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Therapeutic advantage of bifrontal electrode placement in ECT

Published online by Cambridge University Press:  09 July 2009

F. J. J. Letemendia ,
N. J. Delva ,
M. Rodenburg ,
J. S. Lawson ,
J. Inglis ,
J. J. Waldron  and
D. W. Lywood
F. J. J. Letemendia*
Affiliation:
Departments of Psychiatry and Biomedical Engineering, Queen's University and the Kingston Psychiatric Hospital, Kingston, Ontario, Canada
N. J. Delva
Affiliation:
Departments of Psychiatry and Biomedical Engineering, Queen's University and the Kingston Psychiatric Hospital, Kingston, Ontario, Canada
M. Rodenburg
Affiliation:
Departments of Psychiatry and Biomedical Engineering, Queen's University and the Kingston Psychiatric Hospital, Kingston, Ontario, Canada
J. S. Lawson
Affiliation:
Departments of Psychiatry and Biomedical Engineering, Queen's University and the Kingston Psychiatric Hospital, Kingston, Ontario, Canada
J. Inglis
Affiliation:
Departments of Psychiatry and Biomedical Engineering, Queen's University and the Kingston Psychiatric Hospital, Kingston, Ontario, Canada
J. J. Waldron
Affiliation:
Departments of Psychiatry and Biomedical Engineering, Queen's University and the Kingston Psychiatric Hospital, Kingston, Ontario, Canada
D. W. Lywood
Affiliation:
Departments of Psychiatry and Biomedical Engineering, Queen's University and the Kingston Psychiatric Hospital, Kingston, Ontario, Canada
*
1Address for correspondence: Dr F. J. J. Letemendia, Department of Psychiatry, Queen's University, Kingston, Ontario K7L 3N6, Canada.
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Synopsis

Fifty-nine patients suffering from a major depressive episode, for whom electroconvulsive therapy (ECT) was clinically indicated, were randomly assigned to one of three electrode placement groups for treatment with brief pulse, threshold-level ECT: bitemporal (BT), right unilateral (RU) or bifrontal (BF). Comparison of these groups in terms of number of treatments, duration of treatment, or incidence of treatment failure, showed that the bilateral placements were superior to the unilateral; comparison of Hamilton, Montgomery–Åsberg, and visual analogue scale scores showed that the bifrontal placement was superior to both bitemporal and unilateral treatment. Bitemporal treatment showed therapeutic results intermediate between BF and RU. Because BF ECT causes fewer cognitive side effects than either RU or BT, and is independently more effective, it should be considered as the first choice of electrode position in ECT.

Type
Original Articles
Information
Psychological Medicine , Volume 23 , Issue 2 , May 1993 , pp. 349 - 360
Copyright
Copyright © Cambridge University Press 1993

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