In my line of work, I find it extremely difficult to differentiate diagnosis, without diagnostic testing. Unfortunately, this is due to years of training in the scope of practice, without patient input.


The diagnosis of AD/HD is a complex diagnosis, with variable treatments, and prognosis. OBVIOUSLY….you would think. Actually, NO!
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Without going into a complete history, I will attempt to be brief. Daughter was diagnosed in 2005, and I was diagnosed in July 2008. These results came from testing but..not the type I would consider conclusive.
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She had all the standard testing, plus an EEG. I chose to allow this test as it is safe and she was part of a trial study….it showed NO CONCLUSION. HMMMM? But there is research on this…I shall not elaborate, because the point is mute.

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I on the other hand, walked in…she said, I must address something with you, and there it was! BAM! SAY WHAT? I have known my family doctor for years, and she had evaluated me, without knowing. I truly appreciated it, as I have suffered long enough!
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I have NOT read any of the typical books, or talked with anyone. I have however investigated the theory of MRI and AD/HD.


My finding are as follows:<O:p
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All patients were adult, ages 19-53, with the median of 35. All college educated with relatively High IQ. ½ male, ½ female. Bipolar in 1/3.<O:p

Volume deficits in the dosolateral prefrontal and anterior cigulate cortex (ACC) some as much as 6.5% to 14%..(adults) <O:p
This means there are regions of the brain that are not quite filled in. With any tissue and fluid, the body compensates, and fills in with more bodily fluids.<O:p
The volume differences are in regions of the brain that are involved in attention and executive control support.<O:p
To visualize the brain you must map it…inject a contrast, and evaluate the waves(this is my personal theory). This procedure would take time…as I feel you should evaluate on and off of stimulants. Each patient is different, so you would need to test TSH levels for metabolism levels, and test for pituitary abnormalities. WOW….this would take time!<O:p
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There have been many studies done with some conclusion, and some speculation.
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I was amazed to find the limited studies on adults, and several on children.<O:p
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MY Conclusion: this is broadly speculated! Because there are so many sub-conditions, this diagnostic tool will have to used with extreme caution, as it is not the sole perpetuator in the diagnosis, as there are several angles with inattentive, and hyperactivity, not to mention personality and depressive symptoms.<O:p
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My question: Has anyone had an MRI, for the treatment of your AD/HD? Was there a definitive diagnosis? <O:p
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This is a broad subject, but I wrote to several clinical trials, because I am very curious, if there will ever be a diagnostic tool in determining AD/HD, and will it save the patient a few steps.<O:p
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<O:pPlease know, there are several articles on line about this, but FEW, have actual results with references.</O:p
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<O:pI am making no suggestion, for inquiring with your medical practioner, and am truly looking at this from the patients point. Be careful what you read, and know this study will one day be a tool, is helping us all understand the complexity of AD/HD.</O:p
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<O:pThanks,</O:p
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You're looking at multiple disorders under the umbrella AD/HD. Weve definetly come to the conclusion that AD/HD-I is not ADHD at all and is its own disorder entirely. I cant imagine any unifying physical characteristic that would be obvious enough to see with current brain mapping technology. I would go as far as to dismiss the theory that there is such a difference because the brain is simply not that simple. Anyone who's practiced psychiatry for a large amount of time is going to be very jaded about this.

I had an MRI done ten years ago when they thought I was going schizofrenic or may have a tumor, but as far as I was told, there was nothing abnormal about the picture.
I remember they did it without the contrast fluid after discussing it some.
I have no idea if that is a problem or not...I guess not, since they're professionals. ;)

Another thing is, that if you are not looking for a specific illness and it only shows with subtle varieties on said picture, maybe you could miss it if you were in a hurry and actually looking for a tumor? Or maybe not? I don't know...

I still seem to present with most symptoms of ADHD combined (ADD with a bit impulsiveness) I'd like to get someone else look at that MRI with ADHD in the back of their head instead of a tumor, just for kicks..even if it's not conclusive.

Thanks for the post, XrayBabe :)

I asked my psych if I should have a PET scan. He asked why spend money to try to show something he already knows.

I asked my psych if I should have a PET scan. He asked why spend money to try to show something he already knows.


A pet scan is completely different, (nuclear), but he is right, do not have this added exposure, for anything other than Cancer, or primary disabling disease...
Thank-you so much for input.

You're looking at multiple disorders under the umbrella AD/HD. Weve definetly come to the conclusion that AD/HD-I is not ADHD at all and is its own disorder entirely. I cant imagine any unifying physical characteristic that would be obvious enough to see with current brain mapping technology. I would go as far as to dismiss the theory that there is such a difference because the brain is simply not that simple. Anyone who's practiced psychiatry for a large amount of time is going to be very jaded about this.


EXACTLY!!!!!!!!!!!!!!!!!!!!!!!
Thank-you, my point! completely, but I had to hint around....and you got it.
Obviously I do not practice or pretend to be in psychiatry, and have a lot to learn..but I feel the MRI, and the money it expends....well, I will keep negative comments to a low roar!

THANKYOU......so much!
X

I had an MRI done ten years ago when they thought I was going schizofrenic or may have a tumor, but as far as I was told, there was nothing abnormal about the picture.
I remember they did it without the contrast fluid after discussing it some.
I have no idea if that is a problem or not...I guess not, since they're professionals. ;)

Another thing is, that if you are not looking for a specific illness and it only shows with subtle varieties on said picture, maybe you could miss it if you were in a hurry and actually looking for a tumor? Or maybe not? I don't know...

I still seem to present with most symptoms of ADHD combined (ADD with a bit impulsiveness) I'd like to get someone else look at that MRI with ADHD in the back of their head instead of a tumor, just for kicks..even if it's not conclusive.

Thanks for the post, XrayBabe :)

As, I am over cautious...yes, I read for the cause, but we are trained to look beyond the obvious...and go deep. Mis Reads, are less common than years ago with the capability of digital, and pixels, with reduced lag! So, go ahead, put your local, RAD. to the test...if you dare...hehehhe

Well, I have read several MRI's with pt's who presented with ADD...and well...shhhhhh..its a secret...
Thank you for input!.
X

As, I am over cautious...yes, I read for the cause, but we are trained to look beyond the obvious...and go deep. Mis Reads, are less common than years ago with the capability of digital, and pixels, with reduced lag! So, go ahead, put your local, RAD. to the test...if you dare...hehehhe

Well, I have read several MRI's with pt's who presented with ADD...and well...shhhhhh..its a secret...
Thank you for input!.
X

LOL sure, I dare - what would be the worst thing that could happen? ;)
But I must say, I'm afraid Danish MRI machines probably hasn't been updated in the past ten years, so I doubt I'd get better pictures.

Only if I went to a private hospital, and that's not really an option, sadly.

Still, I don't think I want to spend more of my coDanes' taxmoney on MRIs for me, so even if it irks me more than a bit that psychiatry in many aspects is very subjective and therefore, most of the illnesses are not "empirically testable", I'll just get tested for ADHD by a psychiatrist with whatever means they've got in that field.

At least I know what's wrong with me now and I can hint it to them so they don't have to do that "good" old "spin the bottle, see what dx it points to" game they used to do on me. :rolleyes:

They always knew I was a nutjob, they just always had trouble finding out what kind of nut pulled off that job! :D

I'd feel better about things if my illness was easily readable on some medically sound and welproved test like bloodwork or MRI, but hey...none of my other 4-5 dxs came by with "proper scientific testing", so I can take another wild shot at me...as long as I finally think they're having it right this time! :D

Wow you raised a good question. MRI and PET have been used in ADHD research a lot, but no diagnostic method involving these technologies currently exists. The only possible exception is Dr Amen who uses PET scan as a diagnostic tool. However his methods are not generally accepted as nobody else has been able to duplicate his results. It's generally labeled as pseudoscience.

About a year ago I read a short news blurb that said researchers at Harvard were patenting a diagnostic method for ADHD that used medical imaging, but I've not run across any more information on it.

The idea of using medical imaging as a quantitative diagnostic tool for ADHD is attractive, but I don't know of any research being done along those lines.

With the resolution of medical imaging improving constantly and with more and more being learned about the biology of ADHD, it may simply be a matter of time before it is possible to go to a clinic and get a scan that confirms a diagnosis of adhd, but I'd not look for it to happen any time soon. Technologically it is still a pretty big leap.

If I may speculate.... If one goes by some of the recent wisdom regarding adhd, an MRI could map the immature (missing mylein) white matter regions in the brain that ADDer's supposedly have. All you have to do then is is compare that individual statistically to a database of "normal" people to get a number that ranks the probability that the individual has ADHD.... lol It would work IF and only if that were the big factor in ADHD, which it almost certainly is not.



ME :D

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I just want to know why people with High IQ were cherry picked for this particular study. That seems a bit "narrow" don't you think?

The problem with the results from the MRI studies is that they are statistical: if you scan people with ADHD, on average they will have smaller caudate nucleus volume (that's the most commonly seen deficit), but that's looking at the average of 15+ ADHD individuals (sometimes mapping onto a "standard brain") and comparing that to the average of the 15+ "normal" brains. That doesn't mean that there isn't any overlap between the distributions (in fact, there probably is some), and therefore it's really difficult to draw conclusions about 1 individual.

Batman,
I have no reasoning for the patients they choose for any study, but my thoughts: To enlist in any clinical trial, you must have documentation of diagnosis, and you must be aware there is actually a study.
In life how often do you hear "trial study" come check it out....NOT!
Most clients will be looking for a cash reimbursment, or are in constant search of new trials, which takes keen sence of how the system works. So, if you are one who explores the wonders of Clinical Studies, then you have the inside scoop...
Actually, studies are announced, but with low key advertising...so you see...if you have the will to search...you will be found!
X

Batman,
I have no reasoning for the patients they choose for any study, but my thoughts: To enlist in any clinical trial, you must have documentation of diagnosis, and you must be aware there is actually a study.
In life how often do you hear "trial study" come check it out....NOT!
Most clients will be looking for a cash reimbursment, or are in constant search of new trials, which takes keen sence of how the system works. So, if you are one who explores the wonders of Clinical Studies, then you have the inside scoop...
Actually, studies are announced, but with low key advertising...so you see...if you have the will to search...you will be found!
X

Are you suggesting that only "highly intelligent people" are capable of understanding how the system works?

If this is the case then I should like to respectfully disagree with the implication...

I could be reading you wrong, of course, as I have done so before..

(just expressing my viewpoint, not trying to start anything!)

Batman,
By all means no! I would never suggest such a ridiculous notion....
I meant often people make it their full time job to search trials, and be participants. You would not believe the amount of people who volunteer for drug trials, knowing the side effects, just for money...Although with the economy, many of us will do anything to keep the lights on.(completely of subject! must be ADD..ha)
I apologize if I was not clear....as you know...I am quite "abstract". HA
X

...may have a tumor...

Ahem, in the words of Arnold from Kindergarten Cop...

*best Schwarzenegger voice*
"It's NOT a tumor!" :cool: