Finally, a Brain Scan Diagnoses Mental Illness

Finally, a Brain Scan Diagnoses Mental Illness

One of the big criticisms people have of psychiatry is the lack of empirical testing involved in the diagnosis of mental illnesses and antipsychiatrists seem to hang their hats on this lack of biological testing. But finally there is an approved brain scan that stands in the face of this critique. Finally, there is an FDA-approved brain scan to be used in the diagnosis of a mental illness.

FDA-Approved Treatment in the Diagnosis of ADHD

In this case, it is the diagnosis of attention-deficit/hyperactivity disorder (ADHD). A few years back I was surprised to learn how clear the brain evidence was for ADHD and now this clear evidence is being used to facilitate diagnosis. According to Time Magazine,

The Food and Drug Administration (FDA) approved Neba Health’s device for children aged six years to 17 years. It relies on electroencephalogram (EEG) readings, which track electrical impulses released by active nerves. The test lasts 20 minutes and records the frequency of impulses emitted every second. By studying the resulting wave pattern, doctors can determine with relative confidence whether the child has ADHD . . .

Diagnosing and Treating Mental Illness Using Brain Scans

Brain Scan for ADHDAnd rest assured this is just the first brain scan to be used in the diagnosis of mental illness. In my lifetime I believe we will have tests for depression, bipolar disorder, autism and schizophrenia. It’s not easy to develop these tests, but over time they will come. Tests using functional magnetic resonance imaging (fMRIs) are being developed right now to diagnose these other illnesses.

And soon these brain scans will also be able to be used in the assessment of the treatment of mental illnesses as well (assessing how well mental illness treatments are working and ascertaining which treatment would be best). According to researchers:

“I am most interested in us[ing] resting-state fMRI to really examine the effects of treatment,” says Posner. He also published a paper in JAMA Psychiatry last spring showing that antidepressants successfully quieted hyperconnectivity in the brains of individuals with chronic depression.

That trial compared brain scans from 32 people with depression with those from 25 healthy counterparts and confirmed that the former group had more activity in what is known as the default mode network, a collection of disparate brain regions that makes up the baseline, or default level of brain activity necessary to keep a body functioning. When a person performs a mental task, this default network is suppressed. But in the depressed patients, this network was overactive . . .

The patients with depression were then given a 10-week course of either the antidepressant Cymbalta (duloxetine) or a placebo. At the end of the trial, patients who received the drug showed similar connectivity patterns to those seen in healthy individuals, but the depressed participants who received placebo did not . . .

Limitations of Brain Scans in Diagnosing Mental Illness

Naturally, there are limitations to this approach. First off, there is always the problem of a false result from a brain scan – and, of course, there is a margin of error on brain scans, just like on every other test. That is why the FDA has said the above ADHD test should be used in conjunction with medical and psychological evaluations. Brain scans are more an adjunctive tool right now. We’re not sophisticated enough to rely on them totally (but that will come).

The other limitation that’s clear to me is cost. Many people can’t afford to send their child for an expensive brain scan to diagnose a mental illness and even if everyone could afford it, there would be a shortage of equipment with that kind of demand. So, certainly this test is out of reach for many.

More on why brain scans for mental illness matter and why they don’t.

Finally, Brain Scans for Mental Illness

Nevertheless, this is a major advancement in the diagnosis of mental illness. I’m thrilled about it. It doesn’t help me personally, but it does lend credence to every one of us who knows and talks about mental illness being a biological illness.

Images of EEG cap and CT scan provided by Wikipedia.

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