Deep brain stimulation for major depressive disorder: A Systematic Review and Meta-Analysis
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A significant proportion of patients with major depressive disorder (MDD) experience treatment-resistant depression (TRD). Deep brain stimulation (DBS) is a surgical intervention under investigation for TRD which has shown promise in some settings but inconsistent outcomes overall. We conducted a random-effects meta-analysis of open-label and randomized controlled trials to provide an up-to-date assessment of DBS efficacy in TRD. Depressive symptoms improved across short-term (6–9 months), moderate-term (12–24 months), and long-term (>24 months) time points after DBS initiation, with effect sizes (Hedges’ g) of 2.40, 2.83, and 4.33, respectively. Neither study design nor stimulation target significantly influenced outcomes, although subcallosal cingulate stimulation was generally associated with more pronounced effects. Furthermore, higher follow-up frequency correlated positively with rate of symptom improvement. Our findings support that DBS can exert sustained antidepressant effects, and provide insights that can be used to better establish its efficacy vs. placebo and optimize its clinical implementation.
