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Surgical Approaches in Psychiatry

Vernon H. Mark, MD
JAMA. 1974;228(13):1688. doi:10.1001/jama.1974.03230380056035.
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This volume, of medical and social interest, underlines unresolved problem areas in its field. Among the important contributions are those dealing with the morphological plasticity of the synapse as studied by the newer electron microscopic techniques, the axonal connections between the frontal lobe and various portions of the limbic system, monaminergic and cholinergic systems, sensory convergence of the cerebral cortex, and newer advances in electrophysiologic monitoring in both a clinical and experimental setting.

Several clinics have attempted to improve the preoperative and postoperative assessment of the patient, from the psychiatric, neurological, and sociological points of view. One important study dealt with patients undergoing amygdalotomy, another with the pathological substrates in temporal lobe epilepsy with psychosis, in an attempt to correlate pathology with dysfunction.

An unresolved problem involves surgical therapy in patients who do not have a specific diagnosis of brain disease.

"In psychiatry, there are as yet no reliable objective


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