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The Science of Brain Spect Imaging

From Amen Clinc Inc.

Brain Pollution and the Real Reason You Shouldn’t Use Drugs
Studying the effects of drugs and alcohol on the brain has clearly been one of the most informative and fascinating parts of my work. I had a sense growing up that drugs and alcohol weren’t helpful to my overall health. I might add, this notion was helped along by getting drunk on a six pack of Michelob and half a bottle of champagne when I was sixteen years old – I was sick for three days. After that, I’ve been lucky enough to stay away from drugs and alcohol. After doing this work there’s no way you could get me to do marijuana, heroin, cocaine, methamphetamine, LSD, PCP, inhalants or any more than a glass or two of wine or beer. These substances damage the patterns in your brain, and without your brain you are not you.
There is really quite a bit of scientific literature on the physiological effects of drug abuse and alcohol on the brain. SPECT Scans have demonstrated a number of abnormalities in substance abusers in brain areas known to be involved in behavior, such as the frontal and temporal lobes. There are some SPECT similarities and differences between the damage we see caused by the different substances of abuse. I’ll discuss the differences in drug abuse patterns below. There tends to be several similarities seen among classes of abused drugs. The most common similarity among drug and alcohol abusers is that the brain has an overall toxic look to it. In general, the SPECT Scan studies look less active, more shriveled, and overall less healthy. A "scalloping effect" is common amongst drug abusing brains. Normal brain patterns show smooth activity across the cortical surface. Scalloping is a wavy, rough sea-like look on the brain’s surface. I also see this pattern in patients who have been exposed to toxic fumes or oxygen deprivation. My research assistant says that the drug brains she has seen look like someone poured acid on the brain. Not a pretty site.
SPECT can be helpful in evaluating the effects of drugs and alcohol on the brain. On 3D surface brain images, several substances of abuse appear to show consistent patterns. For example, cocaine and methamphetamine abuse appear as multiple small holes across the cortical surface; heroin abuse appears as marked decreased activity across the whole cortical surface; heavy marijuana abuse shows decreased activity in the temporal lobes bilaterally and heavy alcohol abuse shows marked decreased activity throughout the brain. These findings tend to improve with abstinence, although long term use has been associated with continued SPECT deficits seen years after abstinence. SPECT can be helpful in several ways in drug and alcohol abuse. First, 3D surface SPECT brain images of drug and alcohol abusers can be used in drug prevention education. Second, SPECT studies can help break though the denial that often accompanies substance abuse. When one is faced with their own abnormal cerebral perfusion it is hard to remain in denial. Third, SPECT may help evaluate if there is an underlying neuropsychiatric condition that needs treatment.
Effects of Smoking Marijuana
In our experience, the effects of smoking marijuana use typically cause decreased activity in the posterior temporal lobes bilaterally. The damage can be mild or severe, depending on how long a person used, how much use occurred, what other substances were used (nicotine is a powerful vasoconstrictor) and how vulnerable a particular brain is. For more information see Dr. Amen’s article High Resolution Brain SPECT Imaging in Marijuana Smokers with AD/HD, Journal of Psychoactive Drugs, Volume 30, No. 2 April-June 1998. Pgs 1-13.


ide Effects of Smoking Marijuana, 3 years
18 y/o – 3 year history of 4 x week use
underside surface view
decreased pfc and temporal lobe activity

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ide Effects of Smoking Marijuana, 2 years
16 y/o — 2 year history of daily abuse
underside surface view
prefrontal and temporal lobe activity

ide Effects of Smoking Marijuana, 12 Years
38 y/o — 12 years of daily use
underside surface view
decreased pfc and temporal lobe activity

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ide Effects of Smoking Marijuana, 10 years weekend use
28 y/o — 10 years of mostly weekend use
underside surface view
decreased pfc and temporal lobe activity

Side Effects of Marijuana Off and On


ide Effects of Marijuana, Off, Underside View
underside surface view, off THC
decreased pfc and temporal lobe activity

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ide Effects of Smoking Marijuana, On, Underside View
underside surface view, on THC
severe overall decreased activity

ide Side Effects of Smoking Marijuana, Off, Underside View
underside active view, off THC
increased deep left temporal lobe activity

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ide Effects of Smoking Marijuana, On, Underside View
underside active view, on THC
overall calming of activity

ide effects of Smoking Marijuana, Off, Top View
top-down active view, off THC
patchy increased uptake

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ide Effects of Smoking Marijuana, On, Top View
top-down active view, on THC
overall calming of activity

This 57-year-old physician had abused marijuana for 30 years. We performed this SPECT series because he had been unable to stop using without feeling very angry, irritable, agitated and anxious.
The first study (those images in the right column) was performed after he came to the clinic intoxicated from 3 straight days of heavy usage. The second study (those images in the left column) was performed after he abstained from marijuana usage for 1 month.
Notice the study without marijuana shows decreased temporal lobe activity (likely from the chronic marijuana usage), but also patchy increased uptake, especially increased activity in the deep left temporal lobe (often associated with anger, irritability and anxiety). The study with heavy marijuana usage shows marked overall decreased activity, especially in the prefrontal cortex and temporal lobes (associated with attention, memory and motivational problems) but also there is a decrease in the overactive areas noted in the "off marijuana" study.
This scan series argues for the possibility of "self-medication," but unfortunately this medication has the side effect of causing the potential for long term damage to his brain.
Long Term Effects of Heroin & Methadone


ormal Brain Image
Normal view
top down surface view
full, symmetrical activity

ong Term Effects of Drug Abuse (Heroin)
39 y/o — 25 yrs of frequent heroin use
front on surface view
marked overall decreased activity

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ong Term Effects of Heroin and Methadone
40 y/o, 7 yrs on methadone
heroin 10 yrs prior
top down surface view
marked decreased overall activity

Long Term Effects of Cocaine & Methamphetamine


ffects of Drug Abuse (Meth)
52 y/o – 28 yr hx frequent meth use
top down surface view
multiple holes across cortical surface

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ffects of Drug Abuse (Cocaine)
24 y/o — 2 yr hx of frequent cocaine use
top down surface view
multiple holes across cortical surface

ffects of Heavy Meth use
28 y/o – 8 yrs heavy meth use
front on surface view
marked overall decreased activity

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ong Term Effects of Meth
36 y/o, 10 years frequent meth
top down surface view
multiple holes across cortical surface

Effects of Long Term Alcohol
38 y/o – 17 years of heavy weekend use


ong Term Effects of Alcohol, Top View
top-down surface view

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ong Term Effects of Alcohol, Underside View
underside surface view

ong Term Effects of Alcohol, Front View
front on surface view

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ong Term Effects of Alcohol, Right Side View
right side surface view

marked overall decreased activity

Alcohol Abuse and Brain Trauma


PECT Scan Image Underside
underside surface view

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PECT Scan Image Front
front on surface view

48 y/o — 22 years of daily use with history of past head injury
marked scalloping overall decreased activity

PECT Scan Image Underside Surface
44 y/o — 18 years of daily use
underside surface view
marked overall decreased activity

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45 y/o — 25 year history of daily abuse
underside surface view
marked overall decreased activity

Hope for Healing Alcohol, Drug Abuse, Cocaine & Meth On and Off Drugs and Alcohol
Effects of drug abuse and alcohol abuse vs one year substance free


ffects of Drug Abuse and Alcohol Abuse, Top Surface
top-down surface view
during substance abuse

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rug and Alcohol Free One Year , Top Surface
top-down surface view
a year drug and alcohol free

ffects of Drug Abuse and Alcohol Abuse, Underside
underside surface view
during substance abuse

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ne year free from Alcohol and Drug Abuse
underside surface view
a year drug and alcohol free

notice the overall holes and shriveled appearance during
abuse and marked improvement with abstinence

Effects of Heavy Nicotine & Caffeine Abuse
45 y/o — 27 year history of heavy use
Smoking 3 packs of cigarettes and drinking 3 pots of coffee daily


ong Term Effects of Smoking Nicotine
underside surface view
marked decreased overall activity

 


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