Biological: Psychosurgery Flashcards
Leukotomy
Drilling a hole on each side of the skull and inserting a ice-pick like object to destroy the nerve fibres underneath.
To alliminate some severe symptoms of some mental illnesses
EGAZ MONIZ
Transorbital Lobotomy
Inserting a sharp instrument into the brain through the eye-socket.
The prefrontal cortex, lying at the front, is damaged from this.
This is said to reduce aggressive behaviour
WALTER FREEMAN
Thormazine
A medication, that replaced lobotomies
Transorbital lobotomy 2
They used which therapy to make the patients unconscience
Would take 3/4 minutes
5,000 were taken place annually (1949)
19 children under 18 got lobotomised
Freeman’s last patient died from a brain hemmorage
Side effects to lobotomies
Change in personality Lethargy Apathy Becoming irresponsible Social withdrawal Blurred decision making Bruised eyes Hemmoraging Death
Deep brain stimulation (DBS)
Surgeons thread wires through skull, the wires stay embedded in the brain, connected to a battery pack that is implanted in the chest, the batteries produce a high-frequency current that interrupts circulations
Most commonly used for OCD
Can be switched on/off, and there’s no tissue destruction, and is only temporary
Stereotactic psychosurgery
Use brain scanning (MRI) to locate exact points within the brain, to sever connections very precisely.
Can be done by-
• burning away (heating the tip of the electrode)
• radiation (using a gamma knife to focus beams of radiation on targeted site)
Done using anesthetic
Capsulotomy
Surgeons insert probes through the top of the skull and down into the capsule, near the hypothalamus.
They heat the tips of the probes burning away portions of the brain tissue
Lobotomies
Comer (2002) found that lobotomies had a fatality rate of up to 6% (30,000 people) and a range of sever physical side effects such as seizures and lack of emotional responsiveness.
Modern psychosurgery
Cosgrove and Raunch (2001) found that-
•Cingultomies were effective in 56% of OCD patients, and Capsulotomies in 67%
•For major affective disorders the success rate was 65% and 55% for capsulotomies.
Placebo in psychosurgery
You can’t have a placebo in psychosurgery.
Unlike drug trials, psychosurgery is a physical operation, this can’t be faked.
You can’t compare your results the same way a scientist would with a drugs test.
Issues with psychosurgery
Isn’t appropriate for all illnesses
Can be invasive
Only for he most severe case of mental illnesses
Is usually a last resort
Can have extreme side effects
DBS 2
(Mayberg et al, 2005) Has been found to have positive results in a trial of 6 patients, 4 showed improvement in their severe symptoms of depression.
Reversible (preferred surgery)
Ethical code of conduct
Protection from harm Right to withdraw Confidentiality Informed consent Debriefing Deception
