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Has Deep Brain Stimulation Shown Its Full Potential in Treatment-Resistant Depression? A Scoping Review.

Liene Puke1, Joelle Rosselet Amoussou2, Armin von Gunten3

  • 1Division of Adult Psychiatry and Psychotherapy West, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

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Summary

Deep brain stimulation (DBS) shows promise for treatment-resistant depression (TRD) by targeting brain networks. However, inconsistent study methods and definitions of TRD require standardization for clearer clinical benefits.

Keywords:
Deep brain stimulationDeep brain stimulation targetsMajor depressive disorderPersonalized treatment in psychiatryTreatment-resistant depression

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Neuromodulation

Background:

  • Major depressive disorder is increasingly viewed as a brain network dysfunction (networkopathy).
  • Deep brain stimulation (DBS) is explored for treatment-resistant depression (TRD) when other therapies fail.

Purpose of the Study:

  • To review studies on bilateral DBS for TRD, focusing on targets, depression frameworks, and outcomes.
  • To identify variability in TRD definitions, DBS targets, and symptom dimension associations.

Main Methods:

  • Scoping review of peer-reviewed studies on bilateral DBS for TRD.
  • Literature search across 6 databases (September 2024) with citation tracking.
  • PRISMA 2020 guidelines followed for study selection.

Main Results:

  • Significant heterogeneity found in TRD definitions, DBS targets, and symptom mapping.
  • Most studies used standardized scales, but 16.7% lacked specific symptom dimension outcomes.
  • Bilateral DBS shows potential for symptom alleviation in TRD despite methodological variability.

Conclusions:

  • DBS is a promising intervention for TRD, but its full clinical benefits require further establishment.
  • Greater standardization is needed in TRD definitions, symptom mapping, and outcome integration.
  • Future research should explore unilateral and multitarget DBS for personalized neuromodulation.