Comparative study between cognitive adverse effects of bitemporal and bifrontal electroconvulsive therapy

Abstract

In the past 26 years, an increasing number of articles have been published about the effects of bitemporal and bifrontal electroconvulsive therapy (ECT) on cognitive functions. Here, we review these studies, because there have been conflicting reports about the extent and persistence of ECT cognitive adverse effects related to the electrode position. In total, eight psychological and medical databases (Medline, PubMed, Psych INFO, Science Direct, EMBASE, CINAHL, Cochrane, and Web of Knowledge) were searched during June 2016 to investigated studies from 1991 to 2016. The initial search presented 35 articles, of which 13 met the inclusion criteria. The articles studied the cognitive adverse effects of bitemporal and bifrontal ECT. If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, adequate information, and defined assessment measures. Comparisons were made by structured review with the results tabulated. In total, 13 potentially relevant publications were included, most of the included studies found that cognitive impairment is less noticed in bifrontal ECT than bitemporal ECT. Few authors did not see evidences of the advantage of bifrontal ECT regarding cognitive profile. Evidence suggests that cognitive impairment does occur because of bifrontal and bitemporal ECT. Objective measures found cognitive impairment to be relatively fewer and lasting for a short term in bifrontal ECT than bitemporal ECT.