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Neurosurgical Forum: Letters to the Editor To The Editor Richard M. Lehman , M.D. University of Medicine and Dentistry of New Jersey New Brunswick, New Jersey 497 497 Abstract Object. Despite a long and controversial history, psychosurgery has persisted as a modern treatment option for some severe, medically intractable psychiatric disorders. The goal of this study was to review the current state of psychosurgery. Methods. In this review, the definition of psychosurgery, patient selection criteria, and

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Geoffrey Knight and his contribution to psychosurgery

Francesco Marchi, Francesco Vergani, Iacopo Chiavacci, Richard Gullan, and Keyoumars Ashkan

T he birth of modern psychosurgery is usually dated to November 12, 1935, when Egas Moniz and Almeida Lima performed the first successful psychosurgery operation by injecting alcohol into the frontal white matter of a 63-year-old woman with paranoid delusions, anxiety, and melancholia. 7 , 40 , 45 The work of Moniz and Lima was preceded by earlier neurosurgical interventions such as topectomies 5 , 19 and corticotomies, 44 , 45 and by the experimental studies of John Farquhar Fulton, who noticed a lack of emotional expression and frustration behavior

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Contemporary psychosurgery and a look to the future

Robert P. Feldman, Ronald L. Alterman, and James T. Goodrich

P sychosurgery has a long and controversial history. Despite its widespread demise in the 1950s, due in large part to the introduction of psychopharmacology, psychosurgery is still practiced today in the most severe and medically refractory cases of psychiatric disorders. In this review, the development and results of the four most commonly performed psychosurgical procedures are discussed. Examples of recent advances in neuroscience indicating a potential future role of neurosurgical intervention for psychiatric disease are also mentioned. As the debate over

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Modern psychosurgery before Egas Moniz: a tribute to Gottlieb Burckhardt

Sunil Manjila, Setti Rengachary, Andrew R. Xavier, Brandon Parker, and Murali Guthikonda

G ottlieb Burckhardt (1836–1907; Fig. 1 ), a Swiss psychiatrist, was the first physician to perform modern psychosurgery, in which the contemporary theories about brain–behavior and brain–language relationships were amalgamated and practically applied to patient care. Interestingly, however, that landmark text was dedicated to Egas Moniz (1874–1955), the Portuguese neurologist whom the authors credited as the “first who conceived and executed a valid operation for mental disorder.” 4 , 5 , 8 , 9 Thus both names are often associated with the origins of

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Topectomy versus leukotomy: J. Lawrence Pool’s contribution to psychosurgery

Ryan Holland, David Kopel, Peter W. Carmel, and Charles J. Prestigiacomo

T hroughout psychosurgery’s checkered past, there has been a struggle to understand how best to treat patients with psychiatric diseases with a minimum of complications. Optimizing efficacy while maximizing safety was the goal of many surgeons at the time. Though leucotomy was the most common operation offered to this patient population, it was not necessarily considered the best. With this in mind, Dr. J. Lawrence Pool and his colleagues at New Jersey State Hospital at Greystone Park undertook a clinical trial to determine if a topectomy, one of the original

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History of psychosurgery at Sainte-Anne Hospital, Paris, France, through translational interactions between psychiatrists and neurosurgeons

Marc Zanello, Johan Pallud, Nicolas Baup, Sophie Peeters, Baris Turak, Marie Odile Krebs, Catherine Oppenheim, Raphael Gaillard, and Bertrand Devaux

T he treatment of psychiatric patients by means of surgical interventions is an ancient idea. Attempts to cure psychiatric patients through surgical approaches have existed since prehistory. 52 Nevertheless, the term psychosurgery refers to a more recent period, beginning with the work of a Portuguese neurologist, Egas Moniz, in the 1930s. Moniz was a brilliant person. After training in neurology in France, he became involved in politics and held different political positions, including minister of foreign affairs of Portugal. He eventually returned to medicine

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Psychosurgery, ethics, and media: a history of Walter Freeman and the lobotomy

James P. Caruso and Jason P. Sheehan

T he study and practice of neurosurgery uniquely positions its practitioners to explore the relationship between the brain and the mind. The history of neurosurgery includes many attempts to alter patients’ moods and consciousness, ranging from trephination in 5000 bce to modern developments in neuromodulation. 35 Of these procedures, few have achieved more publicity, and more infamy, than the lobotomy. Academic and popular conceptions of the lobotomy, and of psychosurgery, derive in part from the work of Walter J. Freeman II, the first lobotomist in the US

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Neurosurgeons' perspectives on psychosurgery and neuroenhancement: a qualitative study at one center

Clinical article

Daniel Mendelsohn, Nir Lipsman, and Mark Bernstein

development of a brain-machine interface to facilitate independence for paralyzed patients, and the potential use of functional imaging for “lie detection” underscores both the concerns and promise regarding technical advances. 2 , 12 , 28 Neuroethics is the dedicated field that explores the ethical implications of these advances. 1 , 4 , 13 , 22 The misadventures of psychosurgery in the mid-20th century resulted in a stigma on the surgical management of mental illness. Prefrontal leucotomy, or lobotomy, harmed many patients and serves as a reminder of patient safety

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Neuroplasticity and the brain connectome: what can Jean Talairach’s reflections bring to modern psychosurgery?

Pierre Bourdillon, Caroline Apra, Marc Lévêque, and Fabien Vinckier

-Anne Hospital (A and B), and the private collection of Gerard Proust (C). Fig. 2. A: Operating theater in Sainte-Anne Hospital. B: Jean Talairach performing a surgical procedure. Courtesy of the Henri Ey Library collection, Sainte-Anne Hospital. The examination of what he imagined and wrote in the 1950s is of great interest now that psychosurgery is making a comeback due to the difficulty of finding new pharmacological agents, but also due to the progress made in surgery and neurosciences. Therefore, the first goal of this paper is to describe the hypotheses Talairach

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Neursurgical Forum: Letters to the editor To The Editor Vernon H. Mark , M.D. Boston, Massachusetts 475 476 In his review of Dr. Shuman's book (Shuman SI: Psychosurgery and the Medical Control of Violence. Anatomy and Deviance . Detroit: Wayne State University Press, 1977. J Neurosurg 48: 663–664, April, 1978,. Book Review), Dr. Scoville has made a number of interesting points and observations; several of them, however, are open to question. Dr. Scoville states, “Amygdalotomy varies from the rest of