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460; 95% CI 0.223-0.697; P less then 0.001). In 6 controlled studies, the reduction of depression was higher in the surgery group than in the control group (SDM = 0.161; 95% CI 0.027-0.295; P = 0.019). Cognitive function significantly improved after surgery (SDM = 0.254; 95% CI 0.120-0.388; P less then 0.001). In 4 controlled studies, the improvement of cognitive function was higher in the surgery group than in the control group (SDM = 0.188; 95% CI 0.002-0.374; P = 0.048). Results were stable after sensitivity analyses. CONCLUSIONS