Cingulotomy

Cingulotomy

There is a new psychosurgery that replaces the lobotomy used on mental patients. The lobotomy was a barbaric procedure that would sever the nerve connections between the frontal lobes and the rest of the brain. These lobes are unique to human beings as they are the structure of higher functions such as love, concern for others, empathy, self-insight, creativity, initiative, autonomy, rationality, abstract reasoning, judgment, future planning, foresight, willpower, determination and concentration. Without the frontal lobes it is impossible to be "human" in the fullest sense of the word; they are required for a civilized, effective, mature life. Depending on the amount of damage done, the effect can be partial or relatively complete. In a complete lobotomy, the patient becomes obviously demented with the deterioration of all higher mental functions.

 Lobotomist P. MacDonald Tow wrote in 1955:

"Possibly the truest and most accurate way of describing the net effect on the total personality is to say that he is more simple; and being more simple he has rather less insight into his own performance. The mental impairment is greater in the higher and more peculiarly human functions. Deprived of their autonomy, initiative, or willpower, their performance is considerably better in a structured situation".

The new psychosurgery for severely mentally ill patients is called a cingulotomy. It is a surgical technique involving interrupting the cingulate gyrus, a bundle of nerve fibers in the front of the brain. It is sometimes used as a last resort for patients with severe Obsessive Compulsive Disorder (OCD). OCD is an anxiety disorder in which a person feels trapped in repetitive, persistent thoughts (obsessions) and repetitive, ritualized behavior (compulsions). An attempt to resist a compulsion produces mounting tension and anxiety, which are relieved immediately by giving into it. People with obsessive-compulsive disorder derive no pleasure from it other than the release of tension.

A variation of the cingulotomy using magnetic resonance imaging (MRI) to guide the surgeon is resulting in long-term improvement in about one-quarter to one-third of OCD patients in whom it is performed. MRI is a diagnostic imaging technique that uses a magnetic field and radio waves to produce highly detailed images of the body. MRIs produce a 3 dimensional computer model.

The cingulotomy procedure is generally safe with few serious complications and does not affect intellect or memory. This procedure has now replaced the lobotomy and is performed to alleviate mental illnesses such as major depression, bipolar disorder and OCD which have not responded to psychotherapy, behavioral therapy, electroconvulsive therapy, or pharmacological treatment. Occasionally, they are also performed to treat chronic pain in cancer patients.

Source: Lobotomy & Brain Damage Psychiatry's Legacy by Gene Zimmer

Source: Anxiety Annual Report, Dec2001

Source: Loma Linda