Step Four
A Healthier Brain
The goal of NIDS treatment is to “cool down” an overactive immune system, resulting in a reduction of inflammation in the brain and body. To do that, it’s often helpful to get a complete picture of what’s going on in the brain of some patients.
NeuroSPECT Scans: An important Diagnostic Tool in NIDS
The use of NeuroSPECT scans has opened up a whole new level of diagnosis and treatment of NIDS disorders. A NeuroSPECT scan gives us an objective visualization of how the brain is functioning by showing the amount of blood flow occurring throughout the patient’s brain. Highly accurate computer databases, with large numbers of scans, have consistently shown reduced blood flow, and therefore reduced neural activity and impaired function, in the temporal lobes and other key areas in patients with NIDS conditions. This reduced flow is a secondary effect of the neuro-immune shutdown that occurs in NIDS. Early recognition that similar dysfunctions were occurring, first in adults and then in children, helped tie together the critical recognition that this only could be a disease process, which is completely inconsistent with the old ideas of a developmental disorder.
Simply put, the right temporal lobe governs social skills and the left temporal lobe governs language and auditory processing. Higher order executive functions and other higher functions in humans also are governed by key areas in and around the temporal lobes. The cognitive and behavioral deficits seen in autism and other NIDS disorders correlate with problems in those areas of brain functioning. (There is not a mysterious or unknown reason for the dysfunction.) In addition, there have been alterations in blood flow in the cerebellum, which partially controls motor functions, another symptom seen in kids with autism today. Interestingly, these symptoms were not part of Kanner’s original list of symptoms related to autism.
SSRIs and Optimal Neural Functioning
As the immune system begins to function on a more normal level, some of the immune mediated shutdown will begin to ease, allowing return of function and increased blood flow to the previously unused (or shut-down) parts of the brain. The temporal lobes are known to be serotonin-mediated. Medications such as SSRIs (Selective Serotonin Reuptake Inhibitors), if used judiciously and correctly, safely can increase the available amount of serotonin in the brain by blocking the re-uptake of naturally produced serotonin. The goal of treatment is to have the correct amount of this neurotransmitter available (which is not possible to do by outside metabolic input or adjustments) and to try to restore the correct balance needed for proper neural functioning. It is important to stress that SSRIs are not being used to control behavior. Medications that suppress the overall functioning of the brain, or that are not safe in the long term, are not used in the Goldberg Approach™. The goal of treatment is to get a healthier brain and a sharper, brighter patient, with the ultimate goal being a healthy child (or adult).
A NeuroSPECT examination can help affirm the need for an SSRI, and if there is a need for any other supportive medications. Any choices made must be healthy for the brain, not ones that could induce any long term damage or dysfunction. Choice of a specific SSRI is different for each patient, is dependent upon the individual’s response, and must be done carefully.
Clinical goals are judged by evaluating the patient’s health, sleep cycle, and overall cognitive sharpness and alertness. If indicated, changes also can be documented by subsequent NeuroSPECT scans. Specific language and other cognitive gains will show the patient is ready for true rehabilitation, not “training,” in the areas of functioning that have been affected.