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December 1, 1956

Studies in Topectomy

JAMA. 1956;162(14):1349. doi:10.1001/jama.1956.02970310077030

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The New York Associates in Brain Research explored in 1948 to 1949 the potentialities of psychosurgical methods as a therapy for mental disorder. They used topectomy of the frontal lobes on 66 patients, many of whom were chosen for the severity of their mental disorder. The operations, both frontal ablations, performed bilaterally, were of two types, one removing the superior portion and the other the more orbital section of the lobe. There was no operative mortality or lasting neurological changes. Psychiatric evaluation was undertaken about two years after the operation. The results were not impressive. The procedure was considered of limited value for chronic schizophrenics but of slight usefulness for chronic psychoneurotics and for some of the patients with manic-depressive reactions and with involutional psychoses. An independent psychiatric evaluation by another group of investigators was even less enthusiastic, and concluded from the strictly therapeutic viewpoint that the verdict at best

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