Abstract
Deep brain stimulation is currently an experimental treatment for major depressive disorder. Information is lacking, however, on how sham responding may affect efficacy. This article applies exploratory meta-analysis to address that topic. Data on benefits of deep brain electrical stimulation come from a recent review. Stimulated brain regions included subgenual cingulate, capsular interna, nucleus accumbens, and medial forebrain bundle. Expert opinion plus random number software was used to generate hypothetical values for sham responding. An effect size of 1.71 (95% CI: 1.47-1.96) was obtained for deep brain stimulation versus sham treatment in patients suffering from long-term treatment-resistant depression. Preliminary findings on deep brain electrical stimulation suggest that the procedure may be 71% more effective than sham treatment. Expressing these findings as patients-needed-to-treat, deep brain electrical stimulation is required by 2.9 patients with long-term treatment-resistant depression in order for one of them to benefit.
Highlights
Direct electrical stimulation in the brain continues to attract much attention for relief of treatment-resistant depression [1,2]
A random effects model was used, and it provided an estimate of effect size of 1.71 for deep brain stimulation versus sham treatment in patients with long-term treatment-resistant depression
An effect size of 1.71 means that deep brain stimulation was 71% more likely than sham treatment to be of benefit for patients with longterm treatment-resistant depression
Summary
Direct electrical stimulation in the brain continues to attract much attention for relief of treatment-resistant depression [1,2]. There is, still great uncertainty concerning efficacy, due in part to lack of information on sham responding to the intensive selection and surgical procedures [3]. Kennedy et al [11]
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