Psychosurgery: A History from Prefrontal Lobotomy to Deep Brain Stimulation

Authors

  • Aisha Yousaf Departments of Psychiatry , Rydal Ward, Knowsley Resource and Recovery Centre, North West Boroughs Healthcare NHS Foundation Trust, Knowsley, Merseyside, United Kingdom
  • Krishna Singh Departments of Psychiatry , Rydal Ward, Knowsley Resource and Recovery Centre, North West Boroughs Healthcare NHS Foundation Trust, Knowsley, Merseyside, United Kingdom
  • Victoria Tavernor Christ’s College, Cambridge University, Cambridgeshire
  • Ashley Baldwin Departments of Psychiatry , Rydal Ward, Knowsley Resource and Recovery Centre, North West Boroughs Healthcare NHS Foundation Trust, Knowsley, Merseyside, United Kingdom

DOI:

https://doi.org/10.30564/jgm.v1i3.1943

Abstract

Neurosurgical treatment for psychiatric disorders features a long and controversial history. This article explores a ‘spectrum of psychosurgery,’ describing how old-fashioned and controversial prefrontal lobotomy gradually evolved into modern day, mainstream scientific deep brain stimulation (DBS). We focus on the rise, fall and possible re-emergence of psychosurgery as a therapeutic intervention today.We journey through historic indiscriminate use of prefrontal lobotomy, which evoked stern criticism from both public and professionals, through to the development of modern day DBS - performed for patients suffering from severe, treatment resistant symptoms of obsessive-compulsive disorder (OCD), epilepsy and movement disorders.We hope this article will provide a basis for understanding the availability of existing treatment options and potential future opportunities, whilst simultaneously challenging any public/professional preconceptions of psychosurgery, which may indirectly be obstructing patient care.Additionally, we carried out a qualitative survey displayed in WordCloud Format, capturing the intellection of 38 mental health professionals working for North West Boroughs NHS Healthcare Foundation Trust, on ‘psychosurgery,’ ‘prefrontal lobotomy’ and ‘DBS’, which may well reflect wider public opinion.In summary, the article provides a brief, yet comprehensive overview of the controversial history of psychosurgery, present-day practice, and future trends of neurosurgery for psychiatric disorders.

Keywords:

Psychosurgery;Prefrontal Lobotomy;Deep Brain Stimulation;Obsessive Compulsive Disorder;Tourette Syndrome;Epilepsy;Parkinson's Disease;One Flew Over the Cuckoo's Nest

References

[1] Staudt MD, Herring EZ, Gao K, Miller JP, Sweet JA.Evolution in the treatment of psychiatric disorders: from psychosurgery to psychopharmacology to neuromodulation. Frontiers in neuroscience. 2019, 13.

[2] Feldman RP, Goodrich JT. Psychosurgery: a historical overview. Neurosurgery. 2001 Mar 1, 48(3): 647-59.

[3] Cosgrove GR, Rauch SL. Psychosurgery. Neurosurgery Clinics. 1995 Jan 1, 6(1): 167-76.

[4] K.W. Alt, C. Jeunesse, C.H. Buitrago-Tellez, R.Wachter, E. Boes, S.L. Pichler. Evidence for stone age cranial surgery, Nature, 1997, 387: 360.

[5] Weber J, Wahl J. Neurosurgical aspects of trepanations from Neolithic times. International Journal of Osteoarchaeology. 2006, 16(6): 536-45.

[6] Staudt MD, Herring EZ, Gao K, Miller JP, Sweet JA. Evolution in the treatment of psychiatric disorders:from psychosurgery to psychopharmacology to neuromodulation. Frontiers in neuroscience. 2019, 13.

[7] Simpson D. Phrenology and the neurosciences: contributions of FJ Gall and JG Spurzheim. ANZ journal of surgery. 2005, 75(6): 475-82.

[8] Zola-Morgan S. Localization of brain function: The legacy of Franz Joseph Gall (1758-1828). Annual review of neuroscience. 1995, 18(1): 359-83.

[9] Damasio H, Grabowski T, Frank R, Galaburda AM, Damasio AR. The return of Phineas Gage: clues about the brain from the skull of a famous patient.Science. 1994, 264(5162): 1102-5.

[10] Joanette Y, Stemmer B, Assal G, Whitaker H. From theory to practice: the unconventional contribution of Gottlieb Burckhardt to psychosurgery. Brain and language. 1993, 45(4): 572-87.

[11] Stone JL. Dr. Gottlieb Burckhardt the Pioneer of Psychosurgery. Journal of the History of the Neurosciences. 2001, 10(1): 79-92.

[12] Boettcher LB, Menacho ST. The early argument for prefrontal leucotomy: the collision of frontal lobe theory and psychosurgery at the 1935 International Neurological Congress in London. Neurosurgical focus. 2017, 43(3): E4.

[13] Feldman RP, Goodrich JT. Psychosurgery: a historical overview. Neurosurgery. 2001, 48(3): 647-59.

[14] Moniz E. Prefrontal leucotomy in the treatment of mental disorders. The American journal of psychiatry. 1994.

[15] Scull A. Madness in civilisation. The Lancet. 2015,385(9973): 1066-7.

[16] Getz, Marshall J. The Ice Pick of Oblivion: Moniz,Freeman and the Development of Psychosurgery. Trames,2009, 13(2): 129-152.

[17] Pressman, Jack D. 1998. Last Resort: Psychosurgery and the Limits of Medicine. Cambridge: Cambridge University Press.

[18] Getz, Marshall J. The Ice Pick of Oblivion: Moniz,Freeman and the Development of Psychosurgery. Trames, 2009, 13(2): 129-152.

[19] Braslow, Joel. Mental Ills and Bodily Cures. Berkeleyand Los Angeles: University of California Press,1997.

[20] Pressman, Jack D. Last Resort: Psychosurgery and the Limits of Medicine. Cambridge: Cambridge University Press, 1998.

[21] Getz, Marshall J. The Ice Pick of Oblivion: Moniz,Freeman and the Development of Psychosurgery. Trames, 2009, 13(2): 129-152.

[22] Heller AC, Amar AP, Liu CY, Apuzzo ML. Surgery of the mind and mood: a mosaic of issues in time and evolution. Neurosurgery, 2006, 59(4): 720-39.

[23] Feldman RP, Goodrich JT. Psychosurgery: a historical overview. Neurosurgery. 2001, 48(3): 647-59.

[24] Pressman JD. Sufficient promise: John F. Fulton and the origins of psychosurgery. Bulletin of the History of Medicine. 1988, 62(1): 1-22.

[25] Manjila S, Rengachary S, Xavier AR, Parker B,Guthikonda M. Modern psychosurgery before Egas Moniz: a tribute to Gottlieb Burckhardt. Neurosurgical focus. 2008, 25(1): E9.

[26] Getz, Marshall J. The Ice Pick of Oblivion: Moniz,Freeman and the Development of Psychosurgery. Trames, 2009, 13(2): 129-152.

[27] Sargant, The present indications for leucotomy,paper given at RMPA: ts, 1961: 1. Available at the Wellcome Library, London (online collection). PPWWS/F/7/8/20. https://wellcomelibrary.org/item/b18727281#?c=0&m=0&s=0&cv=0&z=-0.0817%2C0.0806%2C1.2084%2C0.9655

[28] Crossley, David. 1993. The introduction of leucotomy: a British case history. History of Psychiatry 4 (16): 553-564.

[29] Jansson B. Controversial psychosurgery resulted in a Nobel Prize. Nobelprize. org. 2007.

[30] Cade JF, Malhi GS. Cade’s lithium. Acta Neuropsychiatrica, 2007, 19(2): 125-6.

[31] López-Muñoz F, Alamo C, Cuenca E, Shen WW,Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine. Annals of Clinical Psychiatry. 2005, 17(3): 113-35.

[32] Tancer ME, Golden RN, Ekstrom RD, Evans DL.Use of electroconvulsive therapy at a university hospital: 1970 and 1980-81. Psychiatric Services. 1989,40(1): 64-8.

[33] Benabid AL, Torres N. New targets for DBS. Parkinsonism & related disorders. 2012, 18: S21-3.

[34] Crowell AL, Riva-Posse P, Holtzheimer PE, Garlow SJ, Kelley ME, Gross RE, Denison L, Quinn S, Mayberg HS. Long-term outcomes of subcallosal cingulate deep brain stimulation for treatment-resistant depression. American Journal of Psychiatry. 2019,176(11): 949-56.

[35] Lyons MK. Deep brain stimulation: current and future clinical applications. InMayo Clinic Proceedings. Elsevier, 2011, 86(7): 662-672.

[36] Benabid AL, Charbardes S, Mitrofanis J, Pollak P.Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. Lancet Neurologie. 2009; 8: 67-81. Medline.

[37] Bejjani BP, Damier P, Arnulf I, et al. Transient acute depression induced by high-frequency deep-brain stimulation. N Engl J Med 1999; 340: 1476-80. Medline (DELETE This Reference)

[38] Tyagi H, Apergis-Schoute AM, Akram H, Foltynie T, Limousin P, Drummond LM, Fineberg NA, Matthews K, Jahanshahi M, Robbins TW, Sahakian BJ. A randomized trial directly comparing ventral capsule and anteromedial subthalamic nucleus stimulation in obsessive-compulsive disorder: clinical and imaging evidence for dissociable effects. Biological psychiatry. 2019, 85(9): 726-34.

[39] Schrock LE, Mink JW, Woods DW, Porta M, Servello D, Visser‐Vandewalle V, Silburn PA, Foltynie T, Walker HC, Shahed‐Jimenez J, Savica R. Tourette syndrome deep brain stimulation: a review and updated recommendations. Movement Disorders. 2015 Apr;30(4):448-71.

[40] Long-Term Outcomes of Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Depression. American Journal of Psychiatry. The American Journal of Psychiatry, 2019.

[41] University Health Network (UHN). Deep brain stimulation continues to show promise for patients with mild Alzheimer’s disease. ScienceDaily.

[42] Vibhangini S. Wasade, Kost Elisevich, Rizwan Tahir,Brien Smith, Lonni Schultz, Jason Schwalb, Marianna Spanaki-Varelas. Long-term seizure and psychosocial outcomes after resective surgery for intractable epilepsy. Epilepsy & Behavior, 2015, 43: 122. DOI:https://doi.org/10.1016/j.yebeh.2014.11.024

[43] Blume S. The Artificial Ear: Cochlear Implants and the Culture of Deafness. Piscataway, NJ: Rutgers University Press [Google Scholar], 2010.

[44] Clinical Commissioning Policy: Deep Brain Stimulation (DBS) In Movement Disorders (Parkinson’s Disease, Tremor and Dystonia).https://www.england.nhs.uk/wp-content/uploads/2013/04/d03-p-b.pdf

[45] https://artuk.org/discover/stories/the-stone-of-follymadness-or-magic

[46] 38 psychiatrists “3 word” response to “Prefrontal lobotomy”

[47] https://www.livescience.com/62591-trepanation-explained.html

[48] 38 psychiatrists “3 word” response to “psychosurgery”

[49] The Way of the Ice Pick - Ice Pick Lobotomy | HowStuffWorks. https://images.app.goo.gl/3V5u128infFjPdaZ8

[50] Lobotomy Tool Set - Hammer & Orbitoclast - Lobotomy ice pick. https://images.app.goo.gl/qf3UgznYr9iP5zgb6

[51] https://www.medicalbag.com/home/features/despicable-doctors/walter-freeman-the-father-of-the-lobotomy/

[52] https://artuk.org/discover/stories/the-stone-of-follymadness-or-magic

[53] https://www.samhs.org.au/Virtual%20Museum/Surgery/Leucotomy/Leucotomy.html

[54] https://www.neurosurgery.pitt.edu/centers/epilepsy/dbs-movement-disorders

[55] 38 psychiatrists “3 word” response to “DBS”

Downloads

How to Cite

Yousaf, A., Singh, K., Tavernor, V., & Baldwin, A. (2020). Psychosurgery: A History from Prefrontal Lobotomy to Deep Brain Stimulation. Journal of Geriatric Medicine, 1(3), 1–8. https://doi.org/10.30564/jgm.v1i3.1943

Issue

Article Type

Articles