Brain scans detect fibromyalgia

[natasa778]

Dr Goldberg has been using SPECT scans to guide treatments for his patients with autism for decades. He is a pediatrician who got 'into' treating autism through researching CFS pathology and treatments (his wife is a sufferer).

In this presentation he talks about SPECT scans a lot, also mentions overlaps with CFS a bit (more so in his book 'The Myth of Autism') http://www.tarzanacme.com/Video.aspx?Vid=158

 

[natasa778]

Hi, all.

Here's something I learned from Prof. Martin Pall a few years ago: SPECT scanning uses a radioactive form of the element technetium bound in a molecule that is injected, and then an image of the gamma ray emission from the brain is made. The resulting image is interpreted in terms of blood flow or perfusion of various parts of the brain. However, the oxidation state of technetium depends on the level of glutathione, and that affects whether the technetium stays inside cells or not, and thus affects the image. So a SPECT scan is not only sensitive to blood perfusion. It is also sensitive to the glutathione distribution. The recent study by Dr. Dikoma Shungu and colleagues has shown that glutathione is depleted in ME/CFS, in the part of the brain that was studied.

Best regards,

Rich

not sure if you are referring to specific SPECT study, but different molecules/procedures are used or have been used by different labs. Dr Goldberg covers some of it in the presentation, link above.

 

[richvank]

Hi Rich,

I don't exactly understand/ Are you saying that because of the depletion of glutathione the spect image will be skewed to the effect that it will not show abnormalities even if they exist?

Hi, Nielk.

What I mean is that the image will be affected both by the distribution of blood perfusion and by the variation of glutathione within the brain (and hence the variation of the redox status of the brain tissue) if the technetium isotope is used, so that it is probably not valid to interpret the image simply in terms of showing the distribution of blood perfusion, which is the way it has been interpreted. It is now possible to evaluate the glutathione levels in different parts of the brain, using special techniques with magnetic resonance spectroscopy. Separating the effects of these two variables in the SPECT scan may not be so easy, unless there are independent ways of determining the distribution of each. See the abstract below.

Best regards,

Rich


J Nucl Med. 1996 Aug;37(8):1413-6.
Oxido-reductive state: the major determinant for cellular retention of technetium-99m-HMPAO.
Jacquier-Sarlin MR, Polla BS, Slosman DO.
Source

Department of Radiology, UFR Cochin, Paris, France.
Abstract

Several clinical observations have suggested that HMPAO cerebral uptake might be related not only to regional cerebral perfusion but also to the nature of the lesion. Our aim was to investigate at the cellular level the nature of the process(es) involved in HMPAO accumulation in vitro.
METHODS:

Time-course incorporation of HM-PAO was studied in a fast-growing human premonocytic line, U937, in a human astrocytic-derived cell line, U373 and a human hybridized endothelial cell line, EaHy926. Minimal differences of HMPAO retention between these cell lines were observed and plateau of %U(HMPAO) (cpm cells/cpm standard of injected) were achieved within 2 hr. Because HMPAO cell retention was related to the intracellular content in glutathione, experiments studying effects of redox were conducted by preexposing U937 cells to D, L dithiothreitol or 2-Mercaptoethanol.
RESULTS:

Overnight incubation with NAC or BSO did not significantly modified the kinetic of 99mTc-HMPAO incorporation while overnight incubation with NAC resulted in a 2-fold increase in intracellular glutathione content and overnight incubation with BSO nearly abolished the intracellular glutathione content. At the opposite, presence of these reducing agents in the medium during the experiments completely abolished 99mTc-HMPAO retention.
CONCLUSION:

Our data thus provide in vitro evidence to support that overall intracellular retention of HMPAO is more dependent upon the redox activity of the tissue than the intracellular glutathione content. SPECT-HMPAO may accurately reflect regional cerebral blood flow in a normal state but possibly not in all pathological situations in which cell metabolism disturbances are characterized by alterations in the redox status.

PMID:
8708786

 

[PNR2008]

In 1992 I had a spect scan ordered by Jay Goldstein MD. Dr Ismael Mena was doing a study and my conclusion was "findings suggestive of chronic myalgic encephalomyelitis". This was 20yrs ago!!!!!!! Dr Mena's work is very interesting and he did not approve of GET. What does it take?

 

[Foggy]

I had a brain SPECT scan last year - I have hypoperfusion of the frontal lobes.

Explains the zombie state I'm constantly in :Retro roll eyes:

But its good that they've finally found a test for FM only sufferers.

 

[RustyJ]

I had a brain SPECT scan last year - I have hypoperfusion of the frontal lobes.

Explains the zombie state I'm constantly in :Retro roll eyes:

But its good that they've finally found a test for FM only sufferers.

Hi Foggy. Was the scan useful for diagnosis and was any treatment offered?

 

[PNR2008]

This is going back in time but has anyone had a BEAM scan?

 

[natasa778]

Hi Foggy. Was the scan useful for diagnosis and was any treatment offered?

fwiw dr Goldberg uses antivirals first followed by low dose SSRIs specifically for hypoperfusion, discussed in presentation...

 

[RustyJ]

fwiw dr Goldberg uses antivirals first followed by low dose SSRIs specifically for hypoperfusion, discussed in presentation...

Thanks for info Natasa. I asked Foggy because he is in Oz, like me, and I am curious about whether anyone here is taking any notice of scans. In my experience they ignore them.

 

[MishMash]

Brain scans are just one "experimental" test that prove, without a doubt, that our immune systems are whacked. Cheney, Klimas, et al, do myriad immunological tests which show huge variations/problems in the results of most ME/CFS patients.

Back in the early nineties I asked a physician to do certain "experimental tests", and was told "even if the tests are positive, nothing can be done about it!" Ahhh, the wonderful wilderness years of the 80s and 90s. We were so popular with the doctors, weren't we....

There is a certain amount of truth in this; if you have "brain hypoprofusion" what can really be done about? Like the rest of you, in the absence of any other data, I choose to know, primarily to prove to the other skeptical doctors that something is wrong. Proving you have ME/CFS is likely proving to a skeptics convention that there were no shooters on the grassy knoll.

 

[Nielk]

I had a spect scan done 4 weeks ago. The following is the result.

- dimished activity in the subfrontl region bilaterally on baseline study
- slightly dimished activity in the temporal lobes bilaterally
- scalloping of the parietal lobes bilaterally
- increased uptake in the basal ganglia and thalamus bilaterally

otherwise, I'm normal - ha

 

[Gamboa]

I had a spect scan done 4 weeks ago. The following is the result.

- dimished activity in the subfrontl region bilaterally on baseline study
- slightly dimished activity in the temporal lobes bilaterally
- scalloping of the parietal lobes bilaterally
- increased uptake in the basal ganglia and thalamus bilaterally

otherwise, I'm normal - ha

Hi Nielk,

What do the results mean? You obviously have diminished activity in certain areas but does this mean you have ME or could it be something else? Did the report and/or your doctor explain this further?

I just had a SPECT scan done in Toronto on Monday so I am especially curious about what the results mean.

Gamboa

 

[August59]

The SPECT scan process or maybe more appropriately processes are the part of the system that is going through most of changes right now and that is a good thing because we certainly want that part of the system to at it's highest possible accuracy. As Rich noted about the glutathinone situation and it is certainly a valid concern, but one that we would certainly want either compensated for with possibly a newer contrast material or it could come down to something as simple as a co-efficient number changed in the MRI scanner to compensate for it. My point is that while SPECT scan or fMRI's have been around for awhile they have typically been research equipment for the most part, but know that they are getting much closer to being a diagnostic procedure. It may very well become one of the most important procedures for us in a couple of years and I certainly want it to be as accurate as it can possibly be. I'm very glad to the SPECT process working so well for other diseases as well.

I would certainly be interested in having one, but not unitl it is ready and capable of finding any and everything it could that would contribute to a possible cure or at least bring the doctors to developing a better treatment plan for me.
Of course I would be very willing to contribute my heading for scannig that may advance our learning of this horrible disease.

 

[Enid]

There does seem to be various "descriptions" of what precisely is going on - my Neurologist (from my brain MRI scan) spoke of "high spots"- blood flow or what ? I think more clearly now so nothing permanent. Looking forward to hearing of any treatments though to improve the situation.

 

[mtnbibliophile]

Can anyone recommend a good place in NYC to get a SPECT scan done? My doc says the folks at Columbia-Presbyterian never seem to spot any hypoperfusion.