Deep Brain Stimulation in Treatment-Resistant Depression: A Systematic Review and Meta-Analysis on Efficacy and Safety
Objective: Deep brain stimulation (DBS) has shown promising outcomes as new therapeutic opportunities for patients with treatment-resistant depression (TRD) who do not respond adequately to several consecutive treatments. This study aims to systematically review and conduct a meta-analysis on the ef...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-04-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2021.655412/full |
| _version_ | 1818855714248982528 |
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| author | Youliang Wu Jiajie Mo Jiajie Mo Lisen Sui Jianguo Zhang Jianguo Zhang Wenhan Hu Wenhan Hu Chao Zhang Chao Zhang Yao Wang Yao Wang Chang Liu Chang Liu Baotian Zhao Baotian Zhao Xiu Wang Xiu Wang Kai Zhang Kai Zhang Xuemin Xie |
| author_facet | Youliang Wu Jiajie Mo Jiajie Mo Lisen Sui Jianguo Zhang Jianguo Zhang Wenhan Hu Wenhan Hu Chao Zhang Chao Zhang Yao Wang Yao Wang Chang Liu Chang Liu Baotian Zhao Baotian Zhao Xiu Wang Xiu Wang Kai Zhang Kai Zhang Xuemin Xie |
| author_sort | Youliang Wu |
| collection | DOAJ |
| description | Objective: Deep brain stimulation (DBS) has shown promising outcomes as new therapeutic opportunities for patients with treatment-resistant depression (TRD) who do not respond adequately to several consecutive treatments. This study aims to systematically review and conduct a meta-analysis on the efficacy and safety of DBS for TRD.Method: The literature was comprehensively reviewed using Medline, Google scholar, Cochrane library, Embase, and World Health Organization International Clinical Trials Registry Platform until January 2019. The studied outcomes included response, remission, recurrence, and adverse events (AEs) rates, and were reported as the rate ratio (RR) or pooled estimate with a 95% confidence interval (95% CI). Heterogeneity was measured by an I-square test and a sensitive analysis.Results: A total of 17 studies involving 7 DBS targets were included. For efficacy, DBS treatment was statistically beneficial for TRD, and the response, remission, and recurrence rates were 56% (ranging from 43 to 69%), 35% (ranging from 27 to 44%), and 14% (ranging from 4 to 25%), respectively. However, only two randomized-controlled trials (RCTs) considered the invalidity of DBS (RR = 1.45, 95% CI = 0.50–4.21). For safety, the AEs rate was 67% (ranging from 54 to 80%). The AEs were common and moderate, but the problems related to suicide and suicidal ideation should not be underestimated.Conclusion: These findings suggest that DBS for TRD is considered promising, which should be confirmed by well-designed and large sample studies. Future basic research and comprehensive clinical trials are needed to reach better understanding on the mechanisms of action and optimal targeted structure. |
| first_indexed | 2024-12-19T08:12:59Z |
| format | Article |
| id | doaj.art-6eeeeebe241b483f8497ab90d33e3210 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-12-19T08:12:59Z |
| publishDate | 2021-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-6eeeeebe241b483f8497ab90d33e32102022-12-21T20:29:35ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2021-04-011510.3389/fnins.2021.655412655412Deep Brain Stimulation in Treatment-Resistant Depression: A Systematic Review and Meta-Analysis on Efficacy and SafetyYouliang Wu0Jiajie Mo1Jiajie Mo2Lisen Sui3Jianguo Zhang4Jianguo Zhang5Wenhan Hu6Wenhan Hu7Chao Zhang8Chao Zhang9Yao Wang10Yao Wang11Chang Liu12Chang Liu13Baotian Zhao14Baotian Zhao15Xiu Wang16Xiu Wang17Kai Zhang18Kai Zhang19Xuemin Xie20Department of Functional Neurosurgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Functional Neurosurgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Functional Neurosurgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaObjective: Deep brain stimulation (DBS) has shown promising outcomes as new therapeutic opportunities for patients with treatment-resistant depression (TRD) who do not respond adequately to several consecutive treatments. This study aims to systematically review and conduct a meta-analysis on the efficacy and safety of DBS for TRD.Method: The literature was comprehensively reviewed using Medline, Google scholar, Cochrane library, Embase, and World Health Organization International Clinical Trials Registry Platform until January 2019. The studied outcomes included response, remission, recurrence, and adverse events (AEs) rates, and were reported as the rate ratio (RR) or pooled estimate with a 95% confidence interval (95% CI). Heterogeneity was measured by an I-square test and a sensitive analysis.Results: A total of 17 studies involving 7 DBS targets were included. For efficacy, DBS treatment was statistically beneficial for TRD, and the response, remission, and recurrence rates were 56% (ranging from 43 to 69%), 35% (ranging from 27 to 44%), and 14% (ranging from 4 to 25%), respectively. However, only two randomized-controlled trials (RCTs) considered the invalidity of DBS (RR = 1.45, 95% CI = 0.50–4.21). For safety, the AEs rate was 67% (ranging from 54 to 80%). The AEs were common and moderate, but the problems related to suicide and suicidal ideation should not be underestimated.Conclusion: These findings suggest that DBS for TRD is considered promising, which should be confirmed by well-designed and large sample studies. Future basic research and comprehensive clinical trials are needed to reach better understanding on the mechanisms of action and optimal targeted structure.https://www.frontiersin.org/articles/10.3389/fnins.2021.655412/fulldeep brain stimulationmajor depressive disordernerve nucleitreatment-resistant depressionpsychiatric surgery |
| spellingShingle | Youliang Wu Jiajie Mo Jiajie Mo Lisen Sui Jianguo Zhang Jianguo Zhang Wenhan Hu Wenhan Hu Chao Zhang Chao Zhang Yao Wang Yao Wang Chang Liu Chang Liu Baotian Zhao Baotian Zhao Xiu Wang Xiu Wang Kai Zhang Kai Zhang Xuemin Xie Deep Brain Stimulation in Treatment-Resistant Depression: A Systematic Review and Meta-Analysis on Efficacy and Safety Frontiers in Neuroscience deep brain stimulation major depressive disorder nerve nuclei treatment-resistant depression psychiatric surgery |
| title | Deep Brain Stimulation in Treatment-Resistant Depression: A Systematic Review and Meta-Analysis on Efficacy and Safety |
| title_full | Deep Brain Stimulation in Treatment-Resistant Depression: A Systematic Review and Meta-Analysis on Efficacy and Safety |
| title_fullStr | Deep Brain Stimulation in Treatment-Resistant Depression: A Systematic Review and Meta-Analysis on Efficacy and Safety |
| title_full_unstemmed | Deep Brain Stimulation in Treatment-Resistant Depression: A Systematic Review and Meta-Analysis on Efficacy and Safety |
| title_short | Deep Brain Stimulation in Treatment-Resistant Depression: A Systematic Review and Meta-Analysis on Efficacy and Safety |
| title_sort | deep brain stimulation in treatment resistant depression a systematic review and meta analysis on efficacy and safety |
| topic | deep brain stimulation major depressive disorder nerve nuclei treatment-resistant depression psychiatric surgery |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2021.655412/full |
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