PMID- 29146474
OWN - NLM
STAT- MEDLINE
DCOM- 20190122
LR  - 20190122
IS  - 1878-4216 (Electronic)
IS  - 0278-5846 (Linking)
VI  - 82
DP  - 2018 Mar 2
TI  - A systematic review and meta-analysis of deep brain stimulation in 
      treatment-resistant depression.
PG  - 224-232
LID - S0278-5846(17)30307-X [pii]
LID - 10.1016/j.pnpbp.2017.11.012 [doi]
AB  - BACKGROUND: Deep brain stimulation (DBS) has been applied in treatment-resistant 
      depression (TRD) as a putative intervention targeting different brain regions. 
      However, the antidepressant effects of DBS for TRD in recent clinical trials 
      remain controversial. METHODS: We searched Scopus, EMBASE, the Cochrane Library, 
      PubMed, and PsycINFO for all published studies investigating the efficacy of DBS 
      in TRD up to Feb 2017. Hamilton depression rating scale (HDRS) scores and 
      Montgomery-Asberg depression rating scale (MARDS) scores were compared between 
      baseline levels and those after DBS using the standardized mean difference (SMD) 
      with 95% confidence intervals (CIs). The pooled response and remission rates were 
      described using Risk Difference with 95% CIs. RESULTS: We identified 14 studies 
      of DBS in TRD targeting the subcallosal cingulate gyrus (SCG), ventral 
      capsule/ventral striatum (VC/VS), medial forebrain bundle (MFB), and nucleus 
      accumbens (NAcc). The overall effect sizes showed a significant reduction in HDRS 
      after DBS stimulation in these four regions, with a standardized mean difference 
      of -3.02 (95% CI=-4.28 to -1.77, p<0.00001) for SCG, -1.64 (95% CI=-2.80 to 
      -0.49, p=0.005) for VC/VS, -2.43 (95% CI=-3.66 to -1.19, p=0.0001) for MFB, and 
      -1.30 (95% CI=-2.16 to -0.44, p=0.003) for NAcc. DBS was effective, with high 
      response rates at 1, 3, 6, and 12months. Some adverse events (AEs), especially 
      some specific AEs related to targeting regions, occurred during the DBS 
      treatment. CONCLUSIONS: DBS significantly alleviates depressive symptoms in TRD 
      patients by targeting the SCG, VC/VS, MFB, and NAcc. Several adverse events might 
      occur during DBS therapy, although it is uncertain whether some AEs can be linked 
      to DBS treatment. Further confirmatory trials are required involving larger 
      sample sizes.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Zhou, Chanjuan
AU  - Zhou C
AD  - Department of Neurology, Yongchuan Hospital of Chongqing Medical University, 
      Chongqing, China; Institute of Neuroscience, Chongqing Medical University, China; 
      Chongqing Key Laboratory of Neurobiology, Chongqing Medical University, China; 
      Institute of Neuroscience and the Collaborative Innovation Center for Brain 
      Science, Chongqing Medical University, China.
FAU - Zhang, Hanping
AU  - Zhang H
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China; Department of 
      Neurology, the First Affiliated Hospital of Chongqing Medical University, 
      Chongqing, China.
FAU - Qin, Yinhua
AU  - Qin Y
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China.
FAU - Tian, Tian
AU  - Tian T
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China; Department of 
      Neurology, the First Affiliated Hospital of Chongqing Medical University, 
      Chongqing, China.
FAU - Xu, Bing
AU  - Xu B
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China; Department of 
      Neurology, the First Affiliated Hospital of Chongqing Medical University, 
      Chongqing, China.
FAU - Chen, Jianjun
AU  - Chen J
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China; Institute of 
      Life Sciences, Chongqing Medical University, Chongqing, China; Institute of 
      Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing 
      Medical University, China.
FAU - Zhou, Xinyu
AU  - Zhou X
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China; Department of 
      Neurology and Psychiatry, the First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China.
FAU - Zeng, Li
AU  - Zeng L
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China; Department of 
      Neurology, the First Affiliated Hospital of Chongqing Medical University, 
      Chongqing, China.
FAU - Fang, Liang
AU  - Fang L
AD  - Department of Neurology, Yongchuan Hospital of Chongqing Medical University, 
      Chongqing, China.
FAU - Qi, Xunzhong
AU  - Qi X
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China; Department of 
      Neurology, the First Affiliated Hospital of Chongqing Medical University, 
      Chongqing, China.
FAU - Lian, Bin
AU  - Lian B
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China.
FAU - Wang, Haiyang
AU  - Wang H
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China; Institute of 
      Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing 
      Medical University, China.
FAU - Hu, Zicheng
AU  - Hu Z
AD  - Institute of Neuroscience, Chongqing Medical University, China; Chongqing Key 
      Laboratory of Neurobiology, Chongqing Medical University, China.
FAU - Xie, Peng
AU  - Xie P
AD  - Department of Neurology, Yongchuan Hospital of Chongqing Medical University, 
      Chongqing, China; Institute of Neuroscience, Chongqing Medical University, China; 
      Chongqing Key Laboratory of Neurobiology, Chongqing Medical University, China; 
      Department of Neurology, the First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China; Institute of Neuroscience and the Collaborative 
      Innovation Center for Brain Science, Chongqing Medical University, China. 
      Electronic address: xiepeng@cqmu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20171113
PL  - England
TA  - Prog Neuropsychopharmacol Biol Psychiatry
JT  - Progress in neuro-psychopharmacology & biological psychiatry
JID - 8211617
SB  - IM
MH  - *Deep Brain Stimulation/adverse effects
MH  - Depressive Disorder, Treatment-Resistant/*therapy
MH  - Humans
OTO - NOTNLM
OT  - Antidepressant effect
OT  - Deep brain stimulation (DBS)
OT  - Meta-analysis
OT  - Safety
OT  - Treatment-resistant depression (TRD)
EDAT- 2017/11/18 06:00
MHDA- 2019/01/23 06:00
CRDT- 2017/11/18 06:00
PHST- 2017/04/20 00:00 [received]
PHST- 2017/11/09 00:00 [revised]
PHST- 2017/11/09 00:00 [accepted]
PHST- 2017/11/18 06:00 [pubmed]
PHST- 2019/01/23 06:00 [medline]
PHST- 2017/11/18 06:00 [entrez]
AID - S0278-5846(17)30307-X [pii]
AID - 10.1016/j.pnpbp.2017.11.012 [doi]
PST - ppublish
SO  - Prog Neuropsychopharmacol Biol Psychiatry. 2018 Mar 2;82:224-232. doi: 
      10.1016/j.pnpbp.2017.11.012. Epub 2017 Nov 13.