What are the electrode placements for electroconvulsive therapy (ECT)?

Updated: Sep 24, 2019
  • Author: Mehul V Mankad, MD; Chief Editor: Dennis M Popeo, MD  more...
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Answer

Answer

Common electrode positions in ECT include the bitemporal, right unilateral (also known as the d'Elia placement), and bifrontal positions. [42]  Bitemporal electrode placement is often referred to as bilateral electrode placement. However, since both bitemporal and bifrontal electrode placements are bilateral, particular care should be given to nomenclature. Further research is needed for the asymmetric bilateral placement and other novel electrode placements. [1, 43]

With bitemporal position, electrodes are placed bifrontotemporally, with the center of each electrode approximately 1 inch above the midpoint of an imaginary line drawn from the tragus to the external canthus. [42]

With unilateral electrode placement, one electrode is typically placed over the nondominant frontotemporal area, and the other electrode is placed just lateral to the midline vertex on the nondominant side. [42]  As the left hemisphere is dominant in most people, unilateral electrode placement is almost always over the right hemisphere and is commonly referred to as right unilateral ECT.

In the bifrontal position, the placement of an electrode on each side of the head is more frontal than in bitemporal placement.


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