Lobotomy in Private Practice

Bernstein, Irving C.; Callahan, William A.; Jaranson, James M.

doi:10.1001/archpsyc.1975.01760260105009

Cited by 18 publications

(2 citation statements)

References 11 publications

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“…The possible neuroanatomical basis of the episodic perseverance or repetition of any and all behaviors in D1CT-7 mice is not known, but we predict that, like their biting during grooming and their leaping, it could be a consequence of neurostimulation of regions also hyperactive in OCD, including the amygdala and somatosensory/insular and orbitofrontal (OFC) cortical regions (Horwitz et al, 1991;Breiter et al, 1996) that in OCD are similarly thought to hyperstimulate the striatum glutamatergically (Bernstein et al, 1975;Kurlan et al, 1990;Breiter et al, 1996). The potentiated amygdalar, somatosensory/insular, and piriform D1ϩ neurons of D1CT-7 mice are thought to excite directly or indirectly not only deep-layer striatally projecting cortical neurons and the striatum but also the OFC among other prefrontal regions (McDonald, 1987;Morecraft et al, 1992;Barbas, 1993).…”

Section: Putative Neuroanatomical Basis For D1ct Mice Compulsive Abnomentioning

confidence: 94%

OCD-Like Behaviors Caused by a Neuropotentiating Transgene Targeted to Cortical and Limbic D1+ Neurons

et al. 1999

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To study the behavioral role of neurons containing the D1 dopamine receptor (D1ϩ), we have used a genetic neurostimulatory approach. We generated transgenic mice that express an intracellular form of cholera toxin (CT), a neuropotentiating enzyme that chronically activates stimulatory G-protein (G s ) signal transduction and cAMP synthesis, under the control of the D1 promoter. Because the D1 promoter, like other CNSexpressed promoters, confers transgene expression that is regionally restricted to different D1ϩ CNS subsets in different transgenic lines, we observed distinct but related psychomotor disorders in different D1CT-expressing founders. In a D1CT line in which transgene expression was restricted to the following D1ϩ CNS regions-the piriform cortex layer II, layers II-III of somatosensory cortical areas, and the intercalated nucleus of the amygdala-D1CT mice showed normal CNS and D1ϩ neural architecture but increased cAMP content in whole extracts of the piriform and somatosensory cortex. These mice also exhibited a constellation of compulsive behavioral abnormalities that strongly resembled human cortical-limbic-induced compulsive disorders such as obsessive-compulsive disorder (OCD). These compulsive behaviors included episodes of perseverance or repetition of any and all normal behaviors, repetitive nonaggressive biting of siblings during grooming, and repetitive leaping. These results suggest that chronic potentiation of cortical and limbic D1ϩ neurons thought to induce glutamatergic output to the striatum causes behaviors reminiscent of those in human cortical-limbic-induced compulsive disorders.

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Section: Putative Neuroanatomical Basis For D1ct Mice Compulsive Abnomentioning

confidence: 94%

OCD-Like Behaviors Caused by a Neuropotentiating Transgene Targeted to Cortical and Limbic D1+ Neurons

et al. 1999

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“…Better results with fewer side effects were possible thanks to the advances in imaging techniques and the rise of the stereotactic surgery. The surgery has enabled the location of the targets with high precision and minimal tissue damage, 4,14,48 which is noticeable when establishing a temporal line in the results presented, dividing the conventional leucotomies, as in the study by Benson et al, 15 of the procedures using a stereotactic technique.…”

Section: Discussionmentioning

confidence: 91%

Neurosurgery for Refractory Schizophrenia: A Systematic Literature Review

Almeida

Aquino

Silva

2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Schizophrenia is a chronic and disabling psychiatric disease that can be refractory to conventional treatment. The present study aims to gather information about the circuitry related to schizophrenia to describe possible surgical targets, and to establish whether psychosurgery can be a safe and effective treatment option for refractory schizophrenia. A systematic review of the literature was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. An electronic search was performed in the Pubmed and BVSalud databases using medical subject headings (MeSH) combined with Boolean operators. Out of the 724 studies retrieved, 13 were included in the review. Regarding leucotomy without a stereotactic approach, we found side effects such as irritability, nervous excitement, cases of disinhibition, and compromised normal social control. In other stereotactic procedures, there was some improvement, mainly regarding aggressiveness and positive symptoms; an anterior capsulotomy had an efficacy rate of 74% according to the Clinical Global Impression (CGI) rating scales. The only deep brain stimulation (DBS) case report found in our study described a significant improvement in the positive and negative symptoms. The use of a stereotactic approach enables psychosurgery to be a safe and effective treatment option in cases of refractory schizophrenia, improving the quality of life and the symptoms. Cognitive and negative symptoms remain a challenge in the treatment of schizophrenia, revealing that more targets in the circuitry must be surgically explored. Furthermore, more clinical trials are needed to compare these many surgical techniques and targets, using a standard evaluation parameter. The results show that DBS has a promising future in the treatment of refractory schizophrenia.

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Psychosurgery and the Porteus Maze Tests

Riddle¹

1978

Arch Gen Psychiatry

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Lobotomy in Private Practice

Cited by 18 publications

References 11 publications

OCD-Like Behaviors Caused by a Neuropotentiating Transgene Targeted to Cortical and Limbic D1+ Neurons

OCD-Like Behaviors Caused by a Neuropotentiating Transgene Targeted to Cortical and Limbic D1+ Neurons

Neurosurgery for Refractory Schizophrenia: A Systematic Literature Review

Psychosurgery and the Porteus Maze Tests

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