title: Lesion procedures in psychiatric neurosurgery.
abstract: OBJECTIVE
  Lesion procedures for psychiatric indications have a history that spans more than a century. This review provides a brief history of psychiatric surgery and addresses the most recent literature on lesion surgery for the treatment of anxiety and mood disorders.
  
  
  METHODS
  Relevant data described in publications from the early 1900 s through the modern era regarding lesion procedures for psychiatric indications, both historical and current use, are reported.
  
  
  RESULTS
  The early procedures of Burkhardt, Moniz, and Freeman are reviewed, followed by descriptions of the more refined techniques of Leksell, Knight, Foltz, White, and Kelly. The application of lesion procedures to obsessive-compulsive disorder, mood disorders, and addiction are discussed.
  
  
  CONCLUSIONS
  Lesioning procedures have informed modern deep brain stimulation targets. Recent lesioning studies demonstrate the efficacy and durability of these procedures in severely disabled patients. Judicious application of these techniques should continue for appropriately selected patients with severe, refractory psychiatric disorders.
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Shaun R
authors.initials: SR
authors.lastname: Patel
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Aronson
authors.forename: Sameer A
authors.initials: SA
authors.lastname: Sheth
authors.forename: Emad N
authors.initials: EN
authors.lastname: Eskandar
mesh_terms: D001921:Brain / Q000473:pathology / Q000601:surgery; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D001523:Mental Disorders / Q000473:pathology / Q000601:surgery*; D019964:Mood Disorders / Q000473:pathology / Q000601:surgery; D009493:Neurosurgery / Q000266:history / Q000379:methods*; D009771:Obsessive-Compulsive Disorder / Q000473:pathology / Q000601:surgery; D011612:Psychosurgery / Q000266:history / Q000379:methods*; D019966:Substance-Related Disorders / Q000473:pathology / Q000601:surgery