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Neurosurgery for psychiatric disorders: from the excision of brain tissue to the chronic electrical stimulation of neural networks

  • Chapter
Operative Neuromodulation

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 97/2))

Abstract

Neurosurgical treatment for psychiatric disorders has a long and controversial history dating back to antiquity. Both enthusiastic reports and social outcry have accompanied psychosurgical practice, particularly over the last century. Frontal lobotomy has probably been the only medical advance which was first awarded a Nobel prize in medicine and then irreparably stigmatized by scientific rejection and public criticism. In the present paper, the historical milestones of psychosurgery are briefly overviewed. The particular circumstances of the rise and fall of frontal lobotomy are also discussed. Furthermore, the clinical and surgical considerations of the four major psychosurgical procedures which are still in practice are presented.

Over the last fifteen years, the advent of deep brain stimulation (DBS) methodology coupled with accurate stereotactic techniques and guided by elaborate neuroimaging methods have revolutionized neurosurgery, particularly for the alleviation of certain disabling movement disorders. Investigationally, chronic electrical stimulation of selected brain structures, clearly implicated in the pathophysiology of neuropsychiatric disorders, has already been applied with promising results. Given the tainted past of psychiatric neurosurgery, modern neuroscientists have to move forward cautiously, in a scientifically justified and ethically approved framework. The transition from the indiscriminate destruction of brain structures to the selected electrical modulation of neural networks lies ahead; contemporary neuroscientists would substantiate this aim but should remind the controversial history of the field.

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Authors and Affiliations

  1. Evangelismos Hospital, Medical School University of Athens, Athens, Greece

    Damianos E. Sakas & E. Singounas

  2. Department of Neurosurgery, Medical School University of Thessaly, Larissa, Greece

    I. G. Panourias

  3. Department of Neurosurgery, University Hospital of Wales, Cardiff, UK

    B. A. Simpson

Authors
  1. Damianos E. Sakas
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  2. I. G. Panourias
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  3. E. Singounas
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  4. B. A. Simpson
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Correspondence to Damianos E. Sakas .

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Editors and Affiliations

  1. Department of Neurosurgery, University of Athens, Athens, Greece

    Damianos E. Sakas

  2. University Hospital of Wales, Cardiff, UK

    Brian A. Simpson

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Sakas, D.E., Panourias, I.G., Singounas, E., Simpson, B.A. (2007). Neurosurgery for psychiatric disorders: from the excision of brain tissue to the chronic electrical stimulation of neural networks. In: Sakas, D.E., Simpson, B.A. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/2. Springer, Vienna. https://doi.org/10.1007/978-3-211-33081-4_42

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  • DOI: https://doi.org/10.1007/978-3-211-33081-4_42

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-33080-7

  • Online ISBN: 978-3-211-33081-4

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