Medical School Berlin, Berlin, Germany.
Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
Transl Psychiatry. 2024 Oct 14;14(1):436. doi: 10.1038/s41398-024-03120-6.
Ketamine is a highly effective antidepressant (AD) that targets the glutamatergic system and exerts profound effects on brain circuits during negative emotional processing. Interestingly, the effects of ketamine on brain measures are sensitive to modulation by pretreatment with lamotrigine, which inhibits glutamate release. Examining the antagonistic effects of ketamine and lamotrigine on glutamate transmission holds promise to identify effects of ketamine that are mediated through changes in the glutamatergic system. Investigating this modulation in relation to both the acute and sustained effects of ketamine on functional activity and connectivity during negative emotional processing should therefore provide novel insights. 75 healthy subjects were investigated in a double-blind, single-dose, randomized, placebo-controlled, parallel-group study with three treatment conditions (ketamine, lamotrigine pre-treatment, placebo). Participants completed an emotional face viewing task during ketamine infusion and 24 h later. Acute ketamine administration decreased hippocampal and Default Mode Network (DMN) activity and increased fronto-limbic coupling during negative emotional processing. Furthermore, while lamotrigine abolished the ketamine-induced increase in functional connectivity, it had no acute effect on activity. Sustained (24 h later) effects of ketamine were only found for functional activity, with a significant reduction in the posterior DMN. This effect was blocked by pretreatment with lamotrigine. Our results suggest that both the acute increases in fronto-limbic coupling and the delayed decrease in posterior DMN activity, but not the attenuated limbic and DMN recruitment after ketamine, are mediated by altered glutamatergic transmission.
氯胺酮是一种有效的抗抑郁药(AD),它作用于谷氨酸能系统,并在负性情绪处理过程中对大脑回路产生深远影响。有趣的是,氯胺酮对大脑测量的影响对拉莫三嗪预处理的调制敏感,拉莫三嗪抑制谷氨酸释放。研究氯胺酮和拉莫三嗪对谷氨酸传递的拮抗作用有望确定氯胺酮通过改变谷氨酸能系统介导的作用。因此,研究这种调节与氯胺酮对负性情绪处理期间功能活动和连接的急性和持续效应的关系,应该提供新的见解。在一项双盲、单剂量、随机、安慰剂对照、平行组研究中,75 名健康受试者被分为三组(氯胺酮、拉莫三嗪预处理、安慰剂)进行研究。参与者在氯胺酮输注期间和 24 小时后完成情绪面孔观看任务。急性氯胺酮给药降低了海马体和默认模式网络(DMN)的活动,并增加了负性情绪处理期间的额-边缘耦合。此外,虽然拉莫三嗪消除了氯胺酮诱导的功能连接增加,但对活动没有急性影响。只有在 24 小时后,才能发现氯胺酮的持续(24 小时后)效应,即后 DMN 的功能活动显著减少。这种效应被拉莫三嗪预处理阻断。我们的结果表明,急性增加的额-边缘耦合和延迟减少的后 DMN 活动,而不是氯胺酮后减轻的边缘和 DMN 募集,都由谷氨酸能传递的改变介导。
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