Neurostimulatory and ablative treatment options in major depressive disorder: a systematic review.
BACKGROUND
Major depressive disorder is one of the most disabling and common diagnoses amongst psychiatric disorders, with a current worldwide prevalence of 5-10% of the general population and up to 20-25% for the lifetime period.


BACKGROUND
Nowadays, conventional treatment includes psychotherapy and pharmacotherapy; however, more than 60% of the treated patients respond unsatisfactorily, and almost one fifth becomes refractory to these therapies at long-term follow-up.
Growing social incapacity and economic burdens make the medical community strive for better therapies, with fewer complications. Various nonpharmacological techniques like electroconvulsive therapy, vagus nerve stimulation, transcranial magnetic stimulation, lesion surgery, and deep brain stimulation have been developed for this purpose.


CONCLUSIONS
We reviewed the literature from the beginning of the twentieth century until July 2009 and described the early clinical effects and main reported complications of these methods.
Andrade
Pablo
P
Department of Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands. p.andrade@np.unimaas.nl
Noblesse
Lieke H M
LH
Temel
Yasin
Y
Ackermans
Linda
L
Lim
Lee W
LW
Steinbusch
Harry W M
HW
Visser-Vandewalle
Veerle
V
D000818:Animals; D001931:Brain Mapping; D002908:Chronic Disease; D046690:Deep Brain Stimulation; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000628:therapy*; D004292:Dominance, Cerebral / Q000502:physiology; D004565:Electroconvulsive Therapy; D004644:Emotions / Q000502:physiology; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000503:physiopathology; D011612:Psychosurgery; D012008:Recurrence; D019233:Retreatment; D017552:Solitary Nucleus / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation; D014630:Vagus Nerve / Q000503:physiopathology; D055536:Vagus Nerve Stimulation