Psychiatry Research EG

Background Several previous studies have shown that unilateral electrode placement produces relatively fewer cognitive adverse effects during electroconvulsive therapy (ECT). There are a few reports comparing bifrontal (BF) and bitemporal (BT) electrode placements during ECT. Objectives The objectives of the present study were to detect and compare cognitive impairment in patients receiving BT-ECT and BF-ECT. Patients and methods In a parallel, double-blind, randomized clinical trial, 40 patients with schizophrenia, bipolar disorder (mania), and major depressive disorder admitted to the psychiatric department of Al Menoufia University Hospital and Abbasia Mental Hospital (Egypt) were assigned randomly to BF (n = 19) and BT (n = 21) ECT groups. The primary outcome measures included the Montreal cognitive assessment (MoCA) scale. All patients were assessed with the ICD-10 checklist and the MoCA scale before receiving ECT. Patients were evaluated using the MoCA test after each even ECT session, and then monthly after the ECT course for 6 months. Results All patients received eight sessions of ECT. The two groups were matched with respect to their MoCA baseline scores. There was a significant difference between the MoCA scores of the BF compared with the BT group after the second ECT session until 3 months after the ECT course (P40.05) with better cognitive functions in the BF-ECT group. This advantage of the BF-ECT in the cognitive profile was restricted to language and executive functions until the end of the ECT course as well as attention abilities and memory assessment until the second and third month, respectively, after the ECT course. Conclusion BF-ECT was associated with fewer cognitive side effects and early recovery than BTECT. Keywords: cognitive impairment, electroconvulsive therapy, electrode placement