Ketamine Normalizes the Structural Alterations of Inferior Frontal Gyrus in Depression.
Ketamine Normalizes the Structural Alterations of Inferior Frontal Gyrus in Depression.
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DOI：
10.1177/2470547020980681
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发表时间：
2020-01
期刊：
影响因子：
--
通讯作者：
Esterlis I
中科院分区：
文献类型：
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作者：
Dai D;Lacadie CM;Holmes SE;Cool R;Anticevic A;Averill C;Abdallah C;Esterlis I
氯胺酮是一种新型的速效抗抑郁药。急性氯胺酮治疗可以逆转大脑微观结构缺陷并使大脑功能改变正常化，但对氯胺酮对抑郁症患者脑容量的影响知之甚少。我们采用3t磁共振成像（MRI）和基于张量的形态学方法研究了29名健康对照（HC）和21名重度抑郁症（MDD）患者的区域体积差异，其中包括10名合并创伤后应激障碍（PTSD）患者。所有受试者在静脉输注氯胺酮前和24 h后均进行MRI扫描。急性氯胺酮给药对HC、MDD和MDD/PTSD组的影响分别采用全脑体素t检验。我们的数据显示，与HC相比，MDD和MDD/PTSD受试者的额下回（IFG，眼窝部分）体积较小，并且仅在MDD受试者中，眼窝IFG体积与抑郁严重程度之间存在显著相关性。氯胺酮给药使MDD组和MDD/PTSD组的眼内IFG结构改变正常化，并显著改善抑郁和PTSD症状。单次氯胺酮输注24小时后，MDD受试者出现两组体素体积变化，包括眼内IFG体积显著增加。在MDD/PTSD或HC组中未发现明显的结构改变。这些发现提供了直接证据，表明急性氯胺酮给药可以使与抑郁症相关的结构改变正常化，并强调了IFG在指导未来治疗靶点方面的重要性。
Ketamine is a novel fast-acting antidepressant. Acute ketamine treatment can reverse microstructure deficits and normalize functional alterations in the brain, but little is known about the impacts of ketamine on brain volumes in individuals with depression. We used 3 T magnetic resonance imaging (MRI) and tensorbased morphological methods to investigate the regional volume differences for 29 healthy control (HC) subjects and 21 subjects with major depressive disorder (MDD), including 10 subjects with comorbid post-traumatic stress disorder (PTSD). All the subjects participated in MRI scanning before and 24 h post intravenous ketamine infusion. The effects of acute ketamine administration on HC, MDD, and MDD/PTSD groups were examined separately by whole-brain voxel-wise t-tests. Our data showed smaller volume of inferior frontal gyrus (IFG, opercular part) in MDD and MDD/PTSD subjects compared to HC, and a significant correlation between opercular IFG volume and depressive severity in MDD subjects only. Ketamine administration normalized the structural alterations of opercular IFG in both MDD and MDD/PTSD groups, and significantly improved depressive and PTSD symptoms. Twenty-four hours after a single ketamine infusion, there were two clusters of voxels with volume changes in MDD subjects, including significantly increased volumes of opercular IFG. No significant structural alterations were found in the MDD/PTSD or HC groups. These findings provide direct evidence that acute ketamine administration can normalize structural alterations associated with depression and highlight the importance of IFG in the guidance of future therapeutic targets.