Several patients with major depressive disorder experience treatment-resistant depression (TRD). Deep brain stimulation (DBS) is a surgical intervention under investigation for TRD that has shown promise in some settings but inconsistent outcomes overall. Here we conducted a random-effects meta-analysis of 25 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 standardized mean change effect sizes of 2.77, 3.15 and 3.87, respectively. Neither study design nor stimulation target significantly influenced outcomes, although subcallosal cingulate stimulation resulted in the largest effect sizes at all time points. Furthermore, higher follow-up frequency correlated positively with the 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 versus placebo and optimize its clinical implementation. This is a preview of subscription content, access via your institution Receive 12 digital issues and online access to articles Prices may be subject to local taxes which are calculated during checkout The dataset for this Analysis is publicly available via Mendeley at https://doi.org/10.17632/cvmnzfd9v7 (ref. 62). The code used for this meta-analysis is available via OSF at https://osf.io/fm2vq/overview.
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