Neural Correlates of Suicidal Ideation and Its Reduction in Depression
Elizabeth D. Ballard, Níall Lally, Allison C. Nugent, Maura L. Furey, David A. Luckenbaugh, Carlos A. Zarate
The International Journal of Neuropsychopharmacology October 31, 2014 DOI: 10.1093/ijnp/pyu069 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Open-label trial Peer reviewed |
|---|---|
| Sample size | 19 |
| Population | Medication-free patients with treatment-resistant major depressive disorder |
| Intervention | Ketamine |
| Dose | 0.5 mg/kg for 40 minutes |
| Duration | 230 minutes after infusion |
| Topics | Ketamine Depression |
| Keywords | Suicidal ideation Anterior cingulate cortex Infralimbic cortex Amygdala Depression economics Cortex anatomy Prefrontal cortex Poison control Suicide prevention Cognition Medical emergency |
| Citations | 74 |
| Key findings | Baseline suicidal ideation and reductions in suicidal ideation after ketamine infusion were significantly correlated with regional cerebral glucose metabolism in the infralimbic cortex. |
Abstract
Background: The neural correlates of suicidal ideation and its reduction after treatment are unknown. We hypothesized that increased regional cerebral glucose metabolism in the infralimbic cortex (Brodmann area 25), amygdala, and subgenual anterior cingulate cortex would be associated with suicidal ideation and its reduction after ketamine infusion.
Methods: Medication-free patients (n=19) with treatment-resistant major depressive disorder underwent positron emission tomography imaging at baseline and 230 minutes after an open-label ketamine infusion (0.5 mg/kg for 40 minutes).
Results: Baseline suicidal ideation and regional cerebral glucose metabolism in the infralimbic cortex were significantly correlated (r=.59, P=.007); but not overall mood scores (r=-.07, P=.79). Reductions in suicidal ideation after ketamine infusion were correlated with decreased regional cerebral glucose metabolism in the infralimbic cortex (r=.54, P=.02). Metabolism in other areas of interest was not significantly correlated with suicidal ideation or depression.
Conclusion: The infralimbic cortex may be implicated in suicidal ideation.
Comparable studies
Other non-randomized and open-label trials on ketamine for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Rapid Resolution of Suicidal Ideation After a Single Infusion of anN-Methyl-D-Aspartate Antagonist in Patients With Treatment-Resistant Major Depressive Disorder Subjects with DSM-IV-diagnosed treatment-resistant major depressive disorder | 2010 | Open-label trial | n = 33 |
| Esketamine Nasal Spray Plus Oral Antidepressant in Patients With Treatment-Resistant Depression Adults (≥ 18 years) with treatment-resistant depression | 2020 | Phase 3, open-label, multicenter, long-term study | n = 802 |
| Intravenous arketamine for treatment-resistant depression: open-label pilot study Humans with treatment-resistant depression | 2020 | Open-label pilot trial | n = 7 |
| A Phase 2 Open Label Study of Efficacy, Safety, and Tolerability of SLS-002 (Intranasal Racemic Ketamine) in Adults with MDD at Imminent Risk of Suicide. Hospitalized patients with Major Depressive Disorder and acute suicidal ideation and... | 2024 | Open label study | n = 17 |
| Ketamine Safety and Tolerability in Clinical Trials for Treatment-Resistant Depression Participants with DSM-IV-defined major depressive disorder and treatment-resistant... | 2014 | Pooled analysis of three clinical trials | n = 97 |