Description |
Although many researchers have examined the effects of electroconvulsive therapy (ECT) on memory and cognition, few investigators have studied the neurocognitive effects of bifrontal electrode placement in ECT treatment. The current study was designed to examine the clinical efficacy and neurocognitive effects of bifrontal ECT. Participants included 17 adults between the ages of 23 and 62 years of age, all of whom had been diagnosed with unipolar or bipolar depression and met hospital criteria for ECT treatment, that is, had failed other treatment efforts. Recruitment of participants took place between 2009 and 2010 at a university-based psychiatric hospital. Following consent to participate and assurance that recruits met study criteria, a psychiatric interview was conducted and psychological/neuropsychological tests were administered. The tests were selected for the purpose of quantifying depressive symptoms and cognitive skills thought to be affected by ECT (anterograde and retrograde memory, executive functions, and processing speed). Results of the study demonstrated that bifrontal ECT can be an effective treatment of depression in that 88% of participants showed reduced depressive symptoms immediately after ECT treatment and 77% of these initial remitters continued to show response to treatment 1 month later. Although data also showed that the participants had posttreatment problems with retrograde amnesia which had not resolved by follow-up 1 month later, and had impaired verbal fluency immediately posttreatment which remitted by follow-up, there were no indications that the ECT treatment caused anterograde memory problems or other nonmemory cognitive problems. Specifically data showed no ill effects of bifrontal ECT on processing speed and executive functions (inhibition, motor planning and response, sequencing, and cognitive flexibility). Without a control group or randomized assignment to treatment, no firm conclusions can be drawn from the current findings; however, the findings are important in that they suggest that bifrontal ECT treatment is as effective in addressing treatmentresistant depression as other ECT methods which entail electrode placements that may produce greater and more persistent cognitive side effects, including bitemporal ECT. |