Ballard Elizabeth D, Lally Níall, Nugent Allison C, Furey Maura L, Luckenbaugh David A, Zarate Carlos A
Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (Dr Ballard, Mr Lally, Dr Nugent, Dr Furey, Mr Luckenbaugh, and Dr Zarate); Institute of Cognitive Neuroscience, University College London, London, WC1N 3AR, UK (Mr Lally).
Int J Neuropsychopharmacol. 2014 Oct 31;18(1):pyu069. doi: 10.1093/ijnp/pyu069.
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.
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).
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.
The infralimbic cortex may be implicated in suicidal ideation.
自杀意念及其治疗后的减轻所涉及的神经关联尚不清楚。我们假设，腹内侧前额叶皮质（布罗德曼25区）、杏仁核和膝下前扣带回皮质区域脑葡萄糖代谢增加与自杀意念及其在输注氯胺酮后的减轻有关。
19例无药物治疗史的难治性重度抑郁症患者在基线时以及开放标签输注氯胺酮（0.5mg/kg，持续40分钟）后230分钟接受正电子发射断层扫描成像。
基线时的自杀意念与腹内侧前额叶皮质区域脑葡萄糖代谢显著相关（r = 0.59，P = 0.007）；但与总体情绪评分无关（r = -0.07，P = 0.79）。氯胺酮输注后自杀意念的减轻与腹内侧前额叶皮质区域脑葡萄糖代谢降低相关（r = 0.54，P = 0.02）。其他感兴趣区域的代谢与自杀意念或抑郁无显著相关性。
腹内侧前额叶皮质可能与自杀意念有关。
