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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

Introduction to deep brain stimulation for psychiatric indications, with a focus on Gilles de la Tourette syndrome

An introduction to dbs in psychiatric indications with a focus on gilles de la tourette syndrome

Deep brain stimulation has become a safe and effective option for carefully selected patients with severe, treatment-resistant Tourette syndrome, but limited evidence makes selecting the optimal target difficult.

The talk addresses deep brain stimulation (DBS), which emerged at the end of the 20th century as a promising option for treatment-resistant psychiatric disorders, with its first psychiatric applications in Gilles de la Tourette syndrome (GTS) and obsessive-compulsive disorder; although previous studies have demonstrated symptom improvement, most are limited by small sample sizes and methodological heterogeneity. Although symptoms improve during adolescence or early adulthood in most individuals with GTS, a subgroup continues to experience disabling motor and vocal tics despite optimally delivered behavioral and pharmacological treatments. In the first report by Vandewalle and colleagues in 1999, the centromedian–substantia periventricularis–ventro-oralis internus (CM-Spv-Voi) region of the thalamus was targeted; since then, DBS has become a safe and effective treatment option for carefully selected patients with severe, treatment-resistant GTS. Growing knowledge of GTS pathophysiology has highlighted dysfunction in cortico-striato-thalamo-cortical (CSTC) circuits, prompting investigation of numerous targets, including the thalamus, globus pallidus internus, globus pallidus externus, anterior limb of the internal capsule and nucleus accumbens, and subthalamic nucleus. Meta-analytic evidence indicates significant tic reduction following chronic DBS, with pallidal stimulation yielding particularly favorable outcomes; however, selecting the optimal target remains difficult because this evidence rests on a small number of randomized, double-blind, controlled trials with limited sample sizes. More recent structural and functional connectivity analyses suggest that individualized target selection based on symptom profiles may improve outcomes; advances such as connectome-guided targeting and adaptive DBS are also suggested to have the potential to further improve clinical outcomes in the future.

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