Brain imaging: SPECT scan at the Amen Clinic

Between Nathan’s freshman and sophomore years, we followed the advice of our family counselor and took Nathan to the Amen Clinic in Newport Beach, CA to obtain SPECT scans of his brain. Our experience there was costly and sometimes confusing, but we did learn things of value.

Our counselor had suggested the imaging because Nathan presented a tough, persistent, puzzling combination of behaviors and attitudes. Her thinking was, it would take years of trial and error for most mental health professionals to hit on the best treatment for him. Why not use a diagnostic tool that would cut to the chase? Her experience with them had been good.

SPECT imaging shows blood flow levels in different parts of the brain. (SPECT stands for Single Photon Emission Computed Tomography – but you knew that, right?) Blood flow is directly related to brain activity, so a SPECT scan can show which areas of the brain are doing fine, which areas are overactive, and which areas aren’t working hard enough. This knowledge can help psychologists and psychiatrists hone in on the most effective medicines and treatments. (Two patients can have similar behavioral challenges, but the underlying combination of brain area misfires that cause the challenges can be different.)

Wanting the best possible outcome as fast as possible, we took Nathan to the Amen Clinic for a series of appointments. First came a lot of paperwork and a lengthy intake interview, in which we did most of the talking because Nathan would hardly say anything (but he spoke up to correct us.)

Then came the scans themselves:  one while concentrating on a simple computer task, the other while resting. The scans required injection of a radioactive tracer. Since Nathan flips out at needles or anything like that, the day of the first scan he had a very loud meltdown in the clinic. The staff later told us they had never had a patient put up as much of a fuss! And that’s saying something, considering all the people with extreme behavior who’ve had scans done there. Anyway, Nathan did eventually cooperate. He was still unhappy, but not loudly so, for the second scan the next day.

Lastly, about a week later one of the psychiatrists on staff presented us with the scans and a report describing the findings and their implications. The report also included a detailed write-up of the intake interview and questionnaires.

To give you an idea of what the findings are like, here is some of what they found for Nathan. Among the 7 diagnoses suggested as a result of the questionnaires were Social Phobia, Overanxious Disorder, and Prefrontal Cortex (Inattention) Symptoms. The brain scans showed several problem areas, including decreased activity in the temporal lobes and increased activity in the parietal lobes – and yes, they explain the implications of all this in plain English.

The overall result was 3 psychiatric diagnoses and one brain-related medical diagnosis (Frontal Lobe and Temporal Lobe Dysfunction.) Among the recommendations were to have thyroid function evaluated, start taking a medication called Lamictal, have psychotherapy, exercise, and take Omega-3 supplements.

The Amen Clinic also offered a nutritional study for an additional charge. Given Nathan’s resistance to changing anything about his routine, including his diet, we did not pursue this even though dietary changes may have led to improvements. (Note that patients can use services at the clinic without having a SPECT scan done.)

Nathan started taking Lamictal and Omega-3, and we had two follow-up appointments with another psychiatrist on staff. That doctor was OK but did not seem to buy in to the overall philosophy of the clinic, which surprised us. We ended up finding a local psychiatrist, saving us the 2-hour round trip. The local psychiatrist, and all other mental health professionals Nathan subsequently dealt with, did not know how to read SPECT scans and didn’t really try to apply the Amen Clinic’s findings.

Well, do I feel that going to the Amen Clinic was worth it? Honestly and reluctantly, I’d have to say no.

The benefits were:

The negatives have been:

  • the cost. Our insurance company covered a small portion of the expense, but we had to pay a few thousand dollars. My understanding is that most insurance companies will not cover SPECT scans in this context.
  • the mental health professionals Nathan saw afterwards didn’t really apply the results, so Nathan’s treatment was trial and error over several years after all.
  • Lamictal didn’t help Nathan noticeably (but really, no medication has.)
  • no one from the Amen Clinic ever said a word about Nathan having Asperger’s, which is now a key part of his diagnosis.

Our experience with the clinic was six years ago. I don’t know if anything has changed. The visibility of the founder, Dr. Daniel Amen, has certainly increased thanks to some best-selling books and his TV specials carried on PBS stations.

I recently double-checked with our family counselor to see if her opinion had changed. She says in her experience the outcomes of patients who go to the Amen Clinic are still better than most anywhere: more precise diagnoses, prescriptions and recommendations that work, better compliance with treatment programs.

However, the psychiatric community has resistance and even hostility toward Dr Amen’s approach. There are persistent questions, as an Internet search will reveal, about whether use of SPECT scans in this way is a scam.

If you are considering using the Amen Clinic, I’d suggest getting a clear picture from your insurer on how much of the cost they would cover. Also, for best results, plan on sticking with the Clinic for awhile, or find a mental health professional (they seem to be rare) who will buy into and apply the Clinic’s evaluation.

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About janet565

I've lived in the Inland Empire of Southern California since 1982. Born and raised in New Jersey, I've also lived in upstate New York and in Oregon. My profession involves maps and geography, which is usually very interesting. My hobbies are pretty boring - none of them involve tigers (or ligers) or jumping out of aircraft - so they do not bear mention here. I hope you find the blog useful, and wish you well....

7 responses to “Brain imaging: SPECT scan at the Amen Clinic”

  1. Ryan Woodward says :

    I disagree with Janet’s conclusion about whether the scan was worth it. One difference is the fact that I’m the patient. In general, I had an almost identical story. Yes, most psychiatrists that I’ve seen since I got the scan done don’t seem to pay as much attention to it as they should.

    The reason I think the scan was worth it is twofold. Having the scan done primed me for being able to request the types of medicine most likely to help. Even though alot of the psychiatrists I’ve seen since don’t utilize the results of the scan, many of them do listen to *me* when I specifically request a medication.

    Also, the scan did ALOT for my self esteem. Before the scan, I had all this emotional baggage: feelings of inadequacy, guilt over perceiving myself as lazy. The scan showed that my prefrontal cortexes were offline. The scan let me see that I wasn’t lazy. At the personality level, I was a hard worker; even with my handicaps, I was still able to be a successful software engineer. The reason for my continuing life underperformance was because I’m running around with very important parts of my brain not functioning.

    Like

    • janet565 says :

      Thanks for sharing your positive experience, Ryan! I’m really glad that you, and many others, have found the SPECT scans to be useful. It didn’t pan out as well in our case, but it’s good to know others have had a better outcome from their experience at the Amen Clinic. I think a lot depends on how committed the patient is to using the results. Wishing you continued success —

      Like

  2. Cassie Zupke says :

    Janet —

    I think you hit a key point in your post. The medical and mental health communities are just starting to figure out how to use brain scans in diagnosis and treatment. They’re using them to figure out what someone’s brain who has autism (for instance) looks like. I don’t think they’re yet to the point of figuring out what someone’s brain with autism is going to look like when that person is taking a particular drug. Eventually brain scans will be fantastic tools, but for right now it’s kind of like when my son was diagnosed 14 years ago. We got a diagnosis of high-functioning autism from a pediatric neurologist, but since no other doctors or educators knew what that meant, it wasn’t really helpful. Now it is, but it wasn’t then.

    Great post.

    — Cassie

    Like

  3. Wendy says :

    I believe the real reason your visit to the Amen Clinic was not successful was because you were missing a very important component — the nutritional study. Changes in diet have had significant benefits for many people on the autism/ADHD spectrum. Removing gluten, dairy,soy, corn, sugar (in all forms), food additives and food colorings for a month to start. All of these can cause GI damage and neurological inflammation. Give it a try and you may be pleasantly surprised at the results.

    Like

    • janet565 says :

      Thanks for mentioning that, Wendy! At the time we knew about the nutritional study, but elected not to pursue it – due to the additional expense, and the likelihood that Nathan wouldn’t cooperate with any dietary changes. Even persuading him to eat the meals we served at home was a big challenge. It is a Catch-22, that the people who can benefit the most from removing items from their diet are often the most resistant in doing so!

      Like

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