Diencephalic stimulation and the effects of ECT in endogenous depression.

We compared conventional bilateral ECT treatment electrode placement with simultaneous unilateral electrode placement to both sides of the head (dominant/nondominant unilateral ECT) in 20 patients with endogenous depression. Under double-blind random assignment conditions we found that six bilateral ECT were significantly more effective than six dominant/nondominant unilateral ECT in reducing depression rating scale scores. In the light of data from intracerebral ECT current distribution studies we interpret our findings to support our previously advanced hypothesis that diencephalic stimulation is requisite for the therapeutic benefit of bilateral ECT in endogenous depression.