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How We Can Actually See Psychiatric Illness

(based on a press release authored by Dr.Michael Breen at michael@drmichaelbreen.com; www.DrMichaelBreen.com)

Traditionally symptoms are how patients with mental illness are diagnosed and treated. The problem is that this approach hasn’t worked as well as expected. Success rates in treating most psychiatric illness haven’t changed in decades.

At The Neuroscience Center in many cases we’ve adopted a new approach. We can now see the unique brain images produced by neuropsychiatric illnesses. What we see is usually the combined functional effect of concurrent disorders as for example various combinations among depression, manic depression, anxiety, chronic pain, traumatic brain injury, toxic exposures, epilepsy, developmental diseases and other conditions.

The key to this new approach to mental disorders is a functional brain imaging procedure called Brain SPECT done under the supervision of Dr. Dan Pavel, Director of PathFinder Brain SPECT Imaging, at The Neuroscience Center. Dr. Pavel, a former Professor and former Director of Nuclear Medicine at the University of Illinois, has focused on Brain SPECT for some 25 years. The Brain SPECT shows in dramatic sectional and 3D fashion the blood perfusion (e.g. level of function) to various regions of the brain’s gray matter. While MRI/CT scans show structural changes in the brain, Brain SPECT shows functional changes i.e. the brain’s underlying biology. Dr. Pavel has used this non-invasive technique on thousands of patients. The patient’s unique perfusion patterns, both in terms of hypo and hyper function, are then analyzed and reported by him. This report subsequently helps the Neuropsychiatrist determine an optimized treatment strategy.

The advantages to this approach are many. First each patient becomes truly unique, with a unique set of functional imbalances. Using clusters of symptoms to lump patients into a single group is now known to be of limited value only. Second, Brain SPECT helps deal with the fact that very often neuropsychiatric illness is in fact the effect of several comorbid conditions a reality which needs to be taken into account when the treatment strategy is planned . Finally, by looking at their abnormal Brain SPECTs, patients themselves get the validation that there truly is a biologic substrate to their illness and thus that they are not just a case of “bad attitude” and that relief through treatment is possible.

We don’t use Brain SPECT on all patients, but only in those with complex, multiple coexisting conditions and / or in those which present as treatment refractory e.g after multiple attempts and often years of treatment there is no clear benefit.

Our belief is that ignoring the uniqueness of each patient is a main reason why so many people with neuropsychiatric symptoms are refractory to medications. Indeed similar types of symptoms may correspond to different patterns identified on Brain SPECT, which in turn may show the need for an individualized treatment.

In the future good quality Brain SPECT should be, and hopefully will, become increasingly used for the evaluation and effective treatment of neuropsychiatric disorders.

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