Ketamine and facial emotion recognition in treatment-resistant depression: a computational account
Zeynep Yoldas, Willys Cantenys, Morgane Tronche, Sarah Hardy, Orphée Morlaàs, Lisa Thonon, Alix Romier, Luc Masset, Marion Imbault, Léonie Samion, Anne Claret Tournier, Philippe Fossati, Liane Schmidt
Study at a glance
AI-extracted from the abstract| Characteristics | Observational case-control study |
|---|---|
| Sample size | 59 |
| Population | Treatment-resistant depression patients and healthy controls |
| Intervention | Ketamine |
| Duration | One week of treatment |
| Topics | Depression Esketamine Ketamine |
| Key findings | TRD patients were slower but as accurate as controls before treatment; after ketamine they became significantly faster. Modeling linked baseline slowness to longer nondecision times and wider decision boundaries, both reduced after ketamine, with no evidence of negative bias. |
Abstract
Background: Facial emotion recognition deficits are well defined in depression but understudied in treatment-resistant depression (TRD). Over the past decades, subanesthetic doses of ketamine have emerged as an effective treatment for TRD, but its effect on affective processing is still little known. Approaches from computational psychiatry, such as sequential evidence sampling models of decision making, can provide useful insight into the underlying cognitive processes of facial emotion recognition in TRD patients before and after ketamine antidepressant treatment.Aim: Provide a computational account of facial emotion recognition in TRD and the effects of ketamine treatment using hierarchical drift diffusion modeling (HDDM).Method: In this observational case-control study, 24 TRD patients and 35 healthy controls completed a FER task. TRD patients were assessed before, 2-4 hours after the initial racemic ketamine infusion, and at one week of treatment. Healthy controls were assessed at similar intervals, without intervention, to assess baseline differences and potential learning effects related to task repetition. Accuracy and reaction times were analyzed and fit with an HDDM to formalize correct facial emotion recognition as a noisy evidence-accumulation process. Parameters of the best-fitting model were compared across groups and timepoints.Results: Before treatment, TRD patients were slower but as accurate as controls. Following ketamine, the patients were significantly faster than at baseline and compared with repeated testing in healthy controls. These effects were underpinned by longer nondecision times and wider decision boundaries in patients at baseline, both of which decreased after starting ketamine. There was no behavioral or computational evidence of a negative bias in patients.Conclusions: Results suggest that processes related to psychomotor slowing and response caution, rather than affective processing, underlie deficits observed during facial emotion recognition in TRD and can be restored after starting a ketamine treatment.
Comparable studies
Other observational and cohort studies on ketamine for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder | 2012 | Observational cohort | n = 30 |
| Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome Healthy controls and actively depressed patients with treatment-resistant depression... | 2017 | Observational cohort | n = 59 |
| Clinical Predictors of Ketamine Response in Treatment-Resistant Major Depression Treatment-resistant inpatients with DSM-IV-TR-diagnosed major depressive disorder or... | 2014 | Post hoc analysis of pooled data from four studies | n = 108 |
| An investigation of amino-acid neurotransmitters as potential predictors of clinical improvement to ketamine in depression Drug-free patients with major depressive disorder | 2011 | Observational cohort | n = 14 |
| Efficacy of ketamine therapy in the treatment of depression Drug-free/naïve men with severe depression, no history of psychotic disorder, head... | 2019 | Observational cohort | n = 25 |