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Geoffrey Knight and his contribution to psychosurgery
- Source :
- Journal of Neurosurgery. 126:1278-1284
- Publication Year :
- 2017
- Publisher :
- Journal of Neurosurgery Publishing Group (JNSPG), 2017.
-
Abstract
- This paper retraces the fundamental achievements of Geoffrey Knight (1906–1994), a British neurosurgeon and a pioneer in the field of psychosurgery. His career developed in the 1950s and 1960s, when—following the unregulated practice of frontal lobotomies—strong criticism arose in the medical community and in the general public against psychosurgery. Geoffrey Knight's clinical research focused on identifying new, selective targets to limit the side effects of psychosurgery while improving the outcome of patients affected by mental disorders. Following the example of William Beecher Scoville, he initially developed restricted orbital undercutting as a less invasive alternative to standard frontal lobotomy. He then developed stereotactic subcaudate tractotomy, with the use of an original stereotactic device. Knight stressed the importance of the anatomy and neurophysiology of the structures targeted in subcaudate tractotomy, with particular regard to the fibers connecting the anterior cingulate region, the amygdala, the orbitofrontal cortex, and the hypothalamus. Of interest, the role of these white matter connections has been recently recognized in deep brain stimulation for major depression and anorexia nervosa. This is perhaps the most enduring legacy of Knight to the field of psychosurgery. He refined frontal leucotomies by selecting a restricted target at the center of a network that plays a crucial role in controlling mood disorders. He then developed a safe, minimally invasive stereotactic operation to reach this target. His work, well ahead of his time, still represents a valid reference on which to build future clinical experience in the modern era of neuromodulation for psychiatric diseases.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Deep brain stimulation
Psychotherapist
Stereotactic surgery
medicine.medical_treatment
03 medical and health sciences
0302 clinical medicine
medicine
Animals
Humans
Psychiatry
business.industry
General Medicine
History, 20th Century
United Kingdom
Neuromodulation (medicine)
Lobotomy
Psychosurgery
030104 developmental biology
Neurology
Anorexia nervosa (differential diagnoses)
Knight
Orbitofrontal cortex
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 19330693 and 00223085
- Volume :
- 126
- Database :
- OpenAIRE
- Journal :
- Journal of Neurosurgery
- Accession number :
- edsair.doi.dedup.....4eefac2db98e2dad3005b4e5978e73df
- Full Text :
- https://doi.org/10.3171/2016.3.jns151756