Shahram Jacobs, M.D.

Board Certified-Internal Medicine

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I had been suffering from back spasms for several years with limited relief from the pain.  At Dr. Jacob’s suggestion, I began to combine acupuncture along with my course of medication.  Within weeks I was feeling better than I had in several years. JP, Tarzana , CA

Dr. Jacobs makes you feel like you are part of his family. He sincerely cares about his patience. My mom was in the hospital, and I was in need of a good internist. The staff at the hospital raved about Dr. Jacobs. He called him and he helped us through one of the most difficult times of my life. He explained every procedure and the pros and cons of every medical decision that the specialists urged us to make.  HR, Encino, CA

Dr. Jacobs is such a caring doctor. After visiting countless doctors for my condition, I am glad I found someone who understands what I am going through, listens and doesn’t just give me a prescription and kick me out.   RR, Calabasas, CA

I am not a fan of taking medications and always want to know my options before starting a treatment. Most doctors have made me feel stupid because of my preferences. Dr. Jacobs not only understood, but he actually educated me on various non-drug options I could take to help with my condition. He understood the importance of my own mind-body connection and helped me use my mind on my journey to health.    GP,  Brentwood, CA


Clinical validation of the watershed sign as a marker for neuropsychiatric systemic lupus erythematosus.

OBJECTIVE: To study the relationship between single-photon-emission computed tomography (SPECT) brain imaging and neuropsychiatric signs/symptoms in a cohort of patients with systemic lupus erythematosus (SLE), analyzed using a stereotactic surface projection (SSP) technique.

METHODS: Thirty-seven SLE patients were referred for (99m)Tc-ethyl cysteinate dimer SPECT brain imaging because of neuropsychiatric signs/symptoms. Nineteen normal controls were studied with the identical protocol. Reconstructed images were computed and Z scores were calculated using the SSP technique with the 2-sample t-tests comparing normal controls with SLE patients, and patients with mild cognitive dysfunction with those with severe cognitive dysfunction. The clinical characteristics of SLE patients were collected by retrospective chart review and categorized according to American College of Rheumatology case definitions for neuropsychiatric SLE. Cognitive dysfunction was rated by the treating physician on a scale of -3.

RESULTS: Thirty of 37 SLE patients had abnormal SPECT results. SLE patients had reduced perfusion in the watershed areas of the frontal lobes bilaterally compared with controls. Additionally, SLE patients with severe cognitive dysfunction had more severe perfusion deficits than those with mild cognitive dysfunction. In some patients with severe cognitive dysfunction, the watershed areas had Z scores >/=4 SDs below controls.

CONCLUSION: A convenience sample of patients with SLE and neuropsychiatric signs/symptoms demonstrated reduced perfusion in the watershed areas of the frontal lobes on SPECT scanning analyzed by the SSP technique. The severity of findings correlated with severity of cognitive dysfunction. The area of the brain affected is one that is susceptible to ischemia.


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