Scheidegger Milan, Henning Anke, Walter Martin, Lehmann Mick, Kraehenmann Rainer, Boeker Heinz, Seifritz Erich, Grimm Simone
Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich University Hospital for Psychiatry, Switzerland.
Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.
Hum Brain Mapp. 2016 May;37(5):1941-52. doi: 10.1002/hbm.23148. Epub 2016 Feb 25.
Increased amygdala reactivity might lead to negative bias during emotional processing that can be reversed by antidepressant drug treatment. However, little is known on how N-methyl-d-aspartate (NMDA) receptor antagonism with ketamine as a novel antidepressant drug target might modulate amygdala reactivity to emotional stimulation. Using functional magnetic resonance imaging (fMRI) and resting-state fMRI (rsfMRI), we assessed amygdalo-hippocampal reactivity at baseline and during pharmacological stimulation with ketamine (intravenous bolus of 0.12 mg/kg, followed by a continuous infusion of 0.25 mg/kg/h) in 23 healthy subjects that were presented with stimuli from the International Affective Picture System (IAPS). We found that ketamine reduced neural reactivity in the bilateral amygdalo-hippocampal complex during emotional stimulation. Reduced amygdala reactivity to negative pictures was correlated to resting-state connectivity to the pregenual anterior cingulate cortex. Interestingly, subjects experienced intensity of psychedelic alterations of consciousness during ketamine infusion predicted the reduction in neural responsivity to negative but not to positive or neutral stimuli. Our findings suggest that the pharmacological modulation of glutamate-responsive cerebral circuits, which is associated with a shift in emotional bias and a reduction of amygdalo-hippocampal reactivity to emotional stimuli, represents an early biomechanism to restore parts of the disrupted neurobehavioral homeostasis in MDD patients. Hum Brain Mapp 37:1941-1952, 2016. © 2016 Wiley Periodicals, Inc.
杏仁核反应性增强可能会导致情绪加工过程中的负性偏差,而抗抑郁药物治疗可以逆转这种偏差。然而,对于作为新型抗抑郁药物靶点的氯胺酮拮抗N-甲基-D-天冬氨酸(NMDA)受体如何调节杏仁核对情绪刺激的反应性,我们知之甚少。我们使用功能磁共振成像(fMRI)和静息态fMRI(rsfMRI),在23名健康受试者中评估了基线时以及在氯胺酮(静脉推注0.12mg/kg,随后以0.25mg/kg/h持续输注)药理刺激期间杏仁核-海马的反应性,这些受试者被给予来自国际情感图片系统(IAPS)的刺激。我们发现,氯胺酮在情绪刺激期间降低了双侧杏仁核-海马复合体的神经反应性。杏仁核对负面图片反应性的降低与到膝前扣带回皮质的静息态连接性相关。有趣的是,在氯胺酮输注期间受试者经历的意识迷幻改变的强度预测了对负面刺激而非正面或中性刺激的神经反应性降低。我们的研究结果表明,谷氨酸反应性脑回路的药理调节与情绪偏差的转变以及杏仁核-海马对情绪刺激的反应性降低有关,这代表了恢复抑郁症患者部分破坏的神经行为稳态的早期生物机制。《人类大脑图谱》37:1941 - 1952, 2016年。© 2016威利期刊公司