A Comparative Study of Clinical Outcome between Bifrontal and Bitemporal ECT among Patients with Schizophrenia

BACKGROUND: Optimizing efficacy and minimizing side effects of ECT are goals of ongoing technical refinements. Bifrontal ECT is a relatively newer technique when compared with Bitemporal ECT that needs evaluation in schizophrenia. AIMS: To compare clinical response and cognitive effects of bifrontal and bitemporal ECT. METHODS: 60 Patients prescribed ECT by treating Psychiatrists at LGBRIMH were enrolled. Patients were allotted to receive Bifrontal (n=30) or Bitemporal (n=30) ECT by matching their socio-demographic data (age, duration of illness, duration of untreated psychosis, duration of onset of illness, and BMI), between groups. The baseline severity of the illness was assessed by PANSS. Baseline cognitive assessment was done using PGI Memory scale. Modified Electroconvulsive therapy was administered using bitemporal and bifrontal electrode placement. 24 hours after 6 sessions of ECT, reassessment done by PANSS and PGI memory scale. Statistical analysis was done by appropriate methods using SPSS™. RESULTS: Change in PANSS score following bifrontal ECT was 40.9 and for bitemporal ECT was 36.83 and statistically not significant between two groups (F (df)=3.713(1,58), p=0.059). Bifrontal group showed a slight improvement in total PGI Memory Scale score when compared with baseline, while Bifrontal ECT group showed a slight decline in total PGI Memory Scale score when compared with baseline. Comparing between two groups was found to be statistically significant (F (df)=10.831(b) (1,58), p=0.002). CONCLUSION: Bifrontal ECT results in superior clinical and cognitive outcomes than Bitemporal ECT in schizophrenia.