Dan G Pavel M.D. Director, PathFinder Brain SPECT Imaging, Deerfield IL 60015.

Functional Brain SPECT perfusion studies provide important information in the evaluation of many psychiatric conditions with comorbidity. Indeed, the presence of comorbidity is a frequent reason for failed treatments. The comorbidity can be induced by a variety of origins including neurodevelopmental problems, traumatic brain injury, neuroinflammation, non-convulsive epilepsy, neurotoxic exposure, nutritional deficiencies, etc, which all contribute to the altering of blood flow levels in various gray matter structures.

A good quality brain SPECT provides detailed information about location, magnitude, and extent of areas of hyper and/or hypoperfusion(s). Such information will, in turn, contribute to the tailoring of a treatment strategy for a specific patient. In other words, brain SPECT (properly done and interpreted) goes a long way towards avoiding the dreaded “trial-and-error” pathway of treatment, by helping the specialist treat the patient and not the symptom.

The following PDF provides some examples of the usefulness of Brain SPECT functional imaging in clinical Psychiatry practice . It also shows how important functional details, can be easily visualized when using an optimized sequence of displays. In other words the effectiveness of a brain SPECT imaging procedure is greatly enhanced when the image results are presented in a consistent and relevant format.

For viewing the PDF click here

(based on a press release authored by Dr.Michael Breen at [email protected]; 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.

By now I assume you have checked out the rest of our PathFinder Brain SPECT Imaging web site and you may have already noted this paragraph:

The approach at The Neuroscience Center (TNC) is to integrate the information provided by Brain SPECT in the workup process of refining the differential diagnosis of complex conditions presenting with multiple comorbidities (co-existing conditions) and very often treatment resistance. Examples can be found in combinations of multiple concussions, concurrent or not, with behavioral changes, development illness, substance abuse, learning disability or cognitive impairment and limbic type seizures . Often patients present after having failed treatment attempts for years. Even in these situations experience has shown that among the multiple treatment plans available at TNC, there is one or a combination that ultimately works.

Here I would just like to briefly comment about it because it touches on several key points:

• PathFinder Brain SPECT Imaging is an integral part of The Neuroscience Center.

• Brain SPECT is only one (albeit an important one) of the multiple components of the workup undergone by patients with complex Neuropsychiatric conditions.

• Why is the word “complex” used ? For at least two reasons : 1. Because patients come to us with comorbidity e.g. they are having not one but multiple conditions. 2. Because most of the time they have been treated with multiple medications and other procedures, often for years , but the disorder persists . They are thus considered “treatment resistant”.

• Once the workup has been completed the Neuropsychiatrist (Steve Best MD) is now able to provide a treatment plan, specific to the functional status of that particular patient.

• Finally, The Neuroscience Center has the possibility to apply a variety of treatments (one of them unique), which is the reason why one treatment plan or a combination of them will almost always work, as the past experience has shown.

Additional details about TNC can be found at :   www.neuroscience.md