PMID- 33867929 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210421 IS - 1662-4548 (Print) IS - 1662-453X (Electronic) IS - 1662-453X (Linking) VI - 15 DP - 2021 TI - Deep Brain Stimulation in Treatment-Resistant Depression: A Systematic Review and Meta-Analysis on Efficacy and Safety. PG - 655412 LID - 10.3389/fnins.2021.655412 [doi] LID - 655412 AB - 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. CI - Copyright (c) 2021 Wu, Mo, Sui, Zhang, Hu, Zhang, Wang, Liu, Zhao, Wang, Zhang and Xie. FAU - Wu, Youliang AU - Wu Y AD - Department of Functional Neurosurgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China. FAU - Mo, Jiajie AU - Mo J AD - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. AD - Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. FAU - Sui, Lisen AU - Sui L AD - Department of Functional Neurosurgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China. FAU - Zhang, Jianguo AU - Zhang J AD - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. AD - Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. FAU - Hu, Wenhan AU - Hu W AD - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. AD - Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. FAU - Zhang, Chao AU - Zhang C AD - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. AD - Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. FAU - Wang, Yao AU - Wang Y AD - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. AD - Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. FAU - Liu, Chang AU - Liu C AD - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. AD - Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. FAU - Zhao, Baotian AU - Zhao B AD - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. AD - Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. FAU - Wang, Xiu AU - Wang X AD - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. AD - Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. FAU - Zhang, Kai AU - Zhang K AD - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. AD - Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. FAU - Xie, Xuemin AU - Xie X AD - Department of Functional Neurosurgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China. LA - eng PT - Systematic Review DEP - 20210401 PL - Switzerland TA - Front Neurosci JT - Frontiers in neuroscience JID - 101478481 PMC - PMC8047101 OTO - NOTNLM OT - deep brain stimulation OT - major depressive disorder OT - nerve nuclei OT - psychiatric surgery OT - treatment-resistant depression COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2021/04/20 06:00 MHDA- 2021/04/20 06:01 PMCR- 2021/01/01 CRDT- 2021/04/19 06:20 PHST- 2021/01/18 00:00 [received] PHST- 2021/02/23 00:00 [accepted] PHST- 2021/04/19 06:20 [entrez] PHST- 2021/04/20 06:00 [pubmed] PHST- 2021/04/20 06:01 [medline] PHST- 2021/01/01 00:00 [pmc-release] AID - 10.3389/fnins.2021.655412 [doi] PST - epublish SO - Front Neurosci. 2021 Apr 1;15:655412. doi: 10.3389/fnins.2021.655412. eCollection 2021.