The Amen Clinics advertising is dangerous, disingenuous bullshit

I’ve written before about Daniel Amen and his network of Amen Clinics, that (amongst other things) give utterly unnecessary doses of radiation to children. To briefly recap, Amen is a psychiatrist, author, motivational speaker etc. who has built his reputation and fortune on performing brain scans and then wildly exaggerating their diagnostic and prognostic usefulness. His clinics use an imaging modality called SPECT, a largely obsolete technology with terrible spatial resolution that’s been superseded by PET and MRI for most clinical and research purposes. The only real advantage of SPECT is that it’s much, much cheaper to perform than either PET or MRI, which is, of course, precisely why he uses it. He’s been at this a while too. This article in Wired from 2008 contains some choice quotes:

“Let’s look at your scans.” He takes the images that he printed out this morning and puts them side by side on a large table. He points to several views of the surface of my brain. “What I see here is that activity in your prefrontal cortex is low at rest but becomes better when you concentrate, and your thalamus becomes more active, too. I think this means you have a predisposition to depression.”

I nod. Scrutinizing the scans some more, he says, “You need to be busy to be happy. Your brain is cool at rest. You need stuff in your life to feel alive, together, and connected.” He looks at another view, this one showing only the most active regions of my brain. “In this scan, you have increased activity in your thalamus, your two basal ganglia, and your cingulate cortex.” He picks up a pen and draws a line connecting these four regions to the right lateral temporal lobe. “I call this the diamond plus.’ It’s a pattern of angst, and we see it in people who have had significant trauma in their lives.”

And these are the scans that he’s supposedly looking at while making these judgements:

mf_neurohacks2_f

What?! You can’t diagnose conditions like depression in an individual subject from even the very best brain scans, and you certainly can’t see the effects of such nebulous existential concepts like ‘angst’. What the hell is ‘angst’ supposed to mean in this context anyway?! He might as well be saying “The connections between your Shatner’s Bassoon and the peri-sinovial labio-ventral cortex is unusually cromulent and this might predispose you to brilligness, and excessive slithy toveing.” So, yeah, he’s a colossal bullshitter, who must have to keep a fire extinguisher handy at all times to dampen down the constant spontaneous combustion happening in his pants. This is nowhere more true than in the adverts for his clinics. Here’s one from the clinics LinkedIn page:

13b9f61

Brains get significantly less lumpy-looking after treatment – good to know. But hang on – brains are lumpy-looking. They’re covered in ridges and bumps! These smooth-looking pretty-coloured brains that Amen seems to think are great actually resemble lissencephaly; a very serious condition where the developing brain lacks the normal cortical folds. In this case, I’m pretty sure that the smoothness of the images is produced by the fact that the SPECT imaging methods he uses are so poor that they simply can’t show that much detail of the cortical surface. Also, I’ve no idea what the pretty colour-washes are meant to signify, if anything. To show you how easy it is to create images like this, here are some I threw together in about five minutes using FSLView and a standard-space MRI template (the MNI152 1mm template, bundled with FSL), by varying the threshold of the 3D rendered surface:

(Clicky for bigness)

(Clicky for bigness)

I’ve written before about why presenting brain images out of context in this way can be extremely misleading. Here’s another choice Amen-sponsored example:

dr-amen-brain-photo

As if it really needed saying; utterly meaningless nonsense. A Google image search brings up loads more examples, but I won’t sully your eyeballs with them unnecessarily. Amen’s use of SPECT images in this way is a gargantuan 20-year effort in energetic turd-polishing of a staggeringly disingenuous and despicable type, and I’m frankly amazed that he still seems to have an active licence to practice medicine.

Many thanks to @CousinAmygdala (and others) who first showed me these kinds of ads, and who also coined the most excellent term ‘neurofearmongering’.

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7 responses to “The Amen Clinics advertising is dangerous, disingenuous bullshit

  1. Does he throw in a tarot card reading for free at least?

  2. I can’t believe you did not highlight the “Ring of Fire ADHD” (http://www.amenclinics.com/southern-california/ways-we-can-help/adhd-add/type-6-ring-fire-add/) which is cited as one of the SEVEN subtypes of ADHD. This is particularly impressive given that the most sophisticated factor mixture modeling done by “conventional” science identifies zero meaningful subtypes of ADHD (e.g., Lubke et al).

  3. This is also being promoted by the British Dyslexia Association. Look at their ‘Visual Stress Webinar’. At 14min 20seconds Amen scans are wrongly attributed to Irvine University and used to justify some neuro-tosh about cortical hyper-exitability and ocular dominance columns.
    Here is the link https://www.youtube.com/watch?v=naA3f612LXI

  4. I would be interested in seeing brain scans of myself, considering my diagnosis’s. I would not goto this place you speak of, Amen. Just the hospital I use. hahha

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  6. Thank you for this! Every other week I get questions about “Can we do brain SPECT scans?” for ADHD, depression, to find love…

    This guy is the worst snake oil peddler ever to practice brain imaging. Forget a medical license. This guy belongs in prison.

  7. I was a patient at the Amen Clinic from 2009-2015. I have been diagnoised at the University of California Irvine, Memory/Mind clinic as having Mild Cognitive Impairment. All the information was or should have been known by my doctors at the AC. Here is my story (briefly). In 2009 I had a SPECT scan which led to a finding of Frontal and Temporal Lobe Disorder. This was never discussed with me, nor were the findings of my SPECT, which showed numerous areas of my brain experiencing decreased blood flow. When I asked my doctor about cognition problems, she said I was fine. In 2012 I got another doctor at the AC. He never ordered a follow up scan or any type of diagnostic procedures to monitor my brain. She left the AC in 2012. My new doctor never reviewed my 2009 SPECT scan and data with me. In 2014 I complained of more cognitive problems than I had in the past. In May he ordered a SPECT scan. My original area of little blood flow has at least doubled is size. New areas are developing. My doctor referred me to a DO at the Amen Clinic who told me I had toxic levels of lead. He ordered I have chelation therapy. Through research, I learned to lab used by the AC to determine heavy metals uses procedures to show extremely high levels of heavy metals. When I went to UCI Memory/Mind clinic, my neurologist tested me for heavy metals. I have none. I AM VERY INTERESTED IN ANY INFORMATION REGARDING PROBLEMS WITH THE AMEN CLINIC. THE FAILURE OF THE CLINIC HAS NOW PLACED ME IN THE POSITION OF HAVING EARLY ALZHEIMER’S DISEASE. PLEASE FEEL FREE TO CONTACT ME .

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