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Related Concept Videos

Electroconvulsive Therapy01:30

Electroconvulsive Therapy

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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
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Related Experiment Video

Updated: Aug 23, 2025

MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
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Stereotactic Radiofrequency Ablation for Treatment-Refractory Depression: A Systematic Review and Meta-Analysis.

Pauline Sarah Münchenberg1, Eileen M Joyce1, Keith Matthews2

  • 1Department of Clinical & Motor Neurosciences, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK.

Brain Sciences
|October 27, 2022
PubMed
Summary

Stereotactic radiofrequency ablation (SRA) shows significant benefit for patients with severe, treatment-resistant major depressive disorder (MDD). This meta-analysis found SRA effectively reduced depression symptoms, with over half of patients responding to the procedure.

Keywords:
anterior capsulotomyanterior cingulotomymajor depressive disorderstereotactic radiofrequency ablationtreatment-refractory depression

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Area of Science:

  • Neurosurgery
  • Psychiatry
  • Medical Statistics

Background:

  • Major depressive disorder (MDD) represents a substantial global health burden.
  • Refractory MDD poses significant challenges, with limited treatment options.
  • The efficacy of Stereotactic radiofrequency ablation (SRA) for MDD requires further clarification.

Purpose of the Study:

  • To systematically review and meta-analyze the effectiveness of SRA for treating refractory MDD.
  • To quantify the effect size of SRA using validated depression scales.
  • To assess patient response and remission rates following SRA.

Main Methods:

  • Systematic literature review and meta-analysis of studies reporting SRA for MDD.
  • Extraction of patient-level data, including pre- and post-operative depression scores (BDI, MADRS).
  • Calculation of standardized mean difference (SMD) as the primary effect size, using a random-effects model.

Main Results:

  • Five studies with 116 patients (64 in meta-analysis) were included.
  • A significant overall effect size (SMD) of 1.66 (CI 1.25-2.07) was observed, indicating substantial symptom improvement.
  • 53% of patients were responders (≥50% symptom improvement), with 34% achieving remission.

Conclusions:

  • SRA demonstrates significant benefit in selected patients with refractory MDD.
  • Anterior cingulotomy and anterior capsulotomy showed comparable positive effect sizes.
  • The findings support SRA as a viable therapeutic option for severe, treatment-resistant depression.