Abstract
In the final installment to this three-part, essay-editorial on psychosurgery, we relate the history of deep brain stimulation (DBS) in humans and glimpse the phenomenal body of work conducted by Dr. Jose Delgado at Yale University from the 1950s to the 1970s. The inception of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1974-1978) is briefly discussed as it pertains to the “determination of the Secretary of Health, Education and Welfare regarding the recommendations and guidelines on psychosurgery.” The controversial work - namely recording of brain activity, DBS, and amygdalotomy for intractable psychomotor seizures in patients with uncontrolled violence – conducted by Drs. Vernon H. Mark and Frank Ervin is recounted. This final chapter recapitulates advances in neuroscience and neuroradiology in the evaluation of violent individuals and ends with a brief discussion of the problem of uncontrolled rage and “pathologic aggression” in today’s modern society – as violence persists, and in response, we move toward authoritarianism, with less freedom and even less dignity.
Highlights
In the mapping of the brain in cerebral localization, neurosurgeon Dr Wilder Penfield found that neither epilepsy nor electrical stimulation of the brain (ESB) at the surface of the cerebral cortex elicited emotional reactions in humans.[26]
I continue to believe that for the foreseeable future, violent individuals, who commit crimes but have no discernible brain neuropathology, should be managed conventionally, prosecuted by the criminal justice system according to the law
On the other hand, who during medical examination are shown to have neuropathology discernible by the current state of medical knowledge, should, after the appropriate informed consent, be further evaluated and treated by qualified medical and nursing personnel trained in the management of “psychopathy.” Their management should include the usual treatments, for example, removal of brain tumors, control of seizure disorders with anticonvulsants, etc., as well as the administration of psychotropic drugs, electroconvulsive therapy (ECT), and functional neurosurgery for their associated psychopathy in private facilities by private and academic physicians, but not government doctors or facilities
Summary
Mental illness, and the brain – A brief history of psychosurgery: Part 3 – From deep brain stimulation to amygdalotomy for violent behavior, seizures, and pathological aggression in humans. Clinical Professor of Neurosurgery (ret.) and Adjunct Professor of Medical History (ret.), Mercer University School of Medicine; President, www.haciendapub.com, Macon, Georgia, USA. This article may be cited as: Faria MA.Violence, mental illness, and the brain - A brief history of psychosurgery: Part 3 - From deep brain stimulation to amygdalotomy for violent behavior, seizures, and pathological aggression in humans. Available FREE in open access from: http://www.surgicalneurologyint.com/text.asp?2013/4/1/91/115162
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