Return of the Neuropundits!

Should presidential candidates have their brains scanned?

Daniel G. Amen

The neurological pundits are back.

Last month, the New York Times foolishly gave space on its op-ed page to a team of self-promoting brain researchers and political consultants who claimed they could use functional magnetic resonance imaging to read the minds of American swing voters. The flaws in their study were numerous and egregious (as I explained here), and three days later, the newspaper published a stern rebuke signed by 17 prominent cognitive neurobiologists: “We are distressed,” they wrote, “by the publication of research in the press that has not undergone peer review, and that uses flawed reasoning to draw unfounded conclusions about topics as important as the presidential election.”

Consider that lesson unlearned: On Wednesday, a second piece of spurious, brain-based punditry made its way into the opinion pages of a major newspaper. This time it’s an essay in the Los Angeles Times from psychiatrist and self-help guru Daniel G. Amen, a medical maverick  who runs a chain of private brain-scanning facilities across the country. Amen doesn’t want to read the minds of swing voters; he wants to study the candidates themselves.

Why? Because the leading candidates appear to be messed up in the head. “Underlying brain dysfunction” might explain Rudy Giuliani’s marital failings, he says, or John McCain’s temper, or Hillary Clinton’s inability to seem authentic. After all, three of the last four presidents “have shown clear brain pathology”: Reagan’s forgetfulness was a symptom of his Alzheimer’s, Clinton’s escapades were a product of prefrontal damage, and George W. Bush’s linguistic gaffes reflect some form of temporal lobe impairment.

When it comes to the brain health of our leaders, the stakes are very high. In the op-ed, Amen argues that both Slobodan Milosevic and Saddam Hussein must have had “poor brain function,” which would have predicted their naughty behavior. In other writings, he has declared it “very likely” that Adolf Hitler had “faulty brain wiring” while Mahatma Gandhi had “optimal brain function.” So, if we’re looking for a presidential candidate who’s less Hitler and more Gandhi, we’d better get the whole lot of them in a scanner, pronto.

The proposal is doubly outlandish: first, for asserting that it’s possible to distinguish a tyrant from a peacemaker—or a philanderer from a loving spouse—on the basis of a few single photon emission computed tomography scans; and second, for suggesting that we might want to use this putative ability to make a priori judgments about anyone. (What if one of our presidential candidates turned out to have a Hitler brain—would we throw him in precautionary lockup?) Amen isn’t indulging in Swiftian irony, either. He truly believes that brain scans can predict behavior and that it’s a good idea to screen the general population for neuropathology: “I’m just always looking for the perfect brain,” he recently told the Sacramento Bee. “If I date someone long enough, they get scanned.”

The notion that we can use cortical maps to improve our lives—romantically, politically, or otherwise—forms the basis for Amen’s business empire. Walk into an Amen Clinic, and you can have your brain scanned for $3,250 (with a 10 percent discount if you bring along a member of your family). Trained interpreters will explain how all your personal problems relate to cerebral blood flow, and they’ll figure out if you have attention deficit disorder, depression, anxiety, brain trauma, Alzheimer’s disease, autism, substance abuse problems, or marital issues.

Amen admits that “all doctors might not agree” with the interpretations he draws from these brain scans, which is a bit like saying that all paleontologists might not agree with Kirk Cameron’s interpretation of the fossil record. In fact, Amen’s work is well outside the mainstream of psychiatry: There’s little evidence to show that brain scans can be used to separate a “normal” brain from one that suffers from autism, Alzheimer’s, or mood disorders. (Some physiological differences have emerged from group studies, but they’re too small to see on a subject-by-subject basis.) The American Psychiatric Association views this work as exploratory and inconclusive (PDF), and major insurers won’t reimburse for the expense.

But Amen’s employees are ready to prescribe an entire treatment program on the basis of these scans. Once they’ve identified your particular brain problems, you’ll be assigned a smorgasbord of flaky and unproven therapies. In addition to the talking cure and psychoactive drugs, your treatment might include hypnosis, prayer, meditation, biofeedback, dietary supplements, hyperbaric oxygen treatment, transcranial magnetic stimulation, and eye-movement desensitization.

Can’t afford a scan? You can still benefit from his wisdom at a lower price point online. His Web store offers branded brain-boosting pills (containing raw neurotransmitters and fish oil, among other things), audio CDs designed to mesmerize you into losing weight or quitting smoking, and books on how to improve your sex life and heal “painful deep soul memories.” (A graduate of the Oral Roberts School of Medicine, Amen claims to have been led by God to pursue his work on brain scans.)

Of course, you won’t learn any of this from his op-ed in the Los Angeles Times. The paper allows him to identify himself as “a neuropsychiatrist and brain-imaging expert,” as if his oddball theories reflected a degree of scientific consensus, rather than a sales pitch for his private clinics. Perhaps the paper’s editors assumed Amen was credible because of all his appearances in other publications. In that case, they’ve only exacerbated the problem, further padding his résumé as an “expert” on the brain.

In the last month, two of the most prestigious opinion pages in journalism have succumbed to the delusion that MRI machines and SPECT imaging have anything meaningful to say about the upcoming elections. Clearly ill-equipped to distinguish between good and bad science, they’ve handed over column space to fringe researchers with glaring commercial interests. When is this brain-based punditry going to stop?