{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T15:31:45Z","timestamp":1793287905093,"version":"4.5.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"funder":[{"name":"Universit\u00e4tsklinikum T\u00fcbingen","id":[{"id":"https:\/\/ror.org\/00pjgxh97","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nervenarzt"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund<\/jats:title>\n                    <jats:p>Depressive St\u00f6rungen gehen mit hoher Krankheitslast einher; ein relevanter Anteil der Patient:innen spricht trotz leitliniengerechter Pharmako- und Psychotherapie unzureichend an, insbesondere bei therapieresistenter Depression (TRD). Neuromodulation etabliert sich als vierte S\u00e4ule der Depressionsbehandlung und umfasst Elektrokonvulsionstherapie (EKT), repetitive transkranielle Magnetstimulation (rTMS), Vagusnervstimulation (VNS), transkranielle elektrische Stimulation (tES), Magnetkonvulsionstherapie (MKT), tiefe Hirnstimulation (THS) und Neurofeedback (NF). Trotz teilweiser gut belegter Wirksamkeit sind diese Verfahren bislang nicht ausreichend in die Regelversorgung integriert. Ziel ist die Darstellung der Evidenzlage und zentraler Implementierungsbarrieren.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material und Methoden<\/jats:title>\n                    <jats:p>Narrative Auswertung klinischer Studien, Metaanalysen und Versorgungsdaten zu Wirksamkeit, Sicherheit und kognitiver Vertr\u00e4glichkeit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>F\u00fcr EKT besteht die beste Evidenz hinsichtlich Akut- und Erhaltungstherapie schwerer depressiver St\u00f6rungen; rTMS ist wirksam und kognitiv gut vertr\u00e4glich. VNS kann eine additive Langzeitoption bei TRD darstellen. F\u00fcr tES werden kleine, heterogene Effekte berichtet. MKT und THS bleiben experimentell; f\u00fcr NF fehlen konsistente Wirksamkeitsnachweise. Zentrale Barrieren sind teilweise heterogene Protokolle, unzureichende Finanzierungsstrukturen, insbesondere im ambulanten Bereich, und fehlende Qualifikationsstandards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerungen<\/jats:title>\n                    <jats:p>Neuromodulation sollte systematisch in gestufte Versorgungsmodelle integriert werden. Standardisierte Protokolle und Registerforschung sind erforderlich, um eine strukturierte und nachhaltige Implementierung neuromodulatorischer Verfahren in die klinische Versorgung zu erm\u00f6glichen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00115-026-01999-8","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T12:02:20Z","timestamp":1785931340000},"page":"540-545","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuromodulation als vierte S\u00e4ule in der Depressionsbehandlung","Neuromodulation as the fourth pillar in the treatment of depression"],"prefix":"10.1007","volume":"97","author":[{"given":"Sarah","family":"Kayser","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrix","family":"Barth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malek","family":"Bajbouj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Christine","family":"Ehlis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin F.","family":"Gerchen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Karim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Koti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils B.","family":"Kroemer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fritz-Georg","family":"Lehnhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Nickl-Jockschat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Nitsche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Luise","family":"Otte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Plewnia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Sartorius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan R.","family":"Schweinberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Siodmiak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surjo R.","family":"Soekadar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Vardiero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Vogelmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tino","family":"Zaehle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Ziemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zilles-Wegner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Gharabaghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Fallgatter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"1999_CR1","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1176\/appi.ajp.2017.16010034","volume":"174","author":"ST Aaronson","year":"2017","unstructured":"Aaronson\u00a0ST, Sears\u00a0P, Ruvuna\u00a0F et\u00a0al (2017) A 5\u2011Year Observational Study of Patients With Treatment-Resistant Depression Treated With Vagus Nerve Stimulation or Treatment as Usual: Comparison of Response, Remission, and Suicidality. 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