Facebook Twitter



Sophisticated computers, used today by medical personnel for everything from keeping medical and insurance records to inventorying drugs, are now being used to help physicians determine the cause and depth of a person's depression.

Brain mapping, a computerized method of reading a person's electroencephalograms, is now being used at Wasatch Canyons Hospital - a first in the state.The painless 20-minute tests, combined with clinical interviews and a series of psychological and blood tests, are helping physicians confirm a diagnosis of depression so they can more accurately treat the abnormality.

"One of the most exciting features of brain mapping is that it's an objective, scientific approach to help people recognize that perhaps their mood changes are related to a medical disease, and not just to their own lack of will, depth of sin or whatever," said Dr. Michael Lowry, the hospital's medical director. "That has been a stigma that mental illness has carried basically forever."

For the past 50 years, physicians have been visually interpreting EEGs, a measurement of the electrical activity that the brain generates as part of its normal daily routine. What they basically have been able to determine from EEGs is evidence of seizure activity and focal areas or spots on the brain, which could be brain tumors or loss of blood flow.

The computer or brain mapping can identify more subtle changes in brain-wave activity that are common in certain psychiatric illnesses when compared to the norm. This provides the physician positive, objective evidence of psychiatric as well as gross neurological problems.

"With about 90 percent accuracy, the computer can tell if the patient is suffering from depression, and if so, to what degree," Lowry said. "We have been surprised as to how well the machine agrees with our clinical impressions among patients tested so far."

The brain-mapping system introduced in Utah by Wasatch Canyons Hospital is based on statistics and a data base that have been developed at New York University over the past 15 years using a large group of patients with different psychiatric problems.

L. RaNae Sanders, coordinator of the clinical neuroscience expert system, said that while there are plenty of precedents for the test (used in 80 centers around the country), it will only be used in complicated cases, with patients who haven't responded to psychotherapy or medical treatment.

"Right now it's a new test, and like any other, it needs to be part of a total clinical evaluation," she said. "At this point in time a good clinical interview can still make the right diagnosis in the vast majority of cases and get people on the right track.

"However, there are some people who would have more tolerance of medical treatment for depression if they had a test that told the cause of the problem and suggested a course of treatment."

One possible drawback to brain mapping may be its cost. The normal series of psychiatric tests (reimbursed by insurance companies) is about $450. The computer test adds an additional $350 to that amount, and Lowry doesn't know if the test will be covered by third-party carriers.

"We have met with representatives of major insurance companies who viewed the test as useful, but we haven't submitted bills on the 20 patients who have received brain maps," he said. "In other states, it has been reimbursed."

Lowry and Sanders hope the costs will be paid in full by insurers. The medical specialists see brain mapping as another step forward in combatting depression, which plagues thousands of Utahns.

"We have come a long way in recognizing that mental illnesses are medical diseases," Lowry said. "But we still have a long way to go.

"The majority of depressed folk struggle with whether their problems are just due to situations or weaknesses within themselves."

He said society still has trouble helping the depressed person "other than just by saying, `Just try harder, pull yourself up by your boot straps.'

"Reliance on medical treatments is still seen as a weakness, an admittance of defeat, despite the evidence that when people do have a severe depression there are significant changes in the chemistry and electrical activity in parts of the brain," he said. "Medical treatment can help when nothing else can."