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Psychosurgery

Current Status

Psychosurgery has gone through periods of widespread, relatively uncritical acceptance, and periods of great disfavor in the medical community. In the early years of its use there were no well-conducted, detailed, rigorous studies of outcome or differences in procedure. The development of various diagnostic and psychological assessment measures has enabled more rigorous follow-up studies of patients assessing the relationship between different procedures, a patient's characteristics, and their long-term outcome.

As stated previously, psychosurgical procedures have changed dramatically since their beginning. Psychosurgery is still rarely used today, despite a recent resurgence in the procedure. It is most likely to benefit patients with particular symptom patterns seen in some patients with chronic major depression or obsessive-compulsive disorder. These include compulsions, obsessions, and long-lasting, high levels of anxiety (often seen as agitation). These patients often respond well to psychosurgery. Moreover, because they are usually coherent and rational, consent can be obtained from the patient and their family. Psychosurgery has benefited greatly from improvements in technology such as magnetic resonance imaging, probe techniques, and stereotaxic instruments. Future technological developments and increased understanding of the brain, particularly the limbic system, show potential for increasing the safety efficacy of psychosurgical techniques.


Resources

Books

Jennett, B., and K.W. Lindsay. An Introduction to Neuro-Surgery. 5th ed. Oxford: Butterworth-Heinemann, 1994.

Valenstein, E.S. Great and Desperate Cures: The Rise and Fall of Psychosurgery and Other Radical Treatments for Mental Illness. New York: Basic Books, 1986.


Marie Doorey

KEY TERMS


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Antipsychotic drugs

—These drugs, also called neuroleptics, seem to block the uptake of dopamine in the brain. They help to reduce psychotic symptoms across a number of mental illnesses.

Computed tomography

—A technique for visualizing a plane of the body using a number of x rays that are converted into one image by computer.

Cortex

—The outer layer of the brain.

Delusions

—Fixed, false beliefs that are resistant to reason or factual disproof.

Dopamine

—A neurotransmitter that acts to decrease the activity of certain nerve cells in the brain, it seems to be involved in schizophrenia.

Hallucinations

—A sensory experience of something that does not exist outside the mind. A person can experience a hallucination in any of the five senses.

Leukotomy

—A rarely used psychosurgical procedure in which tissue in the frontal lobes of the brain is destroyed.

Limbic system

—A part of the brain made up of a number of different structures, it forms an arc and is located in the forebrain. The limbic system seems highly involved in emotional and motivational behaviors.

Magnetic Resonance Imaging

—A technique using radio frequency pulses that creates images which show various size, density and spatial qualities of the targeted body area, e.g. the brain.

Neuroimaging techniques

—High technology methods that enable visualization of the brain without surgery such as computed tomography and magnetic resonance imaging.

Psychotherapy

—A broad term that usually refers to interpersonal verbal treatment of disease or disorder that addresses psychological and social factors.

Stereotaxic instrument

—Generally, a rigid frame with an adjustable probe holder that is secured on patient's skull for psychosurgery, it enables more accurate brain tissue manipulation.

Additional topics

Science EncyclopediaScience & Philosophy: Propagation to Quantum electrodynamics (QED)Psychosurgery - History, Contemporary Psychosurgery, Patient Selection, Postoperative Care, Current Status