Amen on 7 types of ADD via SPECT scans

[Guest guest]

I found this interesting since both Rossignol and Goldberg use SPECT scans.

Goldberg gives SSRIs and Rossignol gives AEDs in some cases.

1. AD/HD, combined type with both symptoms of inattention and

hyperactivity-impulsivity. SPECT Brain imaging typically shows decreased

activity in the basal ganglia and prefrontal cortex during a concentration task.

This subtype of ADD typically responds best to psychostimulant medication.

2. AD/HD, primarily inattentive ADD subtype with symptoms of inattention and

also chronic boredom, decreased motivation, internal preoccupation and low

energy. Brain SPECT imaging typically shows decreased activity in the basal

ganglia and dorsal lateral prefrontal cortex during a concentration task. This

subtype of Inattentive ADD also typically responds best to psychostimulant

medication.

3. Overfocused ADD, with symptoms of trouble shifting attention, cognitive

inflexibility, difficulty with transitions, excessive worrying, and oppositional

and argumentative behavior. There are often also symptoms of inattention and

hyperactivity-impulsivity. Brain SPECT imaging typically shows increased

activity in the anterior cingulate gyrus and decreased prefrontal cortex

activity. This subtype of Overfocused ADD typically responds best to medications

that enhance both serotonin and dopamine availability in the brain, such as

venlafaxine or a combination of an SSRI (such as fluoxetine or sertraline) and a

psychostimulant.

4. Temporal lobe ADD, with symptoms of inattention and/or

hyperactivity-impulsivity and mood instability, aggression, mild paranoia,

anxiety with little provocation, atypical headaches or abdominal pain, visual or

auditory illusions, and learning problems (especially reading and auditory

processing). Brain SPECT imaging typically shows decreased or increased activity

in the temporal lobes with decreased prefrontal cortex activity. Aggression

tends to be more common with left temporal lobe abnormalities. This subtype of

Temporal ADD typically responds best to anticonvulsant medications (such as

gabapentin, divalproate, or carbamazepine and a psychostimulant

5. Limbic ADD, with symptoms of inattention and/or hyperactivity-impulsivity and

negativity, depression, sleep problems, low energy, low self-esteem, social

isolation, decreased motivation and irritability. Brain SPECT imaging typically

shows increased central limbic system activity and decreased prefrontal cortex

activity. This Limbic ADD subtype typically responds best to stimulating

antidepressants such as buprion or imipramine, or venlafaxine if obsessive

symptoms are present.

6. Ring of Fire ADD – many of the children and teenagers who present with

symptoms of ADD have the " ring of fire " pattern on SPECT. They often do not

respond to psychostimulant medication and in many cases are made worse by them.

They tend to improve with either anticonvulsant medications, like Depakote or

Neurontin, or the new, novel antipsychotic medications such as Risperdal or

Zyprexa. The symptoms of this pattern tend to be severe oppositional behavior,

distractibility, irritability and temper problems and mood swings. We think it

may represent an early bipolar pattern.

7. Trauma Induced ADD, especially to the left dorsolateral prefrontal cortex.

The symptoms come on or intensify in the year after a head injury or brain

trauma. The ADD symptoms may respond to psychostimulant medication. If

irritability results secondary to psychostimulant medication the addition of a

low dose anticonvulsant may be helpful