Table 1 Electrode placement and bipolar mania
From: Electroconvulsive therapy electrode placement for bipolar state-related targeted engagement
|  | Electrode placement, study design | N (age ± SD) | Stimulation parameters | Clinical assessment | Clinical outcome |
|---|---|---|---|---|---|
Electrode placement comparison | |||||
 Barekatain et al. (2008) | BT, seizure threshold | 14 (27.4 ± 9) | 1 ms PW, 900 mA, thrice weekly | Young Mania Rating Scale, response criteria > 50% improvement | No significant difference between groups; all completers met response criteria |
BF, 1.5 times seizure threshold | 14 (23.7 ± 4) | ||||
 Hiremani et al. (2008) | BT, 1.5 times seizure threshold | 19 (28.7 ± 9) | 1.5 × ST, 1.5 ms PW, 800 mA, thrice weekly | Young Mania Rating Scale | No significant group differences (88% response for BF, 72% for BT) but BF had a faster response evident by the third ECT treatment |
BF, 1.5 times seizure threshold | 17 (25.8 ± 9) | ||||
No electrode placement comparison | |||||
 Mohan et al. (2009) | BT, seizure threshold | 26 (28.1 ± 7) | 1.5 ms pulse width, 800 mA current amplitude, twice weekly | Young Mania Rating Scale, remission < 10 | 23/26 (88.5%) remitted |
BT, 2.5 times seizure threshold | 24 (25.7 ± 7) | 21/24 (87.5%) remitted | |||
 Jahangard et al. (2012) | BF, 1.5 times seizure threshold with sodium valproate | 21 (32.8 ± 10) | Parameters not documented, thrice weekly | Young Mania Rating Scale, Primary assessment completed after 6th ECT treatment | Pre-ECT YMRS = 33 ± 10 to 6th-ECT YMRS = 19 ± 7 |
BF, 1.5 times seizure threshold without sodium valproate | 21 (31.43 ± 9) | Pre-ECT YMRS = 33 ± 5 to 6th-ECT YMRS = 24 ± 6 (no group differences) | |||
 Rezaei et al. (2012) | BT, pre-medicated with remifentanil | 15 BT (30.8 ± 9) | 1 ms pulse width, other parameters not documented | Young Mania Rating Scale | Pre-ECT YMRS = 29 ± 8 to end-ECT YMRS = 10 ± 9 |
BT, pre-medicated with saline | 14 BT (29.2 ± 9) | Pre-ECT YMRS = 28 ± 6 to End-ECT YMRS = 13.3 ± 8 (no group differences) | |||
 Perugi et al. (2017) | BT, age-based algorithm, community setting | 8 BT (41.0 ± 11) | 1 ms, pulse width 1.5–4 ms, 800 mA, twice weekly | Clinical Global Impression Improvement Scale, responder ≤ 2 | 75% response rate |