PINS Stimulator System for Patients With Treatment Resistant Depression

Inclusion Criteria: 1. Subject is aged ages 20-70 years 2. Diagnosed with non-psychotic major depressive disorder, single or recurrent episode by DSM-IV-TR criteria 3. First episode onset before age 45 4. Current episode \> 12 months duration 5. In the current episode: Documented resistance (i.e. persistence of the major depressive episode) to a minimum of 4 adequate depression treatments from at least 3 different treatment categories (e.g. SSRI's) 6. SNRI's, TCA's, MAO-inhibitors, Mirtazipine, Nefazodone, Trazodone, Bupropion, lithium augmentation, thyroid augmentation, ECT); Adequacy of treatments as defined by a score of at least 3 according to the amended Antidepressant Treatment History Form (ATHF) criteria 7. Hamilton Depression Rating Scale (HDRS) of \> 20 at 3 separate baseline visits, rated by 2 separate psychiatrists, Baseline 2 and Baseline 3 HDRS scores cannot improve ≥ 25% Exclusion Criteria: 1. Patients with hearing impairment 2. Failures of important organs and in severe conditions 3. Be reluctant or disabled to receive neuropsychological assessments; 4. Participate in other clinical trial 5. Has a life expectancy of \< 1 year 6. The investigator and/or enrollment review committee, would preclude participation in the study