Brain Maps for Diagnose and Treatment

[Margaret Webb]

Hello,
I am curious about differences in outcome for autistic kids using Spect Scans vs QEEG for diagnoses and treatment. And, if anyone in this group may have some experience with comparing the two modalities? We are considering one or the other for our 16 year old with Aspergers and PANDAS. Her biggest issues are attention, irritability, and some OCD behaviors.

Thanks in advance!
Margaret Webb

[DrWoeller]

Margaret,
I don’t have a lot of comparison data. I like both tests, but I have seen where the Spect Scan shows the obvious areas of inflammation and dysfunction, but the QEEG gets at things from a more electrical functional standpoint. At least from the QEEG they can determine which wave activities are dysfunctional, i.e. alpha, theta – and I am assuming can initiate some neurofeedback type of intervention.

Sincerely,
Dr. Woeller

[Todd Roach]

If both is not a possibility, I would lean more to the QEEG. My analogy is a computer, the Spect will show hardware issues, the QEEG shows software issues. You already know there is inflammation of CNS tissues, so I lean more towards a QEEG to start making functional improvements. I have compared the two many times and from a treatment standpoint I always prefer the QEEG information, especially with behavioral tendencies of ADHD, irritability and OCD (as you have stated). These really scream connectivity issues. Really suspecting high theta wave activity with frontal lobes (F3 and F4, Fp1 and Fp2). Once you are able to biochemically improve neurotransmitter production and turnover (genetics, OATs, nutrition), training to increase beta wave activity and balance frontal lobes (when comparing wave activity) will work incredibly well. Also monitoring High beta activity at Fz is key. Of course this is only my opinion.
Also, do not get too caught up with databases and that junk. With PANDAS, her brain function is her brain function. Please do not let anyone convince you of comparing her brain to a database. With the inflammatory aspect, I recommend comparing apples to apples, not apples to oranges. I have seen things go bad when training NFB to match a database. Again, my humble opinion.

[DrWoeller]

Todd,
Thanks for your input.

Can you explain a little more about what these databases are with regards to NFB? I am assuming NFB is neurofeedback?

Sincerely,
Kurt Woeller, D.O.

[Todd Roach]

No problem! So there are normative databases that a lot of people use during nfb (neurofeedback) training and/or comparing QEEG results. I have used a lot of these in practice with z-score training. I personally have several concerns with this. My first concern is if there is a normative database that we should all use, then why is there more than one? And these things are not cheap. There are at least three different databases that everyone is selling. The other is that just because someone does not meet DSM criteria for a psychological diagnosis, it does not mean they are “normal”. With the rates of chronic disease and mental health disorders, I think it is hard to find anyone “normal”. This is my opinion of course and I have no affiliation with any company. In my experience, all the negative nfb reactions I have ever had with patients have come from z score training pushing someone’s brain to match their age appropriate database criteria or setting up treatment plans based on database criteria. The “one style fits all” type of thinking. Not my personal cup of tea and I learned this the hard way. I hope this helps!

[Margaret Webb]

Thank you both! Since we are concurrently working with diet and functional lab testing as well, I am leaning towards using the SPECT as a back up test if we cannot get things to shift with the QEEG, pharmaceuticals, and diet/supplements she is on. And, Dr Roach, thanks for the heads up about the database issue.

I did wonder about the contrast dye (SPECT) and how that material may effect the inflammation and irritation that is already present in the brain. Do either of you have any thoughts about the effect of the dye itself and/or a good supplement protocol to help detox post procedure if we do decide to get the scan?

Thanks Again,

Margaret

[DrWoeller]

Margaret,
Unfortunately, I don’t know about the dye or if anything proven would be helpful against it or detoxify it. What comes to mind for me is glutathione and liver support.

Dr. Woeller

[DrWoeller]

Todd,
Thanks so much. I like your approach in making intervention for people personalized instead of the “one size fits all” approach.

Dr. Woeller

[Todd Roach]

I tend to really focus on liver detox with clearing the dye from the scan. If you have a current OATs you can look at 4-hydroxyphenyllactic acid for a loose evaluation of Phase I detox as well as B vitamins, glutathione, etc. and combine this with genetic info including MTHFR, DHFR, FOLR, and especially MTRR.
Also, loose eval on Phase II function on OATs with Orotic Acid (high to high normal) as well as amino acid metabolites, so may need Phase II support to help clear dye as well as everything else. Also, with genetics handy, supporting any CBS, SOD2, NAT2, and NOS2 SNP’s. Also, HUGE factor of looking at Vitamin D so phosphoric on OATs and VDR SNP’s. I am seeing Vit D issues in a lot of PANDAS/PANS cases. Again, these are my thoughts and they may be different from Dr. Woeller’s recommendations.

[Margaret Webb]

Great! Thank you. That is really helpful!

[DrWoeller]

Todd,
Great recommendations.

Also, one thing about the 4-hydroxyphenylacetic acid is the potential link to SIBO. The orotic acid is often high with high ammonia, most likely gut derived, but could be a urea cycle issue to. I completely agree with the Vitamin D and phosphoric acid link.

Sincerely,
Dr. Woeller

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