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Investigation into Intellectual Changes Following Prefrontal Leucotomy

Published online by Cambridge University Press:  08 February 2018

R. K. Freudenberg  and
J. P. S. Robertson
R. K. Freudenberg
Affiliation:
Netherne Hospital, Coulsdon, Surrey
J. P. S. Robertson
Affiliation:
Netherne Hospital, Coulsdon, Surrey
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Extract

This investigation is not concerned with the clinical indications or results of prefrontal leucotomy, but attempts to re-examine changes following the operation, especially in regard to the impairment of some of the manifestations of the highest integrative psychophysiological functions of the central nervous system that may bring about such alterations. Amongst these we were primarily interested in cognitive changes, but the interpretation of apparent cognitive changes led to the consideration of orectic alterations as well. Such changes have so far been impossible to localize exactly, but are considered to be partly related to the phylogenetically more recent parts of the cerebral cortex. Masserman (1946) compared the mechanism of shock treatment and leucotomy with the effects of alcohol and states that “its main actions are those of a cortical depressant,” as manifested by impairment of finer perceptions and discriminations and a “constriction of the integrative field.” He believes that shock therapies and leucotomy partly produce their results by temporary or permanent decorticating effects, “rendering the individual no longer capable of fine spun fantasies or elaborate delusions.” These decorticating effects can be assumed to be reflected in cognitive, conative and emotional alterations following the operation. The interpretation of change following leucotomy presents many difficulties, one of them being that only dysfunction can be related to structural damage of the frontal lobe and not function. Another is that psychotics or severe neurotics operated upon usually do not have a sufficiently intact pre-operative personality to draw conclusions about the normal functions.

Type
Part I.—Original Articles
Information
Journal of Mental Science , Volume 95 , Issue 401 , October 1949 , pp. 826 - 841
Copyright
Copyright © Royal College of Psychiatrists, 1949 

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