Have you been diagnosed with a neurological condition without anyone looking at your actual brain?
Imagine that by some stroke of bad luck, you broke a leg whilst playing a game of football…You go to accident and emergency and tell the doctor you think you have broken your leg. He/she then asks you to stand on it and to walk around, before asking your partner, who was watching the game, if she saw the tackle and if it was likely to have caused a break. Satisfied that it is broken the doctor puts a plaster cast on it… Would you be happy with the medical attention you received?
Or imagine that you found a lump in your neck… You go to your GP and after having a look at this lump and writing down some of the symptoms seemingly related to it, he/she determines it is cancer and decides to start you on a course of chemotherapy. No scan, no biopsy you wonder? Would you think that that was a reasonable course of action ? No. So why do we accept this for so many neurological conditions? When giving a diagnosis, neurologists very often do not look at the brain at all… In fact, they frequently aren’t involved in the diagnosis process.
I expect that less than 10% of people with a diagnosis of autism have ever actually had anyone look at an image of their brain. Instead, we treat clusters of symptoms that a person might be exhibiting and take a stab in the dark about what might help. What is really key is that many people with a neurological condition often have multiple conditions. For example, Autism and epilepsy are commonly sited together, as well as adhd and OCD… However, there can be so many combinations that if we are only ever treating the symptoms rather than the whole picture, we might not get the best outcome at all.
Here is an image of 2 brains both suffering from depression, with the same cluster symptoms. A psychiatrist could treat the 2 patients with the same medication, but yet get a completely different outcome for their patients.
Currently experts believe that 60% of autism cases can be detected by a scan. For other conditions the percentage is even higher. If more people were scanned, this would in all likelihood increase, as would our knowledge of the makeup of the autistic brain.
By learning more about brains of people with neurological conditions, we could perhaps get to the point of being more specific when it comes to diagnosis and treatment plans. Instead of a vague diagnosis of “he is on the autism spectrum” , followed by “as it is a vast spectrum, everyone is very different” as well as “we can’t really tell you much beyond that but wonderful things do happen”, we could get a more specific diagnosis. I certainly believe that it is high time things were changed and doctors adopted a different approach, don’t you think?
We know that the autistic brain is wired differently compared to the neurotypical brain. In most cases, it’s less connected. If we understood how it is connected individually, then diagnosis, treatment, learning and outcomes could be so much better informed and planned for. This could be done in a much more proactive manner with treatments then tailored to the individual in question.
Brain scanning might be useful even after diagnosis to help plan treatment that will work. There is evidence that the brain can become better connected if we target it specifically.
Scanning more people would enable further study further understanding, and potentially a revolution in the treatment of neurological conditions.
Brain scanning isn’t a new technology. It has been around for a while now but is still not routinely used. When you consider the care costs of someone with complex needs (that might be lifelong) wouldn’t it be worth having a little scan to make sure that you are targeting the individual’s care correctly?
What are your thoughts on this? If you had a neurological condition, would you be willing to be scanned and analysed- both for yourself and for future research of that condition?
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