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

Sienaert, P.; Vansteelandt, K.; Demyttenaere, K.; Peuskens, J.

doi:10.1016/j.jad.2009.06.011

« Previous Next »Journal of Affective Disorders
Volume 122, Issue 1 , Pages 60-67, April 2010

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

P. Sienaert
- ECT Department, University Psychiatric Center, Catholic University of Leuven, campus Kortenberg, Leuvensesteenweg 517, 3070 Kortenberg, Belgium
- Department of Mood Disorders, University Psychiatric Center, Catholic University of Leuven, campus Kortenberg, Leuvensesteenweg 517, 3070, Kortenberg, Belgium
- Corresponding author. University Psychiatric Center, Catholic University of Leuven, campus Kortenberg, Leuvensesteenweg 517, 3070 Kortenberg, Belgium. Tel.: +32 2 758 5 11; fax: +32 2 759 53 80.
K. Vansteelandt
- University Psychiatric Center, Catholic University of Leuven, campus Kortenberg, Kortenberg, Belgium
K. Demyttenaere
- University Psychiatric Center, Catholic University of Leuven, campus Leuven, Leuven, Belgium
J. Peuskens
- University Psychiatric Center, Catholic University of Leuven, campus Kortenberg, Kortenberg, Belgium

Received 21 February 2009; received in revised form 10 June 2009; accepted 11 June 2009.

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.

Keywords: Electroconvulsive theraphy, Cognitive function, Depressive disorders, Pulse width, Bifrontal ECT, Unilateral ECT