Bilateral cingulotomy

Bilateral cingulotomy
Intervention
ICD-9-CM	01.32
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Bilateral cingulotomy is a form of psychosurgery, introduced in 1948 as an alternative to lobotomy. Today it is mainly used in the treatment of depression and obsessive-compulsive disorder. In the early years of the twenty-first century it was used in Russia to treat addiction. It is also used in the treatment of chronic pain. The objective of this procedure is the severing of the supracallosal fibres of the cingulum bundle, which pass through the anterior cingulate gyrus.

Cingulotomy was introduced in the 1940s as an alternative to standard prefrontal leucotomy/lobotomy in the hope of alleviating symptoms of mental illness whilst reducing the undesirable effects of the standard operation (personality changes, etc.). It was suggested by American physiologist John Farquhar Fulton who, at a meeting of the Society of British Neurosurgeons in 1947, said "were it feasible, cingulectomy in man would seem an appropriate place for limited leucotomy". This was derived from the hypothesis of James Papez who thought that the cingulum was a major component of an anatomic circuit believed to play a significant role in emotion. The first reports of the use of cingulotomy on psychiatric patients came from J le Beau in Paris, Hugh Cairns in Oxford, and Kenneth Livingston in Oregon.

Bilateral Cingulotomy targets the anterior cingulate cortex, which is a part of the limbic system. This system is responsible for the integration of feelings and emotion in the human cortex. It consists of the cingulate gyrus, parahippocampal gyrus, amygdala and the hippocampal formation.

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