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

Samantha Graf, Gregor Dörl, Christian Milz, Maximilian Kathofer, Peter Stöhrmann, David Gomola, Elisa Briem, Gabriel Schlosser, A Mayerweg, J Semmelweis-Tomits, A Hoti, Benjamin Eggerstorfer, C Schmidt, J Crone, Dan Rujescu, Marie Spies, Rupert Lanzenberger, Benjamin Spurny-Dworak

The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry November 1, 2024 DOI: 10.1080/15622975.2024.2402261 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Single-blind, placebo-controlled study Peer reviewed
Sample size 17
Population Healthy volunteers (6 males, mean age 23.12 ± 1.9 years)
Intervention Racemic ketamine
Dose 0.5 mg/kg
Topics Anxiety Ketamine Esketamine
Keywords Amygdala Hippocampus Morphology Ketamine therapy Brain anatomy Anxiety disorders Neuroscience research Psychopharmacology
Citations 2
Key points Smaller hippocampal head volume was significantly associated with greater anxiety-related experiences during ketamine infusion.

Abstract

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. 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 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. 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.

Comparable studies

Other randomized controlled trials on ketamine for anxiety, most cited first.

Study Year Design Participants
Ketamine for rapid reduction of suicidal ideation: a randomized controlled trial Patients with mood and anxiety spectrum disorders who presented with clinically... 2015 Randomized controlled trial n = 24
Single Versus Repeated Sessions of Ketamine-Assisted Psychotherapy for People with Heroin Dependence Detoxified inpatients with heroin dependence 2007 Randomized controlled trial n = 59
Effects of ketamine in patients with treatment-refractory generalized anxiety and social anxiety disorders: Exploratory double-blind psychoactive-controlled replication study Patients with treatment-resistant generalized anxiety and social anxiety disorders who... 2020 Double-blind, psychoactive-controlled ascending dose study n = 12
Meaningful Change in Depression Symptoms Assessed with the Patient Health Questionnaire (PHQ-9) and Montgomery-Åsberg Depression Rating Scale (MADRS) Among Patients with Treatment Resistant Depression in Two, Randomized, Double-blind, Active-controlled Trials of Esketamine Nasal Spray Combined With a New Oral Antidepressant Patients with treatment resistant depression 2020 Randomized controlled trial
Efficacy of intravenous ketamine treatment in anxious versus nonanxious unipolar treatment-resistant depression Subjects with treatment-resistant depression 2018 Randomized controlled trial n = 99

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