title: Cognitive Effects of Bifrontal Versus Right Unilateral Electroconvulsive Therapy in the Treatment of Major Depression in Elderly Patients: A Randomized, Controlled Trial.
abstract: OBJECTIVE
  Bifrontal (BF) electrode placement has been explored to refine the electroconvulsive therapy (ECT) technique. No previous study has compared the cognitive effects of BF versus right unilateral (RUL) ECT by only including the subgroup that is most likely to receive it: elderly patients with major depression.
  
  
  METHODS
  Nondemented patients (n = 65) with major depression, aged 60 to 85 years, were randomly allocated to BF ECT and RUL formula-based ECT. Cognitive function was assessed at baseline (T1), within 1 week after a course of ECT (T2), and 3 months after T2 (T3). Six neuropsychological test measures of memory, 5 of executive function, and 3 of information-processing speed were administered.
  
  
  RESULTS
  According to linear mixed models, there were no significant differences between the BF and RUL groups at any time. The retrograde memory score for public facts declined more for the RUL group (P < 0.001) than the BF group (P = 0.005) from baseline to the first retest and remained stable for both groups from T2 to T3. A rapid improvement in selective attention was observed in the RUL group from T1 to T2, but the scores remained stable from T2 to T3 (P < 0.001). This measure remained stable in the BF group from T1 to T3.
  
  
  CONCLUSIONS
  Our findings indicate that there were negligible differences in the cognitive effects of formula-based BF or RUL ECT. The overall cognitive effects of ECT were equally favorable for each of the groups.
authors.affiliation: From the *Department of Geriatric Psychiatry, Diakonhjemmet Hospital; †Institute of Clinical Medicine, Campus Ahus, University of Oslo; ‡HØKH, Research Centre; and §Department of Research and Development in Mental Health, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Gro Strømnes
authors.initials: GS
authors.lastname: Dybedal
authors.forename: Tor Magne
authors.initials: TM
authors.lastname: Bjølseth
authors.forename: Jūratė Šaltytė
authors.initials: JŠ
authors.lastname: Benth
authors.forename: Lars
authors.initials: L
authors.lastname: Tanum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D004566:Electrodes; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D016037:Single-Blind Method; D016896:Treatment Outcome