Neurosurgery for psychiatric disorders: reviewing the past and charting the future

Neurosurg Focus. 2023 Feb;54(2):E8. doi: 10.3171/2022.11.FOCUS22622.

Abstract

Surgical techniques targeting behavioral disorders date back thousands of years. In this review, the authors discuss the history of neurosurgery for psychiatric disorders, starting with trephination in the Stone Age, progressing through the fraught practice of prefrontal lobotomy, and ending with modern neurosurgical techniques for treating psychiatric conditions, including ablative procedures, conventional deep brain stimulation, and closed-loop neurostimulation. Despite a tumultuous past, psychiatric neurosurgery is on the cusp of becoming a transformative therapy for patients with psychiatric dysfunction, with an ever-increasing evidence base suggesting reproducible and ethical therapeutic benefit.

Keywords: depression; history of medicine; neurosurgery; obsessive-compulsive disorder; psychiatry; psychosurgery.

Publication types

  • Review

MeSH terms

  • Deep Brain Stimulation* / methods
  • Humans
  • Mental Disorders* / surgery
  • Neurosurgery*
  • Neurosurgical Procedures / methods
  • Psychosurgery*