comment on use of SPECT for ALS diagnosis, and question

[lydia]

I mentioned on previous post about the use of SPECT to diagnose ALS; I was wondering at the time if anyone knew anything about it. As the day I get my SPECT results comes closer, I have been researching this idea more, and have found that there are studies out there where (and please cut me some slack if I get this wrong) 1)SPECT has been used to differentiate ALS patients with Dementia from ALS patients without Dementia, and (these are the ones I find interesting) 2) SPECT has been used to identify particular patterns that patients already diagnosed with ALS might have.

With respect to the latter, it appears that ALS patients have a very distinct pattern of decreased CBF in the frontal and temporal lobes (oh shoot, I might be messing up the lobes and don't have my notes with me!), and that based on that pattern they could be reliably distinguished from other patients with other neurological diagnoses (PD and AD were two of them). And if I remember correctly, detecting the pattern was not dependent on duration or severity of symptoms. This suggests to me a definite possible use for early diagnosis. (Oh, I think the "pattern" was useful for identifying upper motor neuron degeneration, perhaps therein lies the problem...still have to look for the lower...?)

My question is: For those of you who read this sort of stuff (Wright, others...) are you aware of any studies where they used SPECT to differentiate between normal controls and ALS patients? It seems all the studies I have attempted to decipher only utilized people with neurological problems.

And a comment: I have been reading LOTS about the potential for SPECT to identify Parkinson's in the preclinical stage, and despite this potential, have been on a couple of PD forums where very few of the posters have had a SPECT or only a few report getting one as part of a clinical trial or, and this bothers me, only got the SPECT after YEARS of trying to find out what was wrong...only to have it completely confirm the diagnosis of Parkinsons. If SPECT has this much potential then why not use it? I heard from some PD posters that they thought that now that SPECT has been around for awhile in research endeavors that it is starting to become more mainstream in actual practice, that as word gets out neuros are starting to order it. Can you imagine? To me it seems to have the potential to get rid of that horrible eliminate every other possibility first diagnosis process. And that is just with PD...what about ALS as well? How amazing that would be. Just a thought.

 

[lydia]

I withdraw my question on studies with normal controls. I found plenty. Not that it helps!

 

[Al]

Just a wild guess here but I bet there aren't a lot of these machines around so the cost is probably large which might cause a lot of Neuro's to not suggest it which would in turn hinder research with it.

AL.

 

[lydia]

Hi Al,

I heard that SPECT is the much cheaper version of PET. Even so, my insurance company wouldn't let me have it until neuro did some persuading. I haven't seen the bill yet, so I have no idea how much it cost. I know my insurance company did cover it in full. I do know that at the place I had it done, the tech guy told me they are the only place for miles around that does this sort of thing, that people come from Ohio, Penns, Canada (and yet the office was strangely shabby). We are ony about 70 miles or so from Rochester New York though and I bet there is one there as well. I read papers on this until the wee hours last night and I do believe that PET and SPECT are going to play a huge role in diagnoses in the future.

Lydia

 

[Al]

I've been to Buffalo many times. We're only a couple of hours away. I've never heard of SPECT before you brought it up. I have no idea if any Toronto hospitals even have one.

AL.