The frontal lobe has been the main target for surgical treatment of me
ntal illness over the last 60 years. Initially the surgery was crude a
nd performed on patients with many different psychiatric disorders. Co
ntemporary surgery utilizes stereotactic lesions which interrupt front
o-thalamic and/or fronto-cingulate fibres. The findings of clinical, n
eurochemical, neuroimaging, neuropsychological and physiological resea
rch in this area are summarized. Current advances in clinical neurosci
ence methods should be used in patients with these lesions to elucidat
e the neural substrate of post-operative changes and optimize clinical
practice.