Abstract
Neurosurgery for mental disorder (NMD) continues to exist as one of a range of
treatments available to individuals who experience severe and intractable psychiatric
illness. Historically, this particular use of ablative neurosurgery has attracted a
considerable amount of interest and controversy. Despite modern advances in both
technical procedure and understanding of the disorders for which NMD is indicated,
the irreversibility of these procedures continues to attract attention from both public
and professional groups alike. To date, indisputable evidence regarding the efficacy
and frequency of adverse effects has not been established. Therefore, the primary
aim of the present study was to investigate the neuropsychological outcome
following neurosurgery for mental disorder. In light of previous research, the
specific aims were designed to elucidate the impact of such procedures on aspects of
both general and executive functioning, through means of clinical and computerised
neuropsychological assessments. As such, pre- and post-operative performance
scores of an entire population of surgical candidates at a national centre for the
provision of NMD were examined. The principle investigation focussed on a group
of 22 individuals of mixed diagnostic categories, all of whom had undergone
treatment by anterior capsulotomy. Within-subjects comparisons revealed the
overall stability of post-operative performance as measured by tests of general
cognitive and executive function, at follow-up periods of two weeks, one year, and in
a sub-group of individuals, two and a half years post-operatively. A small number of
statistically significant improvements and impairments were noted, and along with
the general trend of improvement observed at long term follow-up, are discussed in
the light of related research.
