For severe OCD, depression, and Tourette syndrome that has not responded to years of treatment, surgery on the brain's emotion circuits can help. Start by finding the condition below.
Surgery is reserved for severe, treatment-resistant illness, and it is always decided by a multidisciplinary team. Each page explains the condition and the surgical options that can help when standard treatment has been exhausted.
These conditions are increasingly understood as disorders of brain circuits, in particular the cortico-striato-thalamo-cortical loops that link the prefrontal cortex, striatum, and thalamus. The most disabling symptoms appear to be carried by the emotion-related (limbic) part of this network.
A defining part of this practice is tractography-guided targeting: using each patient's own white-matter imaging, with both deterministic and probabilistic methods, to find the limbic pathway in the anterior limb of the internal capsule and aim treatment precisely at it while sparing the neighboring associative pathways. The aim is greater benefit with fewer side effects, whether the treatment is laser ablation or deep brain stimulation.
Read more about the circuit and tractography-guided targeting →
Surgery is never a first step. It is considered only after standard treatments have genuinely been exhausted, and only through a deliberate process: a psychiatrist confirms the diagnosis and that adequate trials of medication and evidence-based therapy have failed; a multidisciplinary committee of psychiatry, neurosurgery, neuropsychology, and often an ethicist reviews the case together; and the patient understands and freely chooses the treatment. For some procedures, oversight involves a formal humanitarian device exemption or a research protocol.
Ahmet Fatih Atik, MD is a neurosurgeon focused on stereotactic and functional neurosurgery, including neuromodulation and tractography-guided ablation for severe, treatment-resistant psychiatric illness, with an active research program in connectivity-guided targeting. This site is an independent educational resource and is not, by itself, medical advice.
If you are a patient or family member exploring options for severe, treatment-resistant OCD, depression, or Tourette syndrome, or a clinician considering a referral, share a brief outline and I will be in touch. Please keep it general and do not include detailed medical records or sensitive health information here.