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November 14, 1980

Treating the brain by cingulotomy

JAMA. 1980;244(19):2141-2147. doi:10.1001/jama.1980.03310190005002

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An evaluation by Massachusetts Institute of Technology (MIT) psychologists of 137 patients who have undergone the psychosurgical procedure called bilateral anterior cingulotomy—electrolytic destruction of anatomically normal cerebral cortical tissue in the area of the cingulate gyrus—has yielded the following results:

  • There is a minor but permanent functional deficit in patients who are over age 30 years at the time of surgery.

  • The operation appears to have little or no therapeutic value in several conditions for which it is performed: obsessive-compulsive disorder, panic disorder or generalized anxiety disorder, and schizophrenic disorders. It is still considered beneficial for two other conditions: intractable major depression and severe chronic pain. But there is as yet no way of determining preoperatively which patients with depression or pain will report beneficial effects after surgery.

  • Among patients who report no relief of symptoms after one cingulotomy and who then undergo one or two more (with induction of