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NIMH and Transforming the process of Diagnosis

By Jay Gunkelman

April 30, 2013

Yesterday, Thomas Insel, a Director at NIMH, issued a statement announcing a project to transform the process of diagnosis, moving away from behavioral descriptions and towards biomarkers and lab tests. (see link below) The DSM-V is due out in about a week, and it is obvious that NIMH realizes how INVALID the DSM is (and Thomas actually uses the "I" word in his text).

They have started a project on Research Domain Criteria (RDoC) that will fund projects that look for these biomarkers. It specifically states that the DSM-V will not be held as the "gold standard" to test work against.

"A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories."

I urge you to check out his document, as well as to look beyond the DSM to physiological signals to get your direction clinically!

Jay

http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

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The qEEG "uniquely informs" in acute stroke

By Jay Gunkelman

April 24, 2013

A physician friend of mine sent this link showing the qEEG to be useful in clinical decision making in an acute stroke. Some might think this to be redundant to the older American Academy of neurology support for qEEG as an additive value in vascular issues, but this goes farther than merely stating "additive value" is available. The new paper says that the qEEG "uniquely informs", and allows and expedited decision making in treatment of acute stroke.

The link is below.

Jay

http://www.sciencedirect.com/science/article/pii/S138824571300223X

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The Under-utilization of the EEG: a study

By Jay Gunkelman

April 11, 2013

The Mayo Clinic researchers looked at the EEG utilization clinically, and found that it was being seriously under-utilized. They suggest lowering the threshold for ordering the EEG in cases with alterations of consciousness, lapses in awareneess and cognitive decline. The finding or non-convulsive paroxysms is still treatable with an empirical trial on anticonvulsants when there are paroxysms in these cases.

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