Surgery of the mind, mood, and conscious state: an idea in evolution.
R Aaron Robison, Alexander Taghva, Charles Y. Liu, Michael L J Apuzzo
World neurosurgery 2013 DOI: 10.1016/j.wneu.2013.08.002 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Historical analysis Peer reviewed |
|---|---|
| Topics | Depression PTSD |
| Keywords | Brw Brown-roberts-wells Crw Computed tomography Cosman-roberts-wells Dbs Dti Deep brain stimulation Deep-brain stimulation Diffusion tensor imaging Functional neurosurgery MRI Magnetic resonance imaging Neuromodulation OCD Obsessive-compulsive disorder PET Positron-emission tomography Posttraumatic stress disorder Prefrontal lobotomy Psychosurgery Trepanation Vagal nerve stimulation |
| Key points | The authors argue that psychosurgery's history, from trepanation and prefrontal lobotomy to contemporary focal lesioning and deep-brain stimulation, reflects a shift toward minimalism and reversible modulation of brain activity. They contend that deep-brain stimulation may not only treat psychiatric disorders but also modulate or augment consciousness, memory, and other cerebral functions. |
Abstract
Since the beginning of recorded history, humans have sought a physical means of altering disordered behavior and consciousness. This quest has spawned numerous innovations in neurosurgery and the neurosciences, from the earliest prehistoric attempts at trepanation to the electrocortical and anatomic localization of cerebral function that emerged in the 19th century. At the start of the 20th century, the overwhelming social impact of psychiatric illness intersected with the novel but imperfect understanding of frontal lobe function, establishing a decades-long venture into the modern origin of psychosurgery, the prefrontal lobotomy. The subsequent social and ethical ramifications of the widespread overuse of transorbital lobotomies drove psychosurgery to near extinction. However, as the pharmacologic treatment of psychiatric illness was established, numerous concomitant technical and neuroscientific innovations permitted the incremental development of a new paradigm of treating the disordered mind. In this article, we retrospectively examine these early origins of psychosurgery and then look to the recent past, present, and future for emerging trends in surgery of the psyche. Recent decades have seen a revolution in minimalism, noninvasive imaging, and functional manipulation of the human cerebrum that have created new opportunities and treatment modalities for disorders of the human mind and mood. Early contemporary efforts were directed at focal lesioning of abnormal pathways, but deep-brain stimulation now aims to reversibly alter and modulate those neurologic activities responsible for not only psychiatric disorders, but also to modulate and even to augment consciousness, memory, and other elements of cerebral function. As new tools become available, the social and medical impact of psychosurgery promises to revolutionize not only neurosurgery, but also humans' capability for positively impacting life and society.
Comparable studies
Other theoretical and historical papers on PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Theorizing that Psychedelic Assisted Therapy May Play a Role in the Treatment of Trauma-Induced Personality Disorders. | 2024 | Theoretical or philosophical paper | |
| The potential use of N-methyl-3,4-methylenedioxyamphetamine (MDMA) assisted psychotherapy in the treatment of eating disorders comorbid with PTSD. | 2021 | Theoretical or philosophical paper | |
| MDMA-assisted psychotherapy for PTSD in adolescents: rationale, potential, risks, and considerations. Adolescents with PTSD | 2024 | Theoretical or philosophical paper | |
| Agency in Post-traumatic Stress Disorder: Implications for Therapy | 2023 | Theoretical or philosophical paper | |
| The Inner World in the Outer World: The Phenomenology of Posttraumatic Stress Disorder from a Psychoanalytic Perspective | 1996 | Theoretical or philosophical paper |