Lobotomy (a procedure professionally known as prefrontal lobotomy) involved deliberately damaging the connections of the prefrontal cortex with other brain structures. The procedure was once extremely popular - the number of lobotomies performed in the world can be reported in tens of thousands. Currently, however, lobotomy is definitely not performed anymore.

Lobotomy: what is it?

The termlobotomyis derived from two Greek words: the first is lobos, understood as a lobe, and the second is tome, which can be translated as cutting. Lobotomy is basically a colloquial term, the full name of this procedure isprefrontal lobotomy , in the literature you can also find the procedure referred to asleukotomy .

The essence of the lobotomy was to damage the nerve connections between the prefrontal cortex and other parts of the brain, such as the thalamus or the hypothalamus. It is known, however, that various defects in the nervous tissue - related to, for example, a stroke or the destruction of neurons by a growing intracranial tumor - can lead to irreversible ailments, such as, for example, paralysis.

Why would anyone want tointentionally damage nerve tissue ?

Well, at a time when lobotomy was popular, it was considered a very good method of treating several different psychiatric entities. The word "was" is used here because thelobotomy has been discontinued for a long time . But what was the history of lobotomy, and why could it be one of the most controversial surgeries ever performed by medics?

Lobotomy: history

Lobotomy can be classified as a neurosurgical procedure in the field of psychosurgery. Damage to the connections between the frontal lobes and other parts of the brain was definitely not the first procedure in the above-mentioned group of treatments.

Already in the 1880s, a doctor of Swiss origin,Gottlieb Burkhardt , performedneurosurgical operations , which were aimed atfreeing patients from the mental disorders they experience - incl. fromauditory hallucinations . The procedure proposed by the aforementioned physician consisted in removing fragments of their cerebral cortex from patients. Burkhardt performed his surgery on several patients, one of whom died as a consequence of the surgery, and another, some time after the operation, committed suicide.

It can therefore be assumed that G. Burkhardt was in fact the father of psychosurgery. After his operations, for some time there was a kind of stagnation in this area, but the situation changed in the 1930s. It was then, in 1935, that the Portuguese neurologistAntonio Egas Moniz , along with his colleague, performed the first lobotomy.

The procedure was performed by making special holes in the patient's skull, and then an ethanol solution was injected into the area of ​​the prefrontal cortex .

Quite soonthe original lobotomy techniquehas been modified. Even Moniz himself used a device calledleukotom- it resembled a loop made of wire, which could be inserted through an opening in the skull, and then, by moving it, broken connections between different parts of the brain.

The first lobotomies were carried out in Portugal , but doctors from other countries soon became interested in this procedure. In the United States, enthusiasts of this operation were primarily two neurosurgeons - W alter Freeman and James Watts.

Over timethe popularity of lobotomygrew, but the course of this procedure was also modified. For example, the way in which the connections within the brain centers were broken has been changed. Instead of drilling holes in the patients' skulls, their brains were accessed throughaccess … transorbital .

A special skewer (resembling ice skewers) was used for this purpose, which was hammered into the patients below the eyeball. Such a change led tolobotomy becoming less invasive(if this procedure is at all "less invasive"), andshortening the duration procedure- it turned out that even 10 minutes is enough to perform a lobotomy.

Lobotomy: indications for a leukotomy

At the time when the assumptions of the lobotomy were developed, some doctors were of the opinion that various mental disorders and diseases could be caused by abnormal circulation of nerve impulses in the structures of the brain. ThisThis is why breaking selected connections between the structures of the central nervous system would lead to an improvement in the mental state of patients. Deliberate damage to nervous tissue was mainly usedfor the most severe psychiatric problems .

The following were considered indications for lobotomy :

  • schizophrenia
  • depression with psychotic symptoms
  • bipolar disorder
  • It also happened that the procedure was performed in patients with neurotic disorders, e.g. in people suffering from panic disorder.

Lobotomy in a short time from its development has become an exceptionallypopular method of treating mental illnesses . In the United States alone, a total of40,000 lobotomieswere performed, the procedure was also performed quite often in Europe - in the United Kingdom alone, almost 20,000 patients underwent lobotomy.

As you can see, up to a certain point, the lobotomy was performed on a significant number of patients. In the 1950s, however, this procedure was gradually discontinued, and twenty years later, the medical community decided thatlobotomy should not be performed at all .

The reason for such a change in opinion about lobotomy was, firstly, that in the 1950s, new and at the same timeeffective psychotropic preparations , such as medications, began to appear on the medical market antipsychotics and antidepressants.

Another factor that led tolobotomy disappearing from the list ofprocedures performed in operating rooms was that the procedure often actually worsened the patients' condition.

Lobotomy: effects and consequences of the procedure

If the lobotomy in all patientsled to any dangerous consequences , this procedure would be stopped quickly. However, this was not the case - some of the operated patients managed to improve their mental state by deliberately damaging the connections within the brain. After the operation, the following were obtained, among others the effect of the fact that patients - who before the procedure were characterized by a tendency to fall into states of exceptional psychomotor agitation - became much calmer.

On the other hand, there were some "buts" - some people who underwent a lobotomy becametoo calm . A significant percentage of the operated patients experienced an exceptionalblunting of their emotionality , the patients also became apathetic, passive towards life or had a significant degree of problems with concentration.

At some of the patientsThere were also various somatic problems, including frequent vomiting, but also disturbances in controlling physiological processes, such as urination or stool. It should also be mentioned that somelobotomed patients simply died .

As lobotomywas once a frequently performedprocedure, it probably comes as no surprise that the procedure has become the focus of attention of many different researchers. They assessed, inter alia,the effectiveness of lobotomy- in the end, it turned out that there is no scientific evidence that lobotomy is an effective method of treating mental illness. It is this aspect, as well as the significant problems that lobotomy led to in some patients, that ultimately led to the complete discontinuation of this procedure.

There were definitely more critics of lobotomy than people who were in favor of using this method. However, it is worth mentioning that the person responsible for the creation of this procedure - that isA. E. Moniz- was honored for her discoveries. In 1949, he was awarded theNobel Prize for research , which concerned the effects of lobotomy in patients. Honoring Moniz - which is probably not surprising - was criticized by many people, one of them was a patient who had undergone a lobotomy herself.

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Category:

Psychiatry