Document Detail

A critical examination of bifrontal electroconvulsive therapy: clinical efficacy, cognitive side effects, and directions for future research.
MedLine Citation:
PMID:  18648318     Owner:  NLM     Status:  MEDLINE    
Bifrontal (BF) electroconvulsive therapy (ECT), although researched less extensively than bitemporal (BT) or right unilateral (RUL) ECT, has been suggested to be comparable to the other 2 electrode placements with respect to clinical efficacy while resulting in less cognitive impairment than BT ECT. Imaging studies have indicated that seizures induced by BF ECT affect the brain differently than BT or RUL ECT, in that BF ECT increases cerebral blood flow in the frontal lobes more intensely than either of the other 2 placements. Therefore, it is possible that the cognitive impairment manifested after a course of BF ECT could also be different than the impairment seen with BT and RUL ECT. Research conducted on cognitive impairment from BF ECT to date has been inadequate due to the use of nonspecific cognitive measures (such as the Mini-Mental Status Examination) or an inordinate focus on memory functioning (which is believed to be mostly subsumed in the temporal lobes). Because BF ECT increases cerebral blood flow in the frontal lobes more intensely than either of the other placements, research must instead focus on investigating the possible effects of BF ECT on executive functioning, which is believed to be subsumed in the frontal lobes. This is especially important because of the established relationship between executive dysfunction and depression and also because of the increasing popularity of BF ECT.
Kevin Crowley; Jody Pickle; Roman Dale; Omar Fattal
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The journal of ECT     Volume:  24     ISSN:  1533-4112     ISO Abbreviation:  J ECT     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-05     Completed Date:  2009-03-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808943     Medline TA:  J ECT     Country:  United States    
Other Details:
Languages:  eng     Pagination:  268-71     Citation Subset:  IM    
Department of Psychiatry, Lutheran Hospital/Cleveland Clinic, Cleveland, OH, USA.
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MeSH Terms
Cognition Disorders / etiology*,  psychology*
Depressive Disorder, Major / psychology*,  therapy*
Electroconvulsive Therapy / adverse effects,  methods*
Frontal Lobe*
Functional Laterality
Psychomotor Performance / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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