Journal article
The origins and persistence of psychosurgery in the state of Iowa
Neurosurgical focus, Vol.43(3), pp.E8-E8
09/2017
DOI: 10.3171/2017.6.FOCUS17227
PMCID: PMC6858608
PMID: 28859559
Abstract
Neurosurgery for the treatment of psychological disorders has a checkered history in the United States. Prior to the advent of antipsychotic medications, individuals with severe mental illness were institutionalized and subjected to extreme therapies in an attempt to palliate their symptoms. Psychiatrist Walter Freeman first introduced psychosurgery, in the form of frontal lobotomy, as an intervention that could offer some hope to those patients in whom all other treatments had failed. Since that time, however, the use of psychosurgery in the United States has waxed and waned significantly, though literature describing its use is relatively sparse. In an effort to contribute to a better understanding of the evolution of psychosurgery, the authors describe the history of psychosurgery in the state of Iowa and particularly at the University of Iowa Department of Neurosurgery. An interesting aspect of psychosurgery at the University of Iowa is that these procedures have been nearly continuously active since Freeman introduced the lobotomy in the 1930s. Frontal lobotomies and transorbital leukotomies were performed by physicians in the state mental health institutions as well as by neurosurgeons at the University of Iowa Hospitals and Clinics (formerly known as the State University of Iowa Hospital). Though the early technique of frontal lobotomy quickly fell out of favor, the use of neurosurgery to treat select cases of intractable mental illness persisted as a collaborative treatment effort between psychiatrists and neurosurgeons at Iowa. Frontal lobotomies gave way to more targeted lesions such as anterior cingulotomies and to neuromodulation through deep brain stimulation. As knowledge of brain circuits and the pathophysiology underlying mental illness continues to grow, surgical intervention for psychiatric pathologies is likely to persist as a viable treatment option for select patients at the University of Iowa and in the larger medical community.
Details
- Title: Subtitle
- The origins and persistence of psychosurgery in the state of Iowa
- Creators
- Francis J Jareczek - University of Iowa Carver College of Medicine, Iowa City, IowaMarshall T Holland - Department of NeurosurgeryMatthew A Howard III - Department of NeurosurgeryTimothy Walch - Department of NeurosurgeryTaylor J Abel - Department of Neurosurgery
- Resource Type
- Journal article
- Publication Details
- Neurosurgical focus, Vol.43(3), pp.E8-E8
- Publisher
- United States
- DOI
- 10.3171/2017.6.FOCUS17227
- PMID
- 28859559
- PMCID
- PMC6858608
- ISSN
- 1092-0684
- eISSN
- 1092-0684
- Grant note
- T32 GM007337 / NIGMS NIH HHS
- Language
- English
- Date published
- 09/2017
- Academic Unit
- Neurology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984020504102771
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