Lobotomie

Lobotomia (din greacă λοβός lobos – lob; τομή tomē – tăietură), cunoscută de asemenea și ca leucotomie (din greacă λευκός leukos "curat, alb" și tome – tăietură), este o procedură neurochirurgicală, o formă de psihochirurgie^{⁠(en)[traduceți]}. Ea constă într-o operație pe creier, prin secționarea sau alterarea fibrelor nervoase care leagă lobul frontal de talamus și a fibrelor de asociație ale lobului frontal.

Locația standard a găurii unei lobotomii/leucotomii pre-frontale

Procedura, controversată încă de la apariția sa, a fost acceptată de societate timp de două decenii, fiind prescrisă în cazuri psihiatrice, deși se cunoștea despre apariția frecventă a unor efecte secundare negative serioase. Inițiatorul procedurii, neurologul portughez António Egas Moniz, a primit Premiul Nobel pentru Medicină sau Fiziologie în 1949 pentru „descoperirea valorii terapeutice a leucotomiei în cazul anumitor psihoze”.

Punerea în practică a procedurii a crescut dramatic în unele țări de la începutul anilor 1940 și până în anii 1950. Până în anul 1951, în Statele Unite au fost efectuate aproape 20.000 de lobotomii. După introducerea medicamentelor antipsihotice la mijlocul anilor 1950, ponderea lobotomiilor a cunoscut o scădere drastică.

În prezent ea este interzisă în multe țări și nu mai este considerată o bună practică în medicina modernă.

Cazuri notabile

• Rosemary Kennedy, sora președintelui SUA John F. Kennedy, a suportat o lobotomie în 1941, la vârsta de 23 de ani, râmânând invalidă pe viață.
• Howard Dully a scris un memoriu despre descoperirea sa că ar fi fost lobotomizat în 1960 la vârsta de 12 ani.
• Autorul și poetul neo-zeelandez Janet Frame a primit un premiu literar în 1951 cu o zi înainte de lobotomia care i-a fost programată, ea nemaiavând loc.
• Josef Hassid, un celebru violonist și compozitor polonez, a fost diagnosticat cu schizofrenie și a murit la vârsta de 26 de ani în urma unei lobotomii.
• Pictorul modernist suedez Sigrid Hjertén a murit ca urmare a unei lobotomii în 1948.
• Sora mai mare a scenaristului american Tennessee Williams, Rose, a suportat o lobotomie care a lăsat-o invalidă pe viață; episod, care, după cum spune el, i-a dat inspirație pentru anumite personaje și motive de opere.

În cultura populară

De-a lungul timpului lobotomia a fost subiectul mai multor cărți și filme notorii, printre care:

• All the King's Men (1946), roman de Robert Penn Warren.
• Suddenly, Last Summer (1958) de Tennessee Williams.
• În romanul lui Ken Kesey din 1962, One Flew Over the Cuckoo's Nest, și în adaptarea sa cinematografică din 1975, lobotomia este descrisă ca o „castrare a lobului frontal”, o formă de pedeapsă și control.
• The Bell Jar (1963), roman de Sylvia Plath.
• Romanul lui Elliott Baker din 1964 și ecranizarea din 1966, A Fine Madness.
• Frances, film biopic din 1982.
• Shutter Island, film regizat de Martin Scorsese în 2010
• Sucker Punch, film regizat de Zack Snyder în 2011
• American Horror Story: Asylum, film regizat de Ryan Murphy în 2012
• Ratched, serial regizat de Ryan Murphy în 2020

Bibliografie

• Acharya, Hernish J.. The Rise and Fall of Frontal Leucotomy. In: Whitelaw, W.A. (ed). The Proceedings of the 13th Annual History of Medicine Days. Calgary: 2004. p. 32–41.
• Arnold, William. Shadowland. Berkley Books; 1982. ISBN 0-425-05481-0.
• Bechterev, V.; Puusepp, L.. La chirugie des aliénes [Surgery of the Insane]. Archives Internationales de Neurologie. 1912;34:1–17, 69–89.
• Berrios, German E.. The Origins of Psychosurgery: Shaw, Burckhardt and Moniz. History of Psychiatry. 1997;8(1):61–81. doi:10.1177/0957154X9700802905. PMID 11619209.
• Bianchi, Leonardo. The Mechanism of the Brain and the Function of the Frontal Lobes. New York & Edinburgh: William Wood & Co; E.S Livingstone; 1922.
• Bigsby, C.W.E.. A Critical Introduction to Twentieth-Century American Drama: Volume 2. Cambridge University Press; 1985. ISBN 978-0-521-27717-4.
• Bragg, Lynn. Myths and Mysteries of Washington. 1st ed. TwoDot; 2005. ISBN 978-0-7627-3427-6.^{[nefuncțională]}
• Braslow, Joel T.. Effect of therapeutic innovation on perception of disease and the doctor-patient relationship: a history of general paralysis of the insane and malaria fever therapy, 1910–1950. American Journal of Psychiatry. May 1995;152(2):660–665. PMID 7726304.
• Braslow, Joel T.. Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century. University of California; 1997. ISBN 0-520-20547-2.
• Brickner, Richard M.. An interpretation of frontal lobe function based upon the study of a case of partial bilateral frontal lobotomy. Research Publications – Association for Research for Nervous end Mental Disease. 1932;13:259–351.
• Brown, Edward M.. Why Wagner-Jauregg won the Nobel Prize for discovering malaria therapy for General Paresis of the Insane. History of Psychiatry. 2000;11(4):371–382. doi:10.1177/0957154X0001104403.
• Cooper, Rachel. On deciding to have a lobotomy: either lobotomies were justified or decisions under risk should not always seek to maximise expected utility. Medicine, Health Care and Philosophy. 2014;17(1):143-154. doi:10.1007/s11019-013-9519-8.
• Cooter, Roger. Neuropatients in Historyland. In: Jacyna, Stephen J.; Casper, Stephen T. (eds). The Neurological Patient in History. Rochester NY: University of Rochester Press; 2012. ISBN 978-1-58046-412-3. p. 215–222.
• Format:Vcite news
• Department of Health, Education, and Welfare. Protection on Human Subjects: Use of Psychosurgery in Practice and Research: Report and Recommendations for Public Comment. Part 3. Federal Register. 23 May 1977 [archived 2013-06-18; cited 2015-04-13];42(99):26317–26332.
• Deutsch, Albert. Shame of the States. New York: Harcourt, Brace; 1948.
• Diefenbach, Gretchen; Diefenbach, Donald; Baumeister, Alan; West, Mark. Portrayal of lobotomy in the popular press: 1935–1960. Journal of the History of the Neurosciences. 1999 [archived 2010-03-23; cited 2015-04-13];8(1):60–69. doi:10.1076/jhin.8.1.60.1766. PMID 11624138.
• Doby, T. Cerebral Angiography and Egas Moniz. American Journal of Roentgenology. 1992;359(2):364.^{[nefuncțională]}
• El-Hai, Jack. The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness. Wiley; 2005. ISBN 0-471-23292-0.
• Feldman, Burton. The Nobel prize: a history of genius, controversy, and prestige. Arcade Publishing; 2001. ISBN 1-55970-592-2.
• Feldman, Robert P.; Goodrich, James T.. Psychosurgery: A Historical Overview. Neurosurgery. March 2001;48(3):647–57; discussion 657–9. PMID 11270556.
• Finger, Stanley. Origins of Neuroscience: A History of Explorations into Brain Function. Oxford: Oxford University Press; 2001. ISBN 978-0-19-514694-3.
• Ford, Paul J.; Henderson, Jaimie M.. Functional neurosurgical intervention: neuroethics in the operating rooms. In: Illes, Judy (ed.). Neuroethics: defining the issues in theory, practice, and policy. Oxford University Press; 2006. ISBN 978-0-19-856721-9.
• Freberg, Laura A.. Discovering Biological Psychology. 2nd ed. Belmont, California: Wadsworth; 2010. ISBN 0-547-17779-8.
• Freeman, Walter; Watts, James W.. Psychosurgery: An Evaluation of Two Hundred Cases over Seven Years. Journal of Mental Science. 1944;90(379):532–537.
• Gabbard, Glen O.; Gabbard, Krin. Psychiatry and the Cinema. 2nd ed. American Psychiatric Publishing, Inc.; 1999. ISBN 978-0-88048-964-5.
• Gilyarovsky, Vasily [Гиляровский, Василий]. Учение Павлова — основа психиатрии [Pavlov's teaching is the basis of psychiatry]. Медицинский работник [Health Worker]. 14 September 1950;(37). Russian.
• Gilyarovsky, Vasily [Гиляровский, Василий]. Избранные труды [Selected Works]. Moscow: Медицина [Medicine]; 1973. Russian. p. 4.
• Goldbeck-Wood, Sandra. Norway compensates lobotomy victims. British Medical Journal. 21 September 1996;313(7059):708–709. doi:10.1136/bmj.313.7059.708a. PMID 11644825.
• Green, Alexander; Astradsson, A.; Stacey, R.J.; Aziz, T.Z.. Functional and epilepsy neurosurgery. In: Johnson, Reuben; Green, Alexander (eds). Landmark Papers in Neurosurgery. Oxford University Press; 2010. ISBN 978-0-19-959125-1.
• Grenander, M.E.. Of Graver Import Than History: Psychiatry In Fiction. Journal of Libertarian Studies. 1978 [cited 22 January 2008];2(1):29–44. PMID 11614766.
• Gross, Dominik; Schäfer, Gereon. Egas Moniz (1874–1955) and the "invention" of modern psychosurgery: a historical and ethical reanalysis under special consideration of Portuguese original sources. Neurosurgical Focus. 2011;30(2):8. doi:10.3171/2010.10.FOCUS10214. PMID 21284454.
• Healy, David. Some continuities and discontinuities in the pharmacotherapy of nervous conditions before and after chlorpromazine and imipramine. History of Psychiatry. January 2000;11(44):393–412. doi:10.1177/0957154X0001104405.
• Heller, A. C.; Amar, A.P.; Liu, C.Y.; Apuzzo, M.L.J.. Surgery of the mind and mood: A mosaic of issues in time and evolution. Neurosurgery. 2006;59(4):727.
• Hoenig, J.. Schizophrenia. In: Berrios, German E.; Porter, Roy (eds). A History of Clinical Psychiatry: The Origin and History of Psychiatric Disorders. Athlone; 1995. ISBN 0-485-24011-4.
• Joanette, Yves; Stemmer, Brigitte; Assal, Gil; Whitaker, Harry. From theory to practice: the unconventional contribution of Gottlieb Burckhardt to psychosurgery. Brain and Language. 1993;45(4):572–587. doi:10.1006/brln.1993.1061. PMID 8118674.
• Kaempffert, Waldemar. Turning the Mind Inside Out. Saturday Evening Post. 24 May 1941;213(47):18–19, 69–74.
• Kolin, Philip. Something Cloudy, Something Clear: Tennessee Williams's Postmodern Memory Play. Journal of Dramatic Theory and Criticism. Spring 1998;12(2):35–55.
• Kondratev, Fedor [Фёдор Кондратьев]. Судьбы больных шизофренией: клинико-социальный и судебно-психиатрический аспекты [The fates of the ill with schizophrenia: clinico-social and forensico-psychiatric aspects]. Moscow: ЗАО Юстицинформ [Closed joint-stock company Justitsinform]; 2010. Russian. ISBN 978-5-9977-0014-9.
• Kotowicz, Zbigniew. Gottlieb Burckhardt and Egas Moniz — Two Beginnings of Psychosugery. Gesnerus. 2005;62(1/2):77–101.
• Kotowicz, Zbigniew. Psychosurgery in Italy, 1936–39. History of Psychiatry. December 2008;19(4):476–489. doi:10.1177/0957154X07087345.
• Kragh, J.V.. Shock Therapy in Danish Psychiatry. Medical History. 2010;54(3):341–64. doi:10.1017/S0025727300004646. PMID 20592884. PMC 2889500.
• Levin, Harvey S.; Eisenberg, Howard M.. Frontal Lobe Function and Dysfunction. Oxford: Oxford University Press; 1991. ISBN 978-0-19-506284-7.
• Lichterman, B.L.. On the history of psychosurgery in Russia. Acta Neurochirugie. 1993;125(1–4):1–4. doi:10.1007/BF01401819. PMID 8122532.
• Format:Vcite news
• Manjila, S.; Rengachary, S.; Xavier, A.R.; Parker, B.; Guthikonda, M.. Modern psychosurgery before Egas Moniz: a tribute to Gottlieb Burckhardt. Neurosurgery Focus. 2008;25(1):1–4.
• Macmillan, M.. An Odd Kind of Fame: Stories of Phineas Gage. MIT Press; 2000. ISBN 0-262-13363-6.
• Mareke, Arends; Fangerau, Heiner. Deep brain stimulation in psychiatric disorders. In: Fangerau, Heiner; Jörg, Fegert; Mareke, Arends (eds). Implanted Minds: The Neuroethics of Intracerebral Stem Cell Transplantation and Deep Brain Stimulation. Verlag; 2010. ISBN 978-3-8376-1433-6.
• Format:Vcite news
• Mashour, George A.; Walker, Erin E.; Martuza, Robert L.. Psychosurgery: Past, Present, and Future. Brain Research Reviews. 2005 [archived 2013-01-17; cited 2015-04-13];48(3):409–419. doi:10.1016/j.brainresrev.2004.09.002. PMID 15914249.
• Meduna, L.J.. Autobiography of L.J. Meduna. Convulsive Therapy. 1985;1(1):43–57. PMID 11940805.
• Moniz, Egas. Prefrontal Leucotomy in the Treatment of Mental Disorders (1937) American Journal of Psychiatry 1844–1944. American Psychiatric Publishing; 1994. ISBN 978-0-89042-275-5. p. 237–239.
• Noll, Richard. The encyclopedia of schizophrenia and other psychotic disorders. Infobase Publishing; January 2007. ISBN 978-0-8160-6405-2.
• Noyes, A.P.; Kolb, L.C.. Modern clinical psychiatry. Philadelphia and London: W.B. Saunders; 1962.
• Ogren, K.; Sandlund, M.. Psychosurgery in Sweden 1944–1964. Journal of the History of the Neurosciences. 2005;14(4):353–67. doi:10.1080/096470490897692. PMID 16338693.
• Partridge, Maurice. Pre-frontal leucotomy:. Oxford: Blackwell Scientific Publications; 1950.
• Pressman, Jack D.. Last Resort: Psychosurgery and the Limits of Medicine. Cambridge: Cambridge University Press; 2002. ISBN 0-521-52459-8.
• Format:Vcite news
• Porter, Roy. The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present. Fontana Press; 1999. ISBN 0-00-637454-9.
• Puusepp, L.. Alcune considerazioni sugli interventi chirurgici nelle malattie mentali [Some Considerations about Surgery in Mental Illness]. G Acad Med Torino. 1937;100:3–16.
• Raz, Mical. Psychosurgery, Industry and Personal Responsibility, 1940–1965. Social History of Medicine. 2009;23(1):116–133. doi:10.1093/shm/hkp061.
• Raz, Mical. The lobotomy letters: the making of American psychosurgery. University of Rochester Press; 2013. ISBN 9781580464499.
• Reevy, Gretchen; Ozer, Yvette Malamud; Ito, Yuri. Encyclopedia of Emotion. ABC-CLIO; 2010. ISBN 978-0-313-34576-0.
• Sakas, Damianos E.; Panourias, L.G.; Singounas, E.; Simpson, B.A.. Neurosurgery for psychiatric disorders: from the excision of brain tissue to the chronic electrical stimulation of neural networks. In: Sakas, D.E.; Simpson, B.A. (eds). Operative Neuromodulation. Functional Neuroprosthetic Surgery. Volume II: Neural Networks Surgery. Vol. 2. Springer; 2007. ISBN 978-3-211-33081-4. p. 365–374.
• Shorter, Edward. A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. Wiley; 1997. ISBN 0-471-24531-3.
• Snyder, John; Steffen-Fluhr, Nancy. Overcoming Depression Without Drugs: Mahler's Polka With Introductory Funeral March. AuthorHouse; 2012. ISBN 1-4685-4962-6.
• Shutts, David. Lobotomy: resort to the knife. Van Nostrand Reinhold; 1982. ISBN 978-0-442-20252-1.
• Sargant, William; Slater, Elliot. An Introduction to Physical Methods of Treatment in Psychiatry. Williams & Wilkins; 1963.
• Steck, A.J.. Milestones in the development of neurology and psychiatry in Europe. Schweizer Archiv fur Neurologie und Psychiatrie. 2010;161(3):85–9.
• Stone, James L.. Gottlieb Burckhardt – The Pioneer of Psychosurgery. Journal of the History of the Neurosciences. 2001;10(1):79–92. doi:10.1076/jhin.10.1.79.5634. PMID 11446267.
• Suchy, Yana. Clinical Neuropsychology of Emotion. Guilford Press; 2011. ISBN 978-1-60918-072-0.
• Swayze, V.W.. Frontal leukotomy and related psychosurgical procedures in the era before antipsychotics (1935–1954): a historical overview. American Journal of Psychiatry. 1995;152(4):505–515. PMID 7900928.
• Szasz, Thomas. Coercion as Cure: A Critical History of Psychiatry. New Brunswick, New Jersey: Transaction; 2007. ISBN 0-7658-0379-8.
• Tierney, Ann Jane. Egas Moniz and the Origins of Psychosurgery: A Review Commemorating the 50th Anniversary of Moniz's Nobel Prize. Journal of the History of the Neurosciences. April 2000;9(1):22–36. doi:10.1076/0964-704X(200004)9:1;1-2;FT022. PMID 11232345.
• Tranøy, Joar. Lobotomy in Scandinavian psychiatry. The Journal of Mind and Behavior. 1996 [archived 2008-05-26; cited 2015-04-13];17(1):1–20.
• Tranøy, Joar; Blomberg, Wenche. Lobotomy in Norwegian Psychiatry. History of Psychiatry. 2005 [archived 2007-12-03; cited 2015-04-13];16(1):107–110. doi:10.1177/0957154X05052224.
• USSR Ministry of Health. Приказ МЗ СССР 1003 (9 декабря 1950) [Order 1003 (9 December 1950)]. Невропатология и психиатрия [Neuropathology and Psychiatry]. 1951;20(1):17–18. Russian.
• Valenstein, Elliot S.. The Prefrontal Area and Psychosurgery. In: Uylings, H.B.M.; Van Eden, C.G.; De Bruin, J.P.C.; Corner, M.A.; Feenstra, M.G.P. (eds). The Prefrontal Cortex: Its Structure, Function and Pathology. Amsterdam & New York: Elsevier; 1990. (Progress in Brain Research, Volume 85). ISBN 978-0-444-81124-0. p. 539–554.
• Valenstein, Elliot A.. History of Psychosurgery. In: Greenblatt, Samuel H. (ed.). A History of Neurosurgery: In Its Scientific and Professional Contexts. Contributing editors Dagi, T. Forcht; Epstein, Mel H.. Park Ridge, IL: The American Association of Neurological Surgeons; 1997. ISBN 978-1-879284-17-3. p. 499–516.
• Weiss, Anthony P.; Rauch, Scott L.; Price, Bruce H.. Neurosurgical intervention for psychiatric illness: past, present and future. In: Miller, Bruce L.; Cummings, Jeffrey L. (eds). The Human Frontal Lobes: Functions and Disorders. Guilford Press; 2007. ISBN 978-1-59385-329-7. p. 505–517.
• Whitaker, H.A.; Stemmer, B.; Joanette, Y.. A psychosurgical chapter in the history of cerebral localization: the six cases of Gottlieb Burkhardt. In: Code, Christopher; Wallesch, C.-W.; Joanette Y.; Roch A. (eds). Classic Cases in Neuropsychology. Hove: Psychology Press; 1996. ISBN 978-0-86377-395-2. p. 275–304.
• Wiener, Norbert. Cybernetics. MIT Press; 1948. ISBN 0-262-73009-X.
• Williams, Tennessee. Suddenly Last Summer. Dramatists Play Service; 1998. ISBN 978-0-8222-1094-8.
• Wood, Jeffrey C.; Wood, Minnie. Therapy 101: A Brief Look at Modern Psychotherapy Techniques & How They Can Help. New Harbinger Publications; 2008. ISBN 978-1-57224-568-6.
• Wright, Frank Leon. Out of Sight, Out of Mind: A Graphic Picture of Present-day Institutional Care of the Mentally Ill in America, Based on More Than Two Thousand Eye-witness Reports. Philadelphia: Mental Health Foundation; 1947.

Legături externe

• My Lobotomy Radio story: Interview with Sallie Ellen Ionesco Lobotomised in 1946 Arhivat în 8 septembrie 2006, la Wayback Machine.
• Mental Cruelty: Sunday Times article on lobotomy and contemporary psychosurgery
• Lobotomy's back: Discover article on cingulotomy
• 'My Lobotomy': Howard Dully's Journey. NPR Radio Documentary
• A Qualified Defence of 'Then': QJM
• Ten Notable Lobotomies
• Nobel Panel Urged to Rescind Prize for Lobotomies
• The Lobotomists: BBC Radio 4 documentary on the history of lobotomy
• Lobotomie, article dans Vulgaris-Médical
• Psychosurgery.org
• New England Journal of Medicine article
• Critique de la Lobotomie Arhivat în 16 mai 2011, la Wayback Machine.
• Histoire de la Lobotomie
• http://www.egas-moniz.blogspot.com
• La psychochirurgie. De la lobotomie à la stimulation cérébrale profonde