A systematic review and meta-analysis of deep brain stimulation for depression
Open accessAbstract
BACKGROUND: Deep brain stimulation is increasingly being used for treatment-resistant depression. Blinded, randomized controlled trials of active versus sham treatment have been limited to small numbers. METHOD: We performed a systematic review and meta-analysis on the effectiveness of deep brain stimulation (DBS) in depression. Cochrane Central Register of Controlled Trials, PubMed/Medline, Embase and PsycINFO, Chinese Biomedical Literature Service System, and China Knowledge Resource Integrated Database were searched for single- or double placebo-controlled, crossover, and parallel-group trials in which DBS was compared with sham treatment using validated scales. RESULTS: Ten papers from nine studies met inclusion criteria, all but two of which were double-blinded RCTs. The main outcome was a reduction in depressive symptoms. It was possible to combine data for 190 participants. Patients on active, as opposed to sham, treatment had a significantly higher response (OR = 5.50; 95% CI = 2.79, 10.85; p < .0001) and reductions in mean depression score (SMD = -0.42; 95% CI = -0.72, -0.12; p = .006). However, the effect was attenuated on some of the subgroup and sensitivity analyses, and there were no differences for most other outcomes. In addition, 84 participants experienced a total of 131 serious adverse effects, although not all could be directly associated with the device or surgery. Finally, publication bias was possible. CONCLUSIONS: DBS may show promise for treatment-resistant depression but remains an experimental treatment until further data are available.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164 · see citing works
Basics of meta‐analysis: <i>I</i> <sup>2</sup> is not an absolute measure of heterogeneity
Borenstein, M., Higgins, J. P. T., Hedges, L. V., & Rothstein, H. R. (2017) · Research Synthesis Methods · doi:10.1002/jrsm.1230 · Cited by 1,848 · see citing works
Handbook of clinical neurology
Illis, L. S. (2013) · Spinal Cord · doi:10.1038/sc.2013.79 · Cited by 910 · see citing works
Bewernick, B. H., Hurlemann, R., Matusch, A., Kayser, S., Grubert, C., Hadrysiewicz, B., Axmacher, N., Lemke, M., Cooper-Mahkorn, D., Cohen, M. X., et al. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.09.013 · Cited by 865 · see citing works
DEFINITION AND EPIDEMIOLOGY OF TREATMENT-RESISTANT DEPRESSION
Fava, M., & Davidson, K. G. (1996) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70283-5 · Cited by 797 · see citing works
Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Unipolar and Bipolar Depression
Holtzheimer, P. E. (2012) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.1456 · Cited by 608 · see citing works
Milev, R. V., Giacobbe, P., Kennedy, S. H., Blumberger, D. M., Daskalakis, Z. J., Downar, J., Modirrousta, M., Patry, S., Vila-Rodriguez, F., Lam, R. W., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716660033 · Cited by 586 · see citing works
Holtzheimer, P. E., Husain, M. M., Lisanby, S. H., Taylor, S. F., Whitworth, L. A., McClintock, S., Slavin, K. V., Berman, J., McKhann, G. M., Patil, P. G., et al. (2017) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30371-1 · Cited by 577 · see citing works
Rapid effects of deep brain stimulation for treatment-resistant major depression
Schlaepfer, T. E., Bewernick, B. H., Kayser, S., Mädler, B., & Coenen, V. A. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.01.034 · Cited by 563 · see citing works
Dougherty, D. D., Rezai, A. R., Carpenter, L. L., Howland, R. H., Bhati, M. T., O’Reardon, J. P., Eskandar, E. N., Baltuch, G. H., Machado, A. D., Kondziolka, D., et al. (2015) · Biological Psychiatry · doi:10.1016/j.biopsych.2014.11.023 · Cited by 558 · see citing works
Bergfeld, I. O., Mantione, M., Hoogendoorn, M. L. C., Ruhé, H. G., Notten, P., van Laarhoven, J., Visser, I., Figee, M., de Kwaasteniet, B. P., Horst, F., et al. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.0152 · Cited by 336 · see citing works
Deep brain stimulation for treatment-resistant depression: systematic review of clinical outcomes
Morishita, T., Fayad, S. M., Higuchi, M.-A., Nestor, K. A., & Foote, K. D. (2014) · Neurotherapeutics · doi:10.1007/s13311-014-0282-1 · Cited by 216 · see citing works
de Koning, P. P., Figee, M., van den Munckhof, P., Schuurman, P. R., & Denys, D. (2011) · Current Psychiatry Reports · doi:10.1007/s11920-011-0200-8 · Cited by 202 · see citing works
Deep-Brain Stimulation for Anorexia Nervosa
Wu, H., Dyck-Lippens, P. J. V., Santegoeds, R., van Kuyck, K., Gabriëls, L. A., Lin, G., Pan, G., Li, Y., Li, D., Zhan, S., et al. (2012) · World Neurosurgery · doi:10.1016/j.wneu.2012.06.039 · Cited by 161 · see citing works
Memory and mood outcomes after anterior thalamic stimulation for refractory partial epilepsy
Tröster, A. I., Meador, K. J., Irwin, C. P., & Fisher, R. S. (2016) · Seizure · doi:10.1016/j.seizure.2016.12.014 · Cited by 139 · see citing works
Berlim, M. T., McGirr, A., den Eynde, F. V., Fleck, M. P., & Giacobbe, P. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.02.016 · Cited by 136 · see citing works
Weintraub, D. A., Duda, J. E., Carlson, K., Luo, P., Sagher, O., Stern, M., Follett, K. A., Reda, D. J., Weaver, F. M., & for the CSP 468 Study Group (2013) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2012-304396 · Cited by 134 · see citing works
Choi, K. S., Riva‐Posse, P., Gross, R. E., & Mayberg, H. S. (2015) · JAMA Neurology · doi:10.1001/jamaneurol.2015.2564 · Cited by 133 · see citing works
Negt, P., Brakemeier, E., Michalak, J., Winter, L., Bleich, S., & Kahl, K. G. (2016) · Brain and Behavior · doi:10.1002/brb3.486 · Cited by 126 · see citing works
Deep brain stimulation of the medial forebrain bundle: Distinctive responses in resistant depression
Fenoy, A. J., Schulz, P., Selvaraj, S., Burrows, C., Spiker, D., Cao, B., Zunta-Soares, G., Gajwani, P., Quevedo, J., & Soares, J. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.05.064 · Cited by 125 · see citing works
Merkl, A., Schneider, G., Schönecker, T., Aust, S., Kühl, K.-P., Kupsch, A. R., Kühn, A. A., & Bajbouj, M. (2013) · Experimental Neurology · doi:10.1016/j.expneurol.2013.08.017 · Cited by 114 · see citing works
Deep brain stimulation for treatment of refractory depression
Schlaepfer, T. E., & Lieb, K. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67582-4 · Cited by 109 · see citing works
Ramasubbu, R., Anderson, S., Haffenden, A., Chavda, S., & Kiss, Z. H. T. (2013) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.120160 · Cited by 101 · see citing works
Puigdemont, D., Portella, M. J., Pérez-Egea, R., Molet, J., Gironell, A., de Diego-Adeliño, J., Martín, A., Rodríguez, R., Àlvarez, E., Artigas, F., et al. (2015) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.130295 · Cited by 100 · cited 3× · see citing works
“…studies met inclusion criteria (Bergfeld et al., 2016; Dougherty et al., 2015; Kubu et al., 2016; Merkl et al., 2013; Holtzheimer et al., 2012, 2017; Puigdemont et al., 2015; Ramasubbu, Anderson, Haffenden, Chavda, & Kiss, 2013; Schlaepfer, Bewernick, Braeuer, & Coenen, 2016; Fenoy et al., 2016).”
BackgroundDehydroepiandrosterone (DHEA) supplementation for cognitive function in healthy elderly people
Evans, J. G., Malouf, R. S., Huppert, F. A., & van Niekerk, J. K. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006221 · Cited by 99 · see citing works
Deep brain stimulation for psychiatric disorders: where we are now
Cleary, D. R., Ozpinar, A., Raslan, A. M. T., & Ko, A. L. (2015) · Neurosurgical FOCUS · doi:10.3171/2015.3.focus1546 · Cited by 99 · see citing works
Deep brain stimulation for obsessive–compulsive disorder: a systematic review and meta-analysis
Kisely, S. R., Hall, K. A. A., Siskind, D. J., Frater, J., Olson, S., & Crompton, D. (2014) · Psychological Medicine · doi:10.1017/s0033291714000981 · Cited by 94 · see citing works
Self-citationLimitations in efficacy of antidepressant monotherapy.
Rush, A. J. (2007) · PubMed · Cited by 85 · see citing works
Neuropsychological outcomes from constant current deep brain stimulation for Parkinson's disease
Tröster, A. I., Jankovic, J. J., Tagliati, M., Peichel, D., & Okun, M. S. (2016) · Movement Disorders · doi:10.1002/mds.26827 · Cited by 78 · see citing works
Deep brain stimulation of the posterior gyrus rectus region for treatment resistant depression
Accolla, E. A., Aust, S., Merkl, A., Schneider, G.-H., Kühn, A. A., Bajbouj, M., & Draganski, B. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.01.022 · Cited by 70 · see citing works
Boel, J. A., Odekerken, V. J. J., Schmand, B. A., et al. (2016) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2016.09.018 · Cited by 62 · see citing works
Naesström, M., Blomstedt, P. C., & Bodlund, O. (2016) · Nordic Journal of Psychiatry · doi:10.3109/08039488.2016.1162846 · Cited by 61 · see citing works
Deep brain stimulation in mental health: Review of evidence for clinical efficacy
Fitzgerald, P. B., & Segrave, R. A. (2015) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415598011 · Cited by 47 · see citing works
Kringelbach, M. L., & Aziz, T. Z. (2009) · JAMA · doi:10.1001/jama.2009.551 · Cited by 40 · see citing works
Tramontana, M. G., Molinari, A. L., Konrad, P. E., et al. (2015) · Journal of Parkinson s Disease · doi:10.3233/jpd-140448 · Cited by 33 · see citing works
Downar, J. H., Blumberger, D. M., & Daskalakis, Z. J. (2016) · Canadian Medical Association Journal · doi:10.1503/cmaj.151316 · Cited by 31 · see citing works
Kubu, C. S., Brelje, T., Butters, M. A., Deckersbach, T., Malloy, P., Moberg, P. J., Tröster, A. I., Williamson, E., Baltuch, G. H., Bhati, M. T., et al. (2016) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2016-313803 · Cited by 28 · see citing works
Deep Brain Stimulation for Treatment-Refractory Depression
Narang, P., Retzlaff, A. A., Brar, K., & Lippmann, S. (2016) · Southern Medical Journal · doi:10.14423/smj.0000000000000554 · Cited by 13 · see citing works
Westbay, L. C., Cao, L., Burnett‐Zeigler, I., Reizine, N. M., Barton, B. R., Ippolito, D., Weaver, F. M., & Stroupe, K. T. (2015) · Journal of Parkinson s Disease · doi:10.3233/jpd-140512 · Cited by 3 · see citing works
Deep Brain Stimulation in Treatment Resistant Depression: A Systematic Review
Aiyer, R., & Joffe, R. T. (2015) · Current Psychopharmacologye · doi:10.2174/2211556004666150918194517 · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
McIntyre, R. S., Alsuwaidan, M., Baune, B. T., Berk, M., Demyttenaere, K., Goldberg, J. F., Gorwood, P., Ho, R., Kasper, S., Kennedy, S. H., et al. (2023) · World Psychiatry · doi:10.1002/wps.21120 · Cited by 836 · see citing works
McAllister-Williams, R. H., Arango, C., Blier, P., Demyttenaere, K., Falkai, P., Gorwood, P., Hopwood, M., Javed, A., Kasper, S., Malhi, G. S., et al. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.02.023 · Cited by 278 · see citing works
Efficacy of invasive and non-invasive brain modulation interventions for addiction
Luigjes, J., Segrave, R., de Joode, N., Figee, M., & Denys, D. (2019) · Neuropsychology Review · doi:10.1007/s11065-018-9393-5 · Cited by 125 · see citing works
Canbeyli, R. (2022) · European Journal of Neuroscience · doi:10.1111/ejn.15507 · Cited by 48 · see citing works
Brewerton, T. D. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1149433 · Cited by 46 · see citing works
Brewerton, T. D., Gavidia, I., Suro, G., & Perlman, M. M. (2023) · Journal of Eating Disorders · doi:10.1186/s40337-023-00773-4 · Cited by 38 · see citing works
Aibar-Durán, J. Á., Rodríguez Rodríguez, R., de Diego Adeliño, F. J., Portella, M. J., Álvarez-Holzapfel, M. J., Martín Blanco, A., Puigdemont Campos, D., & Molet Teixidó, J. (2022) · Neurosurgery · doi:10.1227/neu.0000000000001739 · Cited by 16 · see citing works
McCall, M. V., Riva-Posse, P., Garlow, S. J., Mayberg, H. S., & Crowell, A. L. (2020) · Neurology Psychiatry and Brain Research · doi:10.1016/j.npbr.2020.05.002 · Cited by 13 · see citing works
- Authors
- Kisely, S., Li, A., Warren, N., & Siskind, D.
- Affiliations
- Griffith University (AU)
- The University of Queensland (AU)
- Corresponding author
- Kisely, Steve
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2018-04-26
- Volume
- 35
- Issue
- 5
- Pages
- 468-480
- ISSN
- 1091-4269 (ISSN-L)
- OpenAlex
- W2800798196
- Cited by
- 165
- References
- 40
- Citations by year
- 2026: 15 · 2025: 21 · 2024: 23 · 2023: 24 · 2022: 22 · 2021: 28 · 2020: 22 · 2019: 6 · 2018: 4
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion)
- Funders
- University of Queensland Summer Research Scheme
- National Health and Medical Research Council (NHMRC ECF APP1111136)
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Keywords
- deep brain stimulation, treatment-resistant depression, depressive symptom reduction, adverse effects, publication bias
- MeSH terms
- Humans, Outcome Assessment, Health Care, Deep Brain Stimulation, Depressive Disorder, Treatment-Resistant
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
