Longitudinal Single Photon Emission Computed Tomography Neuroimaging as an Indication of Improvement in Psychiatric Disorders in a Community Psychiatric Practice

• Published in: Frontiers in psychiatry Vol. 13; p. 787186
• Main Authors: Thornton, John F, Schneider, Howard, Cohen, Philip F, DeBruin, Simon, Uszler, John Michael, Siow, Yin-Hui, McLean, Mary K, van Lierop, Muriel J, Pavel, Dan G, Henderson, Theodore A
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 25-03-2022
• Subjects: attention-deficit hyperactivity disorder; biomarker; neuroimaging; post-viral syndrome; Psychiatry; SPECT; traumatic brain injury; attention-deficit hyperactivity disorder; traumatic brain injury; post-viral syndrome; biomarker; SPECT; community psychiatry; neuroimaging
• ISSN: 1664-0640; 1664-0640
• DOI: 10.3389/fpsyt.2022.787186

In the community, there is a need to more objectively evaluate the response of common chronic psychiatric disorders to treatment. Brain single photon emission computed tomography (SPECT) indirectly measures cerebral functional activity by uptake of a radiotracer, which follows regional cerebral blood flow. Brain 3D Thresholded SPECT scans are thresholded three dimensional images derived from brain SPECT data. A retrospective community study of longitudinal (before and after treatment) brain 3D Thresholded SPECT scans of 73 patients with all-cause psychiatric disorders (most frequent diagnostic clusters: attention-deficit hyperactivity disorder, post-mild traumatic brain injury, affective disorders, psychotic disorders, post-viral chronic syndromes), shows these baseline SPECT scans predict improvement (non-worsening to large improvement) in clinical functioning with a sensitivity of 94% (95% confidence interval 86-98%) and a specificity of 67% (95% confidence interval 21-94%). In contrast, contemporaneous analysis by the same radiologist of conventional 2D reading of the same before and after treatment brain SPECT scan data of the same 73 patients, predicted improvement (non-worsening to large improvement) in clinical functioning with a sensitivity of only 26% (95% confidence interval 17-37%) although with a specificity of 100% (95% confidence interval 44-100%). These data suggest 3D Thresholded SPECT scans can provide the clinician with a more objective measure for verifying improvement in psychiatric disorders seen in the community, consistent with prior studies of SPECT as a measure of neurobiological change. Furthermore, these data suggest 3D Thresholded SPECT scans may have clinical application in guiding treatment and potentially improving outcomes.