Baseline delta sleep ratio predicts acute ketamine mood response in major depressive disorder.
Baseline delta sleep ratio predicts acute ketamine mood response in major depressive disorder.
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DOI：
10.1016/j.jad.2012.05.042
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发表时间：
2013-02-15
影响因子：
6.6
通讯作者：
Zarate, Carlos A., Jr.
中科院分区：
文献类型：
--
作者：
Duncan, Wallace C., Jr.;Selter, Jessica;Brutsche, Nancy;Sarasso, Simone;Zarate, Carlos A., Jr.
关键词：
脑电睡眠慢波活动(SWA；脑电功率在0.6-4赫兹之间)被认为是中枢突触可塑性的标志。睡眠慢波的产生减少--这是抑郁症睡眠的一个核心特征--表明了疾病潜在的可塑性变化。此前，SWA的各种测量方法已被用于预测抗抑郁药物的治疗反应。这项研究考察了前两个NREM发作的SWA基线模式与急性输注N-甲基-D-天冬氨酸(NMDA)拮抗剂氯胺酮的抗抑郁反应之间的关系。30名符合DSM-IV标准的难治性重度抑郁障碍(MDD)患者(男性20人，女性10人，年龄18-65岁)在停药两周后接受了一次开放标签的盐酸氯胺酮输注(0.5 mg/kg)，持续40分钟。用蒙哥马利-阿斯伯格抑郁量表(MADRS)评定氯胺酮输注前后的抑郁症状。在输液前一晚获得睡眠记录，并进行视觉评分。计算每个无伪影的NREM睡眠时期的SWA，并计算每个NREM发作的平均SWA。增量睡眠比(DSR)按SWANREM1/SWANREM2计算。在基线DSR和从基线到第一天的MADRS评分降低之间观察到显著的正相关(r=.414，p=.02)。样本量相对较小(N=30)，所有受试者都患有耐药MDD，这可能限制了研究结果的推广。需要进一步的研究来将这一观察结果复制并推广到其他患者组。DSR可能是耐药MDD患者氯胺酮反应的有用基线预测指标。
Electroencephalographic (EEG) sleep slow wave activity (SWA; EEG power between 0.6–4 Hz) has been proposed as a marker of central synaptic plasticity. Decreased generation of sleep slow waves—a core feature of sleep in depression—indicates underlying plasticity changes in the disease. Various measures of SWA have previously been used to predict antidepressant treatment response. This study examined the relationship between baseline patterns of SWA in the first two NREM episodes and antidepressant response to an acute infusion of the N-methyl-D-aspartate (NMDA) antagonist ketamine. Thirty patients (20M, 10F, 18–65) fulfilling DSM-IV criteria for treatment-resistant major depressive disorder (MDD) who had been drug-free for two weeks received a single open-label infusion of ketamine hydrochloride (.5 mg/kg) over 40 minutes. Depressive symptoms were assessed with the Montgomery-Asberg Depression Rating Scale (MADRS) before and after ketamine infusion. Sleep recordings were obtained the night before the infusion and were visually scored. SWA was computed for individual artifact-free NREM sleep epochs, and averaged for each NREM episode. Delta sleep ratio (DSR) was calculated as SWANREM1 / SWANREM2. A significant positive correlation was observed between baseline DSR and reduced MADRS scores from baseline to Day 1 (r=.414, p=.02). The sample size was relatively small (N=30) and all subjects had treatment-resistant MDD, which may limit the generalizability of the findings. Further studies are needed to replicate and extend this observation to other patient groups. DSR may be a useful baseline predictor of ketamine response in individuals with treatment-resistant MDD.
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影响因子：
10.6
作者：
Salvadore, Giacomo;Cornwell, Brian R.;Colon-Rosario, Veronica;Coppola, Richard;Grillon, Christian;Zarate, Carlos A., Jr.;Manji, Husseini K.
通讯作者：
Manji, Husseini K.
影响因子：
7.6
作者：
FEINBERG, I;CAMPBELL, IG
通讯作者：
CAMPBELL, IG
影响因子：
7.6
作者：
Salvadore, Giacomo;Cornwell, Brian R.;Zarate, Carlos A., Jr.
通讯作者：
Zarate, Carlos A., Jr.
影响因子：
7.6
作者：
Ibrahim, Lobna;DiazGranados, Nancy;Zarate, Carlos A., Jr.
通讯作者：
Zarate, Carlos A., Jr.
影响因子：
2.9
作者：
Jindal, RD;Friedman, ES;Thase, ME
通讯作者：
Thase, ME