期刊
JOURNAL OF PSYCHOPHARMACOLOGY
卷 29, 期 5, 页码 591-595出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/0269881114544776
关键词
Antidepressant; depression; hippocampus; ketamine; magnetic resonance imaging; major depressive disorder; refractory patients
资金
- Clinical Neuroscience Division of the Veteran's Administration (VA) National Center for PTSD [K23 MH-101498, R01 MH-081870]
- American Psychiatric Foundation (APF Early Academic Career Award
- The Brain and Behavior Research Foundation (NARSAD Independent Investigator and NARSAD New Investigator Awards)
- The Brown Foundation and the Michael E Debakey VA Medical Center
Accumulating evidence underscores the utility of ketamine in treating severely treatment-resistant depressed patients. We investigated the relationship between the rapid antidepressant effects of ketamine and hippocampal volume, a biomarker of antidepressant treatment outcome. We gave 16 medication-free, major depressive disorder (MDD) patients a single, sub-anesthetic dose infusion of ketamine (0.5 mg/kg, over 40 min). We assessed depression severity pre-treatment, and at 24 h post-treatment, with the Montgomery-angstrom sberg Depression Rating Scale (MADRS). Prior to treatment, patients underwent magnetic resonance imaging (MRI) to estimate their hippocampal volume: We obtained viable MRI data in 13 patients. Delta MADRS (post- minus pre-treatment) was significantly correlated with the pre-treatment volumes of the left hippocampus (r = 0.66; p = 0.01), but not the right hippocampus (r = 0.49; p = 0.09). The correlation between delta MADRS and the left hippocampus remained high (r > 0.6; p = 0.13), after controlling for several demographic and clinical variables, although the p value increased due to the reduced degree of freedom (df = 5). Ketamine exerts enhanced antidepressant effects in patients with a relatively smaller hippocampus, a patient population that has been repeatedly shown to be refractory to traditional antidepressants.
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