Morphological correlates of anxiety-related experiences during a ketamine infusion.

IF 3 4区 医学 Q2 PSYCHIATRY World Journal of Biological Psychiatry Pub Date : 2024-11-01 Epub Date: 2024-10-12 DOI:10.1080/15622975.2024.2402261
S Graf, G Dörl, C Milz, M Kathofer, P Stöhrmann, D Gomola, E Briem, G Schlosser, A Mayerweg, J Semmelweis-Tomits, A Hoti, B Eggerstorfer, C Schmidt, J Crone, D Rujescu, M Spies, R Lanzenberger, B Spurny-Dworak
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Abstract

Objectives: Ketamine exerts rapid antidepressant effects by enhancing neuroplasticity, particularly in the amygdala and hippocampus-regions involved in fear processing and learning. While the role of ketamine's dissociative effects in its antidepressant response is debated, anxiety experienced during infusion has been negatively correlated with treatment outcomes.

Methods: In this single-blind, placebo-controlled study, a subset of 17 healthy volunteers (6 males, 23.12 ± 1.9 years) received intravenously a placebo in the first and 0.5 mg/kg racemic ketamine in the second session. Anxiety-related experiences were assessed by the 5D-ASC score obtained post-infusion, structural magnetic resonance imaging scans were acquired 4 h post-infusion. An anxiety-score was obtained from the 5D-ASC. Relation between post-placebo amygdala volume, hippocampal volume, and its subfields with the anxiety-score were assessed using linear regression models.

Results: Results showed a statistically significant negative relation between hippocampal head volume and the anxiety score (β = -0.733, p = 0.006), with trending negative association for each subfield's head and the score.

Conclusion: These findings suggest that anxiety-related experiences during ketamine infusion may be mediated by the hippocampus, with smaller hippocampal volumes leading to more anxiety-related experiences. Thus, hippocampal subfield volumes may be used as a predictor for anxiety-related events during ketamine use and might predict treatment outcome in future approaches.

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氯胺酮输注过程中焦虑相关体验的形态学相关性。
研究目的氯胺酮通过增强神经可塑性,尤其是杏仁核和海马区(参与恐惧处理和学习的区域)的神经可塑性,迅速发挥抗抑郁作用。氯胺酮的分离作用在其抗抑郁反应中的作用尚存争议,但输注过程中的焦虑与治疗效果呈负相关:在这项单盲安慰剂对照研究中,17 名健康志愿者(6 名男性,23.12 ± 1.9 岁)分别在第一次和第二次治疗中静脉注射了安慰剂和 0.5 毫克/千克外消旋氯胺酮。与焦虑相关的体验通过输液后获得的 5D-ASC 评分进行评估,结构磁共振成像扫描在输液后 4 小时获得。根据 5D-ASC 获得焦虑评分。使用线性回归模型评估了安慰剂后杏仁核体积、海马体积及其亚区与焦虑评分之间的关系:结果表明,海马体头部体积与焦虑评分之间存在统计学意义上的显著负相关(β = -0.733,p = 0.006),各子野头部与焦虑评分之间呈负相关趋势:这些研究结果表明,氯胺酮输注过程中的焦虑相关体验可能是由海马介导的,海马体积越小,焦虑相关体验越多。因此,在使用氯胺酮期间,海马亚区体积可作为焦虑相关事件的预测因子,并可在未来的方法中预测治疗结果。
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来源期刊
CiteScore
7.00
自引率
3.20%
发文量
73
审稿时长
6-12 weeks
期刊介绍: The aim of The World Journal of Biological Psychiatry is to increase the worldwide communication of knowledge in clinical and basic research on biological psychiatry. Its target audience is thus clinical psychiatrists, educators, scientists and students interested in biological psychiatry. The composition of The World Journal of Biological Psychiatry , with its diverse categories that allow communication of a great variety of information, ensures that it is of interest to a wide range of readers. The World Journal of Biological Psychiatry is a major clinically oriented journal on biological psychiatry. The opportunity to educate (through critical review papers, treatment guidelines and consensus reports), publish original work and observations (original papers and brief reports) and to express personal opinions (Letters to the Editor) makes The World Journal of Biological Psychiatry an extremely important medium in the field of biological psychiatry all over the world.
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