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What do mu MRI scan test results indicate?

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Posted on Thu, 21 Jul 2016
Question: Hi,
I have some troubles with a kind o "fixation" viewing open windows of cars in a "compulssive" way, it's the second time i have this symptom (i had it before in 2009). The results of functional magnetic resonance show activation of back temporal lobe, interparietal region (to the left) and also in occipital (bilateral).. According to the same exam there is no activity in cingulate cortex and prefrontal córtex, dorsolateral and temporal polar. I would like to know if this result shows a disfunction and if it can explain that kind of "fixation", which changes according to meds i receive. I never had this symptom before 2009 and Keppra helps, while Solian 200mg instead of 100 mg makes this symptom worse and i don't know if there is a problem with dopamine.
Thanks beforehand XXXXXXX
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I understand your concern.

Regarding the functional MRI, the purpose of that MRI is to see which brain areas are more active during specific activities or tasks. It is not a static picture, it changes according to the activity at hand. So active areas expected to be seen on MRI are dependent on the tasks or the stimuli the patient receives (this task or stimuli is otherwise called paradigm). For that matter to evaluate you fMRI more information is needed on the conditions that brain activity you describe is taken, as what could be perfectly abnormal for one activity (say related to speech) may be abnormal for another (say memory).
Judging by only the part of the report you provide I do not find anything worrying, there is more activity in areas related to vision, which if in relation to a visual paradigm would be correct.
So judging from the limited information at hand I do not see any structural explanation for these obsessive fixating issues you have. As for many psychiatric issues the origin is thought to be at a disbalance of neurotransmitters, but the exact cause is not detected by imaging or any other laboratory test.

Let me know if I can further assist you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka (1 hour later)
Thanks for your answer, i would like to know if "more activity in areas related to vision" can be abnormal with another paradigm, in front of stimuli like open windows of cars for example, since the paradigm when the MRI was "emotional prosecution". I would be glad if we avoid things like "obsessive" -i never wrote about this- and "psychiatric issues" .
Last time we talk, you told me that some disfunctions in temporal lobe (not detected by EEG) can create symptoms similar to mine, as well as problems with dopaminergic activity. If possible, i would be glad to stay in the neurologic sphere, since nobody can create a symptom like mine because of an "obsession". I was very carefully when i wrote that the first time i had this symptom was in 2009, so i was more than 40 years (almost 46) and "obsessive"/psychatric issues began between 20 and 30 years and are very unusual after 40 years.
doctor
Answered by Dr. Olsi Taka (8 hours later)
Brief Answer:
Read below.

Detailed Answer:
Hello again! I am sorry that you mind my using terms like obsessive, I didn’t mean for you to feel that way. However in my defense it is you yourself who use terms like compulsive in this query (compulsions are commonly related to obsession) and obsessive in past queries (I am shown in my interface the last few queries you’ve had with Dr Sheppe as well), though I see now you are careful to use them in quotation marks. As for the request to stay on the neurologic side remember that conditions and organs are never separated. Neurologic conditions are often related to other organs and systems and no good doctor looks them as separated, even more so when it is the case of psychiatry which deals with the same nervous system. In the past actually there was just neuropsychiatry, only later the specialties are divided and still now there are many manifestations which cannot be clearly divided whether of a psychiatric or a neurological origin, there are debates whether neurology and psychiatry should be split at all for that matter. Blame the incompetency of medical science if you want, but so it is.

Regarding what we have previously discussed, I do not see that on my interface unfortunately (I can see only the last 8 queries of yours), but now that you mentioned it I do remember it, though not all details perhaps since it must have been over 5 months ago.

As for your other question on fMRI, I am afraid it is not that clear to be honest. I do not think that there is a paradigm such as “emotional prosecution” used really. Also fMRI doesn’t show such divisions such as differences between watching windows or something else. It is not clear what exactly the doctors expected to find in your case with this expensive test. The purpose of the fMRI is generally to assess patients before brain surgery. For example if a patient has a tumor which is near the speech area of the brain, the neurosurgeon would like to know how much this speech area in extended and if it is helped by other areas in the brain (there are variations between individuals) so that he knows how much of the tumor area he can remove without damaging speech and leaving the patient mute.
So fMRI simply shows which brain areas light up when having speech tasks, or which areas for memory tasks, visual tasks and so on. It is a crude distinction, doesn’t really show subtleties regarding fixating windows, just basic distinctions using mainly 4 basic paradigms, visual, motor, speech and memory.
So it is hard for me to understand why it was done, as I do not think that it gives a whole lot of information in your case, it is not clinically indicated. As I said before there is nothing abnormal in what you describe from your fMRI. Perhaps if you provided the full report I might understand better what the doctors expected to find (technology and its use is ever evolving, perhaps they were researching a new function I am not aware of) and what type of stimuli did you have. Otherwise without reading the report the only neurological condition I can suggest is what I suggested the last time around.

Looking forward to hearing from you again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

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What do mu MRI scan test results indicate?

Brief Answer: Read below. Detailed Answer: I read your question carefully and I understand your concern. Regarding the functional MRI, the purpose of that MRI is to see which brain areas are more active during specific activities or tasks. It is not a static picture, it changes according to the activity at hand. So active areas expected to be seen on MRI are dependent on the tasks or the stimuli the patient receives (this task or stimuli is otherwise called paradigm). For that matter to evaluate you fMRI more information is needed on the conditions that brain activity you describe is taken, as what could be perfectly abnormal for one activity (say related to speech) may be abnormal for another (say memory). Judging by only the part of the report you provide I do not find anything worrying, there is more activity in areas related to vision, which if in relation to a visual paradigm would be correct. So judging from the limited information at hand I do not see any structural explanation for these obsessive fixating issues you have. As for many psychiatric issues the origin is thought to be at a disbalance of neurotransmitters, but the exact cause is not detected by imaging or any other laboratory test. Let me know if I can further assist you.