Report in Brief
- What is the clinical effectiveness of deep brain stimulation for adults with treatment-resistance depression?
- What is the clinical effectiveness of deep brain stimulation for adults with post-traumatic stress disorder?
In general, data from a systematic review that included mostly observational studies with small sample sizes found that between 40% and 70% of TRD patients treated with DBS showed at least 50% reduction in Hamilton Depression Rating Scale scores (HDRS) or Montgomery-Asberg Depression Rating Scale scores (MADRS). Response rates to DBS therapy and percentage of changes in depression scores after limited long-term follow-up did not vary significantly between anatomical targets. Meta-analyses of four pre-post observational studies on DBS therapy targeted to the SCC of TRD patients showed remission rate of 26% and drop-out rate of 11% after 12 months of treatment. In terms of safety, there were no serious complications reported except one case of temporary hemiparesis in one study. There were completed or attempted suicides, but the causality of DBS therapy to suicides cannot be proven due to the high risk of suicide in patients with severe depression. The low quality of the study designs (pre-post observational designs) limit the ability to prove causality between intervention (DBS) and outcomes (reduction of depression) in patients with TRD. The heterogeneity in patients’ characteristics and measurement tools among the included trials reduced the robustness and generalizability of findings of the evidence. There is lack of evidence on the clinical effectiveness of DBS on post-traumatic stress disorder.