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Re: Psychosurgery in the new millennium

Posted by Blue Cheer 1 on January 13, 2002, at 23:40:47

In reply to Re: Psychosurgery in the new millennium, posted by OldSchool on January 13, 2002, at 19:17:46

> > Bob, yes- cigulotomy is one—though seems to be a last resort and I don’t know how effective it is.
> >
> > Electrode implants is another.
> >
> > Its been a while, and being that it's Sunday and I want to watch football- I'm too lazy to try to find the articles on the electrode thing, so I'll do my best with the poor memory I have.
> >
> > This may be and probably is pretty inaccurate, but here goes:
> >
> > I read somewhere that way back after the James Olds findings about wire heading rats (back in the 50's), scientist and doctors began to perform psychosurgery by surgically implanting electrodes in the brains of humans. They experimented on just a few very, very ill patients (Extreme Schizophrenics, Catatonic depressives, etc...). All they did is implant an electrode to a certain area of the brain. The electrode had a wire that lead to like a nine-volt battery that the guy had in his pocket or something. The electrode automatically fired every few seconds or so, causing a cascading of neurotransmitter activity. I think there were some minor complications that were easily dealt with, but for the most part, these patients got better immediately.
> >
> > I think, though, that a law was passed, outlawing this type of surgery. I guess the idea of multitudes of wire headed people repulsed enough doctors that they decided not to go down that road.
> >
> > It is quite spooky, but so what if it works?
> >
> > I also think that doctors can remove just a tiny bit of brain tissue, which completely relives depression. Isn't that basically what cigulotomy is?
> >
> > Cigulotomy could be a very viable option for refractory depressives.
> >
> > If anyone is interested in having this done, check out this website:
> >
> > http://neurosurgery.mgh.harvard.edu/
> >
> > Here is an article from the Harvard site:
> >
> > **********************************************
> >
> > Surgical intervention to treat a psychiatric illness
> >
> >
> > by G. Rees Cosgrove, M.D., F.R.C.S. (C.)
> > Neurosurgical Service
> > Massachusetts General Hospital
> >
>
> No old style psychosurgery for me, thank you. Id rather be a catatonic depressed bum on the street, eating out of garbage cans than have an old style psychosurgery. F*ck that. That is WAY too invasive for me. I prefer this modern stuff, like the SPECT scans. Thats why functional neuroimaging is so great...its totally noninvasive and very safe. It uses remote sensing technology to image the function of your brain and improve diagnosing.

Neuroimaging technologies far outpace their application in psychiatric disorders, and they're of no clinical value in diagnosis and treatment. Even in bipolar disorder, an illness with many physiological features, functional neuroimaging isn't diagnostic of anything. I've had two SPECT scans and three MRI's (1990 to 2001). The most recent SPECT showed global, diffuse diminished cortical blood flow, and that when compared to the SPECT in 1990, basal ganglia dysfunction and increased activity in the tips of the temporal lobes had resolved. The diminished cortical blood flow was a reflection of the mood state at that time (depression), and in any case the findings weren't useful because multiple psychiatric drugs can also render the results inconclusive (no clinical significance). When beginning pharmacotherapy, neuroimaging is useful in order to rule out any brain pathology (e.g., tumors). Leading researchers such as Godfrey Pearlson, M.D. from Johns Hopkins and Perry Renshaw, M.D. from McClean Hospital will tell you it's not yet a diagnostic tool. A psychiatrist once told me that the state of neuroradiology today is comparable to going down into a subway concourse and tapping on various pipes leading to street level -- listening for different sounds that would tell you just what was happening up on the street (i.e., the brain). Well, it just doesn't work that way. :)

It's the nature of mental illness and the complexity of the brain; comparing it to AIDS is absurd. When do you suppose a vaccine will be found to cure AIDS? Not for a long time, I suspect. To think that "mental illness", given the countless variables in its expression, should be any different doesn't make sense to me. An _enormous_ amount of funding has gone into psychiatric research, including the 20 million dollar STEP-BD 5-year study.

I couldn't think of a more exciting field for a medical student to pursue right now. The psychiatrists I've had in the past and the present are the most acccessible and hard-working professionals I've known -- period.

Blue


>
> Psychosurgery like you are talking about while it may get rid of your depression (for a while) that kind of psychosurgery also permanently changes your personality. Cingulobotomy is just a variation on a theme of the old frontal lobotomy.
>
> WHY WOULD YOU WANT TO MESS WITH THAT?!!!?
>
> Now some of these newer psychosurgeries like Deep Brain Stimulation are a totally different story. I can go with these modern, high tech psychosurgeries. DBS is considered to be a "MIBS" treatment for refractory depression. MIBS stands for "Minimally Invasive Brain Stimulation." The whole point of it is that its high tech and minimally invasive to your brain and body. But it gets the job done.
>
> Thats the kind of stuff I like. The old style "psychosurgery" you can have that. NO THANK YOU.
>
> Here is a website that talks about MIBS modalities for refractory depression:
>
> http://www.musc.edu/psychiatry/fnrd/tms.htm
>
> Old School


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poster:Blue Cheer 1 thread:88953
URL: http://www.dr-bob.org/babble/20020110/msgs/90040.html