psychosurgical

Psychosurgery refers to surgical interventions that alter brain tissue to treat psychiatric disorders or severe behavioral conditions. The field began in the early 20th century and has shifted from broad frontal lesions to targeted, image-guided procedures.

Lobotomy and leucotomy, popularized by Egas Moniz in the 1930s and 1940s, severed frontal connections and were widely used before outcomes and ethics criticisms led to a decline in the 1950s.

Today, psychosurgical options mainly involve lesioning procedures such as cingulotomy, capsulotomy, and subcaudate tractotomy performed with stereotactic guidance, and radiosurgical approaches like gamma knife. Deep brain stimulation is sometimes included in the broader discussion of psychosurgery as a neuromodulation method for refractory obsessive-compulsive disorder or depression.

Indications are reserved for severe, treatment-resistant conditions after thorough evaluation and informed consent. Outcomes are variable; benefits may include symptom reduction, but risks include cognitive or personality change, apathy, mood alterations, seizures, and neurologic deficits.

Ethical concerns and long-term effects remain central to debates; today psychosurgery is tightly regulated and far less common than in the mid-20th century.