Clinical Usefulness of Therapeutic Neuromodulation for Major Depression: A Systematic Meta-Review of Recent Meta-Analyses

Psychiatr Clin North Am. 2018 Sep;41(3):485-503. doi: 10.1016/j.psc.2018.04.009. Epub 2018 Jul 17.

Abstract

The authors conducted a meta-review of meta-analyses published in the past decade on therapeutic neuromodulation (ie, repetitive transcranial magnetic stimulation, transcranial direct current stimulation, vagus nerve stimulation and deep brain stimulation) for major depression. Active repetitive transcranial magnetic stimulation and transcranial direct current stimulation have been generally associated with small to moderate effect sizes vis-à-vis their efficacy and with similar acceptability compared with sham. Vagus nerve stimulation and deep brain stimulation (although more challenging to investigate) have demonstrated preliminary effectiveness, particularly during longer-term follow-up.

Keywords: Brain stimulation; Deep brain stimulation; Major depression; Neuromodulation; Repetitive transcranial magnetic stimulation; Transcranial direct current stimulation; Treatment-resistant depression; Vagus nerve stimulation.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Deep Brain Stimulation / methods*
  • Depressive Disorder, Major / therapy*
  • Depressive Disorder, Treatment-Resistant / therapy*
  • Humans
  • Transcranial Direct Current Stimulation / methods*
  • Transcranial Magnetic Stimulation / methods*
  • Vagus Nerve Stimulation / methods*