4.6 Article

Functional connectivity between the habenula and default mode network and its association with the antidepressant effect of ketamine

Journal

DEPRESSION AND ANXIETY
Volume 39, Issue 5, Pages 352-362

Publisher

WILEY
DOI: 10.1002/da.23238

Keywords

default mode network; depression; functional connectivity; habenula; ketamine

Funding

  1. National Natural Science Foundation of China [81801345]

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This study explored changes in resting-state functional connectivity of the Hb in responders and nonresponders diagnosed with unipolar or bipolar depression before and after ketamine treatment. Results suggest that ketamine may exert its antidepressant efficacy through downregulation of aberrant habenular functional connectivity with parts of the default mode network.
Background Recently, an animal model for depression has shown that ketamine, an N-methyl- d-aspartate receptor (NMDAR) antagonist, elicits a rapid-acting antidepressant effect by blocking NMDAR-dependent bursting in the lateral habenula (Hb). However, evidence from human studies remains scarce. Methods This study explored the changes of resting-state functional connectivity (FC) of the Hb in responders and nonresponders who was diagnosed with unipolar or bipolar depression before and after ketamine treatment. The response was defined as a >= 50% reduction in the total MADRS score at Day 13 (24 h following the sixth infusion) in comparison with the baseline score. Correlation analyses were performed to identify an association between symptom improvement and the signals of the significantly different brain regions detected in the above imaging analysis. Results In the post-hoc region-of-interest analysis, an enhanced baseline FC between Hb and several hubs of the default mode network (including angulate cortex, precuneus, medial prefrontal cortex, and middle temporal cortex) was observed in responders (>= 50% decrease in the Montgomery-Asberg Scale at 2 weeks) compared with nonresponders. Conclusions These pilot findings may suggest a potential neural mechanism by which ketamine exerts its robust antidepressant efficacy via downregulation of aberrant habenular FC with parts of the default mode network.

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