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.
You keep using this word ‘neuroplasticity’. I do not think it means what you think it means.
So, I wanted to write a post about how the word ‘neuroplasticity’ is the current neuro-bullshitter’s favourite big sciencey-sounding word to throw around these days. I was going to explain how it was actually such a broad umbrella term as to be pretty meaningless, and talk about some things like LTP and synaptogenesis in the hippocampus which (in contrast) are precise, well-defined terms, and fascinating processes, and how your brain is changing in a ‘plastic’ manner even as you read these words. It was really going to be a great post.
Unfortunately (as so often seems to happen), it turns out that the mighty Vaughan Bell beat me to it by a scant three years with this typically outstanding post on mindhacks.com. So. I guess you should all just go and read that instead, and I’ll have to be content with my standard operating procedure and take the piss out of some quacks instead.
The ‘About the Science’ section of the Brain Balance Centers main website has some awesomely meaningless language, that manages to work in some other big sciencey-sounding word too:
“It was once thought that the brain was static, unable to grow or change. But extensive research and in depth study of epigenetics has shown that it’s remarkably adaptable, able to create new neural pathways in response to stimulus in the environment, a branch of science called neuroplasticity.”
Ooh – epigenetics, and neural pathways. Fans of meaningless brain cartoons should definitely check out that site too, their disconnected vs. connected diagram is fabulous.
The Lumosity website (a brain-training company) has some pretty choice language too:
“But when neuroplasticity’s potential is thoughtfully and methodically explored, this physical reorganization can make your brain faster and more efficient at performing all manner of tasks.”
There are lots of other examples I could paste in here. I spend a fair amount of time looking at these companies’ sites and I’ve come to the conclusion that any mention of the word ‘neuroplasticity’ is basically a massive red-flag. People are very fond of using it to promote these things, but mostly their arguments boil down to “Because: neuroplasticity!”, which as Vaughan explained so eloquently, doesn’t mean anything at all without a whole additional layer of explanation, refinement and qualification.
So – a top tip, when you see the word ‘neuroplasticity’ think ‘bollocks’ instead. 99% of the time you’ll be absolutely dead-on.
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