or prescription, yet all take different approaches.

SPECT imaging is cerebral blood flow. Daniel Amen has pioneered some great work in looking as sub-typing of disorders. From a clinical perspective, I find I need to know HOW to treat a brain more so than what's wrong with it. Once SPECT scans identify the areas of abnormality, it is a clinical decision knowing what medicines effect that part of the brain - and if you don't know what's off, that can be helpful. But the problems I see more is a treatment resistant patient who's been on many medications, but still has significant symptoms. I want to know which medicines, or combination of medicines, and sometimes in WHAT ORDER of use will help the person.

As far a I'm concerned, you can't give me enough information to help figure out my patients. This is the neonatal development of neuro-imaging and it won't be long before some form of scan that matches a treatment with a patient will be performed routinely before you ever even see the doctor. We're the only field of medicine that has no test for a diagnosis and this is the beginning. We still have a long way to go.




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