Woody Mary L, Rohac Rebecca, Cooper Iya, Griffo Angela, McDonald Nastasia, Spotts Crystal, Fournier Jay, Jones Neil, Peciña Marta, Young Kymberly, Shivanekar Sharvari, Rengasamy Manivel, Grafton Ben, Price Rebecca B
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
School of Public Health, Boston University, Boston, Massachusetts.
Biol Psychiatry. 2025 Apr 15;97(8):835-842. doi: 10.1016/j.biopsych.2024.10.024. Epub 2024 Nov 22.
Ketamine is known for its rapid antidepressant effect, but its impact on affective information processing (including attentional bias [AB], a putative cognitive mechanism of depression) remains largely unexplored. We leveraged a novel measurement of AB and sought to 1) establish adequate test-retest reliability and validity among participants with depression prior to ketamine treatment and 2) harness a single dose of ketamine to assess mechanistic shifts in AB and their relationship to antidepressant efficacy.
A novel dual probe video task was used to index AB toward sad film clips. In study 1, treatment-seeking adults with moderate-to-severe depression (N = 40) completed the task at baseline, 1-week retest, and 1-month retest; a subset of participants (n = 15) also performed the task at 24 hours postketamine infusion (0.5 mg/kg over 40 minutes). In study 2, participants (N = 43) completed the task pre- and 24 hours postketamine.
Indices from the novel AB task were stable prior to ketamine, demonstrating good 1-week and 1-month test-retest reliability. Participants in both studies exhibited a robust reduction in AB from pre- to 24 hours postketamine infusion. In study 1, cross-sectional correlations were observed between AB and clinician-rated depressive symptoms at each pretreatment assessment. In study 2, changes in AB were correlated with improved symptoms from pre- to postinfusion.
Results provide evidence for the validity of a novel, psychometrically robust measure of AB among individuals with depression. Findings indicate that ketamine reliably and rapidly reduces AB, offering insight into a replicable, potential cognitive mechanism involved in its antidepressant action.
氯胺酮以其快速的抗抑郁作用而闻名，但其对情感信息处理（包括注意偏向[AB]，一种假定的抑郁症认知机制）的影响在很大程度上仍未得到探索。我们采用了一种新颖的AB测量方法，并试图：1）在氯胺酮治疗前的抑郁症患者中建立足够的重测信度和效度；2）利用单剂量氯胺酮来评估AB的机制变化及其与抗抑郁疗效的关系。
采用一种新颖的双探针视频任务来衡量对悲伤电影片段的AB。在研究1中，寻求治疗的中重度抑郁症成年患者（N = 40）在基线、1周重测和1个月重测时完成该任务；一部分参与者（n = 15）在氯胺酮输注后24小时（40分钟内输注0.5mg/kg）也进行了该任务。在研究2中，参与者（N = 43）在氯胺酮治疗前和治疗后24小时完成该任务。
在氯胺酮治疗前，来自新颖AB任务的指标是稳定的，显示出良好的1周和1个月重测信度。两项研究中的参与者在氯胺酮输注前到输注后24小时均表现出AB的显著降低。在研究1中，在每次治疗前评估时，观察到AB与临床医生评定的抑郁症状之间存在横断面相关性。在研究2中，AB的变化与输注前到输注后的症状改善相关。
结果为一种新颖的、心理测量学上稳健的抑郁症患者AB测量方法的有效性提供了证据。研究结果表明，氯胺酮可靠且迅速地降低了AB，为其抗抑郁作用中一种可重复的潜在认知机制提供了见解。
