Radiosurgery for psychiatric disorders

Abstract

Behavioral surgery Behavioral surgery, previously know as Psychosurgery Psychosurgery initiated with lesions Lesions disconnecting pathways in the brain. The infamous Frontal Lobotomy proposed by Moniz, designed to interrupt the pathways of the frontal lobes evolved to more elegant disconnections with the use of the stereotactic technique by Spiegel and Wicys interrupting the thalamo-connections to the frontal lobe through lesions the anterior thalamus. Indeed, the collaboration of the Austrian Neurologist Spiegel with the Neurosurgeon Wicys in Philadelphia led to the first stereotactic surgery Stereotactic surgery in humans. It was an anterior thalamotomy Thalamotomy to modify behavior. The progressive refinement of the understanding of the frontal lobe, know them to control behavior, called for precise lesions Lesions in strategic areas, instead of the massive initial lesions in the frontal lobe. Dr. Leksell from Karolinska University in Stockholm, living that era envisioned the necessity of a non invasive way to treat functional diseases of the brain, i.e. realizing precise lesions Lesions in specific brain pathways without opening the skull to avoid the unacceptable complications, as psychiatric patients were then being brutally violated by the trans orbital frontal lobectomy. The ideas of radiosurgery Radiosurgery matured during the 1950s and 1960s to culminate with the development of the Gamma Knife Gamma Knife which was suitable and promptly applied to treat psychiatric diseases, the one chosen then was obsessive-compulsive disorder Obsessive-compulsive disorder (OCD).