Ring of Fire on SPECT from Amen website

[Guest guest]

One of the new patterns we feel we have discovered is one we affectionately term

the " ring of fire " . It consists of marked hyperactivity throughout the cortex,

often in a ring like pattern. It shows the hyperfrontality pattern (increased

cingulate activity with increased left and right lateral prefrontal cortex

activity) frequently seen in obsessive compulsive spectrum disorders, ADD and

hyperactivity in the left and right lateral parietal and temporal lobe regions.

We have seen this pattern most frequently in children and teenagers. It reminds

us of the patchy increased uptake seen commonly in Bipolar Disorder. We wonder

if it represents a functional brain pattern for children and teens who are

vulnerable to Bipolar Disorder. The children and teenagers are not what most

clinicians would consider in a manic state and their symptoms may or may not

cycle. In a group of 70 patients with this pattern the most common symptoms were

moodiness, problems shifting attention, oppositional behavior, irritability,

temper problems, hypersensitivity to noise and/or touch, inattention,

distractibility and impulse control problems. This pattern seems to be made

worse by psychostimulants and serotonergic agents and better by anticonvulsants,

such as Depakote or Neurontin and the new antipsychotics, such as Risperdal or

Zyprexa.