Brain Scan a good thing.?

Does anybody know if this has improved in recent years, please?  If this is a useful diagnostic tool, how easy is it to get a brain scan and interpretation, and how much is it?

If it is 90% accurate now , maybe with time it would be better. Screening would, I imagine, be followed up. So perhaps false  readings would be filtered out later, as with physical illness such as cancer.

The current situation is that there are a lot of people who don't get diagnosed with ASD because their cases are complicated by lots of consequential comorbidities that are hard to distinguish against alternatives like bipolar disorder or other severe disorders. When a doctor comes to do a differential diagnosis they don't have any reliable tests that get past our communication disorders to the true underlying causes. So, in a lot of cases people are condemned to a life on meds when, in fact, they have the much more benign condition of ASD. Wouldn't it be good if we could save a bunch of people from a lifetime on meds by using a reliable test that could bypass our communication issues?

In any case, this is long term research, I don't think that they are close to having anything that is reliable enough for the really problematic cases where it could be of great benefit.

In my oiwn case, I would have been grateful if something like this could have identified the problem in my father. He had a lifetime on meds that were not successful in treating his depression and anxieties. He ended up with Alzheimers and I wonder whether the meds had something to do with the final outcome. If this scenario could be avoided by having a proper scientific test, rather than having to jump through hoops with vague questions and uncertain diagnoses to convince some practitioner who might just be following a script without any great understanding of how to tell the difference, then I for one would welcome it.

...Im almost literally defaecating in fear!! There is no legitimate reason for developing this technology...behavioural proofs are good enough for benign diagnosis and dont cost millions in R+D, testing and application...this is a targeting tool preparitory to a genocide...

I have just looked and it says that brain scan results usually give the same results of traditional diagnoses but not always.

As traditional diagnoses is subjective might it be that the results of traditional diagnoses could be wrong and the results of the brain scan always right.

Everyone behaves as though they are Autistic some times and it is possible for an Autistic person to overcome their disability in a few cases.

If a brain scan detects differences in the brain structure the computer is objective so is probably correct and is also correct if it does not.

It is true that people who come into daily contact with us are not interested in brain scan results but in how we behave.

The point I am making is that the brain scan might never be wrong in deciding who is Autistic.

David

How do we know if the machines are not a hundred percent accurate.?

I should think it is possible to have difficulty reading without being Dyslexic and some people with Dyslexia over come their difficulties.

The same might be true of Autism.

Are you saying that ninety percent of people who behave as though they are Autistic show up on the brain scan?

Are you also saying that people who do not behave as though there are Autistic do not show up on the brain scan.

David

This story is a very good illustration of the perils of science reporting. Most of the media stories would have been based on the Kings College press release which opens like this.

Scientists from the Institute of Psychiatry (IoP) at King’s College London have developed a pioneering new method of diagnosing autism in adults. For the first time, a quick brain scan that takes just 15 minutes can identify adults with autism with over 90 per cent accuracy. The method could lead to the screening for autism spectrum disorders in children in the future.

That all seems straightforward until you look at the actual paper which is open access so you can download it for free. I wrote "look at" deliberately. It is far too technical for most of us to understand. But I did learn something.

All the test subjects were male, adult, right handed, of normal intelligence, with no history of any psychiatric disorder or illness that might affect their brains (eg psychosis or epilepsy). They all had blood rests to rule out other disorders like fragile X. But even if the test eventually proves viable for women, children, people of low IQ, etc. it faces an even bigger obstacle.

The test was 90% sensitive and 80% specific. This means that 9 times out of to it will correctly identify autistic people taking the test. But it will only correctly identify non-autistic people 8 times out of 10. In the real world screening tests would be used on 1000s of people at a time. If you test 1000 people for autism you would expect to find 10 with autism. 90% sensitivity means the test would find 9 of them. But the test would also incorrectly find autism in 20% of the rest - 198 false positives.

It may turn out to be a useful research tool that adds to our understanding of autism. But it is going to be a long, long time - if ever - before this test is any use as a screen for autism. 

Firstly how does anyone know the scan was wrong.

We are all individuals so it might be that some people who have that difference do not behave in an Autistic way as I explained in Asperger United.

Do not Sterotype Autistic people.

Secondly if the whole world was Autistic we would  be quarelling as we would not get on like the Tower of Bable.  Everyone spoke a different language so the tower was not built.  Autistic people do not always get on as we have our different obsessions.

Thirdly we must not forget about co-existing conditions Autistic people have such as Dyspraxia Dyslexia and Mental Illness Epilepsy.

Many people spend their last few years of their lives in pain and I do not think I could cope.

That might be because of my Asperger Syndrome.

David

Once this invention is in full use the definition of Autism might change.

At the moment it is defined by behaviour.

If we had the brain scan they might say that one is Autistic if it shows in the scan

and if it does not show in the scan they might say that Autistic like behaviour is not Autism.  

According to the American rules one is only supposed to be labelled Autistic if the symptoms started  before the age of three and one was born with Autism.

If one developed Autism as a result of an accident that would not count as Autistic.

Over  twenty years ago I helped in a class of adults with people with learning difficulties.

There was a man from the Merchant Navy who could not speak and could not even find his way round the room.  He caught an infection at sea which caused his condition.

I remember he squeezed my hand hard.

Worse than the others in the class who were born with Learning Difficulties.

Well according to those rules he would not count as Autistic altough he cannot communicate.

David

NAS5317 said:

90% is very good, and far better than for example 60%.

Sorry, I obviously wasn't clear. The sample size is so small that I wouldn't be jumping up and down about the accuracy of the 90% claim.

i think (at least according to wikipedia) the general consensus is that scientists have no clear definition of autism... and i think they need to properly define what it is before they can look for the relevant brain structures... so for the time being i think the best we can expect is that a brain scan can indicate likelihood of having autism (just as having an autistic parent can be an indication of likelihood but not certain confirmation of inheritance) etc

Yes I expect the first brain scans with the new computer might not be perfectly accurate.

On the other hand it is possible to have some of the traits of Austism without being Autistic by having a difficult personality.

I wrote that in the last Asperger United: Do not Sterotype Autistic people.

May be the brain scan will find out who is really Autistic.

If a person is not really Autistic in some cases it might be easier to change the person who is not Autistic by training and in the case of a child by up bringing.

David

This is very preliminary research and to have a significant statistical result we would need to have close to 30,000 case studies in order to cover as many differing neurological structures as possible.

Looking at disablement generally in the world population, it works out at 1 in 4 and in the UK, which should have a low incidence of disablement compared to third world countries we have 1 in 7.

I am in acute and chronic pain and I do not wish that on anyone and frankly if arthritis could be cured I would be the first person to have it done and to apply eugenics to prevent others going through the levels of pain that I have.

Equally if conditions like deafness and autism were painful, you would all be out campaigning to get rid of them.

No country can afford to keep an increasing population of disabled people without that country going bankrupt at some point.

We have a finite size of world, with a finite amount of food production and an increasingly broken set of medical facilities and support systems for us disabled people.

This is not about being deprived of life, this about being realistic and realising that either we change the ways that we live and think about human rights and actively control our breeding or we are heading for World War Three and a fight for who gets to live off the resources.

There is a solution, it is very simple, stop allowing others to stand for Parliament or for District and County Councils and stand up and be counted at local and central government elections; be a councillor or an MP.

Take Parliament and the Councils away from those who wish to place the burden of financial reparations on those whom they think have the least power.

In this country 1 in 4 of the voting public is disabled, so let's get off our backsides and do something constructive.

I am somewhat doubtful as to the claims of 90% accuracy with such a small sample group, particularly when they talk of diffences within the group. I'd have to look at the full paper to make a proper judgement, plus it would of course have to be repeated on a much larger scale including women and children with autism.

I would be particularly hesitant at extrapolating the use to diagnose autistic children based on differences seen in adults as these neurological differences may become more apparent later in life due to using different parts of the brain. The last thing we would want would be for children to be missed based upon a false premise.

Hello David and welcome to the community.

Thank you for starting this interesting discussion.  I'm sure it's one that lots of our members will have opinions on and will want to contribute to.

For people who do not know this study that well, the following links to further information about it might be useful:

An article from the Guardian:
http://www.guardian.co.uk/science/2010/aug/10/autism-brain-scan
 
A BBC news story:
http://www.bbc.co.uk/news/health-10929032
 
The NAS news story:
http://www.autism.org.uk/en-gb/news-and-events/news-archive/8-august/researchers-use-brain-scans-to-diagnose-autism.aspx