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Quantitative Electroencephalographic Analysis of Bifrontal Versus Bitemporal Electrode Placement in a Stable Maintenance Electroconvulsive Therapy Population

Moss, Lori MD*†; Vaidya, Nutan MD*

doi: 10.1097/YCT.0b013e3181b00f45
Original Studies

Objective: Electrode placement in electroconvulsive therapy (ECT) is one of the many variables that can influence clinical outcome. Quantitative electroencephalographic (EEG) measures of the ECT-induced seizure have been studied in an attempt to determine differences in various electrode placements. The objective of this study was to evaluate the differences in the EEG between bifrontal (BF) and bitemporal (BT) placement.

Method: Seventeen patients of maintenance ECT (10 males and 7 females) who received both BT and BF ECTs for a 12-month period starting January 2007 were identified through chart review. Patients were included if their medications, dosages and ECT parameters, and clinical condition remained stable during the study period. Each patient received both BF (n = 124) and BT (n = 112) placements.

Results: We found no significant differences in EEG measures between the 2 placements. We demonstrated that the qualitative EEG measures in both BT and BF electrode placements are similar.

Conclusions: Our findings support that BF electrode placement produces similar quality seizures when compared with BT placement and may be a viable alternative placement to BT.

From the *Department of Psychiatry and Behavioral Sciences, Rosalind Franklin University of Medicine and Science and †Veterans Affairs Medical Center, North Chicago, IL.

Received for publication April 21, 2009; accepted May 21, 2009.

Reprints: Lori Moss, MD, Department of Psychiatry and Behavioral Sciences, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, 60064 IL (e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.