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A critical examination of bifrontal electroconvulsive therapy: clinical efficacy, cognitive side effects, and directions for future research.
J ECT. 2008 Dec; 24(4):268-71.JE

Abstract

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.

Authors+Show Affiliations

Department of Psychiatry, Lutheran Hospital/Cleveland Clinic, Cleveland, OH, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18648318

Citation

Crowley, Kevin, et al. "A Critical Examination of Bifrontal Electroconvulsive Therapy: Clinical Efficacy, Cognitive Side Effects, and Directions for Future Research." The Journal of ECT, vol. 24, no. 4, 2008, pp. 268-71.
Crowley K, Pickle J, Dale R, et al. A critical examination of bifrontal electroconvulsive therapy: clinical efficacy, cognitive side effects, and directions for future research. J ECT. 2008;24(4):268-71.
Crowley, K., Pickle, J., Dale, R., & Fattal, O. (2008). A critical examination of bifrontal electroconvulsive therapy: clinical efficacy, cognitive side effects, and directions for future research. The Journal of ECT, 24(4), 268-71. https://doi.org/10.1097/YCT.0b013e318168e72c
Crowley K, et al. A Critical Examination of Bifrontal Electroconvulsive Therapy: Clinical Efficacy, Cognitive Side Effects, and Directions for Future Research. J ECT. 2008;24(4):268-71. PubMed PMID: 18648318.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A critical examination of bifrontal electroconvulsive therapy: clinical efficacy, cognitive side effects, and directions for future research. AU - Crowley,Kevin, AU - Pickle,Jody, AU - Dale,Roman, AU - Fattal,Omar, PY - 2008/7/24/pubmed PY - 2009/3/13/medline PY - 2008/7/24/entrez SP - 268 EP - 71 JF - The journal of ECT JO - J ECT VL - 24 IS - 4 N2 - 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. SN - 1533-4112 UR - https://www.unboundmedicine.com/medline/citation/18648318/A_critical_examination_of_bifrontal_electroconvulsive_therapy:_clinical_efficacy_cognitive_side_effects_and_directions_for_future_research_ L2 - https://doi.org/10.1097/YCT.0b013e318168e72c DB - PRIME DP - Unbound Medicine ER -