Phantom Sensations (including Phantom Limb Pain)
Alexander R. Toftness in Incredible Consequences of Brain Injury, 2023
But what can be done if the phantom pain already exists? Pharmacological treatments such as painkillers or antidepressants are not very helpful (Flor, 2002). Historically, removing the part of the brain's sensorimotor cortex corresponding to the missing limb was sometimes attempted (e.g., de Gutiérrez-Mahoney, 1944). This psychosurgery is now generally regarded as a bad idea because cutting out parts of the brain has severe side effects. As an interesting sidenote, there are cases of people with phantom pain accidentally becoming cured after acquiring brain damage, allegedly because the part of their brain that was producing the pain was destroyed (e.g., Appenzeller & Bicknell, 1969; Yarnitsky et al., 1988). I absolutely would not recommend such a dangerous “treatment.”
The Psychiatric Body
Roger Cooter, John Pickstone in Medicine in the Twentieth Century, 2020
The most extreme and infamous procedure from this period was lobotomy, or surgery on the cerebral cortex. The idea of intervening surgically on the brain to treat mental illness is as old as ancient Egyptian trepanning. Twentieth-century psychosurgery was first developed in the mid-1930s by Egas Moniz, a Portuguese neurologist, who also received a Nobel Prize for his work. Two other doctors, the neurologist Walter Freeman and neurosurgeon James Watts, popularized Moniz’s work in the United States and coined the term lobotomy. Psychosurgeons used two different techniques: prefrontal leucotomy, which involved boring small holes in the front of the cranium, and transorbital lobotomy, which involved approaching the brain through the roof of the orbit of the eye socket. In both procedures, a scalpel or ice pick-like object was inserted into the brain and used randomly to transect the frontal gray matter. Both measures were reported to tranquilize patients. The heyday of psychosurgery occurred in the United States during the late 1940s and early 1950s. By 1955, over 20,000 of these mutilating procedures had been performed on American mental patients. The practice declined rapidly after the late 1950s, in part because of belated recognition of the irreversible brain damage it often caused and in part because of the introduction of new chemical treatments.
Can Physical Activity Prevent or Treat Clinical Depression? 1
Henning Budde, Mirko Wegner in The Exercise Effect on Mental Health, 2018
Some people may be offered counselling style therapies. Trained professionals who might undertake this therapy include psychiatrists, clinical psychologists, counselling psychologists, hypnotherapists, and social workers. Within this area there are many approaches ranging from psychoanalysis (which perhaps is the lay person’s impression of all therapy), to client-centred and cognitive-behavioral approaches. A particular style that has become popular is cognitive behavioral therapy (CBT). Sometimes the whole family may be involved in the therapeutic process. In extreme cases of depression, Electro Convulsive Therapy (ECT) or psychosurgery (such as prefrontal lobotomy) could be performed. A good source of reference for understanding these treatments is the Royal College of Psychiatrists in the UK (www.rcpsych.ac.uk/default.aspx). Of course, of key interest to us in this chapter is the role of physical activity and exercise in the treatment of clinical depression.
Legal Regulation of Psychosurgery: A Fifty-State Survey
Published in Journal of Legal Medicine, 2019
Roland Nadler, Jennifer A. Chandler
A note on terminology: we view “psychosurgery” as an obsolete term that fails to capture the full range of medical interventions this article aims at addressing. It is also associated with the controversial history of the prefrontal lobotomy. The more recent alternative “neurosurgery for psychiatric disorders” suffers from the same problem with respect to scope. Not all of the procedures of interest here are, strictly speaking, surgical (e.g., focused ultrasound treatment or perhaps even transcranial magnetic stimulation). “Invasive neuromodulation” is perhaps the most appropriately inclusive term, though the word “invasive” is itself imprecise. For the purposes of this research and presentation of findings, however, the terminological decision was simple: the existing U.S. laws use the term “psychosurgery”—even if, to most lawmakers at most of the relevant times these statutes were drafted, that word’s denotation was likely limited to the prefrontal lobotomy and similar interventions—and this article follows suit for clarity and simplicity. Where there is a particular need to emphasize the breadth of interventions actually at issue, “invasive neuromodulation” will be the term of choice, but in all other regards, “psychosurgery” will suffice as shorthand.
Effectiveness of intensive treatment services for obsessive compulsive disorder: outcomes from the first Canadian residential treatment program
Published in International Journal of Psychiatry in Clinical Practice, 2020
Marlene Taube-Schiff, Neil A. Rector, Persephone Larkin, Adrienne Mehak, Margaret A. Richter
For those that are able to receive and engage with CBT treatment, symptom reduction is possible but full remission is often not the expected outcome (Ackerman & Greenland, 2002; Mataix-Cols et al., 2002) and OCD symptoms are known to wax and wane throughout one’s life (Ackerman & Greenland, 2002; Mataix-Cols et al., 2002). Further, within the population of individuals who experience symptoms of OCD, approximately 20% are severely impacted by this illness (Ruscio et al., 2010). These particular individuals are less likely to benefit from weekly outpatient CBT treatment (Stewart, Yen, Stack, & Jenike, 2006; Veale et al. 2016a), and many also fail to respond to conventional drug therapies, leaving them with few treatment options (Richter & Ramos, 2018). Importantly, the majority of psychiatric hospitalizations related to OCD are often accounted for by those individuals with the most severe symptoms of OCD (Ruscio et al., 2010). For some of these individuals, second- and third-line drug treatments have proven to be effective and others have found success with newer types of biological therapies (Richter & Ramos, 2018). For example, a recent meta-analysis found that low-frequency rTMS applied over the brain’s supplementary motor area may afford the greatest effectiveness relative to other cortical areas for individuals with OCD (Rehn, Eslick, & Brakoulias, 2018). Psychosurgery has also been researched within the OCD population for many years with some beneficial results from anterior cingulotomy and anterior capsulotomy (Brown et al., 2016).
Ablative brain surgery: an overview
Published in International Journal of Hyperthermia, 2019
Andrea Franzini, Shayan Moosa, Domenico Servello, Isabella Small, Francesco DiMeco, Zhiyuan Xu, William Jeffrey Elias, Angelo Franzini, Francesco Prada
The study of functional neuroanatomy led to the belief that removing or destroying specific regions of the brain could alter behavior [68]. Originally, psychosurgery was often carried out in an indiscriminate way, with frequent and severe side effects, lack of precision, no regulatory oversight and often bad outcomes, thus casting a shadow over the field. Thereafter, the adoption of stereotactic methodology and more strict patient selection criteria led to the improvement of safety and outcomes [68–70].
Related Knowledge Centers
- Major Depressive Disorder
- Neurosurgery
- Schizophrenia
- Brain
- Mental Disorder
- Neuropsychiatry
- Lobotomy
- Obsessive–Compulsive Disorder
- General Anaesthetic
- Stereotactic Surgery