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Psychosurgery

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there were no simple answers to the question of modern psychosurgery's clinical effectiveness; studies suggested improvements in symptoms following surgery but it was impossible to establish the extent to which other factors contributed to this improvement. Research into the effects of psychosurgery has not been able to overcome a number of methodological problems, including the problems associated with non-standardised diagnoses and outcome measurements, the small numbers treated at any one centre, and
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who have not responded to other forms of treatment, and the evidence that some patients see improvement in their symptoms following surgery. There remain however problems concerning the rationale, indications and efficacy of psychosurgery, and the results of the operation raise questions of "identity, spirit, relationships, integrity and human flourishing".
405:) started a programme of stereotactic cingulotomy for the treatment of drug addiction. About 85 people, all under the age of 35, were operated on annually. In the Soviet Union, leucotomies were used for the treatment of schizophrenia in the 1940s, but the practice was prohibited by the Ministry of Health in 1950. 160:. Lesions are made by radiation, thermo-coagulation, freezing or cutting. About a third of patients show significant improvement in their symptoms after operation. Advances in surgical technique have greatly reduced the incidence of death and serious damage from psychosurgery; the remaining risks include 366:
In the 1980s there were 10–20 operations a year in Australia and New Zealand. The number had decreased to one or two a year by the 1990s. In Victoria, there were no operations between 2001 and 2006, but between 2007 and 2012 the Victoria Psychosurgery Review Board dealt with 12 applications, all them
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Psychosurgery has a controversial history, and despite modifications, still raises serious questions about benefit, risks, and the adequacy with which consent is obtained. Its continued use is defended by references to the "therapeutic imperative" to do something in the case of psychiatric patients
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in 1970. The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in 1977 endorsed the continued limited use of psychosurgical procedures. Since then, a few facilities in some countries, such as the US, have continued to use psychosurgery on small numbers of
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in the UK, and developed in the US by H.T. Ballantine Jr. In recent decades it has been the most commonly used psychosurgical procedure in the US. The target site is the anterior cingulate cortex; the operation disconnects the thalamic and posterior frontal regions and damages the anterior cingulate
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which allowed unhealthy thoughts to circulate continuously in their brains. Moniz hoped that by surgically interrupting pathways in their brain he could encourage new healthier synaptic connections. In November 1935, under Moniz's direction, surgeon Pedro Almeida Lima drilled a series of holes on
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more accurately, and experiments were done with alternatives to cutting instruments such as radiation. Psychosurgery nevertheless went into rapid decline in the 1950s, due to the introduction of new drugs and a growing awareness of the long-term damage caused by the operations, as well as doubts
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to render the patient unconscious and could be performed in mental hospitals lacking surgical facilities. 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 psychiatric hospitals. Freeman's
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Success rates for anterior capsulotomy, anterior cingulotomy, subcaudate tractotomy, and limbic leucotomy in treating depression and OCD have been reported as between 25 and 70 percent. The quality of outcome data is poor and the Royal College of Psychiatrists in their 2000 report concluded that
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to Moniz in 1949, the use of psychosurgery declined during the 1950s. By the 1970s the standard Freeman-Watts type of operation was very rare, but other forms of psychosurgery, although used on a much smaller scale, survived. Some countries have abandoned psychosurgery altogether; in others, for
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A 2012 follow-up study of eight depressed patients who underwent anterior capsulotomy in Vancouver, Canada, classified five of them as responders at two to three years after surgery. Results on neuropsychological testing were unchanged or improved, although there were isolated deficits and one
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In the early 2000s in Spain about 24 psychosurgical operations (capsulotomy, cingulotomy, subcaudate tractotomy, and hypothalamotomy) a year were being performed. OCD was the most common diagnosis, but psychosurgery was also being used in the treatment of anxiety and schizophrenia, and other
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India had an extensive psychosurgery programme until the 1980s, using it to treat addiction, and aggressive behaviour in adults and children, as well as depression and OCD. Cingulotomy and capsulotomy for depression and OCD continue to be used, for example at the BSES MG Hospital in Mumbai.
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In the 20-year period 1971–1991 the Committee on Psychosurgery in the Netherlands and Belgium oversaw 79 operations. Since 2000 there has been only one centre in Belgium performing psychosurgery, carrying out about 8 or 9 operations a year (some capsulotomies and some DBS), mostly for OCD.
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The 1940s saw a rapid expansion of psychosurgery, in spite of the fact that it involved a significant risk of death and severe personality changes. By the end of the decade, up to 5000 psychosurgical operations were being carried out annually in the US. In 1949, Moniz was awarded the
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in 1936, first using Moniz's method but then devised a method of their own in which the connections between the prefrontal lobes and deeper structures in the brain were severed by making a sweeping cut through a burr hole on either side of the skull. They called their new operation a
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Freeman went on to develop a new form of lobotomy which could be dispensed without the need for a neurosurgeon. He hammered an ice pick-like instrument, an orbitoclast, through the eye socket and swept through the frontal lobes. The transorbital or "ice pick" lobotomy was done under
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Modern techniques have greatly reduced the risks of psychosurgery, although risks of adverse effects still remain. Whilst the risk of death or vascular injury has become extremely small, there remains a risk of seizures, fatigue, and personality changes following operation.
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who was responsible for introducing the operation into mainstream psychiatric practice. He also coined the term psychosurgery. Moniz developed a theory that people with mental illnesses, particularly "obsessive and melancholic cases", had a disorder of the
394:, Dundee. The patients have diagnoses of depression, obsessive-compulsive disorder, and anxiety. Ablative psychosurgery was not performed in England between the late 1990s and 2009, although a couple of hospitals have been experimenting with DBS. In 2010, 244:
was developed in Sweden, where it became the most frequently used procedure. It is also used in Scotland and Canada. The aim of the operation is to disconnect the orbitofrontal cortex and thalamic nuclei by inducing a lesion in the anterior limb of
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are used in the treatment of drug and alcohol dependence. Psychosurgery is also used in the treatment of schizophrenia, depression, and other mental disorders. Psychosurgery is not regulated in China, and its use has been criticised in the West.
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During the 1960s and 1970s, psychosurgery became the subject of increasing public concern and debate, culminating in the US with congressional hearings. Particularly controversial in the United States was the work of Harvard neurosurgeon
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was the most commonly used form of psychosurgery in the UK from the 1960s to the 1990s. It targets the lower medial quadrant of the frontal lobes, severing connections between the limbic system and supra-orbital part of the frontal lobe.
504:(cutting of the white matter). After twenty operations, they published an account of their work. The reception was generally not friendly but a few psychiatrists, notably in Italy and the US, were inspired to experiment for themselves. 458:. There have also been archaeological finds in South America, while in Europe trepanation was carried out in classical and medieval times. The first systematic attempt at psychosurgery is commonly attributed to the Swiss psychiatrist 1396:
Gao, G.D.; Wang, X; He, S; Li, W; Wang, Q; Liang, Q; Zhao, Y; Hou, F; Chen, L (2003). "Clinical study for alleviating opiate drug psychological dependence by a method of ablating the nucleus accumbens with stereotactic surgery".
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In Japan the first lobotomy was performed in 1939 and the operation was used extensively in mental hospitals. However, psychosurgery fell into disrepute in the 1970s, partly due to its use on children with behavioural problems.
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Wu HM, Wang XL, Chang CW, Li N, Gao L, Geng N, Ma JH, Zhao W, Gao G (2010). "Preliminary findings in ablating the nucleus accumbens using stereotactic surgery for alleviating psychological dependence on alcohol".
500:. After a few operations using ethanol, Moniz and Almeida Lima changed their technique and cut out small cores of brain tissue. They designed an instrument which they called a leucotome and called the operation a 2710: 1783: 2063: 591:
patients. In the US and other Western countries, the number of operations has further declined over the past 30 years, a period during which there had been no major advances in ablative psychosurgery.
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Medvedev, S. V.; Anichkov, A. D.; Polykov, Y. I. (2003). "Physiological mechanisms of the effectiveness of bilateral stereotactic cingulotomy against strong psychological dependence in drug addicts".
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Price, B.H.; Baral, I; Cosgrove, GR; Rauch, SL; Nierenberg, AA; Jenike, MA; Cassem, EH (2001). "Improvement in severe self-mutilation following limbic leucotomy: a series of five consecutive cases".
454:(or trephining)—the practice of drilling holes in the skull—has been found in a skull from a Neolithic burial site in France, dated to about 5100 BC although it was also used to treat 466:. He presented the results at the Berlin Medical Congress and published a report, but the response was hostile and he did no further operations. Early in the 20th century, Russian neurologist 2952: 1633: 3399: 379:
In France about five people a year were undergoing psychosurgery in the early 1980s. In 2005 the Health Authority recommended the use of ablative psychosurgery and DBS for OCD.
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Casey, B. P. (March 2015). "The surgical elimination of violence? Conflicting attitudes towards technology and science during the psychosurgery controversy of the 1970s".
462:. In December 1888 Burckhardt operated on the brains of six patients (one of whom died a few days after the operation) at the Préfargier Asylum, cutting out a piece of 2945: 2695: 553: 386:
In the UK between the late 1990s and 2009 there were just two centres using psychosurgery: a few stereotactic anterior capsulotomies are performed every year at the
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for many years, underwent a stereotactic anterior capsulotomy at the University of Wales Hospital in Cardiff in 1999. She died of pneumonia three weeks later.
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Fountas, K.N.; Smith, J.R.; Lee, G.P. (2007). "Bilateral stereotactic amygdalotomy for self-mutilation disorder: a case report and review of the literature".
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Heller, A. C.; Amar, Arun P.; Liu, Charles Y.; Apuzzo, Michael L. J. (2006). "Surgery of the mind and mood: a mosaic of issues in time and evolution".
227:—all connected by fibre pathways and thought to play a part in the regulation of emotion. There is no international consensus on the best target site. 157: 542: 548:
Beginning in the 1940s various new techniques were designed in the hope of reducing the adverse effects of the operation. These techniques included
2325: 306:. Controlled studies are very few in number and there have been no placebo-controlled studies. There are no systematic reviews or meta-analyses. 2143:
Swayze II (1995). "Frontal leucotomy and related psychosurgical procedures in the era before antipsychotics (1935–54): an historical overview".
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Sachdev, P.; Chen, X. (2009). "Neurosurgical treatment of mood disorders: traditional psychosurgery and the advent of deep brain stimulation".
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who, during the mid-1930s, developed the operation known as leucotomy. The practice was enthusiastically taken up in the United States by the
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Venezuela has three centres performing psychosurgery. Capsulotomies, cingulotomies and amygdalotomies are used to treat OCD and aggression.
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Gillet, G. (2007). "Psychosurgery and neuroimplantation: changing what is deep within a person". In Ashcroft, R. E.; et al. (eds.).
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about its efficacy. By the 1970s, the standard or transorbital lobotomy had been replaced with other forms of psychosurgical operations.
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Psychosurgery is a collaboration between psychiatrists and neurosurgeons. During the operation, which is carried out under a
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D'Astous, M.; et al. (2013). "Bilateral anterior capsulotomy for obsessive-compulsive disorder: long-term follow-up".
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Although there had been earlier attempts to treat psychiatric disorders with brain surgery, it was Portuguese neurologist
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Robison, RA; Taghva A; Liu CY; Apuzzo ML (2012). "Surgery of the mind, mood and conscious state: an idea in evolution".
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patient was left with long-term frontal psychobehavioral changes and fatigue. One patient, aged 75, was left mute and
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Moniz, E. (1956). "How I succeeded in performing the prefrontal leukotomy". In Sackler, A. M.; et al. (eds.).
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is destroyed or removed. The most common types of psychosurgery in current or recent use are anterior capsulotomy,
3258: 2869: 2665: 2514: 94:. The first significant foray into psychosurgery in the 20th century was conducted by the Portuguese neurologist 3603: 2771: 2741: 2700: 414: 267: 2766: 2715: 2650: 126: 2930: 3116: 657: 633: 516: 508: 387: 3131: 1503: 402: 3392: 2680: 1930:"A psychosurgical chapter in the history of cerebral localization: the six cases of Gottlieb Burkhardt" 1784:"Evaluation of bilateral cingulotomy and anterior capsulotomy for the treatment of aggressive behavior" 283: 640:. She was left with permanent mental incapacity as a result of the procedure, unable to speak or walk. 2996: 2859: 2756: 2751: 2524: 2519: 533: 122: 102: 2157: 3350: 2803: 2798: 2690: 2529: 2474: 2125:
Tooth, G. C. & Newton, M. P. (1961). Leucotomy in England and Wales, 1942–54 (Report). London:
1335: 549: 440: 263: 87: 41: 116:, although the operation was called leucotomy in the United Kingdom. In spite of the award of the 3164: 2891: 691: 390:, Cardiff, while anterior cingulotomies are carried out by the Advanced Interventions Service at 2350: 1941: 1934: 824: 455: 3562: 3434: 3323: 3292: 2966: 2838: 2574: 2534: 2152: 290: 180: 1929: 729:
Mashour, G.A.; Walker, E.E.; Martuza, R.L. (2005). "Psychosurgery: past, present and future".
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who devised what became the standard prefrontal procedure and named their operative technique
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Johnson, J. (2009). "A dark history: memories of lobotomy in the new era of psychosurgery".
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example the US and the UK, it is only used in a few centres on small numbers of people with
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in Bristol performed an anterior cingulotomy on a woman who had previously undergone DBS.
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Currently, interest in the neurosurgical treatment of mental illness is shifting from
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In Canada, anterior capsulotomies are used in the treatment of depression and OCD.
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has a psychosurgery program. Operations are also performed at a few other centres.
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is a combination of subcaudate tractotomy and anterior cingulotomy. It was used at
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Berrios, G.E. (1997). "The origins of psychosurgery: Shaw, Burckhardt and Moniz".
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All the forms of psychosurgery in use today (or used in recent years) target the
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Working Commission to Investigate the Use of Psychiatry for Political Purposes
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In Mexico, psychosurgery is used in the treatment of anorexia and aggression.
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Stewart, D. G.; Davis, K. L. (2008). "Images in psychiatry: the lobotomist".
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In the US, psychosurgery was taken up and zealously promoted by neurologist
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Wainrib, S. (6 December 2006). "Psychiatrie; vers le nouveau 'sujet toc'".
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operated on three patients with mental illness, with discouraging results.
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The great physiodynamic therapies in psychiatry: an historical reappraisal
1713: 86:. Psychosurgery has always been a controversial medical field. The modern 3557: 3297: 3203: 3159: 3044: 3034: 3011: 2983: 2447: 1277: 1260: 1159: 662: 451: 315: 204: 145: 117: 1932:. In Code, Christopher; Wallesch, C.-W.; Joanette, Y.; Roch, A. (eds.). 819:
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Lichterman, B. L. (1993). "On the history of psychosurgery in Russia".
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Psychosurgery Board annual report 2011/12. Melbourne, Australia
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In China, psychosurgical operations which make a lesion in the
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patients included 19 children, one of whom was 4 years old.
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psychosurgery (where the aim is to destroy brain tissue) to
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Feinstein A (1997). "Psychosurgery and the child prodigy".
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to destroy small areas of subcortical white matter in the
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(2004). 743:10.1016/j.brainresrev.2004.09.002 3226:Intervertebral disc annuloplasty 3080:Intracranial pressure monitoring 2914: 2904: 2661:European Psychiatric Association 2641:American Psychiatric Association 2233:Principles of Health Care Ethics 1936:Classic Cases in Neuropsychology 1632:Care Quality Commission (2010). 1324:10.1176/appi.neuropsych.11080189 1029:Neurosurgery for mental disorder 887:Neurosurgery for mental disorder 885:Neurosurgery working group 2000 660:'s youngest patients, author of 426: 408: 296: 266:London in the 1990s and also at 72:neurosurgery for mental disorder 3609:Physical psychiatric treatments 2915: 2666:Global Initiative on Psychiatry 2515:Child and adolescent psychiatry 2394: 2365: 2343: 2318: 2275: 2257: 2224: 2181: 2127:His Majesty's Stationery Office 2083: 2026: 1920: 1866: 1775: 1753: 1728: 1650: 1625: 1599: 1584: 1555: 1544: 1495: 1468: 1450: 1433: 1389: 1345: 1217: 1174: 1139: 1088: 190: 2882:Psychiatric survivors movement 2772:Psychiatric survivors movement 2742:Controversies about psychiatry 2701:Royal College of Psychiatrists 2489: 2454:"Shedding Light on Shadowland" 2444:Brain surgery to cure the mind 2145:American Journal of Psychiatry 2104:10.1176/appi.ajp.2008.08020174 2092:American Journal of Psychiatry 1148:Journal of Clinical Psychiatry 841: 477: 415:Massachusetts General Hospital 289:There is debate about whether 268:Massachusetts General Hospital 26:For the Tourniquet album, see 1: 3364:Mini–mental state examination 2767:Political abuse of psychiatry 2716:World Psychiatric Association 2651:Chinese Society of Psychiatry 1873:Chiappe, G. (30 March 2010). 974:Current Opinion in Psychiatry 942:10.1016/S1130-1473(07)70274-9 697: 325: 127:obsessive-compulsive disorder 3117:Multiple subpial transection 1639:. p. 93. Archived from 1573:. 2002-04-25. Archived from 1367:10.1016/j.neulet.2010.02.019 1031:. Edinburgh: Scottish Office 986:10.1097/YCO.0b013e32831c8475 517:George Washington University 388:University Hospital of Wales 7: 3132:Anterior temporal lobectomy 2353:. NPR.org. 16 November 2005 2241:10.1002/9780470510544.ch109 1989:10.1163/22977953-0620102004 670: 403:Russian Academy of Sciences 10: 3625: 2681:Indian Psychiatric Society 2404:; Charles Fleming (2008). 2296:10.1177/0957154x9700802904 1906:10.1016/j.wneu.2012.03.005 1447:. Berlin: Springer, 155–68 786:10.1177/0957154X9700802905 470:and Estonian neurosurgeon 438: 434: 413:In the United States, the 284:Medical College of Georgia 144:methods, a small piece of 25: 18: 3544: 3523: 3489: 3463: 3422: 3351:Clinical prediction rules 3349: 3316: 3244: 3202: 3184: 3140: 3088: 3053: 3019: 3010: 2997:Decompressive craniectomy 2982: 2973: 2900: 2852: 2757:Electroconvulsive therapy 2752:Biopsychiatry controversy 2724: 2618: 2525:Cross-cultural psychiatry 2520:Cognitive neuropsychiatry 2497: 2202:10.1017/S0269889714000349 1521:10.3171/2017.6.FOCUS17255 1238:10.1007/s12376-009-0031-7 594: 534:electroconvulsive therapy 370: 362:Australia and New Zealand 304:positive publication bias 54: 40: 35: 2804:Psychiatric epidemiology 2799:Philosophy of psychiatry 2691:Philadelphia Association 2530:Developmental disability 1844:10.1136/jnnp-2012-303826 815:Shorter, Edward (1997). 550:William Beecher Scoville 441:History of psychosurgery 352: 343: 330: 264:Atkinson Morley Hospital 88:history of psychosurgery 19:Not to be confused with 3165:Amygdalohippocampectomy 2870:Psychiatric medications 1671:10.1023/A:1024945927301 1114:10.4103/0019-5545.86823 692:The Terminal Man (film) 80:neurosurgical treatment 3563:Mental health tribunal 3435:Involuntary commitment 3324:Electroencephalography 3293:Magnetoencephalography 2967:central nervous system 2839:Psychosomatic medicine 2575:Nutritional psychiatry 2535:Descriptive psychiatry 1477:Nippon Ishigaku Zasshi 731:Brain Research Reviews 588:Violence and the Brain 291:deep brain stimulation 181:deep brain stimulation 3604:Medical controversies 3492:medical interventions 3445:Outpatient commitment 3430:Involuntary treatment 3269:Pneumoencephalography 3110:Bilateral cingulotomy 3075:Suboccipital puncture 2762:Insulin shock therapy 2737:Clinical neuroscience 2656:Democratic Psychiatry 2510:Biological psychiatry 2408:. London: Vermilion. 2284:History of Psychiatry 2167:10.1176/ajp.152.4.505 2033:El-Hai, Jack (2005). 1970:Kotowicz, Z. (2005). 774:History of Psychiatry 562:bilateral cingulotomy 253:Subcaudate tractotomy 154:subcaudate tractotomy 133:and other disorders. 3490:Currently regulated 3450:Voluntary commitment 3278:Transcranial Doppler 3264:Cerebral angiography 3216:Spinal decompression 2875:by condition treated 2814:Psychiatric hospital 2809:Psychiatric genetics 2555:Geriatric psychiatry 2545:Emergency psychiatry 2505:Addiction psychiatry 2375:(7 September 1996). 1694:Acta Neurochirurgica 1278:10.1192/apt.10.3.189 1160:10.4088/JCP.v62n1202 573:1960s to the present 558:anterior capsulotomy 554:orbital undercutting 456:brain cranial trauma 278:, which targets the 242:Anterior capsulotomy 231:Anterior cingulotomy 221:orbitofrontal cortex 3510:Chemical castration 3274:Echoencephalography 3040:Thalamic stimulator 2732:Behavioral medicine 2590:Palliative medicine 2570:Military psychiatry 2550:Forensic psychiatry 1791:Cirugia y Cirujanos 1508:Neurosurgical Focus 1101:Indian J Psychiatry 909:Wall Street Journal 560:, and Hugh Cairn's 556:, Jean Talairach's 460:Gottlieb Burckhardt 446:Early psychosurgery 138:general anaesthetic 92:Gottlieb Burckhardt 3500:Psychoactive drugs 3359:Glasgow Coma Scale 3127:Corpus callosotomy 3056:Ventricular system 2834:Psychopharmacology 2565:Liaison psychiatry 2437:2010-05-29 at the 2271:. 8 December 1999. 2190:Science in Context 1706:10.1007/bf01401819 1462:2009-12-16 at the 648:Tennessee Williams 468:Vladimir Bekhterev 392:Ninewells Hospital 233:was first used by 3581: 3580: 3416:Mental health law 3382: 3381: 3180: 3179: 2928: 2927: 2860:Counseling topics 2794:Pentylenetetrazol 2560:Immuno-psychiatry 2415:978-0-09-192219-1 2048:978-0-471-23292-6 1951:978-0-86377-395-2 1411:10.1159/000075111 1195:10.1159/000098527 1095:Doshi PK (2011). 834:978-0-471-15749-6 687:Elliot Valenstein 582:and psychiatrist 511:and neurosurgeon 396:Frenchay Hospital 337:nucleus accumbens 100:neuropsychiatrist 65: 64: 3616: 3409: 3402: 3395: 3386: 3385: 3308:Microneurography 3194:Meningeal biopsy 3093: 3058: 3028: 3017: 3016: 2955: 2948: 2941: 2932: 2931: 2918: 2917: 2908: 2779:Imaging genetics 2484: 2477: 2470: 2461: 2460: 2420: 2419: 2398: 2392: 2391: 2389: 2387: 2369: 2363: 2362: 2360: 2358: 2347: 2341: 2340: 2338: 2337: 2332:. 15 August 2016 2322: 2316: 2315: 2279: 2273: 2272: 2261: 2255: 2254: 2228: 2222: 2221: 2185: 2179: 2178: 2160: 2140: 2131: 2130: 2122: 2116: 2115: 2087: 2081: 2080: 2078: 2077: 2059: 2053: 2052: 2040: 2030: 2024: 2023: 2015: 2002: 2001: 1991: 1967: 1956: 1955: 1939: 1924: 1918: 1917: 1889: 1883: 1882: 1870: 1864: 1863: 1827: 1821: 1820: 1818: 1817: 1811: 1805:. Archived from 1788: 1779: 1773: 1772: 1757: 1751: 1750: 1748: 1747: 1738:. Archived from 1732: 1726: 1725: 1689: 1683: 1682: 1659:Human Physiology 1654: 1648: 1647: 1645: 1638: 1629: 1623: 1622: 1620: 1618: 1603: 1597: 1596: 1588: 1582: 1581: 1579: 1568: 1559: 1553: 1548: 1542: 1541: 1523: 1499: 1493: 1492: 1472: 1466: 1454: 1448: 1439:P.K. Doshi 2009 1437: 1431: 1430: 1393: 1387: 1386: 1349: 1343: 1342: 1340: 1334:. Archived from 1309: 1300: 1291: 1290: 1280: 1256: 1250: 1249: 1226:Medicine Studies 1221: 1215: 1214: 1178: 1172: 1171: 1143: 1137: 1136: 1126: 1116: 1092: 1086: 1085: 1049: 1032: 1025: 1006: 1005: 969: 954: 953: 921: 912: 903:N. Zamiska 2007 901: 890: 883: 868: 867: 861: 853: 845: 839: 838: 822: 812: 806: 805: 769: 763: 762: 726: 630:Rosemary Kennedy 530:local anesthesia 260:Limbic leucotomy 247:internal capsule 158:limbic leucotomy 84:mental disorders 58:edit on Wikidata 50: 33: 32: 3624: 3623: 3619: 3618: 3617: 3615: 3614: 3613: 3584: 3583: 3582: 3577: 3568:Judicial review 3540: 3519: 3485: 3476:Duty to protect 3459: 3418: 3413: 3383: 3378: 3345: 3341:Polysomnography 3329:Lumbar puncture 3312: 3240: 3198: 3176: 3148:Pituitary gland 3136: 3122:Hemispherectomy 3089: 3084: 3070:Ventriculostomy 3054: 3049: 3026:globus pallidus 3020: 3006: 2978: 2969: 2959: 2929: 2924: 2896: 2892:Psychotherapies 2848: 2829:Psycho-oncology 2789:Neurophysiology 2747:Anti-psychiatry 2720: 2614: 2585:Neuropsychiatry 2540:Eating disorder 2493: 2488: 2439:Wayback Machine 2428: 2423: 2416: 2399: 2395: 2385: 2383: 2370: 2366: 2356: 2354: 2349: 2348: 2344: 2335: 2333: 2324: 2323: 2319: 2280: 2276: 2263: 2262: 2258: 2251: 2229: 2225: 2186: 2182: 2158:10.1.1.455.9708 2141: 2134: 2123: 2119: 2088: 2084: 2075: 2073: 2060: 2056: 2049: 2031: 2027: 2016: 2005: 1982:(1–2): 77–101. 1968: 1959: 1952: 1925: 1921: 1900:(5–6): 662–86. 1894:World Neurosurg 1890: 1886: 1871: 1867: 1838:(11): 1208–13. 1828: 1824: 1815: 1813: 1809: 1786: 1780: 1776: 1759: 1758: 1754: 1745: 1743: 1734: 1733: 1729: 1690: 1686: 1655: 1651: 1643: 1636: 1630: 1626: 1616: 1614: 1605: 1604: 1600: 1589: 1585: 1577: 1566: 1561: 1560: 1556: 1549: 1545: 1500: 1496: 1473: 1469: 1464:Wayback Machine 1455: 1451: 1438: 1434: 1405:(1–4): 96–104. 1394: 1390: 1350: 1346: 1338: 1307: 1301: 1294: 1257: 1253: 1222: 1218: 1189:(2–3): 121–28. 1179: 1175: 1144: 1140: 1093: 1089: 1050: 1035: 1026: 1009: 970: 957: 922: 915: 902: 893: 884: 871: 855: 854: 846: 842: 835: 813: 809: 770: 766: 727: 704: 700: 682:Wylie McKissock 673: 638:John F. Kennedy 606: 597: 575: 480: 464:cerebral cortex 448: 443: 437: 429: 411: 373: 364: 355: 346: 333: 328: 299: 225:cingulate gyrus 193: 70:, also called 61: 46: 31: 24: 21:psychic surgery 17: 12: 11: 5: 3622: 3612: 3611: 3606: 3601: 3596: 3579: 3578: 3576: 3575: 3570: 3565: 3560: 3554: 3552: 3542: 3541: 3539: 3538: 3533: 3527: 3525: 3521: 3520: 3518: 3517: 3512: 3507: 3502: 3496: 3494: 3487: 3486: 3484: 3483: 3478: 3473: 3467: 3465: 3461: 3460: 3458: 3457: 3452: 3447: 3442: 3432: 3426: 3424: 3420: 3419: 3412: 3411: 3404: 3397: 3389: 3380: 3379: 3377: 3376: 3371: 3366: 3361: 3355: 3353: 3347: 3346: 3344: 3343: 3338: 3337: 3336: 3326: 3320: 3318: 3314: 3313: 3311: 3310: 3305: 3300: 3295: 3290: 3285: 3280: 3271: 3266: 3261: 3256: 3250: 3248: 3242: 3241: 3239: 3238: 3233: 3228: 3223: 3218: 3212: 3210: 3200: 3199: 3197: 3196: 3190: 3188: 3182: 3181: 3178: 3177: 3175: 3174: 3169: 3168: 3167: 3157: 3156: 3155: 3153:Hypophysectomy 3144: 3142: 3138: 3137: 3135: 3134: 3129: 3124: 3119: 3114: 3113: 3112: 3107: 3096: 3094: 3086: 3085: 3083: 3082: 3077: 3072: 3067: 3065:Cerebral shunt 3061: 3059: 3051: 3050: 3048: 3047: 3042: 3037: 3031: 3029: 3014: 3008: 3007: 3005: 3004: 2999: 2994: 2988: 2986: 2980: 2979: 2974: 2971: 2970: 2965:involving the 2958: 2957: 2950: 2943: 2935: 2926: 2925: 2923: 2922: 2912: 2901: 2898: 2897: 2895: 2894: 2889: 2884: 2879: 2878: 2877: 2867: 2862: 2856: 2854: 2850: 2849: 2847: 2846: 2841: 2836: 2831: 2826: 2824:Psychoanalysis 2821: 2816: 2811: 2806: 2801: 2796: 2791: 2786: 2781: 2776: 2775: 2774: 2769: 2764: 2759: 2754: 2749: 2739: 2734: 2728: 2726: 2725:Related topics 2722: 2721: 2719: 2718: 2713: 2708: 2703: 2698: 2693: 2688: 2683: 2678: 2673: 2668: 2663: 2658: 2653: 2648: 2643: 2638: 2633: 2628: 2622: 2620: 2616: 2615: 2613: 2612: 2610:Telepsychiatry 2607: 2605:Sleep medicine 2602: 2597: 2592: 2587: 2582: 2577: 2572: 2567: 2562: 2557: 2552: 2547: 2542: 2537: 2532: 2527: 2522: 2517: 2512: 2507: 2501: 2499: 2498:Subspecialties 2495: 2494: 2487: 2486: 2479: 2472: 2464: 2458: 2457: 2451: 2441: 2427: 2426:External links 2424: 2422: 2421: 2414: 2393: 2381:New York Times 2364: 2342: 2317: 2274: 2256: 2249: 2223: 2180: 2151:(4): 505–515. 2132: 2117: 2082: 2054: 2047: 2037:The Lobotomist 2025: 2003: 1957: 1950: 1919: 1884: 1865: 1822: 1774: 1771:on 2010-04-26. 1752: 1727: 1684: 1665:(4): 492–497. 1649: 1646:on 2011-07-20. 1624: 1613:. 27 June 2005 1598: 1583: 1580:on 2011-07-20. 1554: 1543: 1494: 1467: 1449: 1432: 1388: 1355:Neurosci. Lett 1344: 1341:on 2013-06-05. 1292: 1251: 1216: 1173: 1154:(12): 925–32. 1138: 1087: 1060:(4): 720–740. 1033: 1007: 955: 913: 891: 869: 840: 833: 807: 764: 701: 699: 696: 695: 694: 689: 684: 679: 672: 669: 668: 667: 658:Walter Freeman 651: 641: 634:Walter Freeman 627: 621: 605: 602: 596: 593: 574: 571: 509:Walter Freeman 479: 476: 472:Ludvig Puusepp 447: 444: 439:Main article: 436: 433: 428: 425: 410: 407: 372: 369: 363: 360: 354: 351: 345: 342: 332: 329: 327: 324: 298: 295: 192: 189: 110:James W. Watts 103:Walter Freeman 63: 62: 55: 52: 51: 44: 38: 37: 28:Psycho Surgery 15: 9: 6: 4: 3: 2: 3621: 3610: 3607: 3605: 3602: 3600: 3597: 3595: 3592: 3591: 3589: 3574: 3571: 3569: 3566: 3564: 3561: 3559: 3556: 3555: 3553: 3551: 3547: 3543: 3537: 3534: 3532: 3529: 3528: 3526: 3522: 3516: 3515:Psychosurgery 3513: 3511: 3508: 3506: 3503: 3501: 3498: 3497: 3495: 3493: 3488: 3482: 3479: 3477: 3474: 3472: 3469: 3468: 3466: 3462: 3456: 3453: 3451: 3448: 3446: 3443: 3440: 3436: 3433: 3431: 3428: 3427: 3425: 3421: 3417: 3410: 3405: 3403: 3398: 3396: 3391: 3390: 3387: 3375: 3372: 3370: 3367: 3365: 3362: 3360: 3357: 3356: 3354: 3352: 3348: 3342: 3339: 3335: 3332: 3331: 3330: 3327: 3325: 3322: 3321: 3319: 3315: 3309: 3306: 3304: 3301: 3299: 3296: 3294: 3291: 3289: 3286: 3284: 3281: 3279: 3275: 3272: 3270: 3267: 3265: 3262: 3260: 3257: 3255: 3252: 3251: 3249: 3247: 3243: 3237: 3234: 3232: 3229: 3227: 3224: 3222: 3219: 3217: 3214: 3213: 3211: 3209: 3205: 3201: 3195: 3192: 3191: 3189: 3187: 3183: 3173: 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2191: 2184: 2176: 2172: 2168: 2164: 2159: 2154: 2150: 2146: 2139: 2137: 2128: 2121: 2113: 2109: 2105: 2101: 2098:(4): 457–58. 2097: 2093: 2086: 2072:on 2007-10-20 2071: 2067: 2066: 2058: 2050: 2044: 2039: 2038: 2029: 2021: 2014: 2012: 2010: 2008: 1999: 1995: 1990: 1985: 1981: 1977: 1973: 1966: 1964: 1962: 1953: 1947: 1943: 1938: 1937: 1931: 1926:For example, 1923: 1915: 1911: 1907: 1903: 1899: 1895: 1888: 1881:(in Spanish). 1880: 1876: 1869: 1861: 1857: 1853: 1849: 1845: 1841: 1837: 1833: 1826: 1812:on 2016-03-03 1808: 1804: 1800: 1797:(2): 107–13. 1796: 1792: 1785: 1778: 1770: 1766: 1762: 1756: 1742:on 2010-08-29 1741: 1737: 1731: 1723: 1719: 1715: 1711: 1707: 1703: 1699: 1695: 1688: 1680: 1676: 1672: 1668: 1664: 1660: 1653: 1642: 1635: 1628: 1612: 1608: 1602: 1594: 1587: 1576: 1572: 1569:(in French). 1564: 1558: 1552: 1547: 1539: 1535: 1531: 1527: 1522: 1517: 1513: 1509: 1505: 1498: 1490: 1486: 1483:(2): 217–22. 1482: 1478: 1471: 1465: 1461: 1458: 1453: 1446: 1442: 1436: 1428: 1424: 1420: 1416: 1412: 1408: 1404: 1400: 1392: 1384: 1380: 1376: 1372: 1368: 1364: 1360: 1356: 1348: 1337: 1333: 1329: 1325: 1321: 1318:(2): 176–82. 1317: 1313: 1306: 1299: 1297: 1288: 1284: 1279: 1274: 1271:(3): 189–99. 1270: 1266: 1262: 1255: 1247: 1243: 1239: 1235: 1232:(4): 367–78. 1231: 1227: 1220: 1212: 1208: 1204: 1200: 1196: 1192: 1188: 1184: 1177: 1169: 1165: 1161: 1157: 1153: 1149: 1142: 1134: 1130: 1125: 1120: 1115: 1110: 1107:(3): 270–73. 1106: 1102: 1098: 1091: 1083: 1079: 1075: 1071: 1067: 1063: 1059: 1055: 1048: 1046: 1044: 1042: 1040: 1038: 1030: 1024: 1022: 1020: 1018: 1016: 1014: 1012: 1003: 999: 995: 991: 987: 983: 979: 975: 968: 966: 964: 962: 960: 951: 947: 943: 939: 936:(4): 301–11. 935: 931: 927: 920: 918: 910: 906: 900: 898: 896: 888: 882: 880: 878: 876: 874: 865: 859: 851: 850:Psychosurgery 844: 836: 830: 826: 821: 820: 811: 803: 799: 795: 791: 787: 783: 780:(29): 61–82. 779: 775: 768: 760: 756: 752: 748: 744: 740: 737:(3): 409–18. 736: 732: 725: 723: 721: 719: 717: 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Index

psychic surgery
Psycho Surgery
MeSH
D011612
edit on Wikidata
neurosurgical treatment
mental disorders
history of psychosurgery
Gottlieb Burckhardt
Egas Moniz
neuropsychiatrist
Walter Freeman
neurosurgeon
James W. Watts
lobotomy
Nobel prize
depression
obsessive-compulsive disorder
schizophrenia
general anaesthetic
stereotactic
brain
cingulotomy
subcaudate tractotomy
limbic leucotomy
seizures
cognitive
affective
ablative
deep brain stimulation

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