Stereotactic surgery for the relief of suicidal and severe depression and intractable psychoneurosis

Knight, G. C.

doi:10.1136/pgmj.45.519.1

Cited by 16 publications

(3 citation statements)

References 20 publications

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“…21 The surgical technique remained unmodified, with the only exception being the introduction of air encephalography to allow better recognition of the midline and visualization of the anterior horns of the lateral ventricles. 21,23,26,27,29 The clinical outcome was again reported as favorable, particularly for severe depression, with more than 50% of cases free of medical care after the procedure and another 25% significantly improved. 21 Similar overall good results were observed for patients affected by "obsessional illness" and "anxiety states."…”

Section: The Stereotactic Subcaudate Tractotomymentioning

confidence: 98%

“…51 Lesions within the substantia innominata appeared to interrupt fibers from the anterior cingulate region, isolating the posterior orbital cortex and dividing a projection to and from the amygdaloid nucleus. 23 A selective lesion at this site would influence emotional reactions preserving emotional tone and emotional appreciation, thanks to the sparing of the hippocampus-fornix and most of the thalamofrontal pathways. 24 In 1961, Knight devised a stereotactic operation to per-form a localized lesion in the substantia innominata, using "a destructive agent with limited marginal effects."…”

Section: The Stereotactic Subcaudate Tractotomymentioning

confidence: 99%

“…In the following years, Knight popularized his work, thanks to his prominent role in the Postgraduate Medical School and to a series of publications. 23,[26][27][28][29] The number of psychiatric patients referred for surgical treatment continued to increase, and this was remarkable at a time when surgery for psychiatric illness was largely opposed by the general public and part of the medical body.…”

Section: The Stereotactic Subcaudate Tractotomymentioning

confidence: 99%

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Geoffrey Knight and his contribution to psychosurgery

Marchi

Vergani

Chiavacci

et al. 2017

JNS

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This paper retraces the fundamental achievements of Geoffrey Knight (1906-1994), a British neurosurgeon and a pioneer in the field of psychosurgery. His career developed in the 1950s and 1960s, when-following the unregulated practice of frontal lobotomies-strong criticism arose in the medical community and in the general public against psychosurgery. Geoffrey Knight's clinical research focused on identifying new, selective targets to limit the side effects of psychosurgery while improving the outcome of patients affected by mental disorders. Following the example of William Beecher Scoville, he initially developed restricted orbital undercutting as a less invasive alternative to standard frontal lobotomy. He then developed stereotactic subcaudate tractotomy, with the use of an original stereotactic device. Knight stressed the importance of the anatomy and neurophysiology of the structures targeted in subcaudate tractotomy, with particular regard to the fibers connecting the anterior cingulate region, the amygdala, the orbitofrontal cortex, and the hypothalamus. Of interest, the role of these white matter connections has been recently recognized in deep brain stimulation for major depression and anorexia nervosa. This is perhaps the most enduring legacy of Knight to the field of psychosurgery. He refined frontal leucotomies by selecting a restricted target at the center of a network that plays a crucial role in controlling mood disorders. He then developed a safe, minimally invasive stereotactic operation to reach this target. His work, well ahead of his time, still represents a valid reference on which to build future clinical experience in the modern era of neuromodulation for psychiatric diseases.

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Section: The Stereotactic Subcaudate Tractotomymentioning

confidence: 98%

Section: The Stereotactic Subcaudate Tractotomymentioning

confidence: 99%

Section: The Stereotactic Subcaudate Tractotomymentioning

confidence: 99%

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Geoffrey Knight and his contribution to psychosurgery

Marchi

Vergani

Chiavacci

et al. 2017

JNS

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Synthetic Antibacterial Agents

Anand

Remers²

2010

Burger's Medicinal Chemistry and Drug Discovery

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Synthetic antibacterial compounds are divided into topical and systemic agents. Topical agents are called disinfectants or antiseptics depending on how they are used. They show little selectivity between the microbes and the host. Nevertheless, they are indispensable in hospitals, public health, and the home. The development of systemic antibacterial agents had a strong dye connection. Ehrlich's development of selective staining methods led him to propose that dyes may also have selective toxicity for microbes, and to coin the term chemotherapy. Domagk's discovery of antibacterial activity for the azo dye prontosil led to the first effective chemotherapeutic agent, sulfanilamide. This compound provided an excellent lead for structural modification and ushered in the modern era of chemotherapy and drug design. The discovery that sulfonamides act through folate inhibition resulted in the development of dihydrofolate reductase inhibitors such as trimethoprim. The availability of synthetic antibacterials and antibiotics, which were discovered almost concurrently, provided major advances in control of bacterial infections; however, the rise in bacterial resistance prompted the search for newer classes of agents. This search provided fluoroquinolines and oxazolidones. There are also synthetic antibacterials with niche needs, such as nitrofurans and methenamine, which are used for urinary tract infections.

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Long‐Term Treatment of Sulfa‐Resistant Urinary Tract Infections with a Sulfamethoxazole—Trimethoprim Combination

Atkins

MacCANNELL

1978

The Journal of Clinical Pharma

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Stereotactic surgery for the relief of suicidal and severe depression and intractable psychoneurosis

Cited by 16 publications

References 20 publications

Geoffrey Knight and his contribution to psychosurgery

Geoffrey Knight and his contribution to psychosurgery

Synthetic Antibacterial Agents

Long‐Term Treatment of Sulfa‐Resistant Urinary Tract Infections with a Sulfamethoxazole—Trimethoprim Combination

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