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PsychosurgeryThis page contains recent news articles, when available, and an overview of Psychosurgery but does not offer medical advice. You should contact your physician with regard to any health issues or concerns.News: Psychosurgery Helsinki Times (subscription)People suffering from severe depression and obsessive-compulsive disorder (OCD) can be helped with psychosurgery, which is performed on the brain, Henry Molaison, a man without memories, died on December 2nd, aged 82 - Dec 18, 2008 Economist,It was 1953 and psychosurgery—which was later to be banned, or at least restricted, in many countries—was at the height of its popularity. A new logic to treating insanity - Dec 8, 2008 The National,One explanation for this antiquated phenomenon is that it served as an early form of psychosurgery, that is, the hole was drilled to release Nov. 12, 1935: You Should (Not) Have a Lobotomy - Nov 11, 2008 Wired NewsThe notion that a mental patient's behavior could be modified for the good by psychosurgery had its roots in the work of Gottlieb Burckhardt, a 19th century An Industry of Death - A Free Exhibit in the Square - Sep 7, 2008 CollegeOTR,Psych patients are still being subjected to brutal treatments including electroshock therapy, psychosurgery, and debilitating drugs. Official Investigation Needed of Abuses Against Children - Sep 14, 2008 PR-Inside.com (Pressemitteilung),A 1997 report by the then Quebec ombudsman, Daniel Jacoby, found evidence of torture, beatings, ice baths, sodomy, electroshock, psychosurgery, Search this blog - Sep 3, 2008 ScienceBlogsThis is different than other types of psychosurgery, which are irreversible. (1 2) As sort of an added bonus, Lozano et. al. performed neuroimaging (PET) in "Pacemaker For The Brain" Shows New Potential - Jul 3, 2008 Medical News Today (press release),The concept of psychosurgery still makes many people uneasy. It often brings to mind the inappropriate or indiscriminate use of frontal lobotomy, APA: Gamma Knife Surgery Has Obsessive-Compulsive Benefits - May 8, 2008 MedPage Today,The "high-tech psychosurgery" procedure is much less invasive than earlier neurosurgery, Dr. Baron said, and its success in some cases "underlines the role A No-Brainer - Apr 1, 2008 Insurance Networking News,...“MRI, CT scan and results of the performance of psychosurgery patients have been used to determine whether the tests activate the prefrontal cortex (the Biological Influences on Criminal Behavior - Feb 1, 2008 Psychiatric Services (subscription)The author poignantly reviews the checkered history of psychosurgery and describes current psychosurgery applications to criminal behavior. The Abolition of Man? How Politics and Culture Have Been ... - Feb 7, 2008 Heritage.org,They accepted at face value the purported benefits of such procedures as lobotomies, psychosurgery, and forced sterilization. They made grand promises about Lobotomy: Proceeding Without Caution - Jan 20, 2008 Tampa Tribune,A now-discredited form of psychosurgery, the lobotomy at one time was heralded as a medical breakthrough in the treatment of mental disorders. Is he crazy? - Dec 9, 2007 Los Angeles Times,This premise is flawed and has been used to justify the horrors of psychosurgery or a dictator's attempts to eradicate human imperfection. WOULD GOD BLESS AMERICA - Dec 17, 2007 NewsWithViews.com,...“We need a program of psychosurgery for political control of our society. The purpose is physical control of the mind. Everyone who deviates from the given Specialists were stumped by man's unrelenting pains - Dec 2, 2007 Evansville Courier & Press (subscription),The day an ophthalmologist at Johns Hopkins suggested cingulotomy, controversial psychosurgery reserved for intractable psychiatric problems, was arguably the noonday demon by andrew solomon - Nov 5, 2007 Bookslut,...desperation involved. and it does take desperation to convince yourself to try something like electro-convulsive therapy (ect) or psychosurgery. imagine ‘help give them proper memorial’ - Oct 28, 2007 Bradford Telegraph Argus,...benches and a sculpture. mr hutchinson, founder of survivors' campaign against lobotomy and psychosurgery (scalps), said: "to put 2800 people on that a pain in the head - Nov 12, 2007 Washington Post,...controversial psychosurgery reserved for intractable psychiatric problems, was arguably "the worst moment," recalled neta nelson, who accompanied her human rights group commends piedmont regional council for landmark ... - Nov 19, 2007 American Chronicle,...and victims of psychiatric brutalities ranging from electroshock and involuntary commitment to political torture, psychosurgery and the devastating Background information on Psychosurgery [When available] Psychosurgery is a term for surgeries of the brain or autonomic nervous system involving the severance of neural pathways to effect a change in behaviour, usually to treat or alleviate severe mental illness. The procedures typically considered psychosurgery are now almost universally shunned as inappropriate, due in part to the emergence of less invasive methods of treatment such as psychiatric medication. Although the term psychosurgery might imply a broad class of treatments, in reality, it is confined to variations on two themes:
There is evidence that trephining (or trepanning)—the practice of drilling holes in the skull for pseudo-medical reasons—has been in widespread, if infrequent, use since 5000 BCE. This may have been done in an attempt to allow the brain to expand in the case of increased brain fluid pressure, for example after head injuries; several documented cases of healed wounds indicate that such crude surgery could be survived back then. However, psychosurgery as understood today was not commonly practised until the early 20th century. The first systematic attempts at psychosurgery in humans occurred from 1935, when the neurologist Egas Moniz teamed up with the surgeon Almeida Lima at the University of Lisbon to perform a series of prefrontal leucotomies - a procedure severing the connection between the prefrontal cortex and the rest of the brain. This procedure is commonly (and incorrectly) called a "lobotomy", although this name should refer to a whole class of unrelated surgeries (that is, a lobotomy should refer to the removal of a lobe of the brain, not merely the severing of interconnections). Moniz and Lima claimed fair results, especially in the treatment of depression, although about 6% of patients did not survive the operation and there were often marked and adverse changes in the patients' personality and social functioning. Despite the risks the process was taken up with some enthusiasm, notably in the US, as a treatment for previously incurable mental conditions. Moniz received a Nobel Prize in 1949. The initial criteria for treatment were quite steep, only a few conditions of "tortured self-concern" were put forward for treatment. Severe chronic anxiety, depression with risk of suicide and incapacitating obsessive-compulsive disorder were the main symptoms treated. The original leucotomy was a crude operation and the practice was soon developed into a more exact, stereotactic procedure where only very small lesions were placed in the brain. The procedure was popularized in the United States when Walter Freeman invented the "icepick lobotomy" procedure, which literally used an icepick and rubber mallet instead of the standard surgical leucotome. Leaving no visible scars, the icepick lobotomy was heralded as a great advance in "minimally invasive" surgery, and was eventually done under only local anaesthesia. In a minimally invasive procedure, Freeman would hammer the icepick into the skull just above the tear duct and wiggle it around. Between 1936 through the 1950s, he advocated lobotomies throughout the United States. Such was Freeman's zeal that he began to travel around the nation in his own personal van, which he called his "lobotomobile", demonstrating the procedure in many medical centres. He reputedly even performed a few lobotomies in hotel rooms. Freeman's advocacy led to great popularity for lobotomy as a general cure for all perceived ills, including misbehaviour in children. Ultimately between 40,000 and 50,000 patients were lobotomised. A follow-up study of almost 10,000 patients claimed 41% were "recovered" or "greatly improved", 28% were "minimally improved", 25% showed "no change", 4% had died, while only 2% were made worse off (Tooth, et al 1961). Lobotomies gradually became unfashionable with the development of antipsychotics and are no longer performed. The era of lobotomy is now generally regarded as a barbaric episode in psychiatric history. It is possible that some patients did benefit from the more precise psychosurgery, but there was a strong division amongst the medical profession as to the viability of the treatment and concern over the irreversible nature of the operation and the extension of the surgery into the treatment of unsuitable cases (drug or alcohol dependence, sexual disorders etc). Whatever the truth, psychosurgery was offered in only a few centres and by the 1960s the number of operations was in decline. The signal improvements in psychopharmacology and behaviour therapy gave the opportunity for more effective and less invasive treatment. Neurological impact The frontal lobe of the brain controls a number of advanced cognitive functions, as well as motor control. Motor control is located at the rear of the frontal lobe, and is usually unaffected by psychosurgery. The anterior or prefrontal area is involved in impulse control, judgement, language, memory, motor function, problem solving, sexual behaviour, socialization and spontaneity. Frontal lobes assist in planning, coordinating, controlling and executing behaviour. Thus, the efficacy of psychosurgery was often related to changes in personality and reduced spontaneity (this included making the person quieter, and lowering their sex-drive). Certain processes related to schizophrenia are also believed to occur in the frontal lobe, and may explain some success. However, certain types of inappropriate behaviours increased, as a function of reduced impulse control (in some respects they became more child-like). Further, it decreased their ability to function as a member of the community by reducing their problem solving and planning abilities and making them less flexible and adaptive. It usually had no impact on IQ except with respect to problem-solving. Present day Psychosurgery today is almost entirely limited to endoscopic thoracic sympathectomy (ETS surgery). While this is normally used for somatic conditions, many patients with anxiety disorder report significant reduction in fear and alertness after this intervention (Teleranta, Pohjavaara, et al 2003,2004). Today, lobotomy is very infrequently practised. It may be a treatment of last resort of OCD sufferers, and may also be used for people suffering chronic pain. In the latter case, the surgery does not act on the perception of pain, but leads to a lack of concern about the pain. The procedure usually involves a 2-3cm lesion in the cingulum, near the corpus callosum. The efficacy is not high, with improvement in 5 of 18 patients (Baer et al., 1995). Lobotomy is no longer used as a treatment for schizophrenia. From Wikipedia Background information on Search the web for more resources on Psychosurgery |
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