Neurosurgery for psychiatric disorders: reviewing the past and charting the future in: Neurosurgical Focus Volume 54 Issue 2 (2023) Journals

Dr. Suzanne Kerns and colleagues provide a historical and clinical review of neurosurgery for psychiatric disorders, tracing the field from ancient practices such as trephination to modern techniques including deep brain stimulation (DBS), ablative procedures, and closed-loop neurostimulation. The article explains how early psychosurgical interventions, particularly prefrontal lobotomies in the mid-20th century, became controversial due to inconsistent patient selection, ethical concerns, and harmful outcomes. The authors place these developments within the broader evolution of neuroscience and psychiatric care, emphasizing how advances in imaging, surgical precision, and ethical oversight have transformed the field.

The review also examines current and emerging neurosurgical approaches for treatment-resistant psychiatric conditions such as obsessive-compulsive disorder, depression, and other severe mental health disorders. The authors note that modern psychiatric neurosurgery is increasingly guided by evidence-based research and a better understanding of neural circuits involved in cognition and emotion. While the field continues to face ethical and clinical challenges, the article suggests that advances in neuromodulation and brain-targeted therapies may offer new options for patients who do not respond to conventional treatments.

To read the full article, click here.

Dr. Suzanne Kerns, MD, FCTMSS
Owner, Chief Medical Officer Inner Healing Charleston

Dr. Kerns is a board-certified psychiatrist and internationally recognized expert in the field of neuromodulation with over a decade of experience in neuromodulation and interventional psychiatry techniques, including TMS, ECT, and other forms of brain stimulation therapy. Former Director of the Neuromodulation Clinic at the Ralph H. Johnson VA Medical Center, she is a Fellow and current Treasurer of the Clinical TMS Society. Dr. Kerns has trained clinicians globally and held academic appointments as an Assistant Professor of Psychiatry at the University of Washington and the Medical University of South Carolina. Dr. Kerns views every patient as unique, and strives to create individualized care plans using not just medications, but also psychotherapy, lifestyle modifications, and interventional treatments to support her patients in achieving their goals.