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 thorough questionnaires and interview helped document the range of Nathan’s issues.
- the books (we have Change Your Brain, Change Your Life and New Skills for Frazzled Parents) and information put out by Dr. Amen have been helpful to us.
- it got us to acknowledge Nathan needed psychiatric help.
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.