This image states that different mental issues can be shown and found visually in the brain. I doubt the validity of the images used regardless of the validity of the facts. Could somebody who is knowledgeable in this area possibly explain what each image is showing (E.G. blood flow, structure, heat, etc) and whether or not it is actually meaningful?
If a test is measuring glucose metabolism for example, couldn’t it simply be cherry picked to be taken under certain circumstances to “create” a difference between that and a normal brain?
I wrote up a longer reply that got eaten, and I’m not sufficiently motivated to rewrite, so a short take:
The first three images are probably either functional MRI or PET scans (check Wikipedia), which can be used to measure several different parameters; the most common are blood flow and glucose metabolism (both of which are used as proxies for activity). Without hunting down the original sources, I can’t say what exactly they’re showing, except for the one labelled “glucose metabolism”, which is probably showing glucose metabolism. The last one looks like standard MRI, used to look at structure.
I don’t know where the images came from, but they are broadly consistent with some published reports on abnormalities in these disorders. Presumably the sources of these images are studies that looked at a larger number of patients and controls and showed that the differences are consistent, or at least disproportionately common; this type of “single pair of examples” image is expected to serve as a “take-home summary”, not the sole evidence. As to whether the differences could be “cherry-picked”, that is certainly possible but would of course be scientific fraud (unless the authors are trying to make a point about the most extreme cases). It is expected that the studies will try as much as possible to measure each individual under identical conditions.
What makes you think it came from a study (considering it is FB spam type material with no source)? If you have information about that I’d take that readily.
ADHD, Depression: completely meaningless and context-free images, no paper would present them this way. They don’t appear to be fMRI. The second one is probably PET, not sure what’s going on in the first one. More lights != better/more active. Specifically, no matter what is going on there is tons of activity in your brain, but methods are used to only show the important areas, or get a difference between the two conditions, hiding the irrelevant similarities.
OCD: perhaps the best of the 4 images. As I understand it, it is associated with hyperfrontality, although I’ve never studied it in depth.
If any of the first three are from a real study, they are almost certainly not how a person’s brain looks all the time, but only as a result of being shown a specific stimulus such as one that causes anxiety. The first three are also probably showing either oxygenated blood flow associated with brain activity, or glucose present associated with brain activity (the third one explicitly states the latter). They are sometimes called “heat maps” in the literature, but are not representing temperature.
PTSD: The second least egregious. This is a anatomical MRI image, intending to show brain damage as a result of PTSD. It is different in that it is not showing any brain activity but rather the exact same thing you can show with two dead patients and a knife. Honestly, it’s hard to say that these are even slices of the same plane, and thus many of the differences may be a result of looking at a different place! Disorders such as PTSD may cause structural changes such as decreased volume, that part is not a myth. I don’t know enough about PTSD to say whether these are hallmarks. I am also not sure why one is darker, but nothing can be concluded from that.
God yes, and even “real” researchers can do that. But this isn’t even real research but “some guys” page.
I took some time to try to find the sources of the images; they seem to mostly be from older studies but they do seem to be from real studies. If you want to find more current studies, try Googling “neuroimaging” plus the disorder you are interested in.
The ADHD images are similar enough to the ones in this study that I suspect it is the same dataset or at least the same research group, although those actual images are not included. (paywalled, but you can get the abstract)
The OCD images are from here; the patient image has been modified from the one published to outline the most affected area in yellow. (ditto re paywall)
The depression images are from the Brookhaven National Laboratories / New York University PETT Project studies from the 1980’s, but I can’t figure out where they were published.
The PTSD images seem to be from this textbook, but I don’t have access to the contents so I can’t identify the original study.
If you can’t see through the first paywall, the ADHD image has two scans, and both appear very similar to the right one that most people won’t know what to look for. Both are mostly yellow and differ only in small spots of hot colors like red and white. The entire image is NOT blue/green, and fits more with what I’d expect from this type of a study. The Facebook image is likely manipulated to prove the point. Although with all the crappy ghosting around the text, I’m surprised whoever made it can edit images at all.
Yes, the studies appear to be all PET. Although that technique is still used it has been mostly supplanted by fMRI.
Here’s what the National Institute of Mental Health has to say about mental-illness diagnosing with only imaging usage. Basically,* imaging alone (for mental health reasons) is not diagnostic in and of itself, nor strongly suggestive of anything ‘mental’ when used as sole means in diagnostic toolkits*.
I have done a number of fMRIs in past, and they were only done in rare cases to help rule out other possible factors that might be affecting patient. There is promise in the test(s), but there is lots of overlap image-wise in areas of brain’s functioning -v- appearance/metabolism in population as a whole.
No time to look for cite, but I do remember one study I read over awhile back that showed a somewhat strong correlation between certain area(s) of brain ‘highlighting’ w/ fMRI in sociopathic-like persons (at rest, no stimuli, per se) -v- normal/average persons, but not all those with such image appearance were sociopathic in any way. Not highly diagnostic by any means - just possibly suggestive for diagostician to follow-up if warranted. Quite similar in how the OCD images appear showing different activity - but it would take other testing/interviewing/examining patient to make a confirmative diagnosis, by all means. The image itself is not a definitive diagnosis, period, with fMRI (or PET scans)
Oh, for** thelurkinghorror**: the simple reason why the CT-slices are of of different ‘brightness’ is alomst assuredly from the Tech using slighily different windowing levels when saving images. I always windowed images before printing them and rarely were they exact from scan to scan (or between one machine/display -v- another. The ‘raw’ scandata was always sent as well so the viewer could play with the levels as necessary, fwiw.
The images might not be the only or even primary tool used in diagnosis, but they are a very useful tool for proving that the disease is a real physical phenomenon that really exists, which appears to be the point of whoever put the image together.
I don’t know about resting, but antisocial behavior is associated with poor prefrontal activity. Specifically, these regions are associated with suppressing our urges to be aggressive when it is not appropriate, but if they’re not working properly…
Sure, but you would normalize the images before comparing them between two subjects, no? Or if you didn’t, you wouldn’t disingenuously seem to suggest that the apparent differences mean something?
I think the point is that anyone working in the field would know that the overall brightness has no significance, and so it wouldn’t be necessary to worry too much about it.
thelurking horror : Fwiw, I agree with what you have stated, and am not trying to argue with you in any way. Just so you know
I also have to say that, on the CT images of PTSD, the image on the right is poorly windowed for soft-tissue differentiation. Almost looks like a windowing level used for bony-structure evaluation, IMHO. Perhaps that is from the Tech doing the imaging/printing of archival image(s) or maybe a pre-defined windowing-level protocol per Radiologist (oftentimes the case, IME). The two scans may have been done at two places that varied in Rad-defined protocols. Plus, the book that images came from dates to 2005, so imaging must have been done prior to that. I can say from working at various places (doing CT/MRIs) prior to 20005 that it was not unusual to have only the hardcopy films remaining after scan is done (depending on how much earlier the scan was done and how much memory the CT-unit had available). Many places would not release the original films due to irreplacability of exam. Many Docs learned to request that we print out their own set of films at exam time for this very reason, so we printed two sets - one for our archives and one for them to look at in person rather than rely on only a Rad report.
If anyone wanted a copy of exam done on a ‘low-budget’ CT-unit that had been erased from machine’s memory (to make room for newer exams over time), you had to use a film-copier which resulted in lesser-quality images on copy. Many smaller imaging places did not archive the raw data/exams on separate device(s) while the larger/better budgeted places did so routinely if/when a Rad or researcher wanted to review for whatever reason. Digitigal long-term storage was just starting to become somewhat affordable for larger institutions in most Admin’s opinions (IME) around late-90’s/early 2000’s, IIRC. Nowadays, its rather routine in the more ‘modernized’ places. Memory storage is cheaper than film/processing is, and it is not unusual that no films are even printed unless requested specifically - CDs are really common way of ‘copying’ exams for patients/Docs, as an example. This leads to ability to make images more ‘equal’ when comparing separate scans.
But, yes, the ‘contrast’ between the different types of brain tissue should be relatively similar in appearance in images used for comparison, by all means (!).
It’s a bit more interesting than “people diagnosed with depression tend to be depressed”, but not by a spectacular margin.
Even as harsh a critic of psychiatric diagnostic practice as I am will usually concede that there are some recognizable patterns to which the diagnoses get applied (as opposed to random allocation). And yes, mental conditions, emotional states, cognitive states, etc, are correlated with brain states.
I agree, the major point of the slide in total is not whatever specific difference correlates to whatever disease, but merely that these differences DO exist (and are measurable, at least in aggregate) even with today’s technology. There is a school of thought, that every abnormal condition will eventually yield definable anatomic, biochemical, or functional abnormalities that we will someday be able to demonstrate, just as we can demonstrate conditions now that were previously unsuspected and even unknowable.
Basically, the FB poster is making the point that “mental” disease should really be considered “neurologic” disease.
Also, I agree with other posters who feel the images have been manipulated and/or carefully selected to make the “mental disease = neurologic disease” point. This does not invalidate the point.
Lastly, the PTSD images are MRI images. I think they are trying to show dramatically smaller hippocampal structures in the PTSD patient. However, as someonelse pointed out upthread, they are not really matched for position (not quite the same slice), and it is not actually possible to compare the hippocampi in these patients. A paper I glanced at describes an 8% volume reductions in the right hippocampal volumes of PTSD patient’s compared with matched controls. ( MRI-Based Measurement of Hippocampal Volume in Patients With Combat-Related Posttraumatic Stress Disorder - PMC ) This small difference would be difficult or impossible to detect visually, even by experts, so I think the slidemaker fudged the image selection. This goes over the line for me and I find this image pairing to be intellectually dishonest. Maybe I can forgive it, because without arrows to point out the hippocampi, I doubt anyone is sure of what the difference between the images is, except for incidental darker color.
As you point out, most people don’t know where (or what) the hippocampus is, so I additionally assumed that they were pointing to the slight differences in lateral ventricle sizes (the two “holes” in the middle) and whatever lump is on the bottom of the right one (pons? which only tells me again that they are different slices). Larger ventricles (= potentially a loss of brain tissue) is associated with some disorders, but I don’t know if it is for PTSD, and it certainly is not diagnostic of any one disease.
It’s a very old school of thought at this point, with both mold and ivy growing on its crumbling brick walls. Institutional psychiatry (unlike Freudian psychoanalysis) has long had a love-affair with the notion that ‘insanities’ would turn out to each have single physiological causes that the modern rational science of medicine could pinpoint and for which it could devise a cure. And since the 1950s, the medical model of mental illness has reigned supreme in America and in western civ in general.
Meanwhile, more generally, there has been a powerful swing away from social-environmental causation of anything and towards biological essentialism since the 1970s to today.
I have a profound distrust of any essentialism, although I spend less and less time protesting against the social-cultural “you are just a blank slate” stuff these days. It’s all genetics and biology-is-destiny.
At any rate, the psychiatric myth of specific “chemical imbalances” for which psychiatric medications would turn out to be the “balancers” is an unsupported fable. Brain conditions correlate with cognitive and emotional states but correlation isn’t causation. I’m convinced at this point that schizophrenia and depression and so forth are mental coping patterns (or reaction-patterns at least) that any mind can be driven to by situational stimuli, although I also think people vary in the degree to which they have a predisposition towards some of these or a tendency to react more strongly than another person would to the same stimuli.
There is some pretty strong evidence that most people with a psychiatric diagnosis possess one as a consequence of being victimized and traumatized in some fashion. I think that’s a more useful starting point than pursuing, for the zillionth time, the chimera of neurological or neurochemical causation.
(Quoted post severely shortened) I gotta agree those are MRI images - I only took quick glance once, but now noticing the ‘scatter’ outside of head tells me its MR, for sure. CT does not give such random scatter on images for the most part. Mea culpa - but rest of what I said still affects how two scans can vary a bit in end-result hard-copy images; mostly in the not too distant past but much less so nowadays (with better computers and lots more memory/storage being more the norm, etc).
AHunter3 : I’ll have to politely disagree with your post for the most part, and not trying to take this to debate-level. I know personally of a number of folks who had very severe OCD that were ‘cured’ with use of SSRI’s (one being an ex-wife long ago). She had to do a variety of certain things a certain way or she would get quick-onset panic-attacks bad enough to make her go unconscious from tachycardia, unable to breathe adequately, etc. After a few ambulance rides, she got into a program for her Sx’s. Higher doses than usual of Prozac ‘balanced’ her to a normal life, for the most part. She had been OCD-like since birth as her Mom explained (and no real-bad traumatic experiences or whatever), but she got much worse more rapidly over a period of year or so when she got into her 30’s or so, fwiw. Just to give one example of ‘chemical imbalance’ causing major neurological/behavioral prob(s)… But there is a wide spectrum of ‘mental illness’, of course, and many various causes, so I can not and do not say all mental probs are chemical and imageable, of nature, of course.
I kinda wish that fMRI or such had been done on her pre/post med use to see if any difference(s) showed, to keep this on-topic… I’d bet there would have been a good chance of noticeable differences in metabolism/function of brain areas to a small degree at least. But the images would not have been diagnostic by themselves most likely.
Actually, for most diseases, including psychiatric disorders, the current opinion in biology is that symptom onset is due to the interaction of genetic (or other biological) predisposition and environmental stressors. In other words, different people both have different degrees of innate resilience and experience different degrees of external factors. A person with high predisposition to a given condition might become symptomatic at the same level of external stress experienced by the average person, while a person with low predisposition to that condition might be able to resist a degree of stress that would produce symptoms in the average person. So yes, most symptomatic people have undergone environmental stress, but the stress itself isn’t necessarily enough.
But the “psychiatric myth of specific “chemical imbalances” for which psychiatric medications would turn out to be the “balancers”” is working pretty well. We are coming to realize that certain disorders that we currently classify as a collection of symptoms are actually a conglomeration of several disorders, with potentially different causes and consequences and requiring different treatment, and are working out how to break down these conditions to identify the meaningful subtypes and the appropriate treatment for each. That research is nowhere near finished, but so far it seems that we can get better results for patients by considering what the underlying biological defect is and selecting corresponding treatments, rather than treating “schizophrenia” or “depression” as generalized responses to psychological trauma.
The last one looks like standard MRI, used to look at structure.