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

John F Thornton; Howard Schneider; Philip F Cohen; Simon DeBruin; John Michael Uszler; Yin-Hui Siow; Mary K McLean; Muriel J van Lierop; Dan G Pavel; Theodore A Henderson

doi:10.3389/fpsyt.2022.787186

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

Front Psychiatry. 2022 Mar 25:13:787186. doi: 10.3389/fpsyt.2022.787186. eCollection 2022.

Authors

John F Thornton^{1

2}, Howard Schneider^{2

3}, Philip F Cohen^{2

4

5}, Simon DeBruin⁶, John Michael Uszler^{2

7

8}, Yin-Hui Siow^{2

9}, Mary K McLean^{2

10}, Muriel J van Lierop^{2

10}, Dan G Pavel^{2

11}, Theodore A Henderson^{2

12

13

14}

Affiliations

¹ Rossiter-Thornton Associates, Toronto, ON, Canada.
² International Society of Applied Neuroimaging, Denver, CO, United States.
³ Sheppard Clinic North, Vaughan, ON, Canada.
⁴ Nuclear Medicine, Lions Gate Hospital, Vancouver, BC, Canada.
⁵ Department of Radiology, University of British Columbia, Vancouver, BC, Canada.
⁶ Good Lion Imaging LLC, Columbia, MD, United States.
⁷ DrSPECTscan Inc., Lake Elsinore, CA, United States.
⁸ Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA, United States.
⁹ Nuclear Medicine, Southlake Regional Health Centre, Newmarket, ON, Canada.
¹⁰ Private Practice, Toronto, ON, Canada.
¹¹ PathFinder Brain SPECT LLC, Deerfield, IL, United States.
¹² Dr. Theodore Henderson, Inc., Denver, CO, United States.
¹³ The Synaptic Space, Inc., Denver, CO, United States.
¹⁴ Neuro-Luminance, Inc., Denver, CO, United States.

Abstract

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

Keywords: SPECT; attention-deficit hyperactivity disorder; biomarker; community psychiatry; neuroimaging; post-viral syndrome; traumatic brain injury.