ADHD Testing – Now Comprehensive and Biomedical

ADHD Testing and Evaluations Rapidly Evolve With New Technology – Astrocytes Matter

Those of you who closely follow CorePsych Blog and the many

frustrated/dismayed ADHD treatment/medication comments here already appreciate the abyss of misunderstanding about ADHD that exists in both public and academic perceptions. Diagnosis by appearances, diagnosis by looking at the patient and simply running a tape rule on the way they look [asking teachers because the public can't get it] is clearly, mercifully, on the  wane. ADHD testing provides many new possibilities. Neuroscience evidence dramatically changes our ADHD thinking in spite of the petulant institutionally frozen naysayers looking to keep tenure.

ADHD Testing | Beyond Snake Oil

Ever since learning about SPECT functional brain scan evidence, and, having seen thousands of challenged brains through my own SPECT lenses, my ADHD diagnostic world changed – even though the self-important national expert on ADHD [Joseph Biederman MD] “from Harvard” sarcastically remarked that using scans diagnostically was similar to the application of snake oil. “Charlatan” was the word he used to describe Daniel Amen MD, international thought leader on the application of Brain SPECT imaging for psychiatric diagnostic purposes. Sorry Joe, brain information has passed you by, as you have clearly missed this essential point: collaboration counts, listening counts, and new neuroscience evidence clearly finds a useful place in everyday office practice, – in spite of your less-than-visionary proclamations.

Beyond SPECT Brain Imaging

I continue to use SPECT brain evidence, especially in specific cases, e.g. Traumatic Brain Injury, Dementia, Differential Diagnosis in complex presentations. SPECT usefulness, its straightforward utilitarian value, is without doubt. But the limitations of SPECT are several:

1. Cost – Amen now charges 3500$ – [my fee for two – resting and active –SPECT scans is 17% less – but I use his Clinic cameras].
2. The reader of the SPECT may not have a clue – rare to find a deep psych/brain reader – nuclear med guys don't see the psych applications. But, even more importantly, many of the psych SPECT readers don't understand presynaptic, pre-presynaptic, and extrasynaptic psychopharmacology – and completely miss the application process – the mix of meds and neurotransmitter precursors.
3. Most SPECT readings are still macro – deals with blood flow and cerebral metabolic patterns – but not the specific cause of the unbalanced metabolism.
4. Most SPECT doesn't cover specific neurotransmitters, specific immune dysfunction, specific hormone dysregulation – all significantly affect brain function, emotional and cognitive life. SPECT measurement of specific neurotransmitters costs even more.

ADHD Assessment Evolves

Those astrocytes in the photo, dear readers, make a difference in ADHD evaluation. Blood Brain Barrier activities make a difference. Immune system problems effect astrocytes, and astrocytes effect cognitive function, they affect neurotransmitter balance far more than psych meds do, and astrocytes are merely part of the deeper problem of biomedical imbalance. So how does one begin to translate the multiplicity of rusty connections? Ref: The Handbook of Child Neuropsychology: Child Neurophysiology pg 764

With SPECT brain imaging you can see the metabolic outcome, but the informed mind in 2011 seeks the underlying metabolic cause of the ADHD… not simply the brain representation of the underlying cause. Ring of Fire [Amen's term for diffuse cortical hyperperfusion/hypermetabolism] announces much more cellular activity than the suggested outdated bipolar disorder.

Only 161 ADHD Comorbidities?

An interesting, informed reporter on the multiple comorbid conditions associated with ADHD, Tess Messer PA, recently posted a very interesting piece in this regard. – Not on just 6 brain SPECT subtypes of ADHD, but 161 Biomedical Subtypes/Causes of ADHD Appearances. [Updated to 171 subtypes!] The ADHD world has suddenly mushroomed into a much larger complexity, requiring more comprehensive assessment to understand contributory factors, such as those astrocytes 😉 . Deeper testing matters.

Immune, Endocrine and Neurotransmitter Testing – See NEI Below

The good news is that many labs offer specific suggestions, training, and interesting new information avenues to available biomedical evidence. Evidence from these various labs dramatically improves outcomes for all those comorbid conditions, in spite of the fact that some academicians haven't caught up with the process.

I use a variety of labs at CorePsych, and with these new investigations regularly turn up easily correctable challenges. This link shows the multiplicity of biomedical factors and measurable biomarkers that can significantly contribute to ADHD symptoms. Refractory, complex cases often become surprisingly simple with this available information – and you don't have to drive to Va Beach for me to send you a test kit [I don't add any $ to the test kits]. – We can then review the lab findings by phone and communicate with your local doc – or you can see me to write for meds in the VB office.

Getting Started With New Information – Basic Info on Testing

1. Gut and Brain: Why do I always ask about Transit Time and #2? Immune Dysfunction – Accessible through IgG testing is available and paid by most insurances here: NeuroScience IgG for 110 food antigens that can contribute to any brain symptoms from ADHD to Bipolar to Autism – this is a blood draw, and they can come to your home to draw the blood.
2. Hormones and Brain: Why do I always ask about energy, menses, breast pain and thyroid function? Why not test the thyroid, estrogen, testosterone, cortisol and DHEA? Hormone testing here: Endocrine and Neurotransmitter Testing Options.
3. Urinary neurotransmitter testing reviewed in this [Neuroscience and Biobehavioral Reviews] pdf  – and testing is here: NeuroScience Neurotransmitters.
4. For a testing overview see these general remarks about the NEI Testing Protocols.

These tests get us started on the journey, and often one or two of these are all we need. Yes, meds can be used whilst doing the testing as we look for what isn't working in spite of medical interventions already underway. Many other options are available, but this post is to simply open the door on the full discussion so often needed on the hundreds of ADHD comments at CorePsych Blog over the years.

Bottom Line:

ADHD Medications Don't Work Predictably – If Biomedical Problems Continue

See These Video Playlists For Details:

ADHD Meds Tutorial – Overview: http://bit.ly/medstutorial 
ADHD Meds Dosage: http://bit.ly/dosevids
ADHD Meds Problems – Mind and Gut: http://bit.ly/mindgut 
ADHD Meds & Allergies – Milk and Wheat: http://bit.ly/mawimmun
ADHD Meds & Allergies – Street Immunity: http://bit.ly/IorWJs

cp
Dr Charles Parker
Author: New ADHD Medication Rules – Brain Science & Common Sense

Related articles

• Pitfalls in the Diagnosis of Adult ADHD (brainposts.blogspot.com)
• Brain scans show children with ADHD have faulty off-switch for mind-wandering (sciencedaily.com)
• Insight into ADHD and Conduct Disorder (brighthub.com)
• Changing the name of ADHD? (myaddblog.com)
• ADHD Children Have Nearly 4 Times Higher Risk for Suicide Attempts and Depression (adultaddstrengths.com)
• Having Some Visible Diagnostic Criterion Which More Clearly Differentiates Having ADHD From Not Having ADHD (adultaddstrengths.com)
• ADHD Now, Dementia Later? (webmd.com)
• ADHD Treatment Video: Comprehensive Reviews Matter (corepsychblog.com)
• Antidepressants Do Work – Gossip Doesn't (corepsychblog.com)
• ADHD Medications: Your Medical Team (corepsychblog.com)