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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by BrainDamage on July 13, 2013, at 12:27:16
This article scared me a bit, but I have grave doubts about how accurate this method is
Any thoughts?
Posted by Phillipa on July 13, 2013, at 12:34:46
In reply to Images of 'Damaged' Brains? Or Bad Science?, posted by BrainDamage on July 13, 2013, at 12:27:16
Only an autopsy will diagnose Alzheimers. I was under the impression that scans shows tumors, seizures and such and aging of the brain? Phillipa
Posted by SLS on July 13, 2013, at 16:18:02
In reply to Images of 'Damaged' Brains? Or Bad Science?, posted by BrainDamage on July 13, 2013, at 12:27:16
> This article scared me a bit, but I have grave doubts about how accurate this method is
> Any thoughts?
>
> http://www.dailymail.co.uk/health/article-1177258/Are-wrecking-brain-Chilling-pictures-reveal-shocking-effects-alcohol-cigarettes-caffeine-mind.html#ixzz2YwPEfTp0I can't comment on the validity of the SPECT images and the conclusions derived from them. I just don't know enough. I would encourage you to search for other types of imaging and other interpretations of their results. I think PET scans are valid indicators of brain activity. fMRI is another method of measuring brain activity through blood flow and tissue morphology.
Don't confuse reduced neural activity and blood flow with reduced tissue volume, cell death, or injury.
What are your concerns?
- Scott
Posted by Hugh on July 13, 2013, at 17:04:24
In reply to Images of 'Damaged' Brains? Or Bad Science?, posted by BrainDamage on July 13, 2013, at 12:27:16
I belong to some of the biofeedback and neurofeedback groups on Yahoo. Some neurofeedback clinicians have said that they sometimes get new clients who bring SPECT images of their brains. They'll then have qEEGs done, and the findings of SPECT and qEEG are usually consistent with each other.
Posted by SLS on July 13, 2013, at 20:18:51
In reply to Re: Images of 'Damaged' Brains? Or Bad Science?, posted by Hugh on July 13, 2013, at 17:04:24
> I belong to some of the biofeedback and neurofeedback groups on Yahoo. Some neurofeedback clinicians have said that they sometimes get new clients who bring SPECT images of their brains. They'll then have qEEGs done, and the findings of SPECT and qEEG are usually consistent with each other.
Are there any brain illnesses that SPECT is particularly well-suited to diagnose?
- Scott
Posted by SLS on July 13, 2013, at 20:21:38
In reply to Re: Images of 'Damaged' Brains? Or Bad Science?, posted by Hugh on July 13, 2013, at 17:04:24
Do you know what happened to BEAM (brain electrical activity mapping)? I had this done in 1990.
- Scott
Posted by linkadge on July 13, 2013, at 20:29:07
In reply to Re: Images of 'Damaged' Brains? Or Bad Science? » Hugh, posted by SLS on July 13, 2013, at 20:18:51
This is complete junk science IMHO.
Where are the randomized trials? Just because you can find some user of nicotine + caffeine who happens to have holes in his or her brain does not mean that these drugs caused the damage.
I have never seen a single study that links say pure caffeine exposure to this kind of damage.
In fact, regular coffee drinkers have a lower risk of Parkinson's AND Alzheimer's disease. This has been established in very large studies. This is simply not congruent with those kinds of images!Linkadge
Posted by Hugh on July 14, 2013, at 0:05:59
In reply to Re: Images of 'Damaged' Brains? Or Bad Science? » Hugh, posted by SLS on July 13, 2013, at 20:18:51
> Are there any brain illnesses that SPECT is particularly well-suited to diagnose?
I know that Daniel Amen thinks they're useful for diagnosing ADD/ADHD, depression, and anxiety. Scott, in case you didn't see it, I finally responded to the question you asked me nine days ago on the "Does Apathy Ever Go Away" thread. Sorry about the delay.
Posted by Hugh on July 14, 2013, at 0:12:30
In reply to Re: Images of 'Damaged' Brains? Or Bad Science? » Hugh, posted by SLS on July 13, 2013, at 20:21:38
> Do you know what happened to BEAM (brain electrical activity mapping)? I had this done in 1990.
It looks like it's still around, but that it was more popular in the '70s and '80s. What did yours show?
Posted by SLS on July 14, 2013, at 4:58:17
In reply to Re: Images of 'Damaged' Brains? Or Bad Science? » SLS, posted by Hugh on July 14, 2013, at 0:12:30
> > Do you know what happened to BEAM (brain electrical activity mapping)? I had this done in 1990.
>
> It looks like it's still around, but that it was more popular in the '70s and '80s. What did yours show?I'm not sure. I was in a clinic at the time, and they did a bunch of tests on me. I don't recall spending any time discussing the BEAM test.
- Scott
Posted by Willful on July 14, 2013, at 10:46:30
In reply to Re: Images of 'Damaged' Brains? Or Bad Science?, posted by linkadge on July 13, 2013, at 20:29:07
Daniel Amen is a psychiatrist and seems to have clinics staffed by psychiatrists, which leads me to wonder how he got his training in neurology and the interpretation of brain scans.
I also wonder how the images were generated-- and why there are almost no shadows of any sort on the normal brain while there are tons of shadow on the brains on caffeine and cigarettes. It's pretty easy to manipulate images and these images seems pretty simple-- just a flattish slice of a brain--which looks like a green sponge, some of what have stronger shadows than others. I find myself questioning what if anything was done to enhance the images. Why, by the way, are they green?
Having read stories similar to those the Linkage cites, I have to be pretty skeptical about these images. Plus people who drink more than 5 cups of coffee a day have somewhat greater longevity. So it's hard for me to believe coffee is eating away at their brains. And while scientists have been refining their ability to diagnose alzheimer's, as Phillipa points out, I don't think the methods involve SPECT--
I have no idea if Daviel Amen is a scam artist, or just someone who is not qualified to make the claims he's making and doesn't present the research basis for them. There are various brain imaging tools-- SPECT isn't as frequently referred to, at least-- well, I admit, on internet news sites--perhaps not the best source. But there are a lot of unanswered questions here.---Are coffee and caffeine the only possible explanations of the conditions of these brain?- what type of research has he done to establish his interpretations, and to verify that no other explanations are available? Do these conditions evince themselves in every brain of every smoker, etc? And if not, why isn't that reflected in his statements?
Since many other psychiatrists question the legitimacy of the scans, I wouldn't assume that they show anything except a rather crude and possibly (slightly) manipulated version of what various brains look like.
As such, I would simply ignore them-- or before relying on them, do a lot more reading about brain imaging and where the science of imaging is.
Posted by Willful on July 14, 2013, at 11:28:58
In reply to Re: Images of 'Damaged' Brains? Or Bad Science?, posted by linkadge on July 13, 2013, at 20:29:07
1. An overview of brain imaging and psychiatrist diagnosis on an ama website: http://virtualmentor.ama-assn.org/2012/06/stas1-1206.html
Also I append two scientific articles suggesting the in the future SPECT imaging may well be useful in diagnosing alzheimer's, but this requires considerable future development. Both articles state that SPECT is potentially useful in diagnosing (imaging) amyloid strands, but the criteria for these images has not yet been identified.
1.http://www.ncbi.nlm.nih.gov/pubmed/20455860
Semin Nucl Med. 2011 Jul;41(4):283-99.
doi: 10.1053/j.semnuclmed.2011.02.005.
Positron emission tomography radiopharmaceuticals for imaging brain Beta-amyloid.
Vallabhajosula S.
Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Weill Cornell Medical College of Cornell University and New York Presbyterian Hospital, NY, USA. svallabh@med.cornell.edu
Abstract~~~~ "Aβ probes could significantly contribute to the early diagnosis of AD, the elucidation of the underlying neuropathological processes and the evaluation of anti-amyloid therapies which are currently under investigation. The development of SPECT and PET tracers for Aβ imaging represents an active area in radiopharmaceutical design"
(note: beta amyloid = (Aβ) plaques )
~~~
2. http://www.ncbi.nlm.nih.gov/pubmed/17370649
Brain Nerve. 2007 Mar;59(3):233-40.
[Molecular imaging of beta-amyloid plaques in the brain].
[Article in Japanese]
~~~ " Thus, the development of radiotracers for in vivo imaging beta-amyloid plaques in the aging human brain is an important and active area of molecular imaging. When used in combination with positron emission tomography (PET) or single photon emission computed tomography (SPECT), amyloid imaging agents could serve as surrogate markers in early diagnosis and neuropathogenesis studies of AD."Note: the article is in Japanese
~~
These studies suggest that future research holds considerable promise for using PET and SPECT imaging in diagnosing Alzheimer's when the appropriate radioactive binders have been developed. This has yet to be done.
As far as general psychiatic diagnosis: from other reading, as in the overview cited above, it is clear that SPECT imaging is a long way from being used for psychiatrist diagnosis -- but in the long term, it is potentially useful.
To me this all suggests that while SPECT imaging may indeed by revelatory if the appropriate long-term research, testing and evaluation is done-- we are a long way from being able to do this in any sort of meaningful way.
So the best we could say for Amen is that he is seemingly not properly trained, has published no research (despite claiming to have done 50,000 scans-)-- and while he may believe he has found something, he is very much jumping the gun.
Posted by SLS on July 14, 2013, at 12:01:32
In reply to Re: Images of 'Damaged' Brains? Or Bad Science?, posted by Willful on July 14, 2013, at 10:46:30
> Daniel Amen is a psychiatrist and seems to have clinics staffed by psychiatrists, which leads me to wonder how he got his training in neurology and the interpretation of brain scans.
Several of the foremost experts in brain imaging are psychiatrists. Mark E. Schmidt and Terrence A. Ketter come to mind. That not withstanding, I am dubious of the presentation and conclusions of the article. I'm glad that Willful took the time to challenge it.
- Scott
Posted by linkadge on July 14, 2013, at 12:46:03
In reply to Re: Images of 'Damaged' Brains? Or Bad Science?, posted by SLS on July 14, 2013, at 12:01:32
Brain lesions of that magnitude would cause significant and obvious cognitive impairment.
One would need to compare the scans of hundreds of caffeine only, vs. no caffeine brains to come to any reasonable conclusions.
Linkadge
Posted by Willful on July 14, 2013, at 16:10:39
In reply to Re: Images of 'Damaged' Brains? Or Bad Science?, posted by SLS on July 14, 2013, at 12:01:32
~~"Several of the foremost experts in brain imaging are psychiatrists. Mark E. Schmidt and Terrence A. Ketter come to mind. "
- Scott
I'm surprised to hear that the leading experts on brain imaging are psychiatrists. I wonder how they get their training, particularly in Dr. Amen's generation, since most imaging research is relatively recent. Perhaps more recently, it's been included in the curriculum, but I would have thought neuroscientists would be the main experts in the field. But what do I know? really, I would like more information on this if anyone knows more about it.Nonetheless, brain imaging doesn't seem to be a core part of psychiatry, at least if one draws anything from its lack of much inclusion as a basis of DSM 5.
(from one critique of DSM 5: ...." This volume will tweak several current diagnostic categories, from autism spectrum disorders to mood disorders. While many of these changes have been contentious, the final product involves mostly modest alterations of the previous edition, based on new insights emerging from research since 1990 when DSM-IV was published. ...The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.." Tom Insel, http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml)
Anyway, it's a very interesting subject and I personally hope we can have a discussion of it here sometime.
PS sorry for double posting-- I'm not sure how that happened
Posted by SLS on July 14, 2013, at 16:44:10
In reply to Re: Images of 'Damaged' Brains? Or Bad Science?, posted by Willful on July 14, 2013, at 16:10:39
> ~~"Several of the foremost experts in brain imaging are psychiatrists. Mark E. Schmidt and Terrence A. Ketter come to mind. "
> I'm surprised to hear that the leading experts on brain imaging are psychiatrists.
I guess you could say that these guys got in on the ground floor in the early 1990s. They began by practicing their fledgling craft on people like me at the NIH. Dr. Schmidt was my doctor in 1992. I never met Dr. Ketter. He was in Robert Post's department at the time.
- Scott
Posted by Phillipa on July 14, 2013, at 18:17:45
In reply to Re: Images of 'Damaged' Brains? Or Bad Science? » Willful, posted by SLS on July 14, 2013, at 16:44:10
http://survivingantidepressants.org/index.php?/topic/2497-spect-scan-results-need-help/
Posted by Dinah on July 17, 2013, at 8:47:14
In reply to Re: ON Images read full page. Amen No Scientic Evi, posted by Phillipa on July 14, 2013, at 18:17:45
Is the issue that he's using SPECT instead of PET?
I've always been skeptical of the Amen clinics, because I've never been sure whether they are measuring chicken or egg. If one has ruminations, for example, and ruminations cause a certain portion of the brain to light up because obsessive thinking and ruminations occur in that part of the brain, then surely all the PET scans are saying is that you really are having ruminations. And since I know I'm not lying, that doesn't help me overly much. After successful treatment, that area would quit lighting up, which would tell me I'm no longer ruminating, which I would have already known.
It does seem that they do PET scans for research. So are they saying the research is no good? Or just that, since it measures results not cause, it's not helpful for diagnosis.
Although how they get you to ruminate in situ always puzzled me.
As far as the brain on caffeine, it wouldn't surprise me overmuch if, having taken caffeine away from a regular caffeine drinker, that drinker's brain looked a bit sluggish. We get used to that caffeine. I'd hate to see my brain if I forget my Provigil as well.
But I sure wish I could go veg out somewhere for a month or so and not take the Provigil and the caffeine and let my brain reach normal again. For purely practical reasons.
Posted by SLS on July 17, 2013, at 11:12:49
In reply to Re: ON Images read full page. Amen No Scientic Evi, posted by Dinah on July 17, 2013, at 8:47:14
Excellent logic.
The chicken or the egg conundrum.
I don't have enough facts to offer a compelling explanation.
In the past, it has been very difficult to tease out any differences that might exist among subtypes of depression. It still is.
I find it hard to believe that there would be no differences in brain activity in someone with bipolar depression as compared to someone who is bereaved or heartbroken, even though there might be some overlap in affected brain regions. It is not so important to identify the common areas of involvement as it is to identify those that are different.
Ruminations of any origin seem to involve increased activity in the orbitofrontal cortex and anterior cingulate cortex areas of the brain. I imagine a ruminative thought style can be learned and thereby recruit these areas for increased activity. To me, it is conceivable that someone with a biological brain disorder that presents as obsessive and ruminative thought patterns demonstrates on a PET scan the involvement of the raphe nuclei in addition to the cortical structures. Focal brain lesions can result in OCD. In this case, ruminative though styles are acquired through injury, and not learned. Obviously, this is a biological OCD. Where lies the first domino in these different scenarios?
Interesting discussion.
- Scott
Posted by Dinah on July 17, 2013, at 11:48:19
In reply to Re: ON Images read full page. Amen No Scientic Evi » Dinah, posted by SLS on July 17, 2013, at 11:12:49
You've made me think.
It occurs to me that in my example, I'm pretty aware of my ruminations. I'm verbal and I've done a lot of research. For someone who maybe isn't as verbal, or as comfortable with discussions of mental health, as I am, it might not be so easy to tease out how much rumination is a part of their depression.
I suppose one of my questions is whether the SPECT and/or the PET actually do show ruminations in the form of increased activity in the orbitofrontal cortex and anterior cingulate cortex. Is that is what is being argued? That they don't?
If they do, then the clinical usefulness can be argued. If they don't, then I suppose the comparison of SPECT scans to phrenology would be more apt. I'm assuming that phrenology wouldn't show that?
I do firmly believe that depression should not be treated as a monolith. And that medications that are helpful to some sorts of depression might be harmful to others. Anything that could help tease out the differences would be a good thing.
Posted by SLS on July 17, 2013, at 12:20:01
In reply to Re: ON Images read full page. Amen No Scientic Evi » SLS, posted by Dinah on July 17, 2013, at 11:48:19
> I do firmly believe that depression should not be treated as a monolith. And that medications that are helpful to some sorts of depression might be harmful to others. Anything that could help tease out the differences would be a good thing.
Take a peak at this:
http://www.nature.com/news/brain-scan-predicts-best-therapy-for-depression-1.13183
- Scott
Posted by Dinah on July 17, 2013, at 12:51:56
In reply to Re: ON Images read full page. Amen No Scientic Evi » Dinah, posted by SLS on July 17, 2013, at 12:20:01
Wonderful!!
Thanks. :)
Posted by SLS on July 18, 2013, at 7:08:21
In reply to Re: ON Images read full page. Amen No Scientic Evi » SLS, posted by Dinah on July 17, 2013, at 12:51:56
> Wonderful!!
>
> Thanks. :)It may be that CBT is only one of several psychotherapies that would work in cases where insula hypoactivity is observed. However, CBT has a history of scientific inquiry that demonstrates efficacy in controlled trials. The response pattern has been quantified. They had no better choice than to use CBT as the comparator.
- Scott
Posted by Phil on July 18, 2013, at 8:24:28
In reply to Images of 'Damaged' Brains? Or Bad Science?, posted by BrainDamage on July 13, 2013, at 12:27:16
Dr Barrett's thoughts on (In Jesus name...Amen)
Barrett runs Quackwatch and several other sites. I just woke up so I hope this is relevent to the discussion.http://www.quackwatch.org/06ResearchProjects/amen.html
All I know is what I've witnessed. My family were all (heavy) drinkers, smokers and drank caffeine. I was too but kicked cigs and alcohol.
What is meant by brain damage? Can't remember words? Forget how to shave? Can't find the #3 tee box?
To me, I couldn't see any weirdness or anything in my family.
This stuff reminds me of the '60's when experts were saying if you dropped acid your babies would deformed at birth. Sorry, didn't see it.
I'd love to see any studies that can prove these things. But I'm not sure this best selling author and over-price tests is going to be my guru.
This is the end of the thread.
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