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Discussion Starter · #1 ·
This is some important stuff guys, esp. if you are interested in SPECT scans, or how the brain might show up different if someone has a certain mental illness. Seeing something in the brain might or might NOT mean that a symptom is caused by brain damage.

For example, patients who suffer from major depression, over a lifetime, will show significant brain abnormalities on brain scans. The actual regions of the brain (primarily the hippocampus) will be larger in certain areas and reduced in others. It's not literal brain "damage" but it is a CHANGE in the actual structure/size of the brain due to illness.

Likewise, a schizophenic will usually exhibit certain brain structural abnormalities - certain regions are larger, smaller, shrunken, more active, less active, etc. This the power of fMRI and SPECT imaging. It allows doctors to SEE into the actual brain and to see differences in healthy and ill subjects.


Here is the VERy important point that everyone should hear. Nobody knows if the brain is a different size because there is a PHYSICAL reason for it - or if years of living in a certain state of mind CAUSED the size of the brain to change.

Skeptics, please keep reading.

A very famous neurological experiment also detected significant structural changes within the brains of a study group of subjects. These subjects had MUCH larger posterior regions of the hippocampul brain structure - this is the part of the brain heavily involved in the limbic system (emotions, etc.). These subjects brains were visibly different from a wide variety of other control subjects and it would lead one to easily wonder what they "had" in terms of a disease or abnormality.

Want to know what they "Had?"

They were a group of London taxi drivers who had been navigating the streets of London day in and day out for at least 20 years. Over that amount of time, the region of the brain that is used in "scouting for food/storeage/retrieval" in animals such as birds, rats, etc. any scavenger-type will often become significantly enlarged DUE TO THE LIFE EXPERIENCE OF THE SUBJECT. Birds of a specific species, if they are living in the wild and are accustomed to scanning the environment for morsels and hiding/nesting their food for later retrieval, will develop larger areas of the hippocampus over a lifetime. The exact same species of bird, if raised indoors and given food without the need for this radar, will NOT develop enlarged areas of the brain.

The taxi drivers were not mental patients and had nothing "wrong' with their brains. But the neuroplasticity of the brain itself, the ability of our brains to SHAPESHIFT according to longstanding patterns of cognition and developed behavior caused actual changes that were observable on brain scans. From years of looking at the maze of streets and maps all under stressful and hurried activity, their brains physically changed.

Do not assume that if someone's brain is visibly different on a scan, that means it is because of some organic reason. The brain is plastic. It changes over time - and it is a give and take - the neurology changes how we feel and HOW WE FEEL (and how we think consistently) can also change the actual visual structure of the brain.
Fascinating, huh?


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Hmm. Hmmmmm. Hmmmmmmmmmmmmmmm........

Okay, a word to both brain structured and the analytically structured:

Why is there interest in brain imaging mental illnesses in the first place? Why cant all mental illnesses be talked through? True, psychoanalytic theory isnt in vogue at the moment in general medical practice. Plain old talk therapy and CBT are. But talk therapy is still considered a medically viable way to confront mental illness. Why brain image the mentally ill if talk therapy seems to work? Good question. Glad you asked.

The brain isnt the only adaptive organ in the body. Probably the most adaptive to our behaviour, and by far the most regenerative, is the liver. People dont give it the credit it deserves. Everything you breathe, everything which touches your skin, everything which enters your gastrointestinal track, eventually goes through it. Hundreds of thousands of these chemicals are toxic to our bodies. Breakdowns of meat, vegetables, and air produce toxic substances. Its the liver which adapts to these things we take in, and produces a tailored antidote which neutralizes them, allowing our bodies to use them, or pass them from our system. And its regenerative. You can lose all but a tenth of your liver, and it will grow an entirely new organ from that. You lose liver cells all the time when you drink. Luckily, you regain them when you treat it well. In that way, its a little like the brain. And just like the brain, your behaviours can cause it to get sick. Sure, there are viruses like hepatitis C. But then there's diseases like alcoholism. What you put into your liver makes it sick. And there's diseases like porphyria. That can be tricky. Although the liver is adaptive - it isnt perfectly adaptive. Small toxic exposures can allow it to lose the ability to properly break down red blood cells, leaving the toxic porphyrins circulating in your system. So removing the exposure can correct the porphyria. But sometimes that doesnt even help - because the problem is genetic. Now I can look at the problem and say - You know what, you have an elevated Liver Function Test( what doctors call your LFTs). Your AST and ALT are high. If I'm of the alchoholism school of thought ( and an awful doctor) I'll tell the person that if they lay off of alcohol, they'll be fine. Which wont work very well when their liver fails from hepatitis C. Or I can be of the toxic porphyria school of liver disease thought. Your liver is inflammed? Well, just move out of your house. Your liver is adaptive and you'll be fine. Oops. It was the genetic variety. My patient is now in the ICU with paralysis and a sodium of 126 ml.

Brain SPECT studies and fMRIs popped up for a reason. Large tracts of mental illness were not responding to talk therapy. And there seemed to be no apparent reason why. The brain, like the liver adapts to behaviour, right? If alcoholics faced up to their past, wouldnt they be able to stop drinking? The answer of course, is no. The latest research indicates that alchoholics are missing a protein which the rest of us lucky folks have. Drinking alcohol seems to temporarlily fix the problems on their brain scans. Does this mean that talk therapy doesnt work at all? The answer to that, of course, is also no. Talk therapy has been shown to change the scans of many a depressed patient as well. So have meds. Prozac has increased the size of depressed patient's hippocampuses. So has biofeedback. What does this mean? It means that like all organs of the body, there are multiple diseases of the brain with multiple causes. Some of them you need a protein to fix. Some you need to take epilepsy medicine for. Some you need to change your envronment and the way you react to it. Is it worth it in any of these cases to have objective testing done to elucidiate causes and a cure? Yes, absolutely. If you have the means, by all means do. Once you have this information at your disposal, ask yourself if you feel this way because of, or in spite of your actions. If, in your heart of hearts, you know that your actions are bringing on your current emotional funk, take steps to change or talk about them. But if, in your heart of hearts, you know that these mood swings, the 2 dimensional vision, the visual distortion, happens in spite of your life, then you have to ask if the real hidden demons in your life arent your malfunctioning neurons. I dont need a brain scan to tell me that I feel mildly depressed because I've been housebound for most of a year. But I needed one to tell me why I was DPed. Its tough to tell, but science, and young doctors, are getting closer and closer to telling the difference between the causes of mental illness and leaving guesswork psychiatry behind for good. A word to those with actual CT or MRI scan abnormalities: the differences Janine and myself brought up are microscopic changes. You shouldnt see them on an MRI. If you have changes in brain size, lesions, etc...It usually infers a neurologic problem. Thats why you need a neuroligist to check out anything unusual. Yeah, the hippocampus loses cells when your depressed, but to get a change in ventricular size you have to lose a LOT of tissue. You cant think your brain into having a lesion or losing tissue. Anything psychological happens on a molecular or cellular level between the synapses.


Discussion Starter · #3 ·
I think you have excellent points and as always, the TRUTH probably lies in both our worlds, in both our answers. I just made my post, not to discredit brain scans at ALL (again, your points are highly valid), but to add the other side of the coin that is VERY rarely published. It is implied in the literature that a change in a brain structure MUST mean that there is a biochemical cause. I'm only adding the other side of the glass - there can be a biochemical cause. But....the brain can also change, physically change, over time - from the physical actions of our repeated thoughts, feelings and psychological patterns.

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