Brain SPECT Imaging
Helps in Assessing and Treating Complex Neuropsychiatric Conditions
A number of complex neuropsychiatric disorders are difficult to treat. There are two main reasons for this. First is the frequent presence of coexisting conditions, which in turn generate multiple signs and symptoms. The reason for these can be found in abnormal functioning of different parts of the brain, and can be due to a state of local or regional hyper-functioning, or conversely to a state of under-functioning.
Second is the fact that before deciding upon an effective treatment, the physician needs to know details about the functional status of the gray matter structures in the brain. In the presence of multiple coexisting conditions, this is difficult based only on the patient’s history, signs and symptoms. As a consequence, a trial-and-error approach is often taken by trying a succession of medications and procedures that can ultimately lead to the “treatment-resistant” label.
In order to avoid this and correctly identify the effects of multiple conditions on the brain, the use of single-photon emission computed tomography (SPECT) is recommended. It is a non-invasive procedure for functional imaging of the brain; very useful and effective for the evaluation of patients with coexisting neuropsychiatric conditions. Other types of scans such as CT and MRI reveal structure, but not function.
As a practical example, depression can be often treated successfully; nonetheless, when co-existing conditions are present, it will frequently progress to become what is known as treatment-resistant depression. Brain SPECT allows specialists to thoroughly evaluate the functional consequences of coexisting conditions by viewing those gray matter structures which may be in a state of hyper-function and/or which ones may show up as under-functioning. In addition, it can show how pronounced and extensive those changes are.
Once this information is obtained, it contributes significantly to the decision-making process, which ultimately leads to a treatment strategy personally tailored to each patient. Depending on the stage of the disorder, its duration and functional status, the treatment may require such novel approaches as, for example, transcranial magnetic stimulation simultaneous with an infusion of ketamine.
Brain SPECT is used not only for evaluating depression, but also for head trauma, concussion, complex variants of epilepsy, degenerative disorders, chronic pain, ADHD, autism, learning disorders, alcohol and substance misuse and more. A customized software variant generates a set of detailed color images displayed in a variety of complementary views that make them easy to read and understand, even by non-specialists.
Dan Pavel, M.D., practices at The Neuroscience Center, located at 440 Lake Cook Rd., Bldg. 2, in Deerfield. For more information, call 847-945-7284 or visit Pathfinder.md and Neuroscience.md. See ad on page 13 and in the Community Resource Guide.