Comparison of Bifrontal and Bitemporal Electroconvulsive Therapy in Patients with Major Depressive Disorder

Objective: The current study was conducted to compare the efficacy and side effects of bifrontal electrode placement with standard bitemporal electrode placement in the treatment of patients with major depression.
Method: Eighty nine patients with major depression were treated with a course of bifrontal or bitemporal ECT. All patients received 8 sessions of ECT treatment; and the Hamilton Rating scale for Depression and the standardized Mini-Mental state were administered 24 hours prior to the first session and 24 hours after the last session. This study was a Double Blind Randomized Clinical Trial.
Results: 68 of the 89 patients completed the study in the two groups of bifrontal (31 patients) and bitemporal (37 patients). The mean decrease in the Hamilton Rating scale for Depression score after ECT was the same in the both groups and was about 20 (SD 3/2),showing a significant difference between the 2 groups. Nevertheless, the mean decrease in Mini-Mental state Examination score was different in the 2 groups and was 0/67 for the bifrontal ECT group (SD 0/65) and 2/35 for the bitemporal ECT group (SD0/94),, indicating a statistically significant difference(P<0/001).
Conclusion: The result of this study demonstrates that cognitive side effects of bifrontal ECT were significantly lower than bitemperal ECT ; however, the two methods are the same with regards to efficacy.