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A lobotomy (from Greek λοβός (lobos) 'lobe' and τομή (tomē) 'cut, slice') or leucotomy is a discredited form of neurosurgical treatment for psychiatric disorder or neurological disorder (e.g. epilepsy, depression) that involves severing connections in the brain's prefrontal cortex. [ 1 ] The surgery causes most of the connections to ...
- Overview
- Are lobotomies still performed today?
- Uses and benefits of psychosurgery
- Risks associated with lobotomy
- Lobotomy in history
- Medical treatments preferred over lobotomy today
- Takeaway
In the U.S., lobotomies are no longer used as surgery to treat psychiatric problems. Some other types of psychosurgery are still performed when other treatments have failed.
Few medical procedures in history have garnered as much controversy as the lobotomy. Tens of thousands of lobotomies were performed in the United States in the mid-1900s, often leading to devastating outcomes.
A lobotomy, also called a leucotomy, is a type of psychosurgery that was used to treat mental health conditions such as mood disorders and schizophrenia. Psychosurgeries are procedures that involve the physical removal or alteration of part of the brain.
Lobotomies involved separating tissue in an area called the prefrontal cortex in one of two primary ways:
•Frontal lobotomy. A surgeon drilled a hole into each side of the skull and cut through brain tissue with an instrument resembling an ice pick called a leucotome.
•Transorbital lobotomy. A surgeon inserted a leucotome through the eye socket and drove it through a thin layer of bone with a mallet to access the brain.
Lobotomies are no longer performed in the United States. They began to fall out of favor in the 1950s and 1960s with the development of antipsychotic medications. The last recorded lobotomy in the United States was performed by Dr. Walter Freeman in 1967 and ended in the death of the person on whom it was performed.
In Europe, the Soviet Union banned lobotomies in 1950, a year after inventor Dr. Egas Moniz won the Nobel Prize for medicine. They persisted into the 1970s in the rest of Europe and into the 1980s in Scandinavia.
Some other types of psychosurgeries are still used today, such as:
•cingulotomy
•anterior capsulotomy
•subcaudate tractotomy
Cingulotomy
Cingulotomy is the most commonly performed psychosurgery in North America. It’s a type of surgery that involves altering tissue in the anterior cingulate region associated with feeling chronic pain. It’s sometimes used to manage symptoms of: •chronic and severe anxiety disorders, such as obsessive-compulsive disorder (OCD) •severe mood disorders, such as treatment-resistance depression or bipolar disorder •heroin addiction •chronic pain syndromes that don’t respond to other treatments •severe schizophrenia with aggressive behavior
Anterior capsulotomy
An anterior capsulotomy is a potential treatment for severe OCD that doesn’t respond to psychotherapy and medications. It involves altering the part of the brain that carries information from the thalamus and brainstem to the prefrontal region. In a 2019 review, researchers found that of 512 people who received treatment from 1961 to 2018, 73 percent responded to the surgery and 24 percent saw their symptoms resolve.
Subcaudate tractotomy
A subcaudate tractotomy may be used to treat delusions and hallucinations in people with severe schizophrenia with aggressive symptoms. It involves cutting connections between the limbic system and a part of the prefrontal lobe called the orbitofrontal cortex.
Lobotomies were considered experimental even at the height of their popularity. Although some people did see improvements in their conditions, many other people experienced life-alternating side effects, or even died.
One of the highest-profile cases of a failed lobotomy was that of Rosemary Kennedy, younger sister of John F. Kennedy. After undergoing a lobotomy in 1941 to treat seizures and extreme shifts in mood, she lost her ability to walk or talk. Her personality was permanently altered, and she was left with physical disability.
Risks of psychosurgeries include the risk of death and:
•seizures
•loss of bladder control or bowel control
•changes in appetite
António Egas Moniz and his colleague Almeida Lima are credited with the development of the lobotomy in 1935. They promoted their frontal lobotomy procedure across Europe, despite keeping poor patient records and lacking evidence of effectiveness. The procedure quickly gained popularity, despite thousands of people experiencing severe side effects and outcomes, such as seizures, infections, and death.
American neurologist Walter Freeman and surgeon James Watts championed the procedure in America. Influenced by an Italian colleague, Freeman eventually switched to the transorbital method, in which an icepick-like instrument was inserted through the eye socket to reach the brain. He passionately spread the surgery across North America, despite haphazardly performing surgeries without proper sterilization.
Antipsychotics and other medications
Antipsychotics are often the initial treatment for acute schizophrenic episodes. They block the effects of the neurotransmitter dopamine on your brain to reduce feelings of anxiety or aggression as well as hallucinations and delusional thoughts. Many other types of medications are also used to treat mental health conditions, including: •antidepressants •anti-anxiety medications •stimulants •mood stabilizers
Psychotherapy
Psychotherapy, also called talk therapy, is a common type of mental health treatment. It may be administered alone or in combination with medication. There are many types of psychotherapy used to treat mental health conditions. They include: •cognitive behavioral therapy •dialectical behavioral therapy •interpersonal therapy •psychodynamic therapy •psychoanalysis
Hospitalization
Some people with severe mental health conditions may need to be admitted to a medical facility. Laws vary by state, but in most states, a person can be held in facility involuntarily if they pose a danger to themselves or others.
Lobotomies were surgeries that involved altering a part of the brain called the prefrontal cortex. Sometimes these surgeries were performed without consent and without proper sterilization, despite a lack of evidence for their effectiveness.
Lobotomies are no longer performed and have largely been replaced by medications. Some other types of psychosurgeries are performed in very rare circumstances to treat conditions such as severe depression or OCD that doesn’t respond to other treatments. These surgeries are considered last resorts.
- Daniel Yetman
Nov 11, 2022 · What Is a Lobotomy? A lobotomy is a surgical procedure to provide relief to people with mental illnesses unresponsive to standard treatment.
Lobotomy, surgical procedure in which the nerve pathways in a lobe or lobes of the brain are severed from those in other areas. The procedure was formerly used as a radical therapeutic measure to help patients with severe mental illness. It has since been superseded by medications and other therapies.
- The Editors of Encyclopaedia Britannica
May 13, 2024 · A lobotomy is a type of brain surgery that involves separating tissue in the prefrontal cortex. The goal was to treat people with mental health conditions. Learn more.
Jan 30, 2021 · Lobotomy became one of the most notorious surgical procedures of the 20th Century, writes Claire Prentice, but retired neurosurgeon, Henry Marsh, who once carried out a modified version of the ...
Dec 22, 2023 · A lobotomy is a type of brain surgery that involves severing the connection between the frontal lobe and other parts of the brain. Lobotomies became popular in the 1930s as a treatment for...
