History of psychosurgery: a psychiatrist's perspective - PubMed

Affiliations

• PMID: 23419707
• DOI: 10.1016/j.wneu.2013.02.053

Review

History of psychosurgery: a psychiatrist's perspective

Kyle A B Lapidus et al. World Neurosurg. 2013 Sep-Oct.

Abstract

Interest in using neuromodulation to treat psychiatric disorders is rapidly increasing. The development of novel tools and techniques, such as deep brain stimulation (DBS), increases precision and minimizes risk. This article reviews the history of psychosurgical interventions and recent developments of DBS to provide a framework for understanding current options and future goals. We begin by discussing early approaches to psychosurgery, focusing on the widespread use of lobotomy and the subsequent backlash from the public and professionals in the field. Next, we discuss the development of stereotaxis. This technique allows for more targeted, precise interventions that produce discrete subcortical lesions. We focus on four stereotactic procedures that were developed using this technique: cingulotomy, capsulotomy, subcaudate tractotomy, and limbic leucotomy. We subsequently review contemporary theory and approaches with relevance to psychosurgery. We discuss the systems and neurocircuitry that are thought to be involved in psychiatric illness and provide targets for intervention. This discussion includes presentation of basal ganglia thalamocortical pathophysiology including cortico-striato-thalamo-cortical loops. We focus the discussion on two psychiatric disorders that have been targets of neurosurgical interventions: obsessive-compulsive disorder and mood disorders such as major depressive disorder. Evidence from studies of DBS in psychiatric disorders, including efficacy and tolerability, is reviewed. Finally, we look to the future, exploring the possibilities for these approaches to increase understanding, transform societal views of mental illness, and improve treatment.

Keywords: 5-HT; ACC; Anterior cingulate cortex; BD; Bipolar disorder; CSTC; Cortico-striato-thalamo-cortical; DBS; DM; Deep brain stimulation; Dorsomedial; Functional magnetic resonance imaging; HDRS; Hamilton Depression Rating Scale; History; MDD; MRI; Magnetic resonance imaging; Major depression; Major depressive disorder; NAc; Nucleus accumbens; OCD; OFC; Obsessive-compulsive disorder; Orbitofrontal cortex; PET; Positron emission tomography; Psychiatric surgery; SAPAP3; SSRI; STN; Selective serotonin reuptake inhibitor; Serotonin; Subthalamic nucleus; Synapse-associated protein 90/postsynaptic density-95-associated protein 3; Y-BOCS; Yale-Brown Obsessive Compulsive Scale; fMRI.

Similar articles

• Surgery for psychiatric disorders.

  Luigjes J, de Kwaasteniet BP, de Koning PP, Oudijn MS, van den Munckhof P, Schuurman PR, Denys D. Luigjes J, et al. World Neurosurg. 2013 Sep-Oct;80(3-4):S31.e17-28. doi: 10.1016/j.wneu.2012.03.009. Epub 2012 Mar 30. World Neurosurg. 2013. PMID: 22465369 Review.

• [Modern day psychosurgery: a new approach to neurosurgery in psychiatric disease].

  Pedrosa-Sánchez M, Sola RG. Pedrosa-Sánchez M, et al. Rev Neurol. 2003 May 1-15;36(9):887-97. Rev Neurol. 2003. PMID: 12717678 Review. Spanish.

• Surgery of the mind, mood, and conscious state: an idea in evolution.

  Robison RA, Taghva A, Liu CY, Apuzzo ML. Robison RA, et al. World Neurosurg. 2013 Sep-Oct;80(3-4):S2-26. doi: 10.1016/j.wneu.2013.08.002. Epub 2013 Aug 3. World Neurosurg. 2013. PMID: 23916496 Review.

• Lesion procedures in psychiatric neurosurgery.

  Patel SR, Aronson JP, Sheth SA, Eskandar EN. Patel SR, et al. World Neurosurg. 2013 Sep-Oct;80(3-4):S31.e9-16. doi: 10.1016/j.wneu.2012.11.038. Epub 2012 Nov 14. World Neurosurg. 2013. PMID: 23159652 Review.

• [Psychosurgical treatment of malignant OCD: three case-reports].

  Polosan M, Millet B, Bougerol T, Olié JP, Devaux B. Polosan M, et al. Encephale. 2003 Nov-Dec;29(6):545-52. Encephale. 2003. PMID: 15029089 Review. French.

Cited by

• Deep Brain Stimulation (DBS) in Treatment-Resistant Depression (TRD): Hope and Concern.

  Asir B, Boscutti A, Fenoy AJ, Quevedo J. Asir B, et al. Adv Exp Med Biol. 2024;1456:161-186. doi: 10.1007/978-981-97-4402-2_9. Adv Exp Med Biol. 2024. PMID: 39261429 Review.

• The Evolution of Modern Ablative Surgery for the Treatment of Obsessive-Compulsive and Major Depression Disorders.

  Mustroph ML, Cosgrove GR, Williams ZM. Mustroph ML, et al. Front Integr Neurosci. 2022 Apr 6;16:797533. doi: 10.3389/fnint.2022.797533. eCollection 2022. Front Integr Neurosci. 2022. PMID: 35464603 Free PMC article. Review.

• Neuroablative Intervention for Refractory Obsessive-Compulsive Disorder.

  Chang JG, Kim SJ, Kim CH. Chang JG, et al. Psychiatry Investig. 2023 Nov;20(11):997-1006. doi: 10.30773/pi.2023.0214. Epub 2023 Nov 21. Psychiatry Investig. 2023. PMID: 37997327 Free PMC article.

• Bilateral Anterior Capsulotomy for the Treatment of Refractory Somatic Symptom Disorder: A Case Report.

  He W, Shao L, Wang H, Huang H, Zhang S, Li C, Zhang C, Yi W. He W, et al. Front Integr Neurosci. 2022 Jan 18;15:721833. doi: 10.3389/fnint.2021.721833. eCollection 2021. Front Integr Neurosci. 2022. PMID: 35115912 Free PMC article.

• Evolution in the Treatment of Psychiatric Disorders: From Psychosurgery to Psychopharmacology to Neuromodulation.

  Staudt MD, Herring EZ, Gao K, Miller JP, Sweet JA. Staudt MD, et al. Front Neurosci. 2019 Feb 15;13:108. doi: 10.3389/fnins.2019.00108. eCollection 2019. Front Neurosci. 2019. PMID: 30828289 Free PMC article. Review.

Publication types

MeSH terms

LinkOut - more resources

• Full Text Sources

  • ClinicalKey
  • Elsevier Science

• Other Literature Sources

  • scite Smart Citations

• Medical

  • MedlinePlus Health Information