![]() ![]() Impairment in a nonverbal test was greater in the unilateral group after 4 treatments, but greater in the bilateral group 3 months after treatment. ![]() In the second study (16) the results were ambiguous. In the first study (15) impairment in one nonverbal test was somewhat greater after bilateral ECT than after unilateral ECT, but this difference was not statistically significant. Only two studies have addressed this issue directly, employing verbal and nonverbal memory tests with patients receiving bilateral or right unilateral ECT. Accordingly, if memory were assessed with nonverbal tests specifically sensitive to right temporal lobe dysfunction, the amnesic effect of right unilateral ECT might prove to be as great as or even greater than that of bilateral ECT. It has been suggested that the amnesic effects of left or right unilateral ECT may be similar to the effects of left or right temporal lobe dysfunction (18). However, since right unilateral ECT is specifically associated with impairment in nonverbal memory (e.g., memory for spatial relationships, faces, designs and other material that is difficult to encode verbally (14,17), and since most studies of ECT and memory loss have employed verbal memory tests, the actual extent of memory loss associated with right unilateral ECT has remained somewhat unclear. It has been generally accepted that right unilateral ECT is a clinically effective treatment that produces less impairment of new learning capacity and less amnesia for remote events than bilateral ECT (7,13). Memory functions gradually improve as time passes after treatment. For example, following conventional bilateral treatment, memory loss can extend to events that occurred many years before treatment as well as to events that occur during the weeks after treatment. The memory loss associated with electroconvulsive therapy treatment has been well documented (3,5). These findings, taken together with a consideration of the clinical efficacy of the two types of treatment, make what appears to be a conclusive case for unilateral over bilateral ECT.Įlectroconvulsive therapy (ECT) has long been considered an effective treatment for depressive illness (1,2). Nonverbal memory was affected less by right unilateral ECT than by bilateral ECT. Right unilateral ECT impaired delayed retention of nonverbal material without measurably affecting retention of verbal material. Bilateral ECT markedly impaired delayed retention of verbal and nonverbal material. The memory loss associated with bilateral and nondominant unilateral ECT was assessed with verbal memory tests known to be sensitive to left temporal lobe dysfunction. American Journal of Psychiatry 135:11, November 1978 ![]()
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