Electroconvulsive therapy and determination of cerebral dominance

Annals of General Hospital Psychiatry - Tập 3 - Trang 1-4 - 2004
Milan Dragovic1, Lindsay Allet2, Aleksandar Janca2,3
1Centre for Clinical Research in Neuropsychiatry, Graylands Hospital, Perth, Australia
2Inner City Mental Health Service, Royal Perth Hospital, Perth, Australia
3School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia

Tóm tắt

Electroconvulsive therapy (ECT) often results in a number of short- and long-time side effects including memory impairment for past and current events, which can last for several months after ECT treatment. It has been suggested that unilateral ECT (uECT) with electrodes placed over the non-dominant (typically right) hemisphere significantly reduces side effects, especially memory disturbances. It is important to note that cerebral dominance equates to speech dominance and avoiding this area of the brain also reduces speech dysfunction after ECT. Traditionally, the routine clinical determination of cerebral dominance has been through the assessment of hand, foot and eye dominance, which is an easy and inexpensive approach that, however, does not ensure accuracy. This review of literature on different methods and techniques for determination of cerebral dominance and provides evidence that functional transcranial Doppler sonography (fTCD) represents a valid and safe alternative to invasive techniques for identifying speech lateralisation. It can be concluded that fTCD, notwithstanding its costs, could be used as a standard procedure prior to uECT treatment to determine cerebral dominance, thereby further reducing cognitive side-effects of ECT and possibly making it more acceptable to both patients and clinicians.

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Annals of General Hospital Psychiatry

Tập 3

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