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Interest in psychosurgery has been rekindled, as some newer procedures seem more effective and better tolerated than older ones. Three research groups have now reported follow-up studies of procedures that had promising short-term results.
In the first study, 33 patients (mean age, 43) with treatment-resistant major depression (at least 4 antidepressant trials, multiple augmentation trials, and ECT) underwent stereotactic ablative bilateral anterior cingulotomy involving one to three lesions. Sixteen patients who responded unsatisfactorily underwent additional procedures 1 year later; 9 had cingulotomies anterior to the initial lesions, and 7 had subcaudate tractotomies (1 had both in separate operations). At long-term follow-up (mean, 30 mo…