Brain scam

Why is PBS airing Dr. Daniel Amen's self-produced infomercial for the prevention of Alzheimer's disease?

By Robert Burton

Read more: PBS, Science, Neurology, Brains, Life, Mind Reader

May 12, 2008 | It's 10 on a Saturday night and on my local PBS station a diminutive middle-aged doctor with a toothy smile and televangelical delivery is facing a rapt studio audience. "I will show you how to make your brain great, including how to prevent Alzheimer's disease," he declares. "And I'm not kidding."

Before the neurologist in me can voice an objection, the doctor, Daniel Amen, is being interviewed by on-air station (KQED) host Greg Sherwood. Sherwood is wildly enthusiastic. After reading Amen's book, "Change Your Brain, Change Your Life," Sherwood says, "The first thing I wanted to do was to get a brain scan." He turns to Amen. "You could start taking care 10 years in advance of ever having a symptom and prevent Alzheimer's disease," he says. "Yes, prevent Alzheimer's disease," Amen chimes in.

Wait a minute. Prevent Alzheimer's disease? Is he kidding? But Sherwood is already holding up Amen's package of DVDs on learning your risk factors for A.D., as well as his book with a section titled "Preventing Alzheimer's." Then, as though offering a landmark insight into a tragic disease -- and encouraging viewers to pledge money to the station -- Sherwood beams and says, "This is the kind of program that you've come to expect from PBS."

If so, that's a shame. One of the messages of Amen's PBS special and his book on Alzheimer's is that early detection of A.D. can lead to methods that both slow the progression of the disease and prevent it. But this opinion isn't shared by the vast majority of the medical community. Despite decades of studies, there are at present no definitive long-term treatments for A.D. or its prevention, as Amen would have viewers and readers believe.

At the core of Amen's crusade -- both in print and on TV -- is a type of functional brain imaging known as SPECT (single photon emission computed tomography), a radioisotope-enhanced CAT scan that measures blood flow in certain regions of the brain. Amen relies heavily on SPECT to make an early diagnosis of Alzheimer's so that it can be prevented. But medical science does not support his view.

"SPECT scans are not sufficiently sensitive or specific to be useful in the diagnosis of A.D.," neurologist Michael Greicius , who runs the Stanford University memory clinic, and has a special interest in the use of functional brain imaging in the diagnosis of A.D., tells me. "The PBS airing of Amen's program provides a stamp of scientific validity to work which has no scientific validity."

Throughout March and April this year, "Change Your Brain, Change Your Life" aired nearly 1,300 times on PBS stations across the country, reaching more than 75 percent of U.S. television households. As I was to learn after several frustrating phone calls and e-mails with PBS spokespersons, the nation's public broadcasting system did not vet "Change Your Brain, Change Your Life" for scientific validity. As a result, it broadcast what amounts to an unregulated infomercial for Amen's unproven treatments.

When I come across a controversial medical opinion, I try to look at how it might have arisen. Amen, who appears as a medical expert on TV news and talk shows, including CNN and Fox News, the "Today" show and "Oprah," has not followed a traditional scientific path. He received a biology degree from Southern California College, a Pentecostal school, now Vanguard University ("We believe The Bible to be the inspired and only infallible and authoritative Word of God"), and earned his medical degree from Oral Roberts University School of Medicine, defunct as of 1989.

"One of the sustaining factors in my work has been my own personal faith," he declared in his 2002 book, "Healing the Hardware of the Soul: How Making the Brain-Soul Connection Can Optimize Your Life, Love, and Spiritual Growth." "From the first month that I started to order these (SPECT) scans, I felt that they had a special place in science and that I was led by God to pursue this work."

It's hard to dismiss the religious undertones of Amen's work. On his Web site in 2003, he stated, "How your brain and soul work together determines how happy you feel, how successful you become, and how well you connect with others. The brain-soul connection is vastly more powerful than your conscious will. Will power falters when the physical functioning of the brain and the health of your soul fail to support your desires, as seen by illogical behaviors like overeating, smoking, drug and alcohol abuse, and compulsive spending."

And yet Amen's sense of calling hasn't led him to undertake the high-quality clinical investigations that would lend scientific credence to his claims. He is a board-certified psychiatrist and assistant clinical professor at University of California at Irvine School of Medicine, as his current Web site claims. But as U.C. Irvine assistant director of health sciences communications Tom Vasich explains, the title "assistant clinical professor" is the name for an untenured volunteer faculty member, of which the U.C. Irvine School of Medicine has more than 1,000. Amen is not affiliated with the university's Brain Imaging Center; all of his studies on SPECT scanning have been privately performed at his proprietary Amen Clinics.

To understand my concerns regarding Amen's claims, we first need to take a quick look at A.D. and why unsubstantiated promises of prevention and treatment raise real ethical and health considerations. A.D. affects about 5 million Americans; the number will rise as our population ages. Although the disease isn't sufficiently well-understood to assign specific causes, it's clear that there are multiple risk factors, ranging from age to genetics, coexisting heart disease to prior serious brain injury. So far, addressing such risk factors either isn't possible (we can't change our genes or stop getting older), hasn't been prospectively demonstrated to prevent A.D., or is simply part of any common-sense medical practice.

Next page: What is Amen offering that the medical community has overlooked?