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NIMH · Brain Scans ? Not Quite Ready for Prime Time
Dr. Thomas Insel, the director of the National Institute for Mental Health, characterizes brain imaging as “still primarily a research tool.” He cautions that “entrepreneurial zeal capitalizing on scientific advances needs to be tempered by reality checks.”
The differences in brain structure and activity seen in disorders like schizophrenia or ADHD, for example, are typically only meaningful when comparing group statistics.
There is simply too much individual variation in brain structure and function for an individual's scan to be diagnostic or predictive, given the current state of the science.
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Experts in the field:
None of the nation’s most prestigious medical organizations in the field — including the APA, the National Institute of Mental Health, the American College of Radiology, the Society of Nuclear Medicine and Molecular Imaging and the National Alliance on Mental Illness —
validates his claims.
No major research institution takes his SPECT work seriously.
“In my opinion, what he’s doing is the modern equivalent of phrenology,” says
Jeffrey Lieberman, APA president-elect, author of the textbook “Psychiatry” and chairman of Psychiatry at Columbia University College of Physicians and Surgeons. (Phrenology was the pseudoscience, popular in the early 19th century, that said the mind was determined by the shape of the skull, particularly its bumps.) “
The claims he makes are not supported by reliable science, and one has to be skeptical about his motivation.”
“I think you have a vulnerable patient population that doesn’t know any better,” says
M. Elizabeth Oates, chair of the Commission on Nuclear Medicine, Board of Chancellors at the American College of Radiology, and chair of the department of radiology at the University of Kentucky.
“A sham,” says
Martha J. Farah, director of the Center for Neuroscience & Society at the University of Pennsylvania, summing up her thoughts on one of Amen’s most recent scientific papers.
“I guess we’re all amateurs except for him,” says
Helen Mayberg, a psychiatry, neurology and radiology professor at Emory School of Medicine and one of the most respected researchers into depression and brain scanning. “He’s making claims that are outrageous and not supported by any research.”
“I can’t imagine clinical decisions being guided by an imaging test,” says
Steven E. Hyman, former director of the National Institute of Mental Health and current director of the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard.
The APA, in fact, has twice issued papers that dispute “claims being made that brain imaging technology ... was useful for making a clinical diagnosis and for helping in treatment selections.”
The most recent paper was published last month. It was the work of 12 doctors who spent three years assessing the latest research. The summary: “There are
currently no brain imaging biomarkers that are currently clinically useful for any diagnostic category in psychiatry.”
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