Li Qingmei, Liu Shuming, Qin Bangyong, Liu Xingfeng
Department of Anesthesiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, People's Republic of China.
Department of Anesthesiology, The Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, 563003, People's Republic of China.
Neuropsychiatr Dis Treat. 2025 Aug 9;21:1623-1636. doi: 10.2147/NDT.S534938. eCollection 2025.
This review systematically summarizes the research progress of ketamine and its interaction with specific brain regions in the context of neuropathic pain comorbid with depression. As a non-competitive inhibitor of N-methyl-D-aspartate (NMDA) receptors, Ketamine exerts complex mechanisms and controversial topic. The structure and function of NMDA receptors, as well as the binding sites of ketamine, are summarized, and the hypothesis of disinhibition and neuroplasticity of ketamine's antidepressant effect is elaborated. The mechanism of key brain regions, such as hippocampus and anterior cingulate cortex, is discussed in detail, and the antidepressant effect of ketamine is explored from the perspective of transcriptomics. Finally, this review integrates bioinformatics, molecular biology and other interdisciplinary approaches to elucidate the therapeutic effects and potential mechanisms of ketamine in treating neuropathic pain and depression comorbidity, providing a comprehensive theoretical basis, new directions for subsequent research and novel insights for the clinical application of ketamine.
本综述系统总结了氯胺酮及其在合并抑郁症的神经性疼痛背景下与特定脑区相互作用的研究进展。作为N-甲基-D-天冬氨酸（NMDA）受体的非竞争性抑制剂，氯胺酮发挥着复杂的机制且是一个有争议的话题。总结了NMDA受体的结构和功能以及氯胺酮的结合位点，并阐述了氯胺酮抗抑郁作用的去抑制和神经可塑性假说。详细讨论了关键脑区，如海马体和前扣带回皮质的机制，并从转录组学角度探讨了氯胺酮的抗抑郁作用。最后，本综述整合了生物信息学、分子生物学等多学科方法，以阐明氯胺酮治疗神经性疼痛和抑郁症合并症的治疗效果和潜在机制，为后续研究提供全面的理论基础、新方向以及氯胺酮临床应用的新见解。
