Change Your Brain Every Day - Can Imaging Lead To Better Diagnoses for Autism?- Part 2 of an interview with Lisa Ackerman

Episode Date: May 23, 2017

When you see a kid with autism, you’ve seen ONE kid with autism. Unfortunately, autism is not one thing, and you can’t treat every brain the same. Fortunately, there are ways to scan the brain to determine the type of autism your child has, so you can treat them using appropriate methods. In part two of a series with Lisa Ackerman, founder of TACA (Talk About Curing Autism), hosts Dr. Daniel Amen and Tana Amen discuss the role SPECT imaging plays in autism treatment.

Welcome to the Brain Warriors Way podcast. I'm Dr. Daniel Amen. And I'm Tana Amen. Here we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD, and addictions. The Brain Warriors Way podcast is brought to you by Amen Clinics, where we've transformed lives for three decades using brain spec imaging to better target treatment and natural ways to heal the brain. For more information, visit amenclinics.com.

The Brain Warriors Way podcast is also brought to you by BrainMD, where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information, visit brainmdhealth.com. Welcome to the Brain Warriors Way podcast. Welcome back, everybody. Tana and I are blessed to have Lisa Ackerman with us. And Lisa is the founder and the executive director of TACA. Talk about curing autism. You can learn more about it at TACANow.org. She has been a warrior in the autism community for many years.

And it's personal. It came from having her son who was diagnosed with it. And she has literally helped tens of thousands of people. And what we're going to do in this podcast is we're going to talk about something that's actually really special to me, which is imaging and autism. Didn't you come to me five years ago or more that you said,

we need to look at brains of kids with autism and write a study on it, and you were all wanting to get that done? How long ago was that? It was 12 years ago. Okay, sorry. I've aged in dog years, so I apologize. I can't keep track of time. It was actually before I met Tana.

Okay, okay. My apologies, folks. It was 12 years. Don't jip actually before I met Tana. Okay. My apologies, folks. Oh, that's hilarious. Don't jip them on any of those years. Okay. Well, time flies when we're having a good time, right? But I was just so impressed at you looking at and doing it so methodically and then seeing the study.

I think I cried when you sent it to me. I was so excited. So for folks out there, it's, hold on, there's a lot of words. Functional spec neuroimaging using machine learning algorithms distinguishes autism spectrum disorder from healthy subjects. And it's so incredibly important. Tell me about this. Why is it so important? Well, it's the world's largest imaging study with children and adults who have autism. And up until now, there's been no brain way to diagnose them. That autism is a clinical diagnosis.

It's a diagnosis of symptoms right if you have and and the three major symptoms are you get stuck on things you get the same thought in your head over and over so it's the cognitive rigidity you have social skills deficits uh you don't read social situations properly, and their language deficits. So I have a question. So I don't clearly know as much about autism as the two of you do, so I'm the odd man out here. And for the people who are watching and listening, I want to make sure that we cover this. I have a lot of friends who are in this situation. We deal with this a lot in our clinics, but there's things I think I just want to know and clarify. I'd like to know the increase in the rate of autism.

And also, you mentioned something in our last podcast, Lisa, that I think is really important. Not all kids have the same symptoms. So there's like this spectrum we hear about. But what does that mean? Like for a lot of us, we don't understand what that spectrum really means. So help us out. Well, to hit the second question, then we'll come back to the first um so i'm not avoiding you but for autism what we say is once you see a kid with autism you've seen one kid with autism and

it same goes with adults they do present so differently and, it's just the constellation of the same types of experiences that give you that diagnosis. So for example, instead of one kid hand flapping as a self stimulatory behavior, another one may open and close the door. So it appears differently, but it affects you just the same. I can't stop them with my words, or I have to physically move them to stop opening and closing the door, or distract them. I'm great at divert and distract. I'm like, that's my expertise, if you really want to know. Well, besides that, I'm making you dinner. But the point being is, it's when they rise up so much that they can't learn in a typical setting.

They have behaviors because of frustrations, which could be communication or not understanding. But it's just the constellation of them all together that really equates to autism. And there's some great videos on the TACA website and also stories that describe different people's experiences. And, of course, on About Autism, there's literally all the symptoms. Now, you and I may have a couple of these symptoms. I think some of my OCD helps me get through and be successful. But it's something I can turn off. I can go to sleep.

I can have dinner with my husband and not talk about autism. You can shift. Correct. Most of the time. But it's different because OCD is different than autism totally it's just one of the features that when clustered with the other ones can devastate their lives but you know the spectrum issue is it can be so bad you cannot be out of an institution because either of self-harm or harm to others. Or you could be running Microsoft, right?

I mean, the high-functioning Asperger kids, although I know we've recently lost that term, which is just nuts when you think about how we diagnose autism and then all the names it's had from pervasive developmental disorder to Asperger's syndrome. I think many children who used to be diagnosed with mental retardation

are now being diagnosed with autism. It's the nuttiest spectrum. There may be some of that diagnostic substitution, but I don't think that explains, which goes to your second question, the rate and the hockey stick increase. I truly wish autism was corporate profits for some do-good corporation. I really do. But it's a hockey stick increase, and we can't say it's diagnostic substitution to explain all of it, or we just know what autism looks like. I want to just take offense for all of the experts that have been diagnosing autism for 30 years.

They know what autism looks like. They understand what autism presents as. It's like you can't miss it. It's like missing a train wreck. Nope, I'm not trying to be disrespectful to individuals with autism, but we can pick you out of a crowd there's no issue there um there's just more kids so when jeff was diagnosed i think the diagnostic criteria was somewhere one in a thousand um and within five years prior it was one to two and every ten thousand wow when i was in training in the 1980s, when I did my child psychiatry training, it was one in 10,000. What is it now? One in 68 U.S. children. That's insane.

Yeah, and there's a more recent parent survey. But for some reason, they don't trust parents. More recent parent survey, one in 45. One in 45. What the heck? Here in Orange County, our school district district it's one in every 43 children you just gave me like chills so we have a survey so there's something we're missing what is it because genetic disorders don't go up that fast so i think we're missing many of us think it's

an epigenetic phenomenon where there's a gene environment interaction i'm not a scientist nor am i a clinician or epidemiologist, but there's something in the environment. It's environment plus genes that are playing a role. I'm just horrified. Yeah, we should be horrified. We should be really concerned. You know, if 1 in 45 had a special gift

and they could function and do great things, we should celebrate that. But this is not something to celebrate. This could be 1 in 45 that need intensive help and the cost to treat autism over a lifespan is somewhere between two and seven million dollars per affected individual wow we can't afford that as a taxpayer it scares me as a parent scares me even more so to i mean that's a bigger story for a bigger day and do i have an answer no but we do know there's probably. But we have some of the answers.

And one of the things, because here we're going to talk about this. We're going to talk about the study. One of the big lessons I learned early on is autism is not one thing. And that's what you showed. That some autistic kids have really healthy looking brains on the outside, but it's like a bomb went off on the inside of increased overall activity. So really hot. Which is an inflammatory response. And other kids who have autism, their brain is so cold.

It is really low in blood flow and it looks toxic as if they were an alcoholic or as if they had carbon monoxide poisoning or they had mold exposure um or they had an infection that and and so autism and this is what we showed in uh all these subjects nearly a thousand subjects uh you know from you know really young to middle age and what what we found is the classic autism pattern is they're hyper frontal which means their frontal lobes are hyperactive. And so what happens when your frontal lobes work too hard? That's the classic OCD finder. It's in the literature. It's been published hundreds of times that when you can't let go of something, your frontal lobes work too hard. So I think of the frontal lobes as the brain's brake. It stops you from saying or doing stupid things that get you into trouble.

But when it works too hard, it's like the brake's always on. Open the drawer. Close the door. Open. Close. Open. Close. And they just get stuck.

And I had two kids once. Great example. They were surprised. Autistic kids do not like being surprised. They were- If you want to be punched, go for it. They were surprised on their birthdays by being taken to Disneyland. Oh, no. And in the T-Mone parking lot, they had three-hour tantrums. And I i'm looking there's a second story in a week different families not related and i'm looking at the child and i'm like don't you like disneyland and he goes no i like disneyland i said it's okay not to like disneyland you know it's hot

it's crowded mickey's got his hands in your pocket and he's like no i like disneyland and the fact is it wasn't will-driven behavior was brain-driven correct behavior because things didn't happen the way he expected for them to happen and boom exploded simple things like taking my son home from school. If I didn't take the same route, everything that was within reach was thrown at my head. Serious. Correct. Including stuff that I thought was out of his reach thrown at my head. So I'm like, oh, is that the game we're playing?

Great. Left turn for the next hour. Oh, that's so funny. That's how I, like, we need to, need to life is unexpected you're gonna get a curveball i get a curveball every hour i don't know about you i love what you said earlier we actually used to one chloe's yeah flexibility was on her chore chart was on her chore chart she happens to be hyperfrontal um the other thing we saw in our autistic kids is their cerebellum was smaller

and less active, especially in this is what we show. Was that fairly universal? Well, nothing is universal. Statistically relevant. Statistically really important. The cerebellar vermis, which is right in the

middle part, medial part, the inside part, is smaller. I mean, it almost looks atrophied in our autistic kids. And the cerebellum is so important, not just for coordination. And many times they have coordination issues, but also for thought coordination, how quickly they can integrate new information. So I'll look at a scan and I'll go, it's an autistic spectrum disorder child. But then what I realize is they're not all like that. Some of them are really overactive.

Some of them are just cold. And so in the whole vaccination issue, and it's an issue like if you say you like Trump, automatically people like they hate you, and they'll throw stuff at you, and they'll pick it. And if you say that you should be concerned about vaccines, there's a whole bunch of people that will hate you immediately and all i have to say is i've done 129 000 scans on people from all over the world i have more experience than anybody in the history of the world i have vaccination damaged scans and it horrified you see i don't actually care about people hating me i care about the truth right so and So does it mean, and you brought this up in the last podcast we did, does it mean you

shouldn't get your child, children vaccinated? Absolutely not. But to assume that there is no risk from it is just wrong. It's wrong. Open up the insert. It will demonstrate otherwise. Right. Just read the package.

I'm not going to get into this conversation but anyways but the point is if you don't look at the child or the young adult's brain with autism you're missing a really important piece of information and what you said in the last podcast which which I really liked, is you started doing labs. And because how do you know unless you look? You can't change what you don't measure. That's a business principle. Peter Drucker said that. You know, the famous business guru, you can't change what you don't measure.

And so the imaging work that we do here at Amen Clinics, it's all about more data. It's not about getting the answer. It's about getting more data together with the clinical history and with the labs that then can lead, oh, you have really low blood flow to your brain. Hyperbaric oxygen is a really important intervention. Or you have really high activity what's causing that level of inflammation and then we go and hunt that up could that be a mitochondrial could it be an infection could it be a food allergy we don't know unless we look which i

love that about you we don't know unless we look we talked about we have family members and friends that have kids with autism that had mold exposure in utero and throughout the child's first year of life. Different story, but same diagnosis. Different story, different physiology, but same diagnosis. And how do you know unless you look? And MRIs are often normal because parents are panicked and they want to do anything. And what I've always said, because I can order either one, is MRIs, I'll tell you if you need an MRI by looking at the functional study. If you have a hole like my nephew did, he had a cyst the size of a golf ball.

He was aggressive and we took the cyst out. His behavior was fine. Well, I could tell that from the functional study. The MRI, a structural study, will never tell you if you need a functional study because it'll never say things work too hard or not hard enough. It'll just say, is the structure okay or not? Well, it's in the standards of care from the American Pediatrics for Autism to get MRI, rule out brain abnormalities. So that's why a lot of families go out and do it. You check that box.

And I think 95%- But they're so rarely helpful. Yeah, 95% of the families come back with a normal MRI. Thank God, you know, you wanted. That's one lab, you want a normal MRI. But if you don't have a kid operating at their best level, then what else can we look at? Yeah, it's not telling you if it's overactive or not.

And I would actually rather the standard be get a spec scan because it'll tell you if you need an MRI, but an MRI will never tell you is this a toxic brain. Right, or how to treat. Is this a traumatic brain? Is this an inflamed brain? And that's why I fell in love with imaging 26 years ago. Well, and that's what's been incredible watching your work for so many years. And of course, having my son as a patient too.

So talk to me about the autism subtypes. We talked about autism being so different for individuals. What are you seeing in those subtypes? So classic, hyperfrontal, small cerebellum, especially in the vermis. There's a ring of fire subtype where they're not just hyperfrontal. They're parietal lobes. They're temporal lobes. Their whole brain is working way too hard for their age and for their gender. And those are the ones we think about, things like panda syndromes or other inflammatory infectious causes.

And then there is the toxic subtype where their brain's cold. I remember my first patient, I mean, classically autistic. And the parents and I both came to the conclusion it was vaccination damage for this child. But it's not everybody. Sometimes if it looks toxic, it could be mold exposure. It could be the chronic effects of infections. Sometimes, and there's a very interesting autism subtype. I call it the crescent moon type.

It's their right hemisphere is on fire. But their left hemisphere, not. And the right hemisphere is what reads social cues. So in right-handed people, it's the non-dominant, the right hemisphere. It can read, you're happy with me, you're not happy with me. You're interested in what I'm saying. You're completely bored with what I'm saying. But it's that right hemisphere crescent moon pattern that we've seen,

which means for some people, we can interrupt that with things like transcranial magnetic stimulation. But if you don't look and you do TMS on all autistic kids, you're not going to get a great response. Which leads me to my follow-up question. Can you treat every brain the same? Well, if you do that, you're just stupid. I mean, I don't know how else to say that.

But it's like giving everybody who's depressed Prozac. Well, how's that been working out? No better than placebo. Well, I love what you said, Lisa, when you said we didn't know what to do. So we just focused on normalizing the labs. Well, not everybody's labs are going to be the same. Not everybody's scans are going to be the same. So if you're working on, you know, if you, that's a great philosophy, you got to work on normalizing your brain and your labs. Correct. And to me, that's the most important thing that has been my frustration for years is there's no one protocol.

You can't do just one thing and expect the same results across all kids on the spectrum. Because we just talked about, they're all different. Maybe environment was different. Of course, it's different. And then their ability and their strengths and their weaknesses are different. So we have to treat that individual right now i mean there's some universal things that i think are really good to do i think putting them on an elimination diet that just makes sense right to do giving them omega-3 fatty acids optimizing their vitamin d level optimizing their b vitamin

levels i mean you know there's some simple things I think really works, but if you don't look, you don't know. And we want more, I want more information for my patients and I don't want to guess. You know, I always felt like before I was just doing imaging, I always felt like I was Johnny Carson in Carnac the Magnificent, right? It's like, let me tell you what's the answer. And it's like, no, doctors don't act like that. But it's why in 1980, when I told my dad I wanted to be a psychiatrist, he asked me why I didn't want to be a real doctor. And I'm like, who says that to their child, right? I mean, to their son, their offspring. Who says that, right?

But, you know, 35 years later, I totally get it. It's because we didn't act like real doctors, and that's why we were made fun of. Well, what I hope is, based on this study, is doctors and treating physicians out there look at this and go, now I know I can help different kinds of patients by looking, understanding this patient and creating a treatment path just for them. So the paper is open access, which means we'll actually post it

on our journal so you can read the science behind it. It was done in collaboration with the Department of Engineering at the University of Southern California. We're very pleased with our collaboration with them. Also with the University of California at San Francisco. So we had really high-level scientists looking at our data. And we're just really proud of it and proud to serve the autism community. So thank you so much for tuning in to the Brain Warriors Way podcast. Thank you for listening to the Brain Warriors Way podcast. We have a special gift for you. It's an opportunity to win an evaluation at the Amen Clinics.

All you have to do is subscribe to this podcast, leave a review, and rate us on iTunes. To learn more about Amen Clinics and the work we do, go to amenclinics.com. You can also learn about our nutraceutical products at brainmdhealth.com. Thanks for listening.