By Dr. Antonio Rotondo, licensed clinical psychologist, specializing in neuropsychology.
Neurotechnologies that help diagnose and treat brain disorders are, in essence, a form of “information technology” in the behavioral healthcare world. They’re also relatively new in the history of psychiatry, and their advent is allowing us to more accurately diagnose and treat those who suffer from addiction and mental illness.
Subjective pursuit or objective science? Psychiatry vs. other branches of medicine
With most medical diagnoses, doctors have been able to rely on objective tests to diagnose and treat patients’ ailments:
- If a primary care doctor suspects a diagnosis of diabetes, they can order an oral glucose tolerance test and measure blood sugar levels.
- In the case of a broken bone, a simple X-ray should reveal it.
- Even with diagnoses that are far more diabolical, such as cancer, physicians can perform a whole battery of medical procedures (lab tests, ultrasounds, scans, biopsies, etc.) which can provide an objective diagnosis.
On the other hand, in the absence of similarly objective, diagnostic tools, diagnosing and treating mental disorders has long been a more subjective exercise— and probably one big reason that psychiatry has historically been subject to marginalization next to other “more scientific” branches of medicine.
Much also remains to be understood about the neurobiology of mental disorders and their treatment. It’s a fact that the psychotherapist Gary Greenberg, writing in the April 2019 issue of The Atlantic, has rightfully noted is “unsurprising, given that the brain turns out to be one of the most complex objects in the universe.”
Advances in brain imaging technologies and what they can reveal
But in recent years we’ve begun learning more and more about the brain and the neurobiology of its dysfunction, thanks to various brain imaging technologies that allow us to map this incredibly complex organ, trace its activity and locate abnormalities in health and function:
- MRI scans use a strong magnetic field and radio waves to create detailed, 3-D images of the brain and its tissues, allowing doctors to diagnose brain tumors, aneurysms, epilepsy, brain hemorrhages and other issues.
- CT scans use X-rays to produce horizontal, or axial, images (often called slices) of the brain. These allow physicians to detect brain clots, lesions, injuries, intracranial bleeding, infections, structural anomalies, and other conditions. CT scans can also be used to evaluate the effectiveness of treatments for brain tumors.
- SPECT scans—or “single-photon emission computerized tomography”—are a type of nuclear imaging test that takes 3-D pictures using a radioactive substance. SPECT scans can help diagnose dementia, clogged blood vessels, seizures, epilepsy, and head injuries.
- qEEG scans measure the brain’s electrical activity via brainwaves and their patterns, which in turn offer insight into how brain cells are communicating. The “q” in “qEEG” stands for “quantitative”: it means that unlike a typical EEG scan, a qEEG will be able to analyze and compare electrical signals and brainwave patterns against a database of healthy-functioning brains’ electrical signals and brainwave patterns.
Diagnosing and treating mental disorders – in pursuit of a more exact science
Thanks to these developments, we now know with reasonable clinical certainty that specific brain networks and regions are associated with various types of cognitive and psychiatric dysfunction, involving substance addiction, mood disturbances (depression, anxiety, mania, etc.), or neuropsychological deficiencies (attention problems, impulse control issues, learning disabilities, etc.).