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

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

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Department of Psychiatry, Hotchkiss Brain Institute, Mathison Centre for Mental Health Research and Education, University of Calgary, TRW-4D68, 3280 Hospital Drive Northwest, Calgary, Alberta T2N 4Z6, Canada. Electronic address:
Neuromodulation Research Clinic, Depressive Disorders Program, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Montréal, Québec H4H 1R3, Canada. Electronic address:


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.


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

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