Ramezani Farzaneh, Mardani Peyman, Nemati Fatemeh, Cattarinussi Giulia, Sambataro Fabio, Schiena Giandomenico, Brambilla Paolo, Delvecchio Giuseppe
Department of Psychology, University of Tabriz, Tabriz, Iran.
Department of Psychology and Counseling, Faculty of Humanities, West Tehran Branch, Islamic Azad University, Tehran, Iran.
J Affect Disord. 2025 Feb 1;370:181-189. doi: 10.1016/j.jad.2024.10.118. Epub 2024 Nov 2.
Over the last two decades, ketamine has gained significant interest in psychiatry as a potential treatment for major depressive disorder (MDD), especially in individuals who are resistant to traditional therapies or are at a high risk of suicide. Task-based functional magnetic resonance imaging (fMRI) studies can provide insight into how ketamine alters brain function and contributes to its antidepressant properties.
This mini-review followed the MOOSE guidelines for systematic reviews of observational studies. We conducted a literature search in PubMed, Web of Science, and Scopus aiming at identifying fMRI studies investigating the effect of ketamine on brain function in MDD.
Eight articles were included in the study. Results showed that ketamine affects brain activity in MDD, especially in the anterior cingulate cortex (ACC), dorsolateral prefrontal cortex, and amygdala. Interestingly, the majority of the reviewed studies showed a correlation between the changes in brain activity induced by ketamine and improvements in clinical depressive symptoms. These correlations involved the prefrontal cortex, ACC, and cortico-cerebellar circuits.
Lack of longitudinal data on the lasting effects of ketamine on brain activity and the small number of studies.
This review identifies key research areas that can enhance our understanding of ketamine's effects on the brain in MDD. It calls for studies on ketamine's mechanisms of action, long-term impact, dose-response optimization, and comparisons with other fast-acting antidepressants. Addressing these areas can optimize ketamine's therapeutic use and reveal new treatment targets.
在过去二十年中，氯胺酮作为重度抑郁症（MDD）的一种潜在治疗方法，在精神病学领域引起了广泛关注，尤其是对于那些对传统疗法耐药或有高自杀风险的个体。基于任务的功能磁共振成像（fMRI）研究可以深入了解氯胺酮如何改变脑功能并产生其抗抑郁特性。
本小型综述遵循观察性研究系统评价的MOOSE指南。我们在PubMed、科学网和Scopus中进行了文献检索，旨在识别研究氯胺酮对MDD患者脑功能影响的fMRI研究。
该研究纳入了八篇文章。结果表明，氯胺酮会影响MDD患者的脑活动，尤其是在前扣带回皮质（ACC）、背外侧前额叶皮质和杏仁核。有趣的是，大多数综述研究表明，氯胺酮引起的脑活动变化与临床抑郁症状的改善之间存在相关性。这些相关性涉及前额叶皮质、ACC和皮质-小脑回路。
缺乏关于氯胺酮对脑活动长期影响的纵向数据，且研究数量较少。
本综述确定了一些关键研究领域，这些领域可以增进我们对氯胺酮在MDD中对大脑影响的理解。它呼吁开展关于氯胺酮作用机制、长期影响、剂量反应优化以及与其他速效抗抑郁药比较的研究。解决这些领域的问题可以优化氯胺酮的治疗应用并揭示新的治疗靶点。
