Lobotomy

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What is lobotomy?

Lobotomy, also known as prefrontal leukotomy or leucotomy, is a neurosurgical operation in which connections (nerve pathways) in the brain’s prefrontal lobe/lobes are severed from those in other areas.

This surgical procedure is controversial and was formerly used as a treatment for people with chizophrenia, manic depression and mania (bipolar disorder), as well as other mental illnesses.

According to Dr. Barron Lerner, a medical professor at NYU Langone Medical Center in New York, lobotomy refers to a variety of different operations that were aimed to damage brain tissue so as to treat mental illness. Lerner shared with Live Science that the doctors believed bad behaviors they wanted to fix were set down in certain neurological connections. Thus, if they damage those connections, the bad behaviors could be stopped.

Also, he stated that back then when lobotomy was first invented, good ways to treat mental illness were not available, so people were in search for “pretty desperate” types of interventions. However, there were always critics of the procedure.

History of lobotomy

It all started in the late 1880s, when a Swiss doctor named Gottlieb Burkhardt used the surgery to remove parts of the cortex of the brains of patients with auditory hallucinations and other symptoms of schizophrenia hi hope to calm them. In fact, the patients did get calm although one of them died while another one committed suicide after the procedure.

Later, in 1935, António Egas Moniz, a Portuguese neurologist was credited with inventing the lobotomy. This invention brought him a Nobel Prize for Physiology or Medicine in 1949. at that time, there was a movement  revoking the prize started but ended up being unsuccessful.

Also in 1935, John Fulton, a neuroscientist from Yale university and his colleague Carlyle Jacobsen performed procedures resembling lobotomy on chimpanzees. Later that year, first human experiments were performed by Moniz and his colleague Almeida Lima. In those experiments, they targeted the frontal lobes because they associated with behavior and personality.

As perported by Moniz in an article published in 2011 in the Journal of Neurosurgery, the treatment came out successful for patients with conditions such as depression, schizophrenia, panic disorder and mania. However, the operations came with severe side effects which include increased temperature, vomiting, bladder and bowel incontinence and eye problems, as well apathy, lethargy, and abnormal sensations of hunger, among others.

Although themedical community was initially critical of the procedure, physicians started to use it in countries around the world. This is because at the time, there were hundreds of thousands of mental institutions, which were overcrowded and chaotic. By giving unruly patients lobotomies, doctors could maintain control over the institution, according to Lerner.

Methods of lobotomy

In the first procedures, doctors cut a hole in the patients’ skull and ethanol was injected into the brain. This ethanol destroyed the fibers connecting the frontal lobe to other parts of the brain. Later, leucotome, a surgical instrument was introduced by Moniz. This leucotome contains a loop of wire that can create a circular lesion in the brain when being rotated by surgeons.

Lobotomy was early adopted by Italian and American doctors. Adapting Moniz’s technique, the American neurosurgeons Walter Freeman and James Watts later created their own technique called the “Freeman-Watts technique” or the “Freeman-Watts standard prefrontal lobotomy.”

In 1945, Freeman invented the transorbital lobotomy, a method that would not require a traditional surgeon and operating room. Freeman’s procedure was developed with inspiration from another procedure of Amarro Fiamberti, an Italian psychiatrist. In Fiamberti’s procedure, he accessed the frontal lobes through the eye sockets.

Freeman’s transorbital lobotomy involved using an orbitoclast, which is a modified ice pick. Accordingly, the physician would insert this instrument to the patient’s brain through his eye socket using a hammer. Then, the physician move orbitoclast side-to-side to separate the frontal lobes from the thalamus. Thalamus is the part of the brain that receives and relays sensory input.

Side effects of labotomy

Lobotomy can leave negative effects on a patient in many apects, including their:

  • Personality
  • Initiative
  • Inhibitions
  • Empathy
  • Ability to function on their own

The primary long-term side effect was mental dullness, said Lerner said. This means people can not lead their life independently anymore. Also, they lost their personalities.

Labotomy started to subsided in the mid-1950s, as antipsychotic and antidepressant medications were developed and they were much more effective. Nowadays, patients with mental illness are treated with drugs or electroconvulsive therapy.  The removal of brain areas is only employed if all other treatments have failed. And, this procedure is psychosurgery.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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