In 1926 Dr. Egas Moniz working here in Portugal injected dye into brain arteries and took x-rays, inventing cerebal angiography. Later, in 1935, reasoning that mental illness originates from abnormal connections within the brain, particularly with the frontal lobes, he teamed with neurosurgeon Almeida Lima to perform prefontal leucotomies on 20 patients with intractable depression or paranoia or hallucinations. This procedure was then widely adopted and eventually overused and even likely misused with repercussions persisting to today. Now, almost 100 years after his first angiogram, what would Dr. Moniz think if he were here sitting at this meeting? What lessons do we need to keep foremost in mind as a field now, with our incredible technologies. This lecture will briefly review Moniz’s work and the leucotomy ‘lessons’, highlighting the aspects of the leucotomy history that we should avoid. I will also present exciting work showing how we can now modify and change brain connections with precision TMS or focused ultrasound, no longer needing Dr. Moniz’ procedure to help restore our patients to health.
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