{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T02:26:49Z","timestamp":1786242409278,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,7,23]],"date-time":"2019-07-23T00:00:00Z","timestamp":1563840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Electroconvulsive therapy (ECT) has been shown to be the most effective and rapid treatment for severe depression. Electrode placement is one of the most important factors that affect ECT's efficacy and side\u2010effects profile. Bifrontal, bitemporal, and unilateral are the three most used electrode placements. Very few studies have directly compared the efficacy and cognitive side\u2010effects of the three placements. The aim of this study was to compare the efficacy and cognitive side\u2010effects associated with bifrontal, bitemporal, and unilateral electrode placements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multicenter randomized, blinded, controlled trial included 40 patients in each of the three groups. Most of the patients (94.8%) completed six ECT treatments. We used mixed\u2010model analyses to compare differences in 17\u2010item Hamilton Depression Rating Scale (HAMD\u201017) and Clinical Global Impression (CGI) scores among the three groups and the five times series (baseline, Week 1, Week 2, Week 3, and Week 4). The cognitive outcome was Mini\u2010Mental State Examination (MMSE) score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>HAMD\u201017 and CGI scores did not differ significantly across the groups (HAMD\u201017 scores: <jats:italic>z<\/jats:italic> =\u2009\u22121.13, <jats:italic>P<\/jats:italic> =\u20090.259; CGI scores: <jats:italic>z<\/jats:italic> =\u2009\u22120.35, <jats:italic>P<\/jats:italic> =\u20090.729). MMSE scores at pre\u2010 and post\u2010ECT were similar across the three groups (<jats:italic>F<\/jats:italic> =\u20092.06, <jats:italic>P<\/jats:italic> =\u20090.133). However, subgroup analysis using paired <jats:italic>t<\/jats:italic>\u2010tests showed that MMSE scores improved in the right unilateral and bifrontal groups (<jats:italic>t<\/jats:italic> =\u20092.745, <jats:italic>P<\/jats:italic> =\u20090.0098; <jats:italic>t<\/jats:italic> =\u20092.464, <jats:italic>P<\/jats:italic> =\u20090.0204), but did not change in the bitemporal group (<jats:italic>t<\/jats:italic> =\u20091.188, <jats:italic>P<\/jats:italic> =\u20090.2461).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The efficacy of right unilateral and bifrontal ECT placement was similar to that of bitemporal ECT. The physical side\u2010effects were also similar across the three groups. Right unilateral and bifrontal ECT placement were associated with improved cognitive outcomes, but bitemporal ECT placement was not.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pcn.12907","type":"journal-article","created":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T17:58:52Z","timestamp":1562003932000},"page":"636-641","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Multicenter randomized controlled trial of bifrontal, bitemporal, and right unilateral electroconvulsive therapy in major depressive disorder"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9149-4864","authenticated-orcid":false,"given":"Liang","family":"Su","sequence":"first","affiliation":[{"name":"Department of Psychiatry Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Department of Psychiatry, Huashan Hospital Fudan University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuping","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiqiao","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenxun","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Huashan Hospital Fudan University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mellor","sequence":"additional","affiliation":[{"name":"School of Psychology Deakin University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifeng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60660-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60046-5"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMct075234"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2015.15030372"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2010.06.009"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.14r09145"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00008506-200104000-00005"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e3182182be0"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.03.039"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.yct.0000187041.79087.59"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.109.066183"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e3181e48154"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12705-5"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/15622975.2011.615863"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-977X(15)30033-X"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2010.11.001"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e318279c2c9"},{"key":"e_1_2_8_19_1","first-page":"30","article-title":"Evaluation of the reliability and validity of Chinese version of the Mini\u2010International Neuropsychiatric Interview in patients with mental disorders","volume":"23","author":"Mei ST","year":"2009","journal-title":"Chin. 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