Clarifying an ADHD Diagnosis, One Must be Sure Before Being Medicated

Dr. Sheryl Ziegler of CereScan, response to 10/9/12 New York Times article, “Attention Disorder or Not, Pills to Help in School

A recent article in the New York Times highlighted and brought to the forefront America’s obsession with a quick fix using overmedication in an irresponsible fashion. This time it centers around children. Low income children who are struggling in school and are therefore being treated by doctors who are willing to prescribe them medication, in many cases without a diagnosis, for the sake of helping young children improve their grades and focus in school.

The article does an adequate job pointing out the obvious and inherent flaws with this type of practice as well as the doctor rationale for such medical treatment approaches.

However, what the article does not discuss is a counterpoint for the doctor’s arguments that ADHD has “completely subjective” diagnostic criteria and that ADHD “isn’t binary – you have it or you don’t.” There are in fact, objective diagnostic neuro-imaging techniques available to accurately assess which areas of the brain may or may not be compromised. No longer does it have to be the guessing game days of making psychiatric diagnoses such as ADHD without substantial, statistically relevant support. Physicians can refer their patients to have their brain scanned and then receive an objective and comprehensive report that can help them formulate the best treatment plan for their patient. These treatment plans could include best decisions regarding medications and otherwise.

The challenge with this is money (most insurance plans do not cover these scans yet) and the doctor’s willingness to learn more about these neuro-imaging techniques. In an age of big pharmaceutical dollars, an abundance of advertisements on television for the next pill that can help with just about anything and a society that wants a quick fix we are seeing practices such as those described in the New York Times. We are seeing children of all ages being prescribed medications irresponsibly because families and school systems cannot afford, do not choose or do not know how to access more accurate diagnostic information.

The brain imaging data, provided by CereScan to parents and schools on many occasions challenges this trend, and they will continue to work to gain a broader acceptance in the medical community. Parents and schools are starting to take notice. John Kelley, CEO of CereScan mentions, “We have had increasing numbers of parents and school systems inquire as to exactly what kind of information we can provide them, and whether it can further clarify the question as to whether certain medications can improve a particular students performance in school.” He continues, “It really comes back to the accuracy of the diagnosis handed down, and many parents are weary of putting their children on mind altering medications before they know for sure. That is where CereScan can help, since we offer a way for them to know for sure.”

For a full text of the New York Times article, please click here.

-Dr. Sheryl Gonzalez Ziegler

Dr. Ziegler is the founder and managing director of The Child & Family Therapy Center at Lowry. She is a Counseling Psychologist and Licensed Professional Counselor in the state of Colorado. Dr. Ziegler is a member of the Colorado Association for Play Therapy, American Psychological Association and started the Spousal Forum for the Colorado chapter of Entrepreneur Organization (EO). She is also a consultant to CereScan.

CereScan in the News!

KDVR 31 News in Denver recently aired a segment about CereScan and how we are helping brain-injured soldiers returning from combat. Symptoms of Post Traumatic Stress Disorder (PTSD) and mild traumatic brain injury (mTBI) often overlap and may be misdiagnosed. With the help of SPECT brain imaging, doctors can receive a comprehensive evaluation of the brain which provides more accurate diagnostic information and leads to a more precise treatment path for the individual.

Click here to see the full story.


Latest Journal Article Advocates the Use of SPECT Brain Imaging in Psychiatry

Recently, one of CereScan’s consulting physicians, Dr. Theodore Henderson, co-authored a paper published in The Journal of Psychoactive Drugs, titled Specific Ways Brain SPECT Imaging Enhances Clinical Psychiatric Practice. The paper discusses a few case studies that were carried out by doctors around the United States in order to learn more about how SPECT brain imaging can aid in enhancing patient care by giving doctors more accurate information about an individual’s brain function. Many psychiatrists now use the DSM-IV manual as a tool to diagnose psychiatric disorders. But in more complex psychiatric cases, using the DSM-IV alone may not suffice.

The paper explains that in complex psychiatric cases, using SPECT brain imaging in conjunction with other diagnostic tools can help doctors give a more accurate diagnosis and improve patient treatment. The paper states “It has become increasingly unlikely that DSM diagnoses represent distinct neurophysiological entities. They will likely prove to represent groups of neurophysiological processes. Individual symptoms likely represent abnormal neurophysiological processes that span across diagnoses (e.g., impulsivity is a key component of the diagnosis of Impulse Control Disorder NOS, ADHD, bipolar mania, and certain personality disorders; but is also seen following frontal lobe injury, as in mild TBI, and in Frontal Temporal Dementia).” In other words, there are 8 or more known disorders where the DSM alone is not going to be a helpful tool in making a diagnosis. With the use of SPECT brain imaging along with the DSM, doctors can provide a more accurate treatment solution for a patient.

The article in the Journal for Psychoactive Drugs can be found here.

Alzheimer’s and SPECT Brain Imaging

Dr. Ted Henderson, one of CereScan’s consulting physicians, recently presented a webcast addressing neuroimaging in dementia, mild cognitive dementia and Parkinson’s disease. During his presentation, he discusses the merits of SPECT imaging in conjunction with the newly approved beta amyloid biomarker. Usually by the time somebody has had a clinical diagnosis of Alzheimer’s, there is already significant pathology and neuronal loss. With the use of an amyloid biomarker with PET and SPECT imaging, doctors are able to identify the disease before clinical symptoms appear. Early detection allows doctors to take advantage of treatments that have the potential to slow the progression of the disease. Below is an interesting video that was presented on NBC Nightly News about a new clinical trial that is studying potential ways to treat Alzheimer’s.