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Neurological Disorders and Treatments / Obsessive Compulsive Spectrum Disorders · Review
Frontiers in Psychiatry · August 19, 2026
A consensus or society position rather than new primary data.
This is a narrative review that proposes a pragmatic, multidisciplinary preoperative assessment framework for functional psychosurgery in psychiatry. It synthesizes evidence across disorders and assessment domains to guide clinical decision-making in specialized centers, but explicitly disclaims substitution for professional consensus, institutional ethics review, or regulatory oversight. The review positions functional psychosurgery as a promising but largely investigational option outside OCD and Tourette syndrome.
Narrative review. Patients with treatment-resistant psychiatric disorders, particularly those with severe obsessive-compulsive disorder, Tourette syndrome, treatment-resistant depression, substance use disorders, schizophrenia, anorexia nervosa, or pathological aggression considered for functional psychosurgery in specialized centers..
Deep brain stimulation has gained clinical acceptance for selected patients with severe obsessive-compulsive disorder and Tourette syndrome. Other psychiatric indications (treatment-resistant depression, substance use disorders, schizophrenia, anorexia nervosa, pathological aggression) remain largely investigational or restricted to clinical trials. No harmonized preoperative assessment standards exist across centers, highlighting need for structured multidisciplinary framework.
No harmonized preoperative assessment standards exist across centers, highlighting need for structured multidisciplinary framework.
Clinicians and multidisciplinary teams in specialized neurosurgical centers may use this framework to structure preoperative assessment and characterization of candidates for functional psychosurgery. The review emphasizes that such procedures remain investigational for most psychiatric indications and must be embedded within rigorous clinical, ethical, and regulatory oversight.
A narrative review proposing a structured preoperative assessment framework for functional psychosurgery in psychiatry, intended to guide clinical decision-making in specialized centers rather than report new empirical evidence.
As stated by the source record.
Clinicians and multidisciplinary teams in specialized neurosurgical centers may use this framework to structure preoperative assessment and characterization of candidates for functional psychosurgery. The review emphasizes that such procedures remain investigational for most psychiatric indications and must be embedded within rigorous clinical, ethical, and regulatory oversight.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Functional neurosurgery has evolved from a marginal and controversial intervention into a promising, technically feasible option for carefully selected patients with treatment-resistant psychiatric disorders. Among available techniques, deep brain stimulation has gained increasing clinical acceptance for selected patients with severe obsessive-compulsive disorder and Tourette syndrome, while other psychiatric indications, including treatment-resistant depression, substance use disorders, schizophrenia, anorexia nervosa and pathological aggression, remain largely investigational or restricted to clinical trials and highly specialized programs. However, the absence of harmonized preoperative assessment standards across centers highlights the need for a structured, multidisciplinary framework to guide consistent clinical decision-making and ensure procedural safety. The framework proposed in this review is intended to support structured clinical profiling and outcome monitoring, but should not be interpreted as a substitute for professional consensus recommendations, multidisciplinary clinical judgment, ethics committee review, or applicable regulatory requirements. This narrative review examines the current role of functional psychosurgery in psychiatry, with particular focus on structured preoperative assessment models that optimize patient characterization within specialized clinical settings. We propose a pragmatic, circuit-informed framework integrating diagnostic precision, psychopathological assessment, neuropsychological profiling, functional evaluation, and ethical-regulatory oversight. By synthesizing evidence across psychiatric disorders, neurobiological models, and multidimensional assessment strategies, we outline a practical framework for preoperative characterization and outcome monitoring in psychiatric neurosurgery. When applied within specialized centers and under rigorous clinical, ethical, and regulatory oversight, functional psychosurgery may offer clinically meaningful symptom relief and improved quality of life for carefully selected patients who have exhausted conventional treatments.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.