Daniel G. Amen, M.D., directsAmen Clinics, writes books, gives lectures, maintains a website and appears in other media. He recommends single-photon emission computed tomography (SPECT) for the diagnosis and treatment of brain trauma, low performance, school dropout, depression, obsessive-compulsive disorder, anxiety, aggression, cognitive impairment, and brain toxicity from drugs or alcohol. It claims to use SPECT to "rebalance brains whose activity patterns are clearly abnormal." He describes SPECT as 'a window into the material of the soul'. It claims that the SPECT scan "provides guidance on the application of specific drugs or other therapies, such as supplementation, neurofeedback, transcranial magnetic stimulation, and hyperbaric oxygen therapy."
For about four years (2002 to 2006), theAmen Clinic homepagedeclared:
It all starts and ends with your Brain-Soul connection.
How your brain and soul work together determines how happy you feel, how successful you become, and how well you connect with others. The connection between brain and soul is much more powerful than your conscious will. Willpower falters when the physical function of your brain and the health of your soul fail to support your desires, as evidenced by irrational behaviors such as overeating, smoking, drug and alcohol abuse, and compulsive drinking.
(Video) Amen Clinics SPECT Scan; an Alternate Viewpoint - A SPECT cannot diagnose a psychiatric disorderThe purpose of The Amen Clinics is to provide educational programs and materials, assessments and medical care as needed to help you understand and direct your mind to improve your relationships, your work and your health!
The website currently states (2007):
SPECT. . . . it basically tells us three things: parts of the brain that are working well, parts of the brain that are working too hard, and parts of the brain that are not working hard enough. Once we learn how the brain works, the goal of therapy is to balance brain function, such as calming overactive areas and strengthening underactive areas.
SPECT creates a color image that shows blood flow or chemical reactions in different parts of the brain. It requires the injection of radioactive material. Areas of low blood flow appear as prominent "holes" on color images of the brain, giving a moth-eaten appearance. Amen says that when patients improve clinically, the appearance of the follow-up scan usually improves. For example, patients who used marijuana had areas of low activity in the temporal lobes compared to patients who did not use the drug. Dr. Amen says he can literally show his patients "this is what your brain looks like on drugs." In one case, he reported that a patient with attention deficit disorder, obsessive thinking, anger outbursts and depression had marked deficits at the first scan that improved significantly after three years of clomipramine treatment. Dr. Amen says this kind of graphical demonstration can help convince patients that their problem is natural or normal and can be corrected with medication or other treatments.
Amen Clinics charges $3,250 for a "comprehensive evaluation," which includes a patient history, two SPECT scans (a concentration scan and a baseline scan), a doctor's consultation, and a 30-minute follow-up appointment. Follow-up scans after treatment cost $795 each.
Basic questions
The most important question when evaluating a diagnostic test is whether its findings are useful in determining what treatment the patient should have. SPECT is a research tool useful for exploring how the brain works, but its findings are not specific and use in connection with the treatment of emotional or behavioral problems should be considered experimental. Dr. Amen has extensive clinical experience and says he has performed and interpreted more than 35,000 scans. However, I do not believe he has proven that specific scan patterns are a reliable representation of specific clinical problems and how to treat them. Even if he can show a link between a diagnosis and an area of low perfusion (blood flow), he hasn't shown what this actually means and how it might help with clinical management. Is low perfusion an indication of primary pathology or perhaps just a secondary cerebral response to symptoms? His published research includes "preliminary studies" and most psychiatrists believe it is premature to use SPECT clinically. In fact, the American Psychiatric Association (APA) released two skeptical reports, one for children and adolescents and one for adults.
In 2005, theAPA Council for Children, Adolescents and Their Familiescame to the conclusion:
While knowledge is growing about specific pathways and specific brain regions involved in mental illness, the use of brain imaging to study psychiatric disorders is currently still considered a research tool. . . . . Special cautions are given regarding brain imaging using radionucleotides for children and adolescents because of the known greater sensitivity of children to radiation and the risk of radiation-induced cancer. Currently, the available evidence does not support the use of brain imaging for the clinical diagnosis or treatment of psychiatric disorders in children and adolescents.
(Video) Looking at the Brain for Therapy, with Therapist Angelica Gonzalez
The APA Guideline for the Psychiatric Evaluation of Adults (2006) states:
In patients with schizophrenia and mood and anxiety disorders, structural and functional neuroimaging studies have reported differences between patients and healthy controls, as well as differences in certain subgroups of patients and in responders and non-responders to certain treatments. However, the clinical utility of neuroimaging techniques for personalized treatment planning has yet to be proven. Further research is needed to demonstrate the clinical role of structural and functional neuroimaging in making psychiatric diagnoses, monitoring disease progression, and predicting prognosis.
Dr. Amen claims that he can choose the best treatment primarily based on scan results, but this claim is only supported by anecdotal evidence and testimonials.
The following questions may be helpful in evaluating Dr. Amen:
- Do patients treated at Amen clinics fare better than patients treated by skilled professionals who do not use SPECT?
- Are the SPECT findings consistent enough that blinded observers can agree on the diagnosis based on the scan alone?
- What are the false positive and false negative rates?
- Were the results of the different treatments actually compared on the scans?
- What is "brain balance" and how is it measured?
- What does the scan tell us that would change the way we treat a patient?
- Claims Dr. Amen that SPECT can help assess the patient's "soul"? If so, what is being measured?
- Why Dr. Amen went into clinical applications, wrote for the public, appeared on television, and lectured on findings that most physicians would consider tentative?
I believe it is not right to charge thousands of dollars for a test that has not been validated and may not be safe. I don't think any of Amen's research has provided clear evidence that patients who have undergone SPECT scans have better clinical outcomes than adequately treated patients who have not had a scan. That's really the bottom line - especially with an expensive test that involves a lot of radiation. It should at least describe the test as experimental.
Some of the therapeutic suggestions from Dr. Amen, they worry me too. For example, he recommends: (a) use of dietary supplements that is not supported by good evidence, (b) EMDR (a highly questionable approach), and (c) hyperbaric oxygen therapy for conditions that are generally not considered to warrant such treatment.
I have no doubt that many patients who visit Amen clinics are helped. However, the main question is whether SPECT scanning is warranted for most of them. Personally, I wouldn't take the test at Dr. Amen, even if it was free. In my opinion, based on current knowledge, the potential harms outweigh the potential benefits. The "this is your brain on drugs" imagery may impress some people, but I'm much more impressed by the measurable (such as mental performance tests) and clinical consequences (such as improved behavior) than the non-specific ones. "in the brain.
Amen antwoordt
This article was originally published in 2005. In 2007, attorneys representing Amen complained to Dr. Stephen Barrett that it was unfairly negative. Our answer included questions similar to those above. To read the responses we've received and my comments on those responses,click here. For a more recent analysis, I,click here.
For additional information
- Aetna Clinical Policy Bulletin on SPECT
- Aetna Clinical Policy Bulletin on Hyperbaric Oxygen Therapy
- APA report on brain imaging and child and adolescent psychiatry
- Brain scans as mind readers? Don't believe the hype.
- CIGNA HealthCare coverage position with SPECT
- Dr. Amen's love with SPECT scans
- Eye Movement Desensitization and Reprocessing (EMDR)
- Amen's response to Quackwatch criticism
Dr. Hall is a retired family physician and Air Force colonel living in Puyallup, Washington. He contributes to it regularlySkeptic,Skeptical researcher, InScience-based medicine blog.
This article was revised on November 15, 2007.
FAQs
A skeptical view of SPECT scans and Dr. Daniel Amen | Quack? ›
SPECT is a nuclear medicine study that is proven to reliably evaluate blood flow and activity in the brain.
Are SPECT brain scans accurate? ›SPECT is a nuclear medicine study that is proven to reliably evaluate blood flow and activity in the brain.
What are the side effects of a SPECT scan? ›For most people, SPECT scans are safe. If you receive an injection or infusion of radioactive tracer, you may experience: Bleeding, pain or swelling where the needle was inserted in your arm. Very rarely, an allergic reaction to the radioactive tracer.
Is a SPECT scan worth it? ›Conclusion. Knowing whether you need an fMRI or SPECT scan comes down to a matter of how much you need to know in order to receive effective treatment. If you're suffering from post-concussion syndrome, a SPECT scan is better than nothing, but an fMRI is significantly more useful than a SPECT scan.
What is the Amen method? ›The Amen Clinics Method is a multi-modal approach to treatment that uncovers the root cause of your issues or challenges that are not discovered by traditional psychiatry.
Are SPECT scans legitimate? ›Critics say the technology, first developed in the 1960s, is outdated and cannot show the things that Amen claims it does. In conventional medicine, SPECT scanning has limited clinical use, mostly for identifying strokes, epilepsy or severe cases of dementia.
What are the disadvantages of using SPECT? ›( Képes et al., 2021 ) There are however several limitations to SPECT imaging, including that protocols tend to be lengthy and inefficient, potentially unreliable supply of Tc-99m, it requires the use of ionizing radiation and can be prohibitively expensive.
Are SPECT scans FDA approved? ›SPECT Imaging Agent Gets Expanded FDA Approval for Patients with Suspected Dementia with Lewy Bodies. GE Healthcare's DaTscan is reportedly the first radiopharmaceutical tracer agent approved by the Food and Drug Administration (FDA) for use in patients with suspected dementia with Lewy bodies.
Does Medicare pay for SPECT scan? ›Original Medicare and Medicare Part C (Advantage) plans may offer coverage for PET scans. A doctor must order the PET scan, and it must be for a medically necessary reason.
How much radiation is in a SPECT brain scan? ›Importantly, the SPECT scan requires no additional injection of radiopharmaceutical beyond what you would have been given for a standard nuclear medicine scan without SPECT. The CT is usually carried out using a low-dose radiation technique, which is approximately 20–25% the radiation exposure of a normal CT scan.
Does a SPECT scan show inflammation? ›
SPECT-CT is an extremely sensitive test for intervertebral disc, facet joint and sacro-iliac joint inflammation.
What are the limitations of a SPECT scan? ›However, SPECT has issues, including long scan times and low-resolution images prone to artifacts and attenuation. Some artifacts can easily be misidentified as perfusion defects.
Can a SPECT scan show dementia? ›SPECT can reveal abnormal blood flow patterns in the brain so that a doctor can determine if a person's symptoms are from a certain type of dementia or are not related to dementia at all.
What does Dr Amen recommend for brain health? ›Lean protein, complex carbohydrates, and foods rich in omega 3 fatty acids (large cold water fish, such as tuna and salmon, walnuts, Brazil nuts, olive oil, and canola oil) are essential to brain function.
Who is the owner of Amen Clinics? ›Daniel G.
Dr. Amen is a physician, adult and child psychiatrist, and founder of Amen Clinics with 10 locations across the U.S. Amen Clinics has the world's largest database of brain scans for psychiatry totaling more than 200,000 SPECT scans on patients from 155 countries.
Overall, MRI was more sensitive, but SPECT/CT was more specific in the evaluation of causative pathologies. Conclusion: In this initial comparison, SPECT/CT showed higher specificity than MRI in the evaluation of causative pathologies in patients with nonspecific wrist pain. However, MRI was more sensitive.
How accurate is SPECT? ›SPECT reconstructions using CT-based compensation corrections readily achieve accuracy for 99mTc to within ±10% of the known concentration of the radiotracer in vivo.
Which is better a PET scan or a SPECT scan? ›PET Scan Images are Clearer
PET scan images are generally reported to offer a higher resolution of 5 to 7 mm, compared with a cardiac SPECT scan resolution of 12 to 15 mm. With a higher resolution, radiologists can detect changes to the heart's blood flow at a granular level.
Brain SPECT imaging is contraindicated in the following: Pregnancy. Breastfeeding (this should be interrupted for 24 hours prior to imaging) Lack of cooperation.
What is SPECT mostly used for? ›Single-photon emission computed tomography (SPECT) is a nuclear imaging modality used frequently in diagnostic medicine. It allows the clinician to assess the perfusion and functionality of specific tissues.
What are the advantages of SPECT over MRI? ›
Some of the advantages of SPECT/MR include the following: They have better temporal and spatial resolution. Can measure morphology as well as function. MRI offers high spatial resolution which is ideal for tissue phenotyping and anatomical imaging.
Can a SPECT scan show a tumor? ›SPECT Scan
In this procedure, antibodies (proteins that recognize and stick to tumor cells) can be linked to a radioactive substance. If a tumor is present, the antibodies will stick to it. Then a SPECT scan can be done to detect the radioactive substance and reveal where the tumor is located.
In total, about 13,000 SPECT cameras are used in the United States. In 2003, about 1,300 systems, of the approximately 2,000 total worldwide, were added to the US market. Comprising about 65% of the total world market, the United States is an important player in SPECT.
What drugs are used in SPECT? ›The most commonly used tracers are thallium-201 thallous chloride (thallium), technetium-99m-2-methoxy-isobutyl-isonitrile (99mTc MIBI) and 99mTc 1,2-bis [bis(2-ethoxyethyl)phosphino] ethane (tetrofosmin).
What is the cost of SPECT? ›| Test Type | Includes | Test Price |
|---|---|---|
| SPECT Cerebral Perfusion Scan | SPECT Cerebral Perfusion Scan (Nuclear Medicine) | ₹ 15200 ₹ 19000 |
Mayo Clinic's highly specialized radiology teams perform and interpret nearly 10,000 SPECT scans each year.
How much does a SPECT of the brain cost? ›SPECT scans, without insurance coverage, can cost over $1,000.
What is the average cost of a SPECT scan? ›On MDsave, the cost of a Brain SPECT ranges from $1441 to $2817. Those on high deductible health plans or without insurance can shop, compare prices and save. Read more about how MDsave works.
Is a SPECT scan loud? ›Like an MRI, the procedure can be uncomfortable and loud and can make people feel anxious.
Is a SPECT scan claustrophobic? ›CT scans can cause claustrophobia symptoms before the scan. Symptoms can also persist even after the procedure, whether or not the patient has undergone such a procedure before. Claustrophobia is a form of anxiety, so conditions that limit mobility or constrain an individual to a small area cause severe distress.
Why would a doctor order a SPECT? ›
Your doctor has ordered a brain SPECT scan. The role of this procedure is to diagnose Alzheimer's and other neuro-degenerative diseases, stroke, seizure, and to evaluate memory loss.
Does a SPECT scan show arthritis? ›SPECT-CT is useful in localising active arthritis especially in areas where the number and configuration of joints are complex.
What does red mean on a SPECT scan? ›A healthy scan shows full, even, symmetrical perfusion. Fig. ( 2) Shows a healthy 3D active rendering of SPECT information, looking at areas of increased perfusion. Blue equals average perfusion, red equals the top 15% of perfusion and white is the top 8%.
Who can prescribe SPECT scan? ›A SPECT scan is generally performed by a doctor in a hospital under sterile conditions and the patient should inform the medical practitioner if they are already taking any prescription medications or supplements for other pre-existing disorders.
Is SPECT invasive or noninvasive? ›Single photon emission computed tomography (SPECT) is a form of non-invasive nuclear imaging used in order to determine how organs inside the body work.
What is the best scan to detect dementia? ›...
An MRI scan is recommended to:
- help confirm a diagnosis of dementia and the type of disease causing the dementia.
- provide detailed information about the blood vessel damage that happens in vascular dementia.
Health care providers often use a brief test such as the Short Test of Mental Status, the Montreal Cognitive Assessment (MoCA) or the Mini-Mental State Examination (MMSE). More detailed testing may help determine the degree memory is impaired.
Can an eye doctor tell if you have dementia? ›Eye tests can pick up whether you're long or short-sighted, identify glaucoma and monitor your eye health – and recent research suggests that your optician could also predict whether you are at risk of developing dementia. The brain damage of dementia begins many years before any symptoms become apparent.
Which herb is miracle for brain? ›Herbs that may help with memory loss include ginseng, ginkgo biloba, ashwagandha, tumeric, and sage.
What is the best vitamin for brain health? ›Vitamin B9, or folate, is a popular supplement and a key vitamin for supporting brain and neurological health, optimal neurotransmitter function, and balanced psychological health.
What is the strongest brain supplement? ›
- ● NooCube: Best brain supplement for focus, memory, and mental clarity.
- ● Vyvamind: Best alternative to prescription medication for ADHD.
- ● Mind Lab Pro: Best all-in-one daily nootropic formula.
- ● Hunter Focus: Best for professionals and enhancing productivity.
Research shows that the best brain foods are the same ones that protect your heart and blood vessels, including the following: Green, leafy vegetables. Leafy greens such as kale, spinach, collards, and broccoli are rich in brain-healthy nutrients like vitamin K, lutein, folate, and beta carotene.
What does Dr Amen eat for breakfast? ›Breakfast is normally: Over-easy eggs with spinach and a cup of blueberries; or protein shake with Omni Protein Chocolate Powder, a cup of berries and a handful of spinach or kale.
What naturally helps the brain? ›- Exercise regularly. Exercise has many known benefits, and regular physical activity also benefits the brain. ...
- Get plenty of sleep. ...
- Eat a Mediterranean diet. ...
- Stay mentally active. ...
- Remain socially involved. ...
- Keep your blood vessels healthy.
These services and products, moreover, don't come cheap. An initial consultation at one of Dr. Amen's clinics costs $400. A SPECT examination, consisting of two scans, one at rest and one while concentrating, costs $3,950, which most medical insurance does not cover.
Do brain SPECT scans work? ›SPECT scanning can detect altered blood flow in the brain and help diagnose or evaluate certain vascular brain disorders, such as moyamoya disease, a condition in which the arteries in the brain become blocked or narrowed.
How effective are Amen Clinics? ›After only six months, 84% of the patients we have treated at Amen Clinics report significant improvements and 85% report an improved quality of life. For our patients who are treated elsewhere, 79% report significant improvements.
What is the accuracy of SPECT? ›SPECT/CT arthrography has a high diagnostic accuracy (97%) in the evaluation of loosening of both hip and knee arthroplasties in patients with persistent post-procedural pain.
Is SPECT scan better than MRI? ›As an area of the brain becomes more active, blood flow to that area increases in a proportional manner. This is the basis for both functional MRI (fMRI) and SPECT functional brain imaging. SPECT is superior at demonstrating TBI compared to CT and MRI scans.
Is SPECT less accurate than PET? ›In addition, the spatial resolution of PET is better than that of SPECT - far better. This is due to the physical nature of nuclear decay of positrons. Scatter radiation can be calculated better and is less compared with SPECT.
Can a SPECT scan show anxiety? ›
Brain SPECT scans show that overactivity in the basal ganglia is commonly seen in anxiety, but there can also be other brain areas with abnormal activity depending on which of the 7 types of anxiety/depression a person may have.
What is the negative predictive value of SPECT? ›The negative predictive value of the test has been shown to be as high as 98%, offering excellent prognostic value. A normal technetium-201 or technetium-99m scan is generally associated with low risk of future cardiac events (< 1%/yr).
Can a SPECT scan show mental illness? ›SPECT scans have the possibility of facilitating the subtyping of mental illnesses, such as depression, ADHD, obsessive-compulsive disorder, and aggression based on brain system pathophysiology.
Does insurance cover SPECT scan? ›Cost and Health Insurance
Your insurance may require prior authorization in order to cover your SPECT scan. Be sure to check with the company on whether and to what extent the scan is covered so you'll know what, if any, costs you'll need to cover. SPECT scans, without insurance coverage, can cost over $1,000.
Brain CT scans can provide more detailed information about brain tissue and brain structures than standard X-rays of the head, thus providing more data related to injuries and/or diseases of the brain. During a brain CT, the X-ray beam moves in a circle around the body, allowing many different views of the brain.
What is the biggest disadvantage in using a PET scan? ›PET scanning can give false results if chemical balances within the body are not normal. Specifically, test results of diabetic patients or patients who have eaten within a few hours prior to the examination can be adversely affected because of altered blood sugar or blood insulin levels.
Why would a cardiologist order a PET scan? ›A heart PET scan can detect whether areas of your heart muscle are receiving enough blood, if there is heart damage or scar tissue in the heart, or if there is a buildup of abnormal substances in the heart muscle.
Why use SPECT over PET? ›SPECT systems work based on gamma-emitting radioisotopes that combine technetium-99M, iodine-123 and iodine-131. These tracers have a half-life of up to six hours, which is much longer compared to PET systems. These tracers are also less expensive and more readily available than their PET counterparts.