psychosurgery

• early psychosurgery - Moniz


  in the 1930's Egan Moniz developed the leucotomy - involving drilling two holes into either side of the skull, and inserting an ice-pick type instrument which was rotated to seperate the frontal lobes from the rest of the brain.
• early psychosurgery - Moniz


  Moniz later refined this by designing the leucotome - an instrument with a retractable wire loop that could cut into the white matter of the brain and sever the nerve fibres, thus alleviating symptoms of mental illness.
• early psychosurgery: pre-frontal lobtomy


  the pre-frontal lobtomy involves the selective destruction of nerve fibres in the frontal lobe - an area of the brain involved in impulse control and mood regulation.
• early psychosurgery: lobotomies


  • the purpose of this were to alleviate the severe symptoms of mental illness such as depression or OCD.
  • it was the severity of the illness that was more important than the type of illness when considering patients for this treatment.
• early psychosurgery - Freeman

  • in the 1940's Walter Freeman developed the transorbital lobotomy, which involved seperating the frontal lobes by inserting a large needle into the brain through the eye socket.
  • this quick and easy procedure meant that over 50,000 people in the USA received lobotomies during this time.
• modern psychosurgery - stereotactic psychosurgery


  stereotactic psychosurgery uses brain scanning techniques to locate exact points within the brain and sever connections precisely, under anasthetic.
• modern psychosurgery - bilateral cingulotomy

  • the bilateral cingulotomy is designed to surgically interrupt the circuit linking the orbital front lobe to the thalamus in order to treat patients with OCD.
  • by severing this circuit, distressing thoughts can no longer be transported, alleviating symptoms.
  • to sever this circuit, surgeons burn away the tissue by heating the tip of the electrode or using a gamma knife to focus radiation beams at the target site.
• modern psychosurgery - deep brain simulation (DBS)


  • DBS involves threading wires through the skull which is connected to a battery pack in the patient's chest.
  • the wire carries an adjustable high frequency current that interrupts brain activity.
  • it involves no permanent damage, and if it doesn't work it can just be turned off.