Category Archives: Products

Brain stimulation hits the mainstream – commercial tDCS device available soon for $249

Transcranial Direct-Current Stimulation is a technique that involves passing low-level electrical currents through parts of the brain. The effects of this are various, depending somewhat on the area being zapped, but it appears to change the baseline level of cortical excitability, and the effects can persist for several hours (or perhaps days) after a standard 20-minute session. People have been zapping themselves in the head pretty much since electricity was discovered, but tDCS in its modern form is a relatively new technique, and is thought to have potential for treating depression, stroke-recovery, and other clinical issues. It can also apparently lead to enhancements of normal functions (visual, motor, working memory, etc.) in healthy participants. The Guardian published an article this week on the effects of tDCS on maths ability, based on research which has been fairly widely criticised on Twitter.

This potential cognitive-enhancing effect is what’s caught the eye of a company called Foc.us, who are now offering a commercial tDCS system, for use by anyone at home, for $249 (or £179 in the UK). Here it is:

The foc.us tDCS headset

The foc.us tDCS headset

So, it’s a small band with a battery at the back, and four electrodes at the front that sit over the forehead. Foc.us are marketing this as a device for gamers to “Excite your prefrontal cortex and get the edge in online gaming.”

So – does it work? Possibly… But it almost certainly doesn’t do what the company says it does. For a start, if you want to “get the edge in online gaming” wouldn’t you want to stimulate your motor cortex (at the top of the head) and/or the visual cortex (at the back)? It’s unclear how stimulating the prefrontal cortex (behind the forehead) would give you an advantage in games. In fact, (as this article explains) placement of the electrodes over the dorsolateral prefrontal cortex is most often used for treatment of depression and chronic pain, so potentially these devices might have more of an effect on mood or emotions than any useful gaming-related functions. There is no information about effectiveness or effects on the  company website; the standard protocol of 1mA stimulation for five minutes is unlikely to do much beyond delivering a mild sensation on the scalp. The device can be configured to deliver up to 2mA (through a smartphone app), which may be enough to affect the brain.

Furthermore, there are important safety considerations for this kind of device. In fact, tDCS is such a recent technique that researchers are still in the process of working out what the safe limits actually are (in terms of both power delivered, and duration/frequency of stimulation). This article highlights the possibility that the electrodes can cause skin lesions, and tDCS can even potentially cause lesions in the brain  (admittedly in rats, and with currents a couple of orders of magnitude higher than used in humans). Still, potentially people could be using these systems repeatedly for long periods, and we have very little idea about what the effects of that might be.

If you’re still really intent on zapping your own brain to see if you can become an intellectual giant, or give yourself telekinetic powers or X-ray vision (hint: you won’t) then you could also build your own tDCS device using a 9V battery, some wire, a resistor and a couple of sponges, as described here. Total cost: about $5.

ABSOLUTELY DO NOT DO THIS. IT’S A FUCKING STUPID THING TO DO TO YOURSELF.

Passing electrical currents through the body can be fantastically dangerous. A (alternating) current as low as 10 MICRO-Amps can be enough to cause ventricular fibrillation and cardiac arrest, if passed directly across the heart,  current in the 10-20mA range causes severe muscular contractions, while 60-70 mA is usually fatal (source: Wikipedia).  Seriously, let’s leave passing electric currents through the body to the professionals, eh?

Many thanks to tDCS researcher Nick Davis for helpful discussions on Twitter related to this article.

The SMART program promises to raise your IQ by 20-odd points

schoolforthegiftedA write-up in The (Irish) Sun yesterday (posted on Twitter by Simon Dymond)  has brought a site called Raise Your IQ to my attention. It’s a brain-training site that makes a startling claim; that their SMART (Strengthening Mental Abilities with Relational Training) program can raise IQ, by an average of 23 points.  Those are some pretty big words, right there.

The business is a spin-out company from the National University of Ireland, and was started by Bryan Roche and Sarah Cassidy, of the psychology department at NUI. Dr Roche is an expert in a fairly niche area of psychological inquiry known as Relational Frame Theory. RFT is a theoretical framework that seeks to extend the radical behaviourist ideas of BF Skinner to encompass and adequately explain  complex cognitive processes (language, abstract thought, etc.). Skinner himself was firmly of the opinion that cognitive processes are in fact aggregations of lower-level behavioural responses, and that things like our sense of free-will, and our awareness of our own phenomenal consciousness are entirely illusory (views he expressed in his classic book Beyond Freedom and Dignity, as well as in many more academic works). RFT is essentially a neo-Skinnerian approach which takes into account the accumulated evidence for complex (i.e. nominally non-associative) cognition.

As a theoretical approach RFT has some interest then, however Dr Roche has managed to add a practical twist and come up with something marketable, dubbed ‘relational training’. Essentially it’s a set of questions and tests that are based on relationships between different objects, words or categories. Some examples are below (pasted from The Sun article):

LEVEL 1: If a broad bean is a type of bean, is a bean a type of broad bean?

LEVEL 2: If an Alsatian is a type of dog, and a dog is a type of mammal, is an Alsatian a type of mammal? Is a mammal a type of Alsatian?

LEVEL 3: If yesterday I felt sad and today I feel happy, and if now was then and then was now, how did I feel then?

LEVEL 4: “Car” is the English word for the Swedish word “Bil”. “Car” is also the English word for the Italian word “auto”. “Coche” is the Spanish word for the Italian word “auto”. What is a Coche in Swedish?

Readers who were fortunate enough to have endured a Classical education will immediately recognise the broad form of these as a kind of logical puzzle known as a syllogism, the formal description of which dates back to at least Aristotle; plus ça change. Syllogistic reasoning is also a mainstay in various IQ-type tests.

So, what about these pretty radical claims of raising your IQ by 20 or even 30 points? Does it work? What’s the evidence? As usual I’m afraid, the answer is ‘scant, to non-existent’. A prominent page on the Raise Your IQ site is titled ‘Scientific Evidence’ and discusses in some detail this paper by Cassidy et al (2011; PDF), which does indeed show some impressive effects in two separate experiments. However, experiment one had only four participants in each group (training vs. control), and experiment two had only eight participants (with no control group). These are tiny samples and (as has been extensively discussed, very recently) small samples can lead to the ‘winner’s curse’; an inflation of the apparent effect size. The effects reported in this paper are very large indeed, but honestly, I’m surprised the reviewers didn’t flag up the fact that you just can’t do ANOVAs with four data points! It’s a massive violation of the assumptions of the central limit theorem. In addition, the control group in experiment one was an ‘inactive’ control i.e. one that received no training at all, rather than some kind of placebo training.

The rest of the papers listed on the Scientific Evidence page of the site appear to be fairly theoretical, or only tangentially related to the SMART program. The available evidence from the Cassidy et al. (2011) paper is wafer-thin, compared to the startlingly bold claims being made. One other thought that occurred to me is that because the form of the training is so similar to the form of some questions used on many IQ test, it might represent a form of training-to-the-test; practicing IQ tests makes you better at performing IQ tests – well, duh.

I find myself unable to completely condemn these guys though. Maybe I’m going soft, or maybe I’m just a sucker for some good old-school radical-behaviourism-based interventions. The program does have the (somewhat unusual) virtue of being based on a fairly coherent (if not widely-accepted) theoretical foundation. This doesn’t change the fact that the big claims it makes are wildly out of sync with the available evidence, and in this sense, it’s precisely the same as all the other brain-training neurobollocks-merchants out there fighting for a slice of the gullible consumers cash.

 

 

‘Brain Power Miracle’ will make you an Einstein-level genius

There’s a hell of a lot of bullshit self-help brain-training, memory-boosting, whatever products out there and most of them I don’t even bother looking at in any detail, because I value my emotional stability and life’s just too short. Brain Power Miracle  though is worth a mention, purely because of the hilarity of their claims.

The start off with the old canard that we only use a part of our brain – but they go one better than the normal jokers – they say we may only use 2% (but that it ‘isn’t conclusive’). Then:

“Just think about it: what if you could turn your brain into an unstoppable success machine—bringing you all the wealth, success and happiness that you had previously never thought possible?”

And if that wasn’t enough:

“We will show you how to become a genius like Einstein, Mozart, Da Vinci…”

It’s a shame they didn’t employ one of their genius-level users to copy-edit their webpage and remove all the spelling mistakes.

And to finish off, some nice sciencey-looking pictures of frequency spectra:

Screen Shot 2013-04-21 at 21.15.03

Only $37.95 for seven CDs full of white-noise and synthesised dying-whale-noises! What are you waiting for people?! Go get it!

Tapping, or the Emotional Freedom Technique (EFT). What. The. Fuck.

OK, buckle up space-cadets, this is a weird one.  The Emotional Freedom Technique is a kind of psychotherapy, developed in the 90s, that draws on a variety of pseudoscientific bollocks, including accupressure, our old friend NLP, various kinds of laying-on-of-hands-type ‘energy’ therapies and a good dose of very confused neurobollocks.

Essentially, what happens in an EFT counselling session is that you discuss your problem, while stimulating the ‘end points of the body’s energy meridians’. This stimulation takes the form of tapping yourself; on the head, the face, wherever.

Here’s a demonstration video from this site. Forget the bullshit at the beginning and skip through from about 2 minutes in, where she starts literally hitting herself in the face:

She’s hitting herself in the face! What is she doing? If you saw someone doing this in the street you’d assume they were having some kind of psychotic episode.

There are lots of ‘tapping’ sites out there (like this one), but this one is by far the most egregious in terms of neurobollocks. Projecttapping.com appears to have some serious money behind it, and is chock-to-the-brim with teeth-grinding neurobollocks:

“According to Neuroscience, every memory you have is encoded in your brain with an emotional charge. This charge then creates a neural pathway to signal an appropriate physiological response every time you’re reminded of an experience relevant to that memory. For instance, you might start trembling every time you’re faced with the possibility of public speaking. Tapping helps you rewire these neural pathways, so you can eliminate both the subconscious and conscious fears that cause negative reactions in you. After just a few sessions you’ll already notice the difference: fears that once caused you to doubt yourself, reject wealth or avoid change will begin to melt away.”

Also, apologies for the extensive quotes, but this one is just too good not to share too:

Tapping positively modifies your DNA
A study conducted by the Heartmath Institute showed that when a study participant evoked strong positive emotions like love and appreciation through practices like Tapping, their DNA unwound and increased in length. Negative emotions, on the other hand, caused strands of their DNA to shorten and in some cases disappear. In other words, working with your emotions allows you to change your genetic make-up and your life.

There you have it folks, positive emotions unwind your DNA, negative ones make it disappear! There’s also a weird undercurrent on that site about money and wealth – apparently if you’re poor, it’s probably because you’re ‘afraid’ of being wealthy and pushing money away. Riiiight.

There’s plenty of ridiculous stuff on the internet of course, so this is nothing too remarkable. What’s slightly weird about this particular site is that projecttapping.com is published by a company called Mindvalley, who describe themselves as ‘Pushing humanity forward through innovations in education and culture-hacking’. They seem to be a really weird blend of very up-to-date marketing and some really hackneyed new-age bullshit. The kind of company that California just seems to be so good at producing for some reason. Take a look at their ‘about’ page, if you have a chance. Have you ever seen a more self-satisfied bunch of touchy-feely hipster twats? Piss off with your bullshit ‘culture-hacking’ and ‘online meditation portals’. Do some real work.

Telegraph article on neuromarketing – dreadful stuff

I’ve so far resisted talking about a) neuromarketing, and b) how neuroscience is portrayed in the popular press, because I honestly felt that if I started in on either of those topics I would probably never be able to stop and there would just not be enough words on the entire internetz. Fortunately, an opportunity has come along for me to save valuable time and effort and heap derision on both targets at once.

Molly Crockett pointed me towards this article in the Telegraph, which is an uncritically fawning act of fellatio performed on Steven Sands and his Sands Research company. There are plenty of wince-inducing quotes in there, but by far my favourite is this little gem:

“It’s all very Minority Report,” Steve Sands says, referring to the Tom Cruise film in which a special police department known as “PreCrime” tracks down criminals based on knowledge provided by psychics. “But we’re not too far from that now.”

We’re not too far from having mutant humans linked together in a hive-mind predicting future events using psychic pre-cognitive abilities? Good to know, Steve.*

*Unless he meant the computer interfaces of course, which is generally what people mean when they talk about Minority Report. In the movie, Tom Cruise had to put on a pair of special gloves to do whizzy hand-wavy things with his computer; we’re already way beyond that.

 

Some excellent articles on the neurobollocks of brain training

Another short post just to link to a couple of articles on the brain-training trend, and why it’s all highly suspicious.

First up is a really good piece in the New Yorker titled ‘Brain games are bogus’. The piece mostly focuses on CogMed (who are currently launching programs in American schools) and has some good, and damning, quotes from independent researchers who work in the area of working memory.

This post on the Computing for Psychologists blog mentions another company called LearningRX who are also making a play for a slice of the lucrative education sector.

Finally, this blog post focuses on Lumosity, which is perhaps the most well-known (and well-marketed) online brain-training service.

All three articles make very good points, which I won’t bother to repeat here, but the upshot is that brain training is (very likely) bogus. The science behind it is shaky at best, and these companies cannot possibly deliver on the promises they make in their slick marketing videos, like this one:

*Uncontrollable projectile vomiting* Urgh. For God’s sake, just take the ten hours you’d spend pointlessly clicking buttons on the Lumosity website and use it to read a book instead. Science, history, fiction, anything… you’ll get more ‘brain training’ out of that than anything these jokers can produce with their ‘science of neuroplasticity’ and their self-consciously quirky hipster hand-drawn graphics and carefully selected not-too-hot-and-not-too-geeky-looking fresh-faced spokesmodel from central casting.

Except if it’s something by Stephanie Meyer. Seriously, don’t read those Twilight things. They’re adolescent fucking garbage.

Neuro-Linguistic Programming – the 1970s neurobollocks that just refuses to die

get-the-life-you-want-header-nlp-life1

I’d prefer to spend two days in a Siberian gulag than with these two smug bullshitters.

Neuro-Linguistic Programming (NLP) was invented in the mid-70s by Richard Bandler (a psychology and philosophy graduate) and John Grinder (a linguist). It originally grew out of observations made in therapy, and a metaphorical extension of some of the concepts of Chomsky’s transformational grammar. In the fertile grounds of the 70s Californian therapy and self-help movement, it soon blossomed into a multi-faceted set of techniques and philosophies. By the 80s it was being widely touted as a novel therapy technique and attracted some serious attention from researchers. However it was relatively quickly understood that there was no empirical basis for its key claims, and as its practitioners began to make ever more outlandish claims, serious interest from professionals waned.

This didn’t stop the NLP-faithful though. People like Tony Robbins (who studied with Bandler) made incredibly successful careers out of the motivational speaking/books circuit.  Despite this undeniable popular appeal, NLP is nowadays widely-regarded as pseudo-scientific bollocks of a particularly refined and rarefied strain.

It’s actually quite hard to pin down exactly what the key principles of NLP are. This is partly because its founders and practitioners use such vague and amorphous language, full of metaphors and pointless jargon, but also because of the diversity of its supposed applications; from ‘traditional’ therapeutic settings, to sports coaching, to corporate training seminars, to (creepily) seduction. It aspires to include something for everyone; the best way to maximise the market and therefore the potential profit. One relatively common theme is focused on teaching communication skills in order to facilitate the learner’s personal and professional relationships. On the surface this sounds reasonable, but the communication theory that its based on has absolutely zero empirical support. The wackier variants incorporate all kinds of other bollocks like hypnosis, and many NLP-whackos talk about being able to ‘reprogram’ their own (and other’s) brain, often by claiming to influence the subconscious mind in some way.

Despite being nearly 40 years old, and a ridiculous, facile hodge-podge of concepts from psychology, philosophy, linguistics and new-age twaddle with absolutely no support from any reputable sources, amazingly, NLP is still very much alive and kicking. Bandler has kept on developing (and ruthlessly trademarking) a load of new techniques including ‘Design Human Engineering™’, or ‘Charisma Enhancement™’. A lot of his recent work also appears to include hypnosis. His website is essentially one big advertisement for his books, CDs and speaking gigs; and there are literally thousands of individuals, businesses, and ‘institutes’ offering NLP training for a bewildering variety of purposes and people. Bandler has even latterly jumped on the ‘Brain training’ trend with a new company called ‘QDreams‘ (‘Quantum brain training!’; ‘Success at the speed of thought!’ FFS…). Searching on Twitter turns up many, many people earnestly tweeting away about the benefits of NLP. Why is it so persistent? Partly this is because of Bandler’s clear talent for slick marketing, re-invention and dedication to innovative bull-shittery, and partly because NLP was never really clearly defined in the first place, which makes it highly malleable and adaptable to any pseudo-scientific new-age trends that come along. Despite a hiccup in the mid-90s (when Bandler tried to sue Grinder for ninety million dollars) it seems to be as popular as ever, and to be attracting new adherents all the time.

In my opinion the real stroke of genius in NLP, and perhaps the reason why it’s been so successful, is simply the name. These days we’re used to putting the ‘neuro-‘ prefix in front of everything, but back in the ’70s, this was way ahead of its time. Obviously there’s nothing remotely ‘neuro’ about it, though. Plus the ‘programming’ bit has a deliciously Orwellian appeal; promising the potential to effect change in oneself or others, if you just know the right techniques.

But effecting genuinely meaningful behavioural change in yourself is hard work. NLP derives from the quick-fix mentality of the self-help movement and is doomed to failure because of it. Does it actually help people? Perhaps, on some level, but any anecdotal results are almost certainly derived from a version of the placebo effect. Because of its vague nature, it’s not even really clear how its effectiveness would be meaningfully assessed anyway. Until we discover the genuine low-level programming language of the human brain we’ll probably always have to put up with this kind of bollocks being peddled.

There’s another really good article on NLP at the Skeptics Dictionary.

Interactive metronome treatment for ADHD/ADD; swing your arms about, cure your brain

Ian Dury. Because… any excuse.

One of the best things about starting this blog was several e-mails I got from like-minded people saying nice things, and often, pointing me towards interesting bits of neurobollocks that I wasn’t aware of. Such was a series of e-mails from Deborah Budding and Michael Thaut (who must be one of only a few people in the world who holds posts as Professor of Music, and Professor of Neuroscience – cool) about the ‘interactive metronome’ technique. Michael’s research (unsurprisingly) focuses on the interplay between the brain and music, and in particular, the processing of temporal information as it relates to rhythmicity, so it’s probably fair to say he certainly knows his way around a metronome.

But what’s this interactive metronome business? Well, as you can see in this video on the hypochondriac’s website of choice (WebMD), it’s basically waving your arms about and moving your feet in time to a regular beat. So, it’s basically dancing then, but much more boring.

Surprisingly, given it appears to be such a simple technique, some people are claiming that it can have profound effects, and assist with various disorders such as ADHD, Parkinson’s, MS and even post-brain injury and stroke. The usual bunch of jokers with slickly-designed websites have sprung up offering treatment for all these things and more. The ‘How it works’ section of that website claims that the underlying deficit in a variety of disorders, claiming that the underlying dysfunction in ADHD, autism, dyslexia, Parkinson’s and others is just a ‘neural timing deficit’. The exercises used in IM correct the timing deficit, and therefore (supposedly) treat the disorder.

To say this is startlingly simplistic would be a massive understatement; it’s just plain wrong. The precise neurological issues in many of these disorders are difficult to pin down and are the subject of active investigation but, to take a simple example, we know exactly what the problem is in Parkinson’s; neuronal depletion in the substantia nigra. To claim that it’s some vague neural ‘timing’ issue goes well beyond disingenuousness and into the realm of outright deception.

There’s even a home-based version of IM therapy, that can be run on any computer – however the basic equipment (wiresless button boxes, tap mats for the feet etc.) and the software licence cost $800.

A PubMed search for ‘interactive metronome adhd’ actually produces five hits! However, on closer inspection, all five articles are seriously compromised in some way – studies with no control group, or with very low numbers. Interestingly, one of the papers that pops up is one I’ve discussed before in reference to Brain Balance Centers. So, IM appears to form a cornerstone of what the Brain Balance guys (chiropractic, with a thin layer of neuro-woo laid on top) are pushing too. The IM guys have gone to a lot of trouble to make their approach appear scientific – there’s a well-populated ‘Science’ section on the website, that contains links to lots of articles, however, many of them are ‘white papers’ of uncertain provenance, and the rest are articles from obscure journals, or on barely relevant topics.

Another problem with IM is that it gets conflated with serious interventions. There’s a large field of study focussed on the use and effectiveness of musical-type interventions for a variety of neurological disorders (broadly, called Neurologic Music Therapy, or NMT) that has some solid research behind it. The slick marketing of IM seeks to conflate their approach with much more high-standard music-based therapy approaches.

In Prof. Thaut’s words (my emphases added):

First, where is the research? Studies that back up the clinical effect of IM directly, are very rare or nonexistent. A small study from 2001 is one that comes up repeatedly. One small study does not build clinical evidence. IM seems in general a well marketed but unresearched application. From a research point I see no evidence for the therapeutic benefit of IM.

Second, brain mechanisms in therapy work differently. Possibly to fill the research void IM generously includes ‘borrowed’ research that has nothing to do with their device. Since I am one of the authors they use I have to clearly  state that my brain research in music and rhythm does not address IM and our results do not support IM applications, neither with patients nor physiologically in explanatory brain mechanisms. The only forms of therapy in brain rehabilitation that work are active and specific exercises based on functional learning and training paradigms, not machine tapping. 

Last, rhythm has its own life. The claim that tapping to a metronome improves timing in patients which in turn transfers to all kinds of cognitive and motor improvements is not only unsupported by research but seems based on a misunderstanding. Rhythmic synchronization is a very complex process that fluctuates continuously on a millisecond level and is inherently unstable and variable. This time flexibility is the actual hallmark of functional entrainment. Therefore the IM definitions and measurements of what constitutes rhythmic improvement seem physiologically and functionally meaningless.

So, there you have it. If you’re concerned about your child’s sense of rhythm (for some reason?) you’d probably be much better off signing them up for dance classes, or piano lessons. It’ll almost certainly be cheaper, and they’ll likely have a lot more fun too.

Dietary supplement snake-oil neurobollocks

neurozanAs a wise lady once said, “If you want to sell something, stick a brain on it.” Or in this case, the prefix ‘neuro’. And then the suffix ‘zan’ – whatever the hell that’s supposed to mean. Neurozan dietary supplements are widely advertised in the UK, and the parent company, Vitabiotics, markets a bewildering variety of dietary supplements targeted at different demographic groups.  The Neurozan supplements come in two varieties, original and plus, with the only difference being the ‘plus’ version includes some omega-3 capsules as well. They retail at around £10 for 30-odd tablets. 

A pubmed search for ‘neurozan’ yields precisely zero results, so it appears that there’s no published work on the effects or effectiveness of these supplements. Despite this, the website proclaims ‘Each Neurozan® tablet combines all round nutritional support with a careful balance of vitamins and minerals based on a wealth of published research.’ They contain a long list of vitamins and minerals (the kind you normally find in any multi-vitamin supplement) plus a few ‘special’  ingredients such as gingko biloba and 5-HTP – both of which may actually be psychoactive compounds, but you’d need a considerably larger dose to see any possible effects. A good detailed discussion of the list of ingredients in Neurozan is available in this post on the Ministry of Truth blog.

The research on dietary supplements suggests that with very few exceptions (pregnant women, other people with specific medical conditions) taking a daily multivitamin supplement is unnecessary, as long as you’re generally healthy and eat a sufficiently varied diet (review papers: 1, 2, 3). To be fair to Vitabiotics they studiously avoid making any particularly egregious claims on their website about the effectiveness of Neurozan. They use typical weasel/marketing phrases like “[contains] important nutrients to help contribute to normal cognitive function”, which essentially mean nothing at all.

Other neuro-snake-oil merchants are much bolder in the claims they make though. FOCUSfactor pills are the same old blend of vitamins and fish-oils, yet claim to be ‘Clinically shown to improve memory, concentration and focus’. Hilariously, in tiny text at the bottom of the website are the words “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.” They’re very proud of a ‘clinical study’ that apparently showed improvements on a particular memory test after six weeks of taking their product, however the study’s never been published in any form, and the smart money says it probably never will be.

765There are hundreds more of these products available, with the only real difference between them being the aggressiveness of their advertising and the variety (probably some are more constrained by local advertising regulations than others) of maladies they claim to treat. Really, little has changed since the 19th Century days of Clark Stanley. As long as people can be induced to buy magic potions, unscrupulous people will make money selling them, the only difference now is that to be convincing, you have to put the word ‘Neuro’ on the bottle somewhere.

Utterly shameless diagnostic brain imaging neurobollocks

The impish Dr Amen, with (presumably) some fans. Wonder if he's planning on scanning their brains?

The impish Dr Amen, with (presumably) some fans.

Christian Jarrett’s article in Psychology Today (“Your 5-Step Self-Defence Program Against Neuro-Nonsense”) that I linked to in my previous post briefly mentioned diagnostic SPECT (Single-Photon Emission Computed Tomography) imaging, and the paper he cites (Chandler and Chatterjee, 2011 – open access – yay!) goes into some more detail about this particular brand of neurobollocks. After looking into it myself a little bit, I was absolutely stunned that some doctors a) had the gall to to continue offering these diagnostic methods and treatments to people, and b) that they were allowed to continue doing so by medical regulators (I guess that’s the USA’s free-market, laissez-faire approach to medical care – gotta love it!).

So, a little background. A common theme in neuroimaging research is attempting to identify differences in the brains between different groups of people. Male/female, musicians/non-musicians, schizophrenics/non-schizophrenics, whatever. This is all very interesting and worthwhile – if we can identify a common brain pattern or structure that is different in say, schizophrenia then we may be able to devise better treatments that target it. Voxel-based morphometry is one common method of looking at differences and assesses the relative size/shape of different brain structures, but there are lots of other methods that either look at anatomical or functional differences. The important point here is that you always need a group of people of each type that you want to compare. People’s brains vary pretty widely in the size and shape of the sulci and gyri, and in the amount/location of functional activity that you see in a given task. What is being sought in these studies is a reliable difference that is consistent across the group, and remains as a statistical effect, once all the (random) individual variation has been taken into account. Many people’s brains are a bit funny-looking, but 99 times out of 100 it’s just normal individual variation.

What this means is that developing imaging-based biomarkers that reliably indicate particular states or conditions in an individual is fraught with difficulty. Some progress is apparently being made in this endeavour, but a lot of people are still very sceptical about the idea, and rightly so.

However, Dr Amen, (of the eponymous ‘Amen Clinics‘) is certainly not one of those people. He’s been using diagnostic SPECT imaging for years, and has clinics in six major US cities. Dr Amen uses SPECT imaging to diagnose ADHD, anxiety, depression, addiction, autism, ‘marital conflict'(?!), and for generally healthy people who want to lose weight, or just ‘optimise’ their brain. How does taking a SPECT image of their brain help with this? It’s not really clear, but unsurprisingly, Dr Amen has a slick-looking brain-training-like program (‘The Amen Solution’) that promises all the usual bollocks, and an online store filled with his (many!) books, DVDs, etc. plus (of course) his own brand of dietary supplements. So, basically, I’m guessing that the results of the SPECT scans in his clinics typically indicate that the patient needs to complete a course of his brain-training, or supplements, or both.

Just to be clear – there’s absolutely no way that a SPECT scan of an individual can show up anything useful in diagnosing these disorders. Dr Amen is charging people thousands of dollars, and injecting them with radioactive substances, for absolutely no sound medical reason. 

Why use SPECT? The spatial resolution of the images is crap, and no-one uses it for clinical or research work that much anymore. However, it’s the cheapest of the 3D imaging techniques that can show functional activation. MRI scanners are expensive to buy and maintain, and need fairly large facilities. PET scanners use short-lived radio-isotopes, meaning you have to synthesise them yourself and use them immediately – you need a team of chemists and a well-kitted out laboratory. SPECT uses off-the-shelf isotopes with long half-lives; much, much cheaper and easier.

Dr Amen is a funny one, to be honest. Unlike the Brain Balance Center charlatans , he at least has some medical training and certification, and he publishes some research papers, occasionally even in peer-reviewed journals. He may perhaps be a true believer in what he’s doing, which makes him less mendacious but unfortunately also more stupid. Of course, where one quack leads others will follow, and copycat clinics have sprung up, also using SPECT, and claiming similar things; Dr SPECT scan, and CereScan are two of them. Dr Amen’s slick, media-savvy approach (he seems to be a regular on those dreadful audience-whooping, self-help TV shows they have in the US) marks him out as a serious operator though. Because he has some appropriate training, and has published some research, the Amen Clinics only gets a 9 out of 10 on the Neurobollocks rating scale; I know, I know, I’m just too generous sometimes, it’s a problem.

You can read more about the radiant Dr Amen and his techniques here, and there’s also an interesting Q & A with him over on QuackWatch.