Modulation of habenular and nucleus accumbens functional connectivity by ketamine in major depression.
Brandon Taraku, Joana R Loureiro, Ashish K Sahib, Artemis Zavaliangos-Petropulu, Noor B. Al-Sharif, Amber M Leaver, Benjamin Wade, Shantanu Joshi, Roger P Woods, Randall Espinoza, Katherine L Narr
Brain and Behavior June 1, 2024 DOI: 10.1002/brb3.3511 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 58 |
| Population | Adults with major depressive disorder |
| Intervention | Ketamine infusion |
| Dose | 0.5 mg/kg |
| Duration | Four infusions over 2-3 weeks, with scans and assessments at baseline and 24 hours after the last infusion |
| Topics | Ketamine Depression Esketamine |
| Keywords | FMRI Habenula Nucleus accumbens Depression treatment Brain imaging Psychopharmacology Reward circuits |
| Citations | 11 |
| Key findings | Subanesthetic ketamine modulates functional connectivity between the habenula and nucleus accumbens with visual, parietal, and cerebellar regions, and these changes correlate with improvements in mood and anhedonia in major depressive disorder. |
Abstract
Major depressive disorder (MDD) is associated with dysfunctional reward processing, which involves functional circuitry of the habenula (Hb) and nucleus accumbens (NAc). Since ketamine elicits rapid antidepressant and antianhedonic effects in MDD, this study sought to investigate how serial ketamine infusion (SKI) treatment modulates static and dynamic functional connectivity (FC) in Hb and NAc functional networks. MDD participants (n = 58, mean age = 40.7 years, female = 28) received four ketamine infusions (0.5 mg/kg) 2-3 times weekly. Resting-state functional magnetic resonance imaging (fMRI) scans and clinical assessments were collected at baseline and 24 h post-SKI. Static FC (sFC) and dynamic FC variability (dFCv) were calculated from left and right Hb and NAc seeds to all other brain regions. Changes in FC pre-to-post SKI, and correlations with changes with mood and anhedonia were examined. Comparisons of FC between patients and healthy controls (HC) at baseline (n = 55, mean age = 32.6, female = 31), and between HC assessed twice (n = 16) were conducted as follow-up analyses. Following SKI, significant increases in left Hb-bilateral visual cortex FC, decreases in left Hb-left inferior parietal cortex FC, and decreases in left NAc-right cerebellum FC occurred. Decreased dFCv between left Hb and right precuneus and visual cortex, and decreased dFCv between right NAc and right visual cortex both significantly correlated with improvements in mood ratings. Decreased FC between left Hb and bilateral visual/parietal cortices as well as increased FC between left NAc and right visual/parietal cortices both significantly correlated with improvements in anhedonia. No differences were observed between HC at baseline or over time. Subanesthetic ketamine modulates functional pathways linking the Hb and NAc with visual, parietal, and cerebellar regions in MDD. Overlapping effects between Hb and NAc functional systems were associated with ketamine's therapeutic response.