2005 issue 3

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Volume 14, issue 3

Review article

Bifrontal electroconvulsive therapy - comparison of efficacy and tolerance to right unilateral and bitemporal electrode placement

DANUTA PALIŃSKA1, Tomasz Sobów1, Iwona Kłoszewska1
1. Klinika Psychiatrii Wieku Podeszłego i Zaburzeń Psychotycznych Uniwersytetu Medycznego w Łodzi
Postępy Psychiatrii i Neurologii 2005; 14 (3): 195-207
Keywords: bifrontal electroconvulsive therapy, cognitive impairment, right unilateral electroconvulsive therapy, bitemporal electroconvulsive therapy

Abstract

Objective. Ever since electroconvulsive therapy was introducedfor mental disorders, researchers have been striving to improve the performance of the interventions so as to increase their efficacy and reduce the risk of the electric current harming cognitive functions.

Review. One of the focuses of research is electrode placement. Unilateral placement over the non-dominant hemisphere causes fewer complications in the form of disturbed memory and learning but it is often less effective than bitemporal or bifrontal electrode placement. On the other hand, bitemporal placement involves greater risk ofdamaging the cognitivefunctions. Bifrontal electroconvulsions were first conducted in 1973 and reverted to in the nineteen-nineties. This is when the Canadian researchers, Lawson et al. published their work supporting earlier hypotheses that bifrontal electroconvulsions are just as effective for the treatment of depression as bitemporal electroconvulsions but cause less harm to the cognitive functions.

Conclusions. Bifrontal electrode placement is gaining more and more acclaim world-wide. However, there is still too little research comparing bifrontal placement with other placements to recommend bifrontal placement as the treatment of choice in the managing of mental disorders.

Address for correspondence:
Dr Danuta Palińska, Klinika Psychiatrii Wieku Podeszłego i Zaburzeń Psychotycznych Uniwersytetu Medycznego,
ul. Czechosłowacka 8/10, 92-216 Łódź, tel./fax: (42) 6783699