Yale University School of Medicine, Department of Psychiatry, New Haven, USA.
Yale University, Department of Psychology, New Haven, USA.
Transl Psychiatry. 2021 Apr 8;11(1):205. doi: 10.1038/s41398-021-01327-5.
Intravenous (IV) subanesthetic doses of ketamine have been shown to reduce psychiatric distress in both major depressive (MDD) and posttraumatic stress disorder (PTSD). However, the effect of ketamine on cognitive function in these disorders is not well understood. To address this gap, we examined the effect of a single dose of IV ketamine on cognition in individuals with MDD and/or PTSD relative to healthy controls (HC). Psychiatric (n = 29; 15 PTSD, 14 MDD) and sex- age- and IQ matched HC (n = 29) groups were recruited from the community. A single subanesthetic dose of IV ketamine was administered. Mood and cognitive measures were collected prior to, 2 h and 1 day post-ketamine administration. MDD/PTSD individuals evidenced a large-magnitude improvement in severity of depressive symptoms at both 2-hours and 1 day post-ketamine administration (p's < .001, Cohen d's = 0.80-1.02). Controlling for baseline performance and years of education, IV ketamine induced declines in attention (ATTN), executive function (EF), and verbal memory (VM) 2 h post-administration, all of which had resolved by 1 day post-ketamine across groups. The magnitude of cognitive decline was significantly larger in MDD/PTSD relative to HC on attention only (p = .012, d = 0.56). Ketamine did not affect working memory (WM) performance. Cognitive function (baseline, change from baseline to post-ketamine) was not associated with antidepressant response to ketamine. Results suggest that while ketamine may have an acute deleterious effect on some cognitive domains in both MDD/PTSD and HC individuals, most notably attention, this reduction is transient and there is no evidence of ketamine-related cognitive dysfunction at 1 day post-administration.
静脉注射（IV）亚麻醉剂量的氯胺酮已被证明可减轻重度抑郁症（MDD）和创伤后应激障碍（PTSD）患者的精神困扰。然而，氯胺酮对这些疾病认知功能的影响尚不清楚。为了弥补这一空白，我们研究了单次静脉注射氯胺酮对 MDD 和/或 PTSD 个体相对于健康对照（HC）的认知功能的影响。从社区招募了精神科（n=29；15 例 PTSD，14 例 MDD）和性别、年龄和智商匹配的 HC（n=29）组。给予单次亚麻醉剂量的 IV 氯胺酮。在给予氯胺酮之前、2 小时和 1 天后采集情绪和认知测量值。MDD/PTSD 个体在给予氯胺酮后 2 小时和 1 天的抑郁症状严重程度均有较大幅度的改善（p<0.001，Cohen d=0.80-1.02）。控制基线表现和受教育年限，IV 氯胺酮诱导注意力（ATTN）、执行功能（EF）和言语记忆（VM）在给药后 2 小时下降，所有这些在各组中均在给予氯胺酮后 1 天内得到解决。仅在注意力方面，MDD/PTSD 与 HC 相比，认知下降的幅度明显更大（p=0.012，d=0.56）。氯胺酮对工作记忆（WM）性能没有影响。认知功能（基线，从基线到氯胺酮后的变化）与氯胺酮的抗抑郁反应无关。结果表明，虽然氯胺酮可能对 MDD/PTSD 和 HC 个体的一些认知领域（尤其是注意力）有急性有害影响，但这种减少是短暂的，在给予氯胺酮后 1 天内没有证据表明与氯胺酮相关的认知功能障碍。
