different Imaging TECHNIQUES and their use
Neuroimaging falls into two broad categories:
- Structural imaging, which deals with the structure of the brain and the diagnosis of large-scale intracranial disease (such as a tumor), as well as injury.
- Functional imaging, which is used to diagnose metabolic diseases and lesions on a finer scale (such as Alzheimer’s disease), and also for neurological and cognitive-psychology research. Functional imaging allows the brain’s information processing to be visualized directly, because activity in the involved area of the brain increases metabolism and “lights up” on the scan. common types of brain scans are X-RAYS, MRI, SPECT and EEG (qEEG).
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI) scans are the form of neural imaging most directly useful to the field of psychology.
An MRI uses strong magnetic fields to align spinning atomic nuclei (usually hydrogen protons) within body tissues, then disturbs the axis of rotation of these nuclei and observes the radio frequency signal generated as the nuclei return to their baseline status. Through this process, an MRI creates an image of the brain structure. MRI scans are noninvasive, pose little health risk, and can be used on infants and in utero, providing a consistent mode of imaging across the development spectrum. One disadvantage is that the patient has to hold still for long periods of time in a noisy, cramped space while the imaging is performed.
X-Rays, also known as radiography, is a medical imaging technique. It uses very small amounts of electromagnetic radiation to create images of structures inside of the body that can be viewed on film or digitally. X-rays often are done to view bones and teeth, making it useful for diagnosing breaks, fractures, and diseases such as arthritis. A doctor may order an X-ray to look at organs and structures inside of the chest, including the lungs, heart, and breasts, and in the abdomen to evaluate the digestive tract.
The discovery of X-rays and the invention of CT represented major advances in medicine. X-ray imaging exams are recognized as a valuable medical tool for a wide variety of examinations and procedures. They are used to:
- noninvasively and painlessly help to diagnose disease and monitor therapy;
- support medical and surgical treatment planning; and
- guide medical personnel as they insert catheters, stents, or other devices inside the body, treat tumors, or remove blood clots or other blockages.
Brain SPECT (Single Photon Emission Computed Tomography) imaging is a sophisticated nuclear medicine study that produces clear, real-time pictures of blood flow and activity in the brain. This allows clinicians to identify which areas of the brain are functioning normally and which are under- or over-active. With a clearer understanding of the physiological source of the problem, clinicians are better able to create a treatment plan to balance brain function.
Pioneered by Dr. Daniel Amen, brain SPECT imaging involves injecting a compound into the patient’s blood stream. This compound makes its way to the brain where it emits pulses of energy that light up active areas of the brain. A camera captures images of the brain and sends them to a computer that reconstructs a three-dimensional picture of the brain. Clinicians use this picture to identify patterns of brain activity that indicate a psychiatric disorder.
WHAT ARE THE BENEFITS OF BRAIN IMAGING?
Brain SPECT imaging is a safe, accurate way to inform doctors about how a patient’s brain is functioning. This information can be used to make more accurate diagnoses, design a more effective treatment plan and to educate the patient about their disorder.
Additional benefits of brain SPECT imaging include:
- Helps addicts break through denial and comply with treatment
- Improves ability to detect brain trauma and other problems that may contribute to substance abuse
- Gives patients a medical view of their problem, reducing feelings of shame and guilt
- Enhances patients’ understanding of their illness and their struggles to make healthy decisions
WHAT CONDITIONS/DISORDERS DOES BRAIN IMAGING TREAT?
Research suggests that brain SPECT imaging is useful in treating the following disorders:
- Brain trauma
- Substance abuse
- Cerebral vascular disease
- Violent or aggressive behavior
Brain SPECT imaging also can be utilized to treat eating disorders, sex addiction, emotional trauma, mood and anxiety disorders, and chronic pain. It has proven highly beneficial in complex or treatment-resistant cases.
QUANTITATIVE EEG (QEEG, BEAM, BRAIN MAPPING)
These tests focus on the brain activity. the test will detect any part of the brain that is not functioning correctly. This test is performed in a way similar to EEG. Brain wave activity varies throughout the day depending on the state of alertness. Each area of the brain normally spends a characteristic amount of time in alpha, beta, theta, and delta activity. Brain mapping computers are now capable of creating a map of the brain’s electrical activity depicting how long each area of the brain spends in each of the basic rhythms. By comparing the patient’s map with that of a control population, it is possible to localize areas of focal slowing of electrical activity.
Assists in identifying problems with brain timing
Pinpoints specific areas of the brain that are not functioning optimally that can impact mood, behavior, attention, sleep, learning and more
Helps indicate which interventions and neurofeedback protocols to target
Provides information that can suggest which class of medications is appropriate or not suitable to the problem. (This knowledge can help reduce prescribing by trial and error)
Main qEEG or “Brain Mapping” benefits are :
- Assists in identifying problems with brain timing
- Pinpoints specific areas of the brain that are not functioning optimally that can impact mood, behavior, attention, sleep, learning and more
- Helps indicate which interventions and neurofeedback protocols to target
- Provides information that can suggest which class of medications is appropriate or not suitable to the problem. (This knowledge can help reduce prescribing by trial and error)
- Helps explain why remedies tried up to that point haven’t worked
EEG/QEEG REPORTS HELPS DECIDE THE BEST TREATMENT METHOD
“Deciding on a course of treatment without knowing exactly what is going on with the patient, is as bad as a Firefighter trying to put out a gasoline fire with water. It will only make things worse!”
EEG neurofeedback, also known as EEG (electroencephalogram) biofeedback, is a safe, non-invasive, painless learning procedure during which sensors are placed on the surface of the patient’s head. The sensors record brain electrical activation level and enable participants to learn to improve mental performance, normalize behavior and/or stabilize mood. The information is displayed on a computer screen, together with sounds, which change according to the brain’s activity levels. Therefore, the patient can read, understand and influence his or her brainwave activity. Once the patient learns to access and regulate the brain more effectively, symptoms begin to improve or performance optimizes.
EEG neurofeedback is a natural, self-regulating approach that helps restore the brain’s ability to function in the manner in which it was designed to function. It is perhaps the biggest breakthrough in non-invasive medicine in the last 50 years.
Also known as EEG biofeedback, braintraining and brain computer interface (BCI), neurofeedback utilizes the operant conditioning learning model to achieve self-regulation. Additionally, monitoring the brain’s bioelectrical system advises us of chemical as well as the electrical activity within the brain.
A neurofeedback session involves the client sitting in a comfortable chair in a quiet room. He or she will have electrodes placed on the part of the scalp where the training will occur, which is determined by the QEEG interpretation. The visual feedback on the computer screen and auditory feedback through speakers or headphones are positive reinforcement. Creating these reward parameters involves skill and training.
When the brain’s electrical system is performing optimally, the computer will provide the sound and visual approval the clinician set sup. The brain responds to positive feedback and the absence of it on a very basic level and chooses to be rewarded.
After a number of sessions, to be determined by the clinician, and based upon session-to-session review and mid-treatment assessments, the changes are generally permanent. Once the optimized profile is established, the client may see subtle to dramatic behavioral changes. There are different forms of visual and auditory feedback. Knowing which ones to administer is the key to successful treatment.
TMS (Transcranial Magnetic Stimulation Therapy is an alternative treatment for patients suffering from depression who haven’t found success from past treatment using antidepressants. This revolutionary technology has been long-studied but has only been recently introduced to the market.
Despite being cleared by the FDA only in 2008, TMS has immediately made a mark as an impressive treatment for depression, proving to be both noninvasive and effective for treatment-resistant patients who haven’t responded to medications.
TMS was adapted from MRI imaging technology, and development began as far back as 1985. For the first time in the history of psychiatry, we have a tool that can actually make changes within targeted areas of the brain without any invasive procedures, injections, or surgeries.
Simple magnetic pulses delivered to the surface of the brain activate the parts of the brain associated with depression or anxiety. TMS is completely safe, non-invasive, doesn’t involve radiation, and provides superior benefits to antidepressant medications – without the side effects associated with them.
The use of the TMS has grown as research continues to prove its safety and efficacy. Tens of thousands of clients have received treatment without any negative side effects. Since December 2010, the American Psychiatric Association has designated TMS as the go-to treatment when clients have failed 1-4 antidepressant medications, using the “Best Practices of Depression Treatment” guidelines.
Although TMS has been in use in Europe and Canada since 1994, the FDA finally cleared it for use in the United States in 2008, following a massive 100 site study that showed it to be a safe and effective method of treatment.
Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that has been used to improve cognitive functions such as memory, language, and attention.
Several studies have found transcranial direct-current stimulation (tDCS) to lead to improvements in working memory, learning, decrease depression, alleviate chronic pain, and reduce symptoms of Parkinson’s and schizophrenia.
The stimulation technique, known as transcranial direct current stimulation, or tDCS, can enhance activity in areas of the brain by applying a weak electrical current to the scalp.
There has been some research looking into tDCS as a stand-alone treatment for conditions such as depression, but our findings suggest that it might be best used in conjunction with specific cognitive training tasks.
Transcranial magnetic stimulation has shown its potential to help patients suffering from depression and headaches. Also, patients with OCD who have not responded to traditional treatments now have another option.