Back

Non-ablative stereotactic radiosurgery for subgenual cingulate neuromodulation in treatment-resistant depression: a randomized dose-seeking pilot trial

Zhao, Y.; Bai, Y.; Yu, A.; Jin, X.; Zhenxiang, Z.; Zou, F.; Ma, Q.; Wang, B.; Zhu, X.; Yang, Z.; Hang, H.; Wang, Y.; Wang, J.; Wang, C.; Liu, X.; Xu, Y.; Qin, Q.; Sun, G.; Wang, Y.; Qu, B.; Zhang, J.; Zhang, L.; Wu, H.; Adler, J. R.; Pan, L.; Wang, G.

2026-08-17 neurology
10.64898/2026.08.13.26360283 medRxiv
Show abstract

The subgenual anterior cingulate cortex (sgACC) is a key node in treatment-resistant depression (TRD), but precise non-invasive neuromodulation of this target is challenging. Preclinical studies of non-ablative stereotactic radiosurgery (SRS) have shown neuromodulatory ("radiomodulation") effects. In this single-center, double-masked, randomized, dose-seeking pilot trial, nine adults with TRD were randomly assigned to bilateral sgACC radiomodulation at a dose of either 15, 20, or 25 Gy per hemispheric target. Primary endpoints were safety and feasibility; the efficacy endpoint was week-4 change in the Montgomery-Asberg Depression Rating Scale (MADRS). Both primary endpoints were met: the only treatment-related adverse event was transient grade 1 dizziness, with no structural MRI abnormality through week 12. Mean MADRS fell from 33.0 to 17.0 (48.5% reduction); 67% responded and 44% remitted, with benefit sustained to week 12. Resting-state fMRI revealed regional connectivity changes correlating with clinical improvement, with tractography showing streamline counts differing by response status. These first-in-human findings support a larger randomized controlled trial of sgACC radiomodulation for TRD. ClinicalTrial.gov registration: NCT07274917.

Matching journals

The top 15 journals account for 50% of the predicted probability mass.

50% of probability mass above

"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.