Anterior default mode network and posterior insular connectivity is predictive of depressive symptom reduction following serial ketamine infusion.
Anterior default mode network and posterior insular connectivity is predictive of depressive symptom reduction following serial ketamine infusion.
复制标题
前部默认模式网络和后部岛叶连接可预测连续氯胺酮输注后抑郁症状减轻。
DOI：
10.1017/s0033291722001313
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发表时间：
2022-09
影响因子：
6.9
通讯作者：
Narr, Katherine L.
中科院分区：
文献类型：
--
作者：
Wade, Benjamin S. C.;Loureiro, Joana;Sahib, Ashish;Kubicki, Antoni;Joshi, Shantanu H.;Hellemann, Gerhard;Espinoza, Randall T.;Woods, Roger P.;Congdon, Eliza;Narr, Katherine L.
关键词：
氯胺酮是一种起效迅速的抗抑郁治疗方法，有效率较高。先前的研究报告称，连续的氯胺酮治疗会调节几个大规模网络的静息态功能连接性，不过大脑结构、功能和连接性的变化是否会影响后续治疗的成功仍然未知。我们采用一种数据驱动的方法来确定治疗前的多模态神经影像学测量是否能预测连续输注氯胺酮后抑郁症症状维度的变化。
60名抑郁症患者在治疗前接受了结构、静息态功能和弥散磁共振成像扫描。在患者于2周内接受4次（0.5毫克/千克）消旋氯胺酮输注之前和之后24小时，使用17项汉密尔顿抑郁评定量表（HDRS - 17）、抑郁症状量表（IDS - C）和反刍反应量表（RRS）对抑郁症状进行评估。19名未患病的对照组在相似的时间点接受评估。随机森林回归模型使用治疗前的多模态神经影像学和人口统计学测量来预测症状变化。
HDRS - 17的两个分量表，即HDRS - 6以及核心情绪和快感缺乏（CMA）症状，以及RRS的反思（RRSR）量表得到了显著预测，分别解释了19%、27%和1%的方差。右侧内侧前额叶皮质/前扣带回和后岛叶（PoI）的增加以及上纵束峰度的降低预测了治疗后HDRS - 6和CMA症状的减轻。RRSR的变化由左侧后扣带回、左侧岛叶和右侧顶上小叶的整体连接性所预测。
我们的研究结果支持前默认模式网络和PoI的连接性可能作为核心抑郁症状抗抑郁治疗结果的潜在生物标志物。
Ketamine is a rapidly-acting antidepressant treatment with robust response rates. Previous studies have reported that serial ketamine therapy modulates resting state functional connectivity in several large-scale networks, though it remains unknown whether variations in brain structure, function, and connectivity impact subsequent treatment success. We used a data-driven approach to determine whether pretreatment multimodal neuroimaging measures predict changes along symptom dimensions of depression following serial ketamine infusion. Patients with depression (n = 60) received structural, resting state functional, and diffusion MRI scans before treatment. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HDRS-17), the Inventory of Depressive Symptomatology (IDS-C), and the Rumination Response Scale (RRS) before and 24 h after patients received four (0.5 mg/kg) infusions of racemic ketamine over 2 weeks. Nineteen unaffected controls were assessed at similar timepoints. Random forest regression models predicted symptom changes using pretreatment multimodal neuroimaging and demographic measures. Two HDRS-17 subscales, the HDRS-6 and core mood and anhedonia (CMA) symptoms, and the RRS: reflection (RRSR) scale were predicted significantly with 19, 27, and 1% variance explained, respectively. Increased right medial prefrontal cortex/anterior cingulate and posterior insula (PoI) and lower kurtosis of the superior longitudinal fasciculus predicted reduced HDRS-6 and CMA symptoms following treatment. RRSR change was predicted by global connectivity of the left posterior cingulate, left insula, and right superior parietal lobule. Our findings support that connectivity of the anterior default mode network and PoI may serve as potential biomarkers of antidepressant outcomes for core depressive symptoms.