The Society for Nuclear Imaging officially recognizes only four common indicators for the clinical use of SPECT: to detect and evaluate strokes, brain trauma, and suspected dementia (a recent article says that brain scans like SPECT can predict Alzheimer's disease nine years before people have symptoms), or to locate focal points of epileptic-seizure activity. But SPECT has been used in a huge and highly eclectic number of research studies on almost every conceivable psychiatric and neurological condition, as well as some nonpsychiatric studies, like measuring the impact of meditation and prayer on blood flow to different brain areas.
The lecturer at Amen's hospital, a local nuclear physician named Jack Paldi, showed brain images of patients with depression, dementia, schizophrenia, and head trauma, comparing them with normal brains. Using these amazing images, Paldi tried to demonstrate that one could actually see the differences between brains that worked well and those that didn't, see how medications changed the way brains functioned and where those changes occurred. In this rush of graphically astonishing images, Amen thought he could begin, finally, to understand why some of his patients just couldn't seem to benefit from therapy or get their lives in order, no matter how hard they tried. It wasn't psychological resistance or personality type or deep-seated unconscious motives that kept them from getting better: it was simply that the software of their brains wasn't up to speed!
"I was absolutely blown away," remembers Amen, who took up Paldi's offer to do no-cost SPECTs on interested physicians and, six months later, got one himself. Shortly after the lecture, however, he ordered 10 scans on particularly difficult patients, which, according to Amen, resulted in "literally miraculous changes" in five of them. One patient was a 12-year-old boy with a nasty temper, a history of aggression, and school failure, who'd been hospitalized three times, prescribed assorted drugs (including Ritalin, which made him hallucinate), and treated with two years of psychoanalytic therapy. The scan showed low temporal-lobe function (associated, as in Kip Kinkel's case, with anger, violence, and mood swings), as well as frontal-lobe problems (which kept him from being able to concentrate in school). Amen placed him on mood stabilizers and a different stimulant, and voila! Within three weeks, he became milder tempered, began making friends, and, says Amen, "turned into the sweetest boy you'd ever want to meet." His school performance improved dramatically as well.