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{"title"=>"Clinical utility of SPECT neuroimaging in the diagnosis and treatment of traumatic brain injury: A systematic review", "type"=>"generic", "authors"=>[{"first_name"=>"Cyrus A.", "last_name"=>"Raji", "scopus_author_id"=>"24390928100"}, {"first_name"=>"Robert", "last_name"=>"Tarzwell", "scopus_author_id"=>"8839388900"}, {"first_name"=>"Dan", "last_name"=>"Pavel", "scopus_author_id"=>"57197267359"}, {"first_name"=>"Howard", "last_name"=>"Schneider", "scopus_author_id"=>"56114489700"}, {"first_name"=>"Michael", "last_name"=>"Uszler", "scopus_author_id"=>"56115269100"}, {"first_name"=>"John", "last_name"=>"Thornton", "scopus_author_id"=>"56114700700"}, {"first_name"=>"Muriel", "last_name"=>"Van Lierop", "scopus_author_id"=>"56115430900"}, {"first_name"=>"Phil", "last_name"=>"Cohen", "scopus_author_id"=>"56114521200"}, {"first_name"=>"Daniel G.", "last_name"=>"Amen", "scopus_author_id"=>"6604058523"}, {"first_name"=>"Theodore", "last_name"=>"Henderson", "scopus_author_id"=>"55343517100"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"24646878", "doi"=>"10.1371/journal.pone.0091088", "sgr"=>"84898603414", "isbn"=>"EN :1932-6203", "scopus"=>"2-s2.0-84898603414", "issn"=>"19326203", "pui"=>"372838746"}, "id"=>"d7475333-56c2-3651-b032-14b989c2239f", "abstract"=>"PURPOSE: This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT) in traumatic brain injury (TBI).\\n\\nMETHODS: After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild, moderate, or severe TBI with cerebral lobar specificity of SPECT findings. Other inclusion criteria were comparison modalities in the same subjects and articles in English. Foreign language articles, SPECT studies that did not include comparison modalities, and case reports were not included for review.\\n\\nRESULTS: We identified 19 longitudinal and 52 cross-sectional studies meeting inclusion criteria. Three longitudinal studies examined diagnostic predictive value. The first showed positive predictive value increases from initial SPECT scan shortly after trauma to one year follow up scans, from 59% to 95%. Subsequent work replicated these results in a larger cohort. Longitudinal and cross sectional studies demonstrated SPECT lesion localization not detected by CT or MRI. The most commonly abnormal regions revealed by SPECT in cross-sectional studies were frontal (94%) and temporal (77%) lobes. SPECT was found to outperform both CT and MRI in both acute and chronic imaging of TBI, particularly mild TBI. It was also found to have a near 100% negative predictive value.\\n\\nCONCLUSIONS: This review demonstrates Level IIA evidence (at least one non-randomized controlled trial) for the value of SPECT in TBI. Given its advantages over CT and MRI in the detection of mild TBI in numerous studies of adequate quality, and given its excellent negative predictive value, it may be an important second test in settings where CT or MRI are negative after a closed head injury with post-injury neurological or psychiatric symptoms.", "link"=>"http://www.mendeley.com/research/clinical-utility-spect-neuroimaging-diagnosis-treatment-traumatic-brain-injury-systematic-review", "reader_count"=>67, "reader_count_by_academic_status"=>{"Unspecified"=>4, "Professor > Associate Professor"=>5, "Librarian"=>3, "Student > Doctoral Student"=>12, "Researcher"=>11, "Student > Ph. D. Student"=>9, "Student > Postgraduate"=>2, "Other"=>6, "Student > Master"=>11, "Student > Bachelor"=>2, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>4, "Professor > Associate Professor"=>5, "Librarian"=>3, "Student > Doctoral Student"=>12, "Researcher"=>11, "Student > Ph. D. Student"=>9, "Student > Postgraduate"=>2, "Other"=>6, "Student > Master"=>11, "Student > Bachelor"=>2, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Engineering"=>3, "Unspecified"=>6, "Nursing and Health Professions"=>3, "Biochemistry, Genetics and Molecular Biology"=>2, "Materials Science"=>1, "Medicine and Dentistry"=>22, "Agricultural and Biological Sciences"=>9, "Neuroscience"=>3, "Sports and Recreations"=>1, "Psychology"=>12, "Social Sciences"=>4, "Computer Science"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>3}, "Materials Science"=>{"Materials Science"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>22}, "Neuroscience"=>{"Neuroscience"=>3}, "Social Sciences"=>{"Social Sciences"=>4}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Psychology"=>{"Psychology"=>12}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>9}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Unspecified"=>{"Unspecified"=>6}}, "reader_count_by_country"=>{"Republic of Singapore"=>1, "United States"=>2, "Japan"=>1, "Australia"=>1, "Switzerland"=>1}, "group_count"=>5}

ORCID

CrossRef

• http://doi.org/10.1186/s13036-019-0145-8
• http://doi.org/10.1016/j.pscychresns.2014.11.003
• http://doi.org/10.1212/CON.0000000000000389
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• http://doi.org/10.1364/BOE.6.003256
• http://doi.org/10.1136/bjsports-2016-097447
• http://doi.org/10.3233/JAD-170281
• http://doi.org/10.3389/fneur.2014.00158
• http://doi.org/10.1111/head.13269
• http://doi.org/10.1371/journal.pone.0129659
• http://doi.org/10.1179/1743132815Y.0000000018
• http://doi.org/10.1016/j.clineuro.2018.05.019
• http://doi.org/10.1016/j.expneurol.2019.113116
• http://doi.org/10.1016/j.neuron.2019.06.002
• http://doi.org/10.1016/j.nic.2017.09.002
• http://doi.org/10.1016/j.cger.2018.06.008
• http://doi.org/10.1016/j.disamonth.2019.02.009
• http://doi.org/10.3390/ijms160611903
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• http://doi.org/10.3389/fneur.2014.00114
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• 4575682
• 4488529
• 4550182
• 4552256
• 4490422
• 4574654
• 4083561
• 4138441

Scopus | Further Information

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• {"domain"=>"self.tabled", "banned_by"=>nil, "media_embed"=>{}, "subreddit"=>"tabled", "selftext_html"=>"<!-- SC_OFF --><div class=\"md\"><p><strong>Verified?</strong> <em>(This bot cannot verify AMAs just yet)</em></p>\n\n<p><strong>Date:</strong> 2015-10-29</p>\n\n<p><strong><a href=\"http://www.reddit.com/r/IAmA/comments/3qqcwk/\">Link to submission</a></strong> (<em>Has self-text</em>)</p>\n\n<table><thead>\n<tr>\n<th align=\"left\">Questions</th>\n<th align=\"left\">Answers</th>\n</tr>\n</thead><tbody>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfpxw?context=5\">Can you go into some detail on the different types of ADD?</a></td>\n<td align=\"left\">Classic (hyperactive, impulsive, inattentive) ... Inattention (not hyperactive or very impulsive) ... ADD + Overfocused (cannot shift attention) ... ADD + Sad or Limbic ... ADD + Temporal Lobe Symptoms (mood instability, irritability, memory and learning issues) ... Ring of Fore ADD (too much overall brain activity) ... ADD + Anxiety</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhgvhb?context=5\">How do you respond to accusations that your practices are not based in evidence, that you are the Dr. Oz of neuropsych? Link to www.washingtonpost.com.</a></td>\n<td align=\"left\">Thanks for this question. on <a href=\"http://www.amenclinics.com\">www.amenclinics.com</a> we he have 3,000 scientific abstracts about SPECT in psychiatry. I have published 60 papers, which report we have the best outcomes on complex psychiatric patients and that SPECT changes what doctors do 8 times out of 10. If you read the Washington Post article you will notice many of my colleagues who refer and support our work. 40% of our new patients are referred by our own patients. The critics in that article have never come to the clinics even though I have invited them. I stand behind our work and have done so for 25 years.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhekj7?context=5\">I know a lot of people who take SSRIs who claim to have serotonin deficiency in their brain. Is there a way to actually measure serotonin levels in the brain, and if so, why isn't it being used as a diagnostic tool for treating depression?</a></td>\n<td align=\"left\">A lot of people use urine testing to measure serotonin levels. Unfortunately, no one has shown what is in your urine is matched with what is in your brain. When we do brain imaging with SPECT we have shown low serotonin levels are associated with increased anterior cingulate activity and worried, rigid, inflexible thinking. I talk a lot about this in my newly revised book, Change Your Brain, Change Your Life.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwheoa1?context=5\">Mr. Dr. Amen do you think we'll cure schizophrenia in the, say, next 15 years?</a></td>\n<td align=\"left\">It depends on the cause of schizophrenia. It's just not one thing. If the cause is Lyme, then it can be cured. If it is mold exposure it can be helped. If it is gluten allergy it can be helped. Unfortunately, no one looks at the brains of most schizophrenic patients so doctors think it is one thing and only use antipsychotic meds.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhf5qo?context=5\">Why do you think it's not common to examine their brains properly?</a></td>\n<td align=\"left\">It's not part of our tradition. It goes against the DSM-V driven paradigm that symptoms = diagnosis = treatment. No other medical professionals act that way.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfy89?context=5\">One more quick follow up question: Let's say I know somebody who has schizophrenia who came into contact with cat's excrement due to a bet, how likely would it be that toxoplasmosis caused the schizophrenia? Should he tell this to his attending psychiatrist, even if it's now 5 years ago that the illness broke out?</a></td>\n<td align=\"left\">Yes, toxoplasmosis is a cause of psychosis and should be checked.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhf402?context=5\">What was your path to becoming a brain disorder specialist like? It sounds like a super interesting, but difficult field, I'd be really curious to learn more about how you got into it.</a></td>\n<td align=\"left\">It was quite a journey.</td>\n</tr>\n<tr>\n<td align=\"left\"></td>\n<td align=\"left\">Infantry medic ... x-ray technician ... medical school ... fell in love with psychiatry after someone I loved tried to kill herself ... But psychiatrists didn't use imaging ... My x-ray background caused me to want to look ... So I pushed myself and my colleagues to start looking at the brain of psychiatric patients ... I am still pushing them. :)</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhgdw1?context=5\">I enjoy daydreaming about torturing and killing all sorts of people, even people I like. Do I need to worry?</a></td>\n<td align=\"left\">This is a fascinating question. As long as your frontal lobes are OK and you can control your behavior, you can keep these thoughts in check and stay out of jail or hell. The brain is a sneaky organ. We all have weird, crazy, sexual, violent thoughts that no one should ever hear. Your brain acts as a filter. Keep it healthy.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhg6nw?context=5\">What are some activities or tips can you give former military members dealing with PTSD?</a></td>\n<td align=\"left\">Engage in brain healthy habits to help heal the brain. There are simple techniques like EMDR and havening I like. Also check out our new paper, that will be highlighted as one of 2015's top 100 stories in science.</td>\n</tr>\n<tr>\n<td align=\"left\"></td>\n<td align=\"left\"><a href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.012965\">Link to journals.plos.org</a></td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfa9y?context=5\">What's wrong with Donald Trumps brain?</a></td>\n<td align=\"left\">It is a fascinating question. I wrote an Op Ed piece for the LA Times on whether or not we should scan presidential candidates. I have my suspicions about all of the candidates. See this link.</td>\n</tr>\n<tr>\n<td align=\"left\"></td>\n<td align=\"left\"><a href=\"http://www.latimes.com/news/la-oe-amen5dec05-story.html\">Link to www.latimes.com</a></td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfnkc?context=5\">Marijuana seems to be an effective medication for seizures/epilepsy, depression, anxiety, ADHD etc. Have you done any research on the effectiveness of marijuana as a medication for these or other disorders and conditions? What is your stance on marijuana as a medication? </a></td>\n<td align=\"left\">I have scanned literally thousands of brains on marijuana. It shows toxic effects on scans. Yes, it can help with anxiety, but often makes depression and ADHD worse. Xanax helps with anxiety but is toxic to brain function. I think of marijuana the same way. Perhaps CBD by itself will be helpful. I caution my patients about its use.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhhj57?context=5\">What do you mean with "toxic effects"?</a></td>\n<td align=\"left\">It makes the brain look older than the person is. It is a pattern we see with alcohol and infections. Not a good thing.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfudw?context=5\">How can someone with Hashimoto's improve their brain function, memory, stamina and overall health?</a></td>\n<td align=\"left\">We see this a lot. Make sure you get your thyroid levels optimized, then do all the other great things for your brain I discuss in the new book, such as diet, exercise, simple supplements, and avoiding obesity, diabetes, hypertension, insomnia.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhgm83?context=5\">Thank you. Do you notice thyroid deficiency affecting a particular part of the brain in Spect scans?</a></td>\n<td align=\"left\">It tends to have a global negative effect.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhet3v?context=5\">What's the most interesting comparison or contrast that you've noticed between brains ?</a></td>\n<td align=\"left\">All brains are not the same, even when they have the same symptoms. For example, I scanned 2 15 year old multiple murderers. One had really low activity globally, while one had really high activity. How do we know unless we look?</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfozr?context=5\">Do you ever encounter malingerers? What is sure sign that someone is faking the extent of their brain injury?</a></td>\n<td align=\"left\">Of course. The scans can tell if it is real or not real. Check out our article on SPECT and TBI.</td>\n</tr>\n<tr>\n<td align=\"left\"></td>\n<td align=\"left\"><a href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0091088\">Link to journals.plos.org</a></td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhehkr?context=5\">What do you consider to be the singles greatest threat to long-term brain health?</a></td>\n<td align=\"left\">There are many, but if I had to choose 1 it would be diabetes and pre-diabetes, which damages the brain and now affects 50% of the population according to a recent study in JAMA.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwheu34?context=5\">So would that mean the highest impact lifestyle changes we can make to better our brain are things like diet and exercise?</a></td>\n<td align=\"left\">You bet. I play this game with my daughter called Chloe's brain ... Is this good for my brain or bad for it?</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhh0re?context=5\">Has any patient's scan caused you to fear them or for them? </a></td>\n<td align=\"left\">Some scans are cause for great concern to make sure our patients take brain health seriously or they will experience bad consequences.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwheejf?context=5\">What do you think of the new Will Smith movie coming out about brain injury in the NFL? Did you encounter any political problems when you began researching NFL players? </a></td>\n<td align=\"left\">Love the movie. Powerful, clear and very scary. Was a consultant for it. The NFL was not happy about our work, but there was great enthusiasm among players.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwheosn?context=5\">I read something, somewhere about low fat diets causing decreased brain function. Is there truth to this? </a></td>\n<td align=\"left\">Yes. 60% of the solid weight of the brain is fat. Cholesterol levels under 160 are associated with depression, suicide and murder.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhft8w?context=5\">Should I be worried about a constant dull ache in the back of my head ever since I tripped and banged my head into a brick wall 14 years ago?</a></td>\n<td align=\"left\">I wouldn't be extremely concerned. If there are other symptoms such as light sensitivity, memory, learning or mood, I would get assessed.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhgdwj?context=5\">I tell you what, I occasionally would think to myself that somehow my memory, or just the general way I think or process day to day things, has been affected by the accident. So much so that my mum recommended I get tested for Aspergers syndrome but that never took off. Maybe I should revisit. </a></td>\n<td align=\"left\">Yes, a SPECT scan may be helpful to answer the question of concussion or something else.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhgi17?context=5\">My son has absent septum pallucidum, what does this mean? </a></td>\n<td align=\"left\">It is a part of the brain often involved in pleasure. It may be missing in normal people.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfy8a?context=5\">Is long term ketogenic diet harmful to the brain?</a></td>\n<td align=\"left\">No, the ketogenic diet has some healing properties for the brain. Sugar is more harmful than ketones.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfy8a?context=5\">Also, my parents are in their 60's, recently retired, and interested in establishing a healthier lifestyle, they're both quite concerned about dementia and stroke. If they were to focus on just one lifestyle commitment, what should they focus on? </a></td>\n<td align=\"left\">Always diet first. It is the most important thing you can do for your brain.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfj3x?context=5\">Why do SSRI medications cause the inability or difficulty to achieve orgasm?</a></td>\n<td align=\"left\">Serotonin also works on nerves outside the brain to delay orgasm. It can also lower desire.</td>\n</tr>\n<tr>\n<td align=\"left\"><a href=\"https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfpp0?context=5\">You mentioned diabetes and the brain. How does diabetes affect it?</a></td>\n<td align=\"left\">Diabetes damages blood vessels and the brain uses 20% of the blood flow in the body.</td>\n</tr>\n</tbody></table>\n\n<p><em>Last updated: 2015-10-29 19:54 UTC</em> | <em>Next update: 2015-10-29 20:04 UTC</em></p>\n\n<p><em>This post was generated by a robot! Send all complaints to <a href=\"/message/compose/?to=epsy\">epsy</a>.</em></p>\n</div><!-- SC_ON -->", "selftext"=>"**Verified?** *(This bot cannot verify AMAs just yet)*\n\n**Date:** 2015-10-29\n\n**[Link to submission](http://www.reddit.com/r/IAmA/comments/3qqcwk/)** (*Has self-text*)\n\n\n\nQuestions|Answers\n:--|:--\n[Can you go into some detail on the different types of ADD?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfpxw?context=5)|Classic (hyperactive, impulsive, inattentive) ... Inattention (not hyperactive or very impulsive) ... ADD + Overfocused (cannot shift attention) ... ADD + Sad or Limbic ... ADD + Temporal Lobe Symptoms (mood instability, irritability, memory and learning issues) ... Ring of Fore ADD (too much overall brain activity) ... ADD + Anxiety \n[How do you respond to accusations that your practices are not based in evidence, that you are the Dr. Oz of neuropsych? Link to www.washingtonpost.com.](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhgvhb?context=5)|Thanks for this question. on www.amenclinics.com we he have 3,000 scientific abstracts about SPECT in psychiatry. I have published 60 papers, which report we have the best outcomes on complex psychiatric patients and that SPECT changes what doctors do 8 times out of 10. If you read the Washington Post article you will notice many of my colleagues who refer and support our work. 40% of our new patients are referred by our own patients. The critics in that article have never come to the clinics even though I have invited them. I stand behind our work and have done so for 25 years. \n[I know a lot of people who take SSRIs who claim to have serotonin deficiency in their brain. Is there a way to actually measure serotonin levels in the brain, and if so, why isn't it being used as a diagnostic tool for treating depression?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhekj7?context=5)|A lot of people use urine testing to measure serotonin levels. Unfortunately, no one has shown what is in your urine is matched with what is in your brain. When we do brain imaging with SPECT we have shown low serotonin levels are associated with increased anterior cingulate activity and worried, rigid, inflexible thinking. I talk a lot about this in my newly revised book, Change Your Brain, Change Your Life.\n[Mr. Dr. Amen do you think we'll cure schizophrenia in the, say, next 15 years?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwheoa1?context=5)|It depends on the cause of schizophrenia. It's just not one thing. If the cause is Lyme, then it can be cured. If it is mold exposure it can be helped. If it is gluten allergy it can be helped. Unfortunately, no one looks at the brains of most schizophrenic patients so doctors think it is one thing and only use antipsychotic meds.\n[Why do you think it's not common to examine their brains properly?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhf5qo?context=5)|It's not part of our tradition. It goes against the DSM-V driven paradigm that symptoms = diagnosis = treatment. No other medical professionals act that way. \n[One more quick follow up question: Let's say I know somebody who has schizophrenia who came into contact with cat's excrement due to a bet, how likely would it be that toxoplasmosis caused the schizophrenia? Should he tell this to his attending psychiatrist, even if it's now 5 years ago that the illness broke out?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfy89?context=5)|Yes, toxoplasmosis is a cause of psychosis and should be checked.\n[What was your path to becoming a brain disorder specialist like? It sounds like a super interesting, but difficult field, I'd be really curious to learn more about how you got into it.](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhf402?context=5)|It was quite a journey.\n |Infantry medic ... x-ray technician ... medical school ... fell in love with psychiatry after someone I loved tried to kill herself ... But psychiatrists didn't use imaging ... My x-ray background caused me to want to look ... So I pushed myself and my colleagues to start looking at the brain of psychiatric patients ... I am still pushing them. :)\n[I enjoy daydreaming about torturing and killing all sorts of people, even people I like. Do I need to worry?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhgdw1?context=5)|This is a fascinating question. As long as your frontal lobes are OK and you can control your behavior, you can keep these thoughts in check and stay out of jail or hell. The brain is a sneaky organ. We all have weird, crazy, sexual, violent thoughts that no one should ever hear. Your brain acts as a filter. Keep it healthy.\n[What are some activities or tips can you give former military members dealing with PTSD?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhg6nw?context=5)|Engage in brain healthy habits to help heal the brain. There are simple techniques like EMDR and havening I like. Also check out our new paper, that will be highlighted as one of 2015's top 100 stories in science.\n |[Link to journals.plos.org](http://journals.plos.org/plosone/article?id=10.1371/journal.pone.012965) \n[What's wrong with Donald Trumps brain?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfa9y?context=5)|It is a fascinating question. I wrote an Op Ed piece for the LA Times on whether or not we should scan presidential candidates. I have my suspicions about all of the candidates. See this link.\n |[Link to www.latimes.com](http://www.latimes.com/news/la-oe-amen5dec05-story.html) \n[Marijuana seems to be an effective medication for seizures/epilepsy, depression, anxiety, ADHD etc. Have you done any research on the effectiveness of marijuana as a medication for these or other disorders and conditions? What is your stance on marijuana as a medication? ](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfnkc?context=5)|I have scanned literally thousands of brains on marijuana. It shows toxic effects on scans. Yes, it can help with anxiety, but often makes depression and ADHD worse. Xanax helps with anxiety but is toxic to brain function. I think of marijuana the same way. Perhaps CBD by itself will be helpful. I caution my patients about its use.\n[What do you mean with \"toxic effects\"?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhhj57?context=5)|It makes the brain look older than the person is. It is a pattern we see with alcohol and infections. Not a good thing. \n[How can someone with Hashimoto's improve their brain function, memory, stamina and overall health?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfudw?context=5)|We see this a lot. Make sure you get your thyroid levels optimized, then do all the other great things for your brain I discuss in the new book, such as diet, exercise, simple supplements, and avoiding obesity, diabetes, hypertension, insomnia. \n[Thank you. Do you notice thyroid deficiency affecting a particular part of the brain in Spect scans?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhgm83?context=5)|It tends to have a global negative effect.\n[What's the most interesting comparison or contrast that you've noticed between brains ?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhet3v?context=5)|All brains are not the same, even when they have the same symptoms. For example, I scanned 2 15 year old multiple murderers. One had really low activity globally, while one had really high activity. How do we know unless we look?\n[Do you ever encounter malingerers? What is sure sign that someone is faking the extent of their brain injury?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfozr?context=5)|Of course. The scans can tell if it is real or not real. Check out our article on SPECT and TBI.\n |[Link to journals.plos.org](http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0091088) \n[What do you consider to be the singles greatest threat to long-term brain health?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhehkr?context=5)|There are many, but if I had to choose 1 it would be diabetes and pre-diabetes, which damages the brain and now affects 50% of the population according to a recent study in JAMA.\n[So would that mean the highest impact lifestyle changes we can make to better our brain are things like diet and exercise?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwheu34?context=5)|You bet. I play this game with my daughter called Chloe's brain ... Is this good for my brain or bad for it?\n[Has any patient's scan caused you to fear them or for them? ](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhh0re?context=5)|Some scans are cause for great concern to make sure our patients take brain health seriously or they will experience bad consequences.\n[What do you think of the new Will Smith movie coming out about brain injury in the NFL? Did you encounter any political problems when you began researching NFL players? ](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwheejf?context=5)|Love the movie. Powerful, clear and very scary. Was a consultant for it. The NFL was not happy about our work, but there was great enthusiasm among players.\n[I read something, somewhere about low fat diets causing decreased brain function. Is there truth to this? ](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwheosn?context=5)|Yes. 60% of the solid weight of the brain is fat. Cholesterol levels under 160 are associated with depression, suicide and murder.\n[Should I be worried about a constant dull ache in the back of my head ever since I tripped and banged my head into a brick wall 14 years ago?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhft8w?context=5)|I wouldn't be extremely concerned. If there are other symptoms such as light sensitivity, memory, learning or mood, I would get assessed.\n[I tell you what, I occasionally would think to myself that somehow my memory, or just the general way I think or process day to day things, has been affected by the accident. So much so that my mum recommended I get tested for Aspergers syndrome but that never took off. Maybe I should revisit. ](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhgdwj?context=5)|Yes, a SPECT scan may be helpful to answer the question of concussion or something else.\n[My son has absent septum pallucidum, what does this mean? ](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhgi17?context=5)|It is a part of the brain often involved in pleasure. It may be missing in normal people.\n[Is long term ketogenic diet harmful to the brain?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfy8a?context=5)|No, the ketogenic diet has some healing properties for the brain. Sugar is more harmful than ketones.\n[Also, my parents are in their 60's, recently retired, and interested in establishing a healthier lifestyle, they're both quite concerned about dementia and stroke. If they were to focus on just one lifestyle commitment, what should they focus on? ](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfy8a?context=5)|Always diet first. It is the most important thing you can do for your brain.\n[Why do SSRI medications cause the inability or difficulty to achieve orgasm?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfj3x?context=5)|Serotonin also works on nerves outside the brain to delay orgasm. It can also lower desire.\n[You mentioned diabetes and the brain. How does diabetes affect it?](https://www.reddit.com/r/IAmA/comments/3qqcwk/hi_im_dr_daniel_amen_psychiatrist_and_brain/cwhfpp0?context=5)|Diabetes damages blood vessels and the brain uses 20% of the blood flow in the body.\n\n\n*Last updated: 2015-10-29 19:54 UTC* | *Next update: 2015-10-29 20:04 UTC*\n\n*This post was generated by a robot! Send all complaints to [epsy](/message/compose/?to=epsy).*\n\n", "likes"=>nil, "suggested_sort"=>nil, "user_reports"=>[], "secure_media"=>nil, "link_flair_text"=>nil, "id"=>"3qqw8j", "from_kind"=>nil, "gilded"=>0, "archived"=>false, "clicked"=>false, "report_reasons"=>nil, "author"=>"tabledresser", "media"=>nil, "score"=>0, "approved_by"=>nil, "over_18"=>false, "hidden"=>false, "num_comments"=>0, "thumbnail"=>"", "subreddit_id"=>"t5_2tkmw", "hide_score"=>false, "edited"=>false, "link_flair_css_class"=>nil, "author_flair_css_class"=>"tabler", "downs"=>0, "secure_media_embed"=>{}, "saved"=>false, "removal_reason"=>nil, "stickied"=>false, "from"=>nil, "is_self"=>true, "from_id"=>nil, "permalink"=>"/r/tabled/comments/3qqw8j/table_iama_hi_im_dr_daniel_amen_psychiatrist_and/?ref=search_posts", "locked"=>false, "name"=>"t3_3qqw8j", "created"=>1446177253.0, "url"=>"https://www.reddit.com:80/r/tabled/comments/3qqw8j/table_iama_hi_im_dr_daniel_amen_psychiatrist_and/", "author_flair_text"=>"", "quarantine"=>false, "title"=>"[Table] IAmA: Hi, I’m Dr. Daniel Amen, psychiatrist and brain disorder specialist. Ask me anything!", "created_utc"=>1446148453.0, "distinguished"=>nil, "mod_reports"=>[], "visited"=>false, "num_reports"=>nil, "ups"=>0}

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• {"id"=>"446392803686645762", "text"=>"Live on PLOS ONE!! SPECT in traumatic brain injury http://t.co/pbZktxFtZ6 @ubcnews", "created_at"=>"2014-03-19T21:08:32Z", "user"=>"1MinMedSchool", "user_name"=>"Dr Rob", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3386302252/cac4fc272203be1c353d3e0555f2462d_normal.png"}
• {"id"=>"446395885514010624", "text"=>"PLOS ONE: Clinical Utility of SPECT Neuroimaging in the Diagnosis and Treatment...: ...Associates, Toronto, On... http://t.co/ZYe93lBT5B", "created_at"=>"2014-03-19T21:20:47Z", "user"=>"zeefred", "user_name"=>"zefred", "user_profile_image"=>"http://pbs.twimg.com/profile_images/219250693/CRW_6422_150pix_normal.jpg"}
• {"id"=>"446395887455985664", "text"=>"PLOS ONE: Clinical Utility of SPECT Neuroimaging in the Diagnosis and Treatment...: ...Associates, Toronto, On... http://t.co/EuyAyOekwY", "created_at"=>"2014-03-19T21:20:47Z", "user"=>"kervarus", "user_name"=>"Fred Ansaldo", "user_profile_image"=>"http://pbs.twimg.com/profile_images/230578888/CRW_6422_150pix_normal.jpg"}
• {"id"=>"446396167031910400", "text"=>"A great day for @lionsgatehospital #UBC psychiatry and nuclear medicine!\nhttp://t.co/3FokK4cMIu", "created_at"=>"2014-03-19T21:21:54Z", "user"=>"UBC_Radiology", "user_name"=>"UBC Radiology", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3257411107/b6765bebec389132652fea17caacd033_normal.jpeg"}
• {"id"=>"446396653327908865", "text"=>"@ubcnews @UBCmedicine @UBC_Radiology http://t.co/pbZktxFtZ6", "created_at"=>"2014-03-19T21:23:50Z", "user"=>"1MinMedSchool", "user_name"=>"Dr Rob", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3386302252/cac4fc272203be1c353d3e0555f2462d_normal.png"}
• {"id"=>"446397645875998721", "text"=>"#PLOSONE: Clinical Utility of SPECT Neuroimaging in the Diagnosis/Treatment Traumatic Brain Injury: Systematic Review http://t.co/raZBf8v2xC", "created_at"=>"2014-03-19T21:27:47Z", "user"=>"UBC_Radiology", "user_name"=>"UBC Radiology", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3257411107/b6765bebec389132652fea17caacd033_normal.jpeg"}
• {"id"=>"446418348297834496", "text"=>"Clinical Utility of SPECT Neuroimaging in the Diagnosis and Treatment of Traumatic Brain Injury: A Systematic Review http://t.co/WH0OGLqsyM", "created_at"=>"2014-03-19T22:50:02Z", "user"=>"painfultweets", "user_name"=>"Paul Ingraham", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1231896413/sal3_normal.jpg"}
• {"id"=>"446419660750065664", "text"=>"RT @painfultweets: Clinical Utility of SPECT Neuroimaging in the Diagnosis and Treatment of Traumatic Brain Injury: A Systematic Review htt…", "created_at"=>"2014-03-19T22:55:15Z", "user"=>"1MinMedSchool", "user_name"=>"Dr Rob", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3386302252/cac4fc272203be1c353d3e0555f2462d_normal.png"}
• {"id"=>"446424323163967488", "text"=>"RT @UBC_Radiology: #PLOSONE: Clinical Utility of SPECT Neuroimaging in the Diagnosis/Treatment Traumatic Brain Injury: Systematic Review ht…", "created_at"=>"2014-03-19T23:13:47Z", "user"=>"1MinMedSchool", "user_name"=>"Dr Rob", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3386302252/cac4fc272203be1c353d3e0555f2462d_normal.png"}
• {"id"=>"446429476281671681", "text"=>"You've got 30 mins to kill, & my dear childhood friend, Dr. Rob Tarzwell, just published his first paper! SO PROUD! http://t.co/VRdpTsCjnz", "created_at"=>"2014-03-19T23:34:16Z", "user"=>"KikkiPlanet", "user_name"=>"Kathleen Smith", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000676782099/2aa1655a6c91336f9f053464eec40b2c_normal.jpeg"}
• {"id"=>"446670429785051136", "text"=>"RT @1MinMedSchool: Live on PLOS ONE!! SPECT in traumatic brain injury http://t.co/pbZktxFtZ6 @ubcnews", "created_at"=>"2014-03-20T15:31:43Z", "user"=>"PLOSONE", "user_name"=>"PLOS ONE", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2429958559/mzjl6as5u2m09r2erof6_normal.jpeg"}
• {"id"=>"446670543731687424", "text"=>"RT @1MinMedSchool: Live on PLOS ONE!! SPECT in traumatic brain injury http://t.co/pbZktxFtZ6 @ubcnews", "created_at"=>"2014-03-20T15:32:11Z", "user"=>"silversurfer8", "user_name"=>"joe a acosta", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000557599886/8b2e4fdda08186ecf7957015d2cfaa34_normal.jpeg"}
• {"id"=>"446682559091843072", "text"=>"RT @1MinMedSchool: Live on PLOS ONE!! SPECT in traumatic brain injury http://t.co/pbZktxFtZ6 @ubcnews", "created_at"=>"2014-03-20T16:19:55Z", "user"=>"ucl_crucitwit", "user_name"=>"Cruciform Library", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1120924008/cruciform_small_normal.jpe"}
• {"id"=>"446725535838646273", "text"=>"Clinical Utility SPECT Neuroimaging Dx + Tx of Traumatic Brain Injury: Systematic Review http://t.co/t0Hl9Yli4l", "created_at"=>"2014-03-20T19:10:42Z", "user"=>"creddingvye", "user_name"=>"CRedding", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000328552678/dea968ab51bef272919ca9e690dce58a_normal.png"}
• {"id"=>"447807137075699712", "text"=>"@neurobollocks @DocAmen conclusion: \"may be an important second test in settings where CT or MRI are negative\" http://t.co/gXqM7OrxnC", "created_at"=>"2014-03-23T18:48:35Z", "user"=>"JohnKubie", "user_name"=>"John Kubie", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000223204194/bbdabc85a6313c22b097e3357b61565c_normal.png"}
• {"id"=>"447811172612702208", "text"=>"RT @JohnKubie: @neurobollocks @DocAmen conclusion: \"may be an important second test in settings where CT or MRI are negative\" http://t.co/g…", "created_at"=>"2014-03-23T19:04:38Z", "user"=>"neurobollocks", "user_name"=>"neurobollocks", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3318911568/f577202d6b08169f4a474d66702317f1_normal.png"}
• {"id"=>"448176903334014976", "text"=>"Clinical Utility of SPECT Neuroimaging in Traumatic Brain Injury: A Systematic Review http://t.co/HybTr3cWOi", "created_at"=>"2014-03-24T19:17:55Z", "user"=>"Darren_S_Warren", "user_name"=>"Darren Warren", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000300920016/b651baaabc759c0118520af780099003_normal.jpeg"}
• {"id"=>"448939033406611456", "text"=>"@MishalHusainBBC New research I published on functional neuroimaging in Traumatic Brain Injury in PLoS One: http://t.co/fAwUDqEmkl", "created_at"=>"2014-03-26T21:46:21Z", "user"=>"cyrusraji", "user_name"=>"Cyrus Raji, MD, PhD", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1181057966/me_white_coat_normal.jpg"}
• {"id"=>"448939248184356864", "text"=>"New research on functional neuroimaging in traumatic brain injury published in PLoS One: http://t.co/fAwUDqEmkl", "created_at"=>"2014-03-26T21:47:12Z", "user"=>"cyrusraji", "user_name"=>"Cyrus Raji, MD, PhD", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1181057966/me_white_coat_normal.jpg"}
• {"id"=>"480042976991666179", "text"=>"@MITAtoday Thanks a lot for posting! I published a systematic review in PLoS One on functional brain imaging and TBI. http://t.co/pQGVlsDYR1", "created_at"=>"2014-06-20T17:42:19Z", "user"=>"cyrusraji", "user_name"=>"Cyrus Raji, MD, PhD", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1181057966/me_white_coat_normal.jpg"}
• {"id"=>"480043416525365249", "text"=>"@AlvinWyatt2 Thanks! Check out a systematic review I published in PLoS One on brain SPECT and TBI. http://t.co/pQGVlsDYR1", "created_at"=>"2014-06-20T17:44:03Z", "user"=>"cyrusraji", "user_name"=>"Cyrus Raji, MD, PhD", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1181057966/me_white_coat_normal.jpg"}
• {"id"=>"480045628026675200", "text"=>"RT @cyrusraji: @AlvinWyatt2 Thanks! Check out a systematic review I published in PLoS One on brain SPECT and TBI. http://t.co/pQGVlsDYR1", "created_at"=>"2014-06-20T17:52:51Z", "user"=>"AlvinWyatt2", "user_name"=>"Alvin Wyatt, MD", "user_profile_image"=>"http://pbs.twimg.com/profile_images/452317123725893632/_YwlO32o_normal.jpeg"}
• {"id"=>"480073388614877184", "text"=>"@PLOS SNM mentioned story on @AuntMinnie on my TBI work: http://t.co/wq9By4T8io . Fits PLoS One paper: http://t.co/pQGVlsDYR1", "created_at"=>"2014-06-20T19:43:09Z", "user"=>"cyrusraji", "user_name"=>"Cyrus Raji, MD, PhD", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1181057966/me_white_coat_normal.jpg"}
• {"id"=>"816868564586078208", "text"=>"https://t.co/5nxPDqIv60", "created_at"=>"2017-01-05T04:46:57Z", "user"=>"Oxyconmdamu", "user_name"=>"AlphaOmega, PharmC", "user_profile_image"=>"http://pbs.twimg.com/profile_images/762309401386426368/V2WepToB_normal.jpg"}

Wikipedia | Further Information

• {"title"=>"Philip F. Cohen", "url"=>"http://en.wikipedia.org/wiki/Philip_F._Cohen", "timestamp"=>"2019-03-15T21:59:00Z"}

Wordpress.com | Further Information

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Figshare

• {"files"=>["https://ndownloader.figshare.com/files/1426973"], "description"=>"<p>The second column describes each of these aspects for the current study.</p>", "links"=>[], "tags"=>["Clinical research design", "Systematic reviews", "Mental health", "psychiatry", "Neuropsychiatric disorders", "neurology", "Head injury", "neuroimaging", "Public health", "preventive medicine", "Socioeconomic aspects of health", "radiology", "Nuclear medicine", "SPECT imaging", "describes", "components", "pico"], "article_id"=>967428, "categories"=>["Medicine"], "users"=>["Cyrus A. Raji", "Robert Tarzwell", "Dan Pavel", "Howard Schneider", "Michael Uszler", "John Thornton", "Muriel van Lierop", "Phil Cohen", "Daniel G. Amen", "Theodore Henderson"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0091088.g001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_This_figure_describes_the_different_components_of_a_PICO_statement_and_they_are_Patient_Intervention_Comparison_and_Outcome_/967428", "title"=>"This figure describes the different components of a PICO statement and they are Patient, Intervention, Comparison, and Outcome.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-19 03:37:52"}
• {"files"=>["https://ndownloader.figshare.com/files/1426974"], "description"=>"<p>This figure outlines a flowchart of article selection in this study from the initial 1600 that were identified to the final 71 manuscripts that were included in the systematic review.</p>", "links"=>[], "tags"=>["Clinical research design", "Systematic reviews", "Mental health", "psychiatry", "Neuropsychiatric disorders", "neurology", "Head injury", "neuroimaging", "Public health", "preventive medicine", "Socioeconomic aspects of health", "radiology", "Nuclear medicine", "SPECT imaging", "outlines", "flowchart", "1600", "71", "manuscripts", "included", "systematic"], "article_id"=>967429, "categories"=>["Medicine"], "users"=>["Cyrus A. Raji", "Robert Tarzwell", "Dan Pavel", "Howard Schneider", "Michael Uszler", "John Thornton", "Muriel van Lierop", "Phil Cohen", "Daniel G. Amen", "Theodore Henderson"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0091088.g002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_This_figure_outlines_a_flowchart_of_article_selection_in_this_study_from_the_initial_1600_that_were_identified_to_the_final_71_manuscripts_that_were_included_in_the_systematic_review_/967429", "title"=>"This figure outlines a flowchart of article selection in this study from the initial 1600 that were identified to the final 71 manuscripts that were included in the systematic review.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-19 03:37:52"}
• {"files"=>["https://ndownloader.figshare.com/files/1426975"], "description"=>"<p>This table describes a summary of cross sectional studies included in this systematic review and include columns on sample size, lobar distribution, relative lesion identification on SPECT compared to other modalities, when SPECT imaging took place, and classification of TBI. Paper citations are integrated into the table.</p>", "links"=>[], "tags"=>["Clinical research design", "Systematic reviews", "Mental health", "psychiatry", "Neuropsychiatric disorders", "neurology", "Head injury", "neuroimaging", "Public health", "preventive medicine", "Socioeconomic aspects of health", "radiology", "Nuclear medicine", "SPECT imaging", "sectional"], "article_id"=>967430, "categories"=>["Medicine"], "users"=>["Cyrus A. Raji", "Robert Tarzwell", "Dan Pavel", "Howard Schneider", "Michael Uszler", "John Thornton", "Muriel van Lierop", "Phil Cohen", "Daniel G. Amen", "Theodore Henderson"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0091088.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_Cross_Sectional_Studies_/967430", "title"=>"Summary of Cross Sectional Studies.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-19 03:37:52"}
• {"files"=>["https://ndownloader.figshare.com/files/1426976"], "description"=>"<p>This table describes a summary of longitudinal and intervention trials included in this systematic review. Underlined first authored names denote intervention studies. The column on Lesion Localization denotes lobar distributions of SPECT abnormalities described in the evaluated articles with F = Frontal lobe, T = temporal lobe, P = Parietal lobe, O = Occipital lobe, and C = cerebellum. The (Y) denotes a yes to answer the question if a given evaluated paper described abnormalities on SPECT not visualized or described on comparison modality imaging. The column marked NOS denotes the Newcastle-Ottawa Scale score assigned for each longitudinal study or intervention article. Paper citations are integrated into the table.</p>", "links"=>[], "tags"=>["Clinical research design", "Systematic reviews", "Mental health", "psychiatry", "Neuropsychiatric disorders", "neurology", "Head injury", "neuroimaging", "Public health", "preventive medicine", "Socioeconomic aspects of health", "radiology", "Nuclear medicine", "SPECT imaging", "longitudinal"], "article_id"=>967431, "categories"=>["Medicine"], "users"=>["Cyrus A. Raji", "Robert Tarzwell", "Dan Pavel", "Howard Schneider", "Michael Uszler", "John Thornton", "Muriel van Lierop", "Phil Cohen", "Daniel G. Amen", "Theodore Henderson"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0091088.t001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_Longitudinal_and_Intervention_Trials_Underline_8202_8202_Intervention_/967431", "title"=>"Summary of Longitudinal and Intervention Trials. Underline = Intervention.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-19 03:37:52"}
• {"files"=>["https://ndownloader.figshare.com/files/1426977"], "description"=>"<div><p>Purpose</p><p>This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT) in traumatic brain injury (TBI).</p><p>Methods</p><p>After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild, moderate, or severe TBI with cerebral lobar specificity of SPECT findings. Other inclusion criteria were comparison modalities in the same subjects and articles in English. Foreign language articles, SPECT studies that did not include comparison modalities, and case reports were not included for review.</p><p>Results</p><p>We identified 19 longitudinal and 52 cross-sectional studies meeting inclusion criteria. Three longitudinal studies examined diagnostic predictive value. The first showed positive predictive value increases from initial SPECT scan shortly after trauma to one year follow up scans, from 59% to 95%. Subsequent work replicated these results in a larger cohort. Longitudinal and cross sectional studies demonstrated SPECT lesion localization not detected by CT or MRI. The most commonly abnormal regions revealed by SPECT in cross-sectional studies were frontal (94%) and temporal (77%) lobes. SPECT was found to outperform both CT and MRI in both acute and chronic imaging of TBI, particularly mild TBI. It was also found to have a near 100% negative predictive value.</p><p>Conclusions</p><p>This review demonstrates Level IIA evidence (at least one non-randomized controlled trial) for the value of SPECT in TBI. Given its advantages over CT and MRI in the detection of mild TBI in numerous studies of adequate quality, and given its excellent negative predictive value, it may be an important second test in settings where CT or MRI are negative after a closed head injury with post-injury neurological or psychiatric symptoms.</p></div>", "links"=>[], "tags"=>["Clinical research design", "Systematic reviews", "Mental health", "psychiatry", "Neuropsychiatric disorders", "neurology", "Head injury", "neuroimaging", "Public health", "preventive medicine", "Socioeconomic aspects of health", "radiology", "Nuclear medicine", "SPECT imaging", "spect", "traumatic", "systematic"], "article_id"=>967432, "categories"=>["Medicine"], "users"=>["Cyrus A. Raji", "Robert Tarzwell", "Dan Pavel", "Howard Schneider", "Michael Uszler", "John Thornton", "Muriel van Lierop", "Phil Cohen", "Daniel G. Amen", "Theodore Henderson"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0091088"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinical_Utility_of_SPECT_Neuroimaging_in_the_Diagnosis_and_Treatment_of_Traumatic_Brain_Injury_A_Systematic_Review_/967432", "title"=>"Clinical Utility of SPECT Neuroimaging in the Diagnosis and Treatment of Traumatic Brain Injury: A Systematic Review", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-19 03:37:52"}

PMC Usage Stats | Further Information

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Relative Metric

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F1000Prime