{"id":"d546a9b9-d77f-4ff9-a024-144ed48c6663","slug":"violence-mental-illness-and-the-brain-a-brief-history-of-psychosurgery-part-2-from-the-limbic-system-and-cingulotomy-to-deep-brain-stimulation","title":"Violence, mental illness, and the brain – A brief history of psychosurgery: Part 2 – From the limbic system and cingulotomy to deep brain stimulation","authors":["Miguel A. Faria"],"abstract":"Background: The history of psychosurgery reveals significant advancements in understanding the brain's anatomy and physiology, particularly through studies involving the limbic system and its connections. Early observations, including those by P.A. Bard and Paul Yakovlev, highlighted the relationship between brain lesions and emotional responses, leading to the development of functional neurosurgery techniques such as cingulotomy. Methods: Modern cingulotomy, developed in the early 1960s, utilized stereotactic techniques to create targeted lesions in the cingulum, interrupting connections between cortical and deeper limbic areas. The procedure was refined to include radiofrequency thermal coagulation and was applied to various severe psychiatric disorders, including chronic pain and depression. Results: Studies indicated that a significant percentage of patients undergoing cingulotomy experienced substantial improvements in their psychiatric symptoms, with reports suggesting that 75% of patients showed significant enhancement in their condition post-surgery. Furthermore, evaluations by the National Commission for the Protection of Human Subjects revealed that many patients did not suffer permanent deficits and some even demonstrated improved cognitive function. Conclusion: Cingulotomy represents a pivotal advancement in psychosurgery, offering relief for patients with intractable psychiatric disorders. The procedure's evolution reflects a more nuanced understanding of the brain's emotional circuitry and emphasizes the importance of ethical considerations in psychosurgical practices. Keywords: psychosurgery, cingulotomy, limbic system, deep brain stimulation, mental illness, neurosurgery, Klüver-Bucy syndrome, functional neurosurgery","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/d546a9b9-d77f-4ff9-a024-144ed48c6663/featured/hero-1782421045051.png","publishDate":"2013-06-01T00:00:00.000Z","doi":"10.4103/2152-7806.112825","categories":["Original Article"],"fullTextUrl":"http://sni.wpengine.com/wp-content/uploads/2015/05/3731/SNI-4-75.pdf"}