Why frontal lobotomy

Develop and improve products. List of Partners vendors. A frontal lobotomy is a psychosurgery that was used in the mids to treat mental and neurological illnesses, including schizophrenia , bipolar disorder , and epilepsy. It involves severing the nerve pathways from the frontal lobe—the largest section of the brain—from the other lobes. Frontal lobotomies have always been controversial, even when they were mainstream.

The surgery was risky and permanently altered the patient's personality. Many patients died and many more awoke with severe, life-changing side effects and disabilities. This article discusses the history of lobotomies along with how they worked, why they were used, and what effects they had on patients with mental illness.

The front lobes make up one of four distinct sections of the brain. You have two frontal lobes, one on each side of your brain, right behind your forehead. The frontal lobes are involved in making decisions, movement, speech, and shaping your personality. Lobotomies were part of a wave of new treatments for neurological diseases in the early 20th century, including electroconvulsive therapy shock therapy.

While others before Dr. Moniz had made attempts at similar surgical procedures, their success was limited and not well-received by the medical community.

Moniz's lobotomies were initially considered successful. His first 20 lobotomy patients all survived without serious side effects, leading neurosurgeons in Brazil, Italy, and the United States to begin performing lobotomies as well.

Moniz believed that patients with mental illness had abnormal connections between different regions in their brains, and that severing these "fixed circuits" could help. Part of his inspiration came from a research paper about chimpanzees who were described as calmer and more cooperative after having their frontal lobes removed. This focus on neural circuits and connectivity, rather than on just one piece of the brain, remains relevant to 21st-century neuroscience.

Some forms of psychosurgery are still used in rare cases when a patient does not respond to other treatments. Deep brain stimulation is one such procedure used to treat Parkinson's disease , epilepsy , and obsessive-compulsive disorder OCD. The first lobotomy in America was performed by a neuroscientist named Walter Freeman and a neurosurgeon named James Watts in The procedure became prevalent in the United States due to their efforts.

The initial procedure had to be done in an operating room , but Dr. Freeman thought this would limit access to the procedure for those in mental institutions who could potentially benefit from a lobotomy. Freeman came up with a new, more simplified version of the procedure that could be done by doctors in those institutions, without general anesthesia or proper sterilization. Watts did not agree with these decisions and stopped working with Dr.

Freeman in protest. The lobotomy was a mainstream procedure until it fell out of favor in the mids. Nonetheless, Dr. Freeman continued to perform the surgery until when he had his last lobotomy patient, a woman named Helen Mortensen.

She died three days after the operation and Freeman was banned from performing lobotomies shortly after. The creator of the lobotomy, a Portuguese neurologist, believed that mental illness was caused by abnormal circuits between parts of the brain and that severing these circuits could relieve symptoms. In , two doctors began to perform the first lobotomies together in the United States, but later split ways over disagreements about safety and ethics.

Two main techniques were used to perform lobotomies. The techniques differed in how the surgeon accessed the patient's brain. This Issue. October 16, Access through your institution. Add or change institution. Save Preferences. Privacy Policy Terms of Use. The chance of a cure through lobotomy seemed preferable to the life sentence of incarceration in an institution. But by far the most prolific lobotomist in the country, and indeed the world, was the neurosurgeon Sir Wylie McKissock, based at the Atkinson Morley hospital in Wimbledon.

He believes his former boss performed around 3, lobotomies, as part of his famously speedy approach to surgery. Very quickly done," says Dr Gould. As well as operating at Atkinson Morley, McKissock would travel across the south of England at weekends, performing extra leucotomies at smaller hospitals. He says the operation could have dramatic benefits for some patients, including one who was terrified of fire.

However, he had increasing doubts about lobotomy, especially for patients with schizophrenia. He found that around a third benefited, a third were unaffected and a third were worse off afterwards.

Although he himself had authorised lobotomies, he later turned against the practice. Even so, there were always critics of the procedure, he added. Even before the first lobotomy, doctors were manipulating the brain to change behavior. Beginning in the late s, the Swiss physician Gottlieb Burkhardt removed parts of the cortex of the brains of patients with manic agitation, auditory hallucinations and symptoms of schizophrenia.

Burkhardt noted in an paper that the surgery calmed his patients, though some suffered complications such as motor weakness, sensory aphasia inability to understand speech, writing or tactile symbols and epilepsy, and one patient died five days after the procedure, researchers reported in in the Journal of Neurosurgery.

Moniz's breakthrough was inspired by lobotomy-like procedures that Yale neuroscientist John Fulton and his colleague Carlyle Jacobsen performed on chimpanzees. They removed both frontal lobes in a female chimpanzee who had previously displayed anger and frustration if she made a mistake while performing tasks in experiments; after the surgery, the chimp became more cooperative and did not show signs of frustration, scientists wrote in in the Singapore Medical Journal.

Later that year, Moniz and his colleague Almeida Lima performed the first human lobotomy experiments, operating on 20 people. The doctors targeted the patients' frontal lobes because that brain region is associated with behavior and personality. Moniz reported the surgeries as a success in treating patients with conditions such as depression, schizophrenia, panic disorder and mania, according to an article published in in the Journal of Neurosurgery.

But the operations had severe side effects, including increased body temperature, vomiting, bladder and bowel incontinence and eye problems, as well as apathy, lethargy and abnormal sensations of hunger, among others. The medical community was initially critical of the procedure, but nevertheless, physicians started using it in countries around the world.

Moniz's first lobotomy procedures involved cutting a hole in the skull and injecting ethanol into the brain to destroy the fibers that connected the frontal lobe to other parts of the brain.