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


METHODS
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.
Sienaert
P
P
ECT Department, University Psychiatric Center, Catholic University of Leuven, campus Kortenberg, Leuvensesteenweg 517, 3070 Kortenberg, Belgium. pascal.sienaert@uc-kortenberg.be
Vansteelandt
K
K
Demyttenaere
K
K
Peuskens
J
J
D000328:Adult; D000368:Aged; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000503:physiopathology* / Q000628:therapy*; D004292:Dominance, Cerebral / Q000502:physiology; D004565:Electroconvulsive Therapy / Q000379:methods*; D056344:Executive Function / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012153:Retention, Psychology / Q000502:physiology; D014706:Verbal Learning / Q000502:physiology