Sierra Tucson implemented Brain SPECT (Single Photon Emission Computed Tomography) Imaging in 2009 to expand our neuroscience capability. Functional brain scanning, which produces vivid, real-time pictures of brain physiology, is an innovative tool that can provide helpful diagnostic data, enable more targeted therapies, and enhance patient motivation for treatment.
SPECT Imaging can be utilized for any of Sierra Tucson’s programs, including Addictions, Eating Disorders, Mood and Anxiety Disorders, Pain Management, Trauma Recovery, or the Assessment & Diagnostic Program. This service is offered selectively and when clinically indicated to help understand specific brain patterns to further assist in evaluation and treatment.
Brain SPECT scanning generates colorful, three-dimensional images of blood flow in the brain, which relates to actual brain physiology. Sierra Tucson’s Medical Director stated, “In experienced hands, Brain SPECT Imaging provides clinically useful information on how an individual’s brain functions, particularly in complex or treatment-resistant cases. This more complete diagnostic picture adds biological information to the presenting problem, often helping to inform treatment planning.”
For patients, SPECT studies help them break through denial. When faced with abnormal brain SPECT scans, patients find it harder to minimize the impact of drug or alcohol use. A SPECT scan helps patients see their problems from a medical point of view, thus reducing shame and guilt.
One of the ways SPECT is helpful to patients is when it shows pre-frontal cortex (PFC) abnormalities. This is actually a very common finding, and one that is easily visualized by patients. The PFC serves a very specific function: it helps our brains orchestrate goal-directed behavior. It’s the part of our brain that helps intention guide behavior, by coordinating thoughts and actions in the service of our goals. It does so by:
There is “competition” in brain processing, where different pathways compete for expression via behavior; the winners are those with the strongest sources of support. For example, in substance abuse recovery, a person is said to be still “in their disease” when they are unable to sustain a healthy recovery mindset and related set of behaviors—whether they are actively using or not.
But is being “in their disease” always related to “willfulness run riot” (motivational and control issues), or could there be something in their brain which makes it difficult for them to manage impulses that are contrary to their stated long-term recovery goals?
At Sierra Tucson we find that many of our chemical dependency and dual-disorder patients have extremely damaged frontal lobes (see second image):
|Frontal Lobe Damage
Thus, SPECT images give patients a way of understanding part of why they struggle to make healthy choices. Their brain has largely lost its ability to filter out unhealthy impulses, even when they are consciously motivated to achieve long-term recovery.
Instead of making decisions that track to healthy, long-term, sustainable gains, they cannot resist the temptation of immediate gratification, and give into activities that satisfy their brain’s hunger for short-term thrills, like renewed drug/alcohol abuse, compulsive and illicit sex, or other defeating behaviors.
In that context, the SPECT images facilitate healthy conversations with patients about what their long-range goals really are and what is required to achieve them. Functional brain imaging is helping us to ask better questions and initiate more powerful conversations with our patients.
In summary, SPECT imaging is useful because it helps inform the doctor about how the patient’s specific brain is functioning—what is working well, and what is not working so well. Information from this neuroimaging can assist the multidisciplinary treatment team in developing the very best possible individualized treatment plan.