A systematic review of left unilateral electroconvulsive therapy

Kellner, Charles H.; Farber, Kate G.; Chen, X. R.; Mehrotra, Anita; Zipursky, Gillian

doi:10.1111/acps.12740

Cited by 17 publications

(13 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The short-term cognitive side effects of ECT change depending on the electrode placement (i.e., bilateral vs. unilateral). Right unilateral electrode placement has been shown to have less cognitive side effects than bilateral electrode placement (Kolshus et al, 2017), and left unilateral electrode placement tended to have more verbal memory impairment than right unilateral electrode placement (Kellner et al, 2017). The interpretation of these results is understandable based on the theory that the left hemisphere is dominant for language and verbal processing for most people.…”

Section: Discussionmentioning

confidence: 99%

Electroconvulsive Therapy Modulates Resting-State EEG Oscillatory Pattern and Phase Synchronization in Nodes of the Default Mode Network in Patients With Depressive Disorder

Takamiya

Hirano

Yamagata

et al. 2019

Front. Hum. Neurosci.

View full text Add to dashboard Cite

Introduction: Electroconvulsive therapy (ECT) has antidepressant effects, but it also has possible cognitive side effects. The effects of ECT on neuronal oscillatory pattern and phase synchronization, and the relationship between clinical response or cognitive change and electroencephalogram (EEG) measurements remain elusive.Methods: Individuals with unipolar depressive disorder receiving bilateral ECT were recruited. Five minutes of resting, eyes-closed, 19-lead EEG recordings were obtained before and after a course of ECT. Non-overlapping 60 artifact-free epocs of 2-s duration were used for the analyses. We used exact low resolution electromagnetic tomography (eLORETA) to compute the whole-brain three-dimensional intracortical distribution of current source density (CSD) and phase synchronization among 28 regions-of-interest (ROIs). Paired t-tests were used to identify cortical voxels and connectivities showing changes after ECT. Montgomery Asberg Depression Rating Scale (MADRS) and Mini-Mental State Examination (MMSE) were used to evaluate the severity of depression and the global cognitive function. Correlation analyses were conducted to identify the relationship between changes in the EEG measurements and changes in MADRS or MMSE.Results: Thirteen depressed patients (five females, mean age: 58.4 years old) were included. ECT increased theta CSD in the anterior cingulate cortex (ACC), and decreased beta CSD in the frontal pole (FP), and gamma CSD in the inferior parietal lobule (IPL). ECT increased theta phase synchronization between the posterior cingulate cortex (PCC) and the anterior frontal cortex, and decreased beta phase synchronization between the PCC and temporal regions. A decline in beta synchronization in the left hemisphere was associated with cognitive changes after ECT.Conclusion: ECT modulated resting-state EEG oscillatory patterns and phase synchronization in central nodes of the default mode network (DMN). Changes in beta synchronization in the left hemisphere might explain the ECT-related cognitive side effects.

show abstract

Section: Discussionmentioning

confidence: 99%

Electroconvulsive Therapy Modulates Resting-State EEG Oscillatory Pattern and Phase Synchronization in Nodes of the Default Mode Network in Patients With Depressive Disorder

Takamiya

Hirano

Yamagata

et al. 2019

Front. Hum. Neurosci.

View full text Add to dashboard Cite

show abstract

“…The search strategy identified 2882 citations (PubMed 675, Embase 816, Scopus 707 and PsycINFO 684). Ten additional references were then added from a recent systematic review . Following the removal of duplicates and screening by two independent reviewers (FL and RT), 66 references were screened against the study inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

A systematic review and computational modelling analysis of unilateral montages in electroconvulsive therapy

Martin

Lin

Bai

et al. 2019

Acta Psychiatr Scand

View full text Add to dashboard Cite

S, Loo CK. A systematic review and computational modelling analysis of unilateral montages in electroconvulsive therapy Objective: To examine the clinical outcomes of ECT unilateral placements compared in prior studies and apply insights from computational modelling to understand differences between placements. Methods: PubMed, Embase, Scopus and PsycINFO and reference lists were systematically searched for studies of depressed patients where two unilateral placements were compared and clinical outcomes were reported. Computational modelling was done to generate electric field maps for each unilateral placement identified in the systematic review. Results: A total of 29 studies met criteria for inclusion. Eight studies reported efficacy outcomes and 23 studies reported cognitive outcomes. Most studies found no significant difference in efficacy between right unilateral (RUL) and left unilateral (LUL) ECT, and no difference was found between temporo-parietal and fronto-temporal ECT. For the majority of studies, RUL placements had better verbal anterograde memory outcomes compared with the LUL placements. There was some evidence suggestive of cognitive advantages for fronto-frontal and fronto-parietal placements relative to temporo-parietal ECT. Conclusions: For efficacy, studies mainly focused on the comparison of right vs. left hemispheric stimulation, with the available evidence suggesting no substantive difference. RUL placements tended to have better verbal anterograde memory outcomes relative to LUL placements, though limited differences were found between the RUL placements.• RUL and LUL ECT were found to be comparable in efficacy in most studies.• RUL tended to have better verbal memory outcomes relative to LUL ECT placements. • Fronto-frontal and fronto-parietal placements may be superior to temporo-parietal placement in cognitive outcomes. Limitations• The included studies were small, and heterogeneous in methodology and the reporting of treatment methods and clinical outcomes.• Insufficient report of unilateral montage details in the included studies may have hindered the accuracy of interpreting the clinical outcomes and computational modelling. 408

show abstract

“…A) Bilateral ECT is traditional with placement on both temples. B) While right unilateral placement on the right temple and 2 cm right from the vertex is increasingly used, studies suggest that administering the stimulus to the nondominant hemisphere causes fewer cognitive side-effects [10]. C) Bifrontal electrodes are in a small study as efficacious as bitemporal placement and with less cognitive impairment [10].…”

Section: Declaration Of Competing Interestmentioning

confidence: 99%

Cochlear implant should not be absolute contraindication for electroconvulsive therapy and transcranial magnetic stimulation

et al. 2020

View full text Add to dashboard Cite

A systematic review of left unilateral electroconvulsive therapy

Cited by 17 publications

References 58 publications

Electroconvulsive Therapy Modulates Resting-State EEG Oscillatory Pattern and Phase Synchronization in Nodes of the Default Mode Network in Patients With Depressive Disorder

Electroconvulsive Therapy Modulates Resting-State EEG Oscillatory Pattern and Phase Synchronization in Nodes of the Default Mode Network in Patients With Depressive Disorder

A systematic review and computational modelling analysis of unilateral montages in electroconvulsive therapy

Cochlear implant should not be absolute contraindication for electroconvulsive therapy and transcranial magnetic stimulation

Contact Info

Product

Resources

About