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Comptes Rendus Biologies 2015At the Paris Colloquium held forty years ago, and which this paper celebrates, the issue of psychosurgery had not been tackled yet. At that time psychosurgery was...
At the Paris Colloquium held forty years ago, and which this paper celebrates, the issue of psychosurgery had not been tackled yet. At that time psychosurgery was tainted by the controversial history of lobotomy and leucotomy. Supporters of psychosurgery at the time of the Colloquium were preparing their fourth International Conference, which was held in Madrid the following year. This represented a key characteristic of the collective, institutional and symbolic action of psychosurgery practitioners. At the end of the seventies, their strategy changed as noted below. Furthermore, we focus on the special importance of the results presented and commented on by psychosurgery supporters, including its conception and classification throughout the rhetoric historically involved (its supposed ventriloquism, its persuasive strength). Based on this view, we suggest a critical reflection encompassing old and new psychosurgery, while questioning the value of new rhetorical devices for the assessment and presentation of psychosurgery results after the surge of Deep Brain Stimulation.
Topics: Deep Brain Stimulation; History, 20th Century; History, 21st Century; Humans; Mental Disorders; Psychosurgery
PubMed: 26149524
DOI: 10.1016/j.crvi.2015.06.004 -
Stereotactic and Functional Neurosurgery 2019In order to shed light on the first application of human functional stereotactic neurosurgery, whether it was in the realm of movement disorders, as has been claimed... (Review)
Review
In order to shed light on the first application of human functional stereotactic neurosurgery, whether it was in the realm of movement disorders, as has been claimed repeatedly, or in the realm of psychiatry, a review of the original scholarly literature was conducted. Tracking and scrutinising original publications by Spiegel and Wycis, the pioneers of human stereotactic neurosurgery, it was found that its origin and the very incentive for its development and first clinical use were to avoid the side effects of frontal leucotomy. The first applications of functional stereotactic neurosurgery were in performing dorsomedial thalamotomies in psychiatric patients; it was only later that the stereotactic technique was applied in patients with chronic pain, movement disorders and epilepsy. Spiegel and Wycis' first functional stereotactic operations were for obsessive-compulsive disorder, schizophrenia, and other psychiatric conditions.
Topics: Chronic Pain; Epilepsy; Humans; Movement Disorders; Nervous System Diseases; Neurosurgery; Obsessive-Compulsive Disorder; Psychosurgery; Stereotaxic Techniques
PubMed: 30759450
DOI: 10.1159/000496157 -
Neurosurgical Focus Sep 2017Neurosurgery for the treatment of psychological disorders has a checkered history in the United States. Prior to the advent of antipsychotic medications, individuals...
Neurosurgery for the treatment of psychological disorders has a checkered history in the United States. Prior to the advent of antipsychotic medications, individuals with severe mental illness were institutionalized and subjected to extreme therapies in an attempt to palliate their symptoms. Psychiatrist Walter Freeman first introduced psychosurgery, in the form of frontal lobotomy, as an intervention that could offer some hope to those patients in whom all other treatments had failed. Since that time, however, the use of psychosurgery in the United States has waxed and waned significantly, though literature describing its use is relatively sparse. In an effort to contribute to a better understanding of the evolution of psychosurgery, the authors describe the history of psychosurgery in the state of Iowa and particularly at the University of Iowa Department of Neurosurgery. An interesting aspect of psychosurgery at the University of Iowa is that these procedures have been nearly continuously active since Freeman introduced the lobotomy in the 1930s. Frontal lobotomies and transorbital leukotomies were performed by physicians in the state mental health institutions as well as by neurosurgeons at the University of Iowa Hospitals and Clinics (formerly known as the State University of Iowa Hospital). Though the early technique of frontal lobotomy quickly fell out of favor, the use of neurosurgery to treat select cases of intractable mental illness persisted as a collaborative treatment effort between psychiatrists and neurosurgeons at Iowa. Frontal lobotomies gave way to more targeted lesions such as anterior cingulotomies and to neuromodulation through deep brain stimulation. As knowledge of brain circuits and the pathophysiology underlying mental illness continues to grow, surgical intervention for psychiatric pathologies is likely to persist as a viable treatment option for select patients at the University of Iowa and in the larger medical community.
Topics: History, 20th Century; History, 21st Century; Hospitals, Psychiatric; Humans; Iowa; Mental Disorders; Neurosurgeons; Psychosurgery; Universities
PubMed: 28859559
DOI: 10.3171/2017.6.FOCUS17227 -
Psychiatry Investigation Nov 2023This review aims to investigate the progression of neuroablation, along with documented clinical efficacy and safety, in the management of treatment-resistant...
OBJECTIVE
This review aims to investigate the progression of neuroablation, along with documented clinical efficacy and safety, in the management of treatment-resistant obsessive-compulsive disorder (OCD).
METHODS
We searched and compiled clinical research results of neuroablation therapy reported to date. We extracted outcomes related to clinical efficacy, side effects, and surgical complications. Additionally, we summarized key claims and findings.
RESULTS
Neuroablative intervention is a potential treatment approach for refractory OCD. Recent advancements, such as real-time magnetic resonance monitoring and minimally invasive techniques employing ultrasound and laser, offer distinct advantages in terms of safety and comparative efficacy when compared to conventional methods. However, the absence of randomized controlled trials and long-term outcome data underscores the need for cautious consideration when selecting neuroablation.
CONCLUSION
Neuroablative intervention shows promise for refractory OCD, but vigilant consideration is essential in both patient selection and surgical method choices due to the potential for rare yet serious complications.
PubMed: 37997327
DOI: 10.30773/pi.2023.0214 -
Postgraduate Medical Journal Dec 1973It seems fundamentally improbable that different mental symptoms and personality disorders should be relieved by one single form of operation on the brain. The present...
It seems fundamentally improbable that different mental symptoms and personality disorders should be relieved by one single form of operation on the brain. The present paper describes five operations which can be performed with benefit to different types of psychiatric abnormality; namely, unilateral temporal lobectomy, unilateral or bilateral temporal lobotomy, inferior quadrant pre-frontal leucotomy, paramedian frontal leucotomy and posterior cingulectomy. The symptoms that represent an indication for these various operations and the results of the operations on the symptom complexes are described. The proposition is put forward that only operations suitable for the precise psychiatric diagnosis should be used. A new form of analysis of sphenoidal lead examinations is described which is of primary importance in conjunction with psychiatric examination in deciding which operation a particular patient would or would not benefit from. A concept of diencephalic instability is introduced in connection with this EEG analysis to supplement the usual concept of centrencephalic epilepsy. Diencephalic instability as defined here seems to respond specifically to paramedian lobotomy, provided of course the clinical condition justifies such a step.
Topics: Electroencephalography; Frontal Lobe; Gyrus Cinguli; Humans; Psychosurgery; Temporal Lobe
PubMed: 4806267
DOI: 10.1136/pgmj.49.578.834 -
Journal of Neurology, Neurosurgery, and... Jul 1983Hemispherectomy is probably the best operation for treating epilepsy. It was abandoned because of the delayed haemorrhagic complications that developed some years after...
Hemispherectomy is probably the best operation for treating epilepsy. It was abandoned because of the delayed haemorrhagic complications that developed some years after the operation. A hypothesis is described to account for the mechanism of such complications and modifications made to the operative technique to prevent such complications. This modified hemispherectomy has been carried out on four patients since 1980.
Topics: Brain; Cerebral Hemorrhage; Epilepsy; Hematoma, Subdural; Hemostasis, Surgical; Humans; Hydrocephalus; Postoperative Complications; Psychosurgery; Siderosis
PubMed: 6886697
DOI: 10.1136/jnnp.46.7.617 -
Frontiers in Neuroscience 2019The treatment of psychiatric patients presents significant challenges to the clinical community, and a multidisciplinary approach to diagnosis and management is... (Review)
Review
The treatment of psychiatric patients presents significant challenges to the clinical community, and a multidisciplinary approach to diagnosis and management is essential to facilitate optimal care. In particular, the neurosurgical treatment of psychiatric disorders, or "psychosurgery," has held fascination throughout human history as a potential method of influencing behavior and consciousness. Early evidence of such procedures can be traced to prehistory, and interest flourished in the nineteenth and early twentieth century with greater insight into cerebral functional and anatomic localization. However, any discussion of psychosurgery invariably invokes controversy, as the widespread and indiscriminate use of the transorbital lobotomy in the mid-twentieth century resulted in profound ethical ramifications that persist to this day. The concurrent development of effective psychopharmacological treatments virtually eliminated the need and desire for psychosurgical procedures, and accordingly the research and practice of psychosurgery was dormant, but not forgotten. There has been a recent resurgence of interest for non-ablative therapies, due in part to modern advances in functional and structural neuroimaging and neuromodulation technology. In particular, deep brain stimulation is a promising treatment paradigm with the potential to modulate abnormal pathways and networks implicated in psychiatric disease states. Although there is enthusiasm regarding these recent advancements, it is important to reflect on the scientific, social, and ethical considerations of this controversial field.
PubMed: 30828289
DOI: 10.3389/fnins.2019.00108 -
Proceedings of the Royal Society of... Feb 1964
Topics: Appendectomy; Cholecystectomy; Colostomy; Endocrine Glands; Hernia; Humans; Intestines; Neoplasms; Neurosurgery; Palliative Care; Psychosurgery; Stomach; Surgical Procedures, Operative; Sympathectomy; Tracheotomy
PubMed: 14116031
DOI: No ID Found -
British Medical Journal Jan 1975
Topics: Agoraphobia; Behavior Therapy; Humans; Life Style; Phobic Disorders; Psychoanalytic Therapy; Psychosurgery
PubMed: 1120241
DOI: 10.1136/bmj.1.5948.40-a -
Canadian Medical Association Journal Apr 1970
Topics: Humans; Male; Morals; Psychosurgery
PubMed: 5445058
DOI: No ID Found