Randomized comparison of ultra-brief bifrontal and unilateral electroconvulsive therapy for major depression: cognitive side-effects

Abstract Objective The cognitive side-effects of bifrontal (BF) and right unilateral (UL) ultra-brief pulse (0.3 ms) electroconvulsive therapy (ECT) were compared, in the treatment of patients with a depressive episode. Method Neuropsychological functioning in patients with a medication refractory d...

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Bibliographic Details
Published in:Journal of affective disorders 2010-04, Vol.122 (1), p.60-67
Main Authors: Sienaert, P, Vansteelandt, K, Demyttenaere, K, Peuskens, J
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Aged
Antidepressant drugs
Attention - physiology
Bifrontal ECT
Biological and medical sciences
Cognition Disorders - diagnosis
Cognition Disorders - physiopathology
Cognition Disorders - psychology
Cognitive function
Depression
Depressive Disorder, Major - physiopathology
Depressive Disorder, Major - therapy
Depressive disorders
Deterioration
Dominance, Cerebral - physiology
Electroconvulsive theraphy
Electroconvulsive therapy
Electroconvulsive Therapy - methods
Executive Function - physiology
Female
Follow-Up Studies
Frontal Lobe - physiopathology
Humans
Male
Medical sciences
Middle Aged
Mood disorders
Neuropsychological Tests - statistics & numerical data
Personality Inventory - statistics & numerical data
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychometrics
Psychopathology. Psychiatry
Pulse width
Retention (Psychology) - physiology
Side effects
Stimulus
Treatments
Unilateral ECT
Verbal Learning - physiology
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Summary:Abstract Objective The cognitive side-effects of bifrontal (BF) and right unilateral (UL) ultra-brief pulse (0.3 ms) electroconvulsive therapy (ECT) were compared, in the treatment of patients with a depressive episode. Method Neuropsychological functioning in patients with a medication refractory depressive episode, that were treated with a course of BF ultra-brief ECT at 1.5 times seizure threshold (ST) or UL ultra-brief ECT at 6 times ST, by random assignment, was assessed before treatment, and 1 and 6 weeks after the treatment course, by a blinded rater. Results Of the 64 patients that were included, 32 (50%) received BF ECT, and 32 (50%) received UL ECT, by random assignment. Neuropsychological testing 1 and 6 weeks after treatment was performed by 30 (93.75%) and 19 (59.37%) patients, respectively, in the BF-group and 29 (90.62%) and 20 (62.50%), respectively, in the UL-group. There was no deterioration in any of the neuropsychological measures. Patients rated their memory as clearly improved after treatment. There were no significant differences between the patients given BF ECT and those given UL ECT. Conclusions Ultrabrief pulse ECT, used either in combination with a UL electrode position and a stimulus of 6 times ST, or a BF electrode position with a stimulus of 1.5 times ST, are effective antidepressant techniques, that do not have a deleterious effect on cognitive function.
ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2009.06.011