About ECT

Let me explain a little bit about the bifrontal method of electroconvulsive therapy I will be receiving. It is a newer application of electrodes, but the studies I have seen on it do seem promising, although we don't know as much about it since it hasn't had the time to be used long-term or even experience widespread usage.

The Three Types of ECT Currently Available

• Bilateral: I think this was the older electrode placement. In this placement, the electrodes are placed on the temples of the face, one on either side. During the procedure, electricity travels between the two electrodes through the temporal lobes of the brain. This placement has shown to be the most effective, but also carries the highest risk of memory effects. The electricity used is I believe about one-and-a-half times the seizure threshold, the seizure threshold being the amount of electricity required to initiate a seizure.
• Unilateral: Pretty sure this one is newer than bilateral. In this form of ECT, two electrodes are placed on the same side of the head, on the temple. This way there is no electric circuit travelling across the brain, but is instead limited to one side of the brain, I assume this one is effecting the temporal lobe as well. Although this placement is effecting a smaller portion of the brain, it is done at a minimum of six times the seizure threshold of the individual. Although the cognitive and memory effects have been shown to be significantly lower than the bilateral placement, the effectiveness unfortunately is noteably lower as well.
• Bifrontal: This is the newest placement. During this procedure the electrodes are place on either side of the front of the forehead and I believe the amount of electrical current used is similar to that in bilateral. The point of this placement is to avoid running current through the temporal lobes all together, which are attributed substantially to memory. Indeed, the effeated that bifrontal may carry more weight in side effects of a cognitive rather than memory nature. Time will tell, I suppctiveness of this placement is nearly comparable to bilateral with a lower memory side effect profile, however one has to wonder about cognitive effects instead, since the frontal lobes are attributed to cognitive functioning. It has been speculose.