Increased anterior cingulate cortical activity in response to fearful faces: a neurophysiological biomarker that predicts rapid antidepressant response to ketamine
Salvadore G, Cornwell BR, Colon-Rosario V, Coppola R,
Grillon C, Zarate CA Jr, Manji HK.
Mood and Anxiety Disorders Program, National Institute of Mental Health,
National Institutes of Health, Department of Health and Human Services,
Bethesda, Maryland, USA.
Biol Psychiatry. 2009 Feb 15;65(4):289-95.
ABSTRACTBACKGROUND: Most patients with major depressive disorder (MDD) experience a period of lengthy trial and error when trying to find optimal antidepressant treatment; identifying biomarkers that could predict response to antidepressant treatment would be of enormous benefit. We tested the hypothesis that pretreatment anterior cingulate cortex (ACC) activity could be a putative biomarker of rapid antidepressant response to ketamine, in line with previous findings that investigated the effects of conventional antidepressants. We also investigated patterns of ACC activity to rapid presentation of fearful faces compared with the normal habituation observed in healthy subjects. METHODS: We elicited ACC activity in drug-free patients with MDD (n = 11) and healthy control subjects (n = 11) by rapidly presenting fearful faces, a paradigm known to activate rostral regions of the ACC. Spatial-filtering analyses were performed on magnetoencephalographic (MEG) recordings, which offer the temporal precision necessary to estimate ACC activity elicited by the rapid presentation of stimuli. Magnetoencephalographic recordings were obtained only once for both patients and control subjects. Patients were subsequently administered a single ketamine infusion followed by assessment of depressive symptoms 4 hours later. RESULTS: Although healthy subjects had decreased neuromagnetic activity in the rostral ACC across repeated exposures, patients with MDD showed robust increases in pretreatment ACC activity. Notably, this increase was positively correlated with subsequent rapid antidepressant response to ketamine. Exploratory analyses showed that pretreatment amygdala activity was negatively correlated with change in depressive symptoms. CONCLUSIONS: Pretreatment rostral ACC activation may be a useful biomarker that identifies a subgroup of patients who will respond favorably to ketamine's antidepressant effects.
Ketamine and memory
Ketamine and cognition
Comfortably numb? (PDF)
Anaesthesia and anaesthetics
Ketamine as an antidepressant
Ketamine and opiate withdrawal
Ketamine and the nucleus accumbens
Ketamine: medical and non-medical use
The role of ketamine in pain management
Glutamate modulators to treat mood disorders?
Ketamine is not a long-acting antidepressant for rats
Ketamine racemate versus S-(+)-ketamine and midazolam
Ketamine and the glutaminergic hypothesis of schizophrenia
Low-dose ketamine as a fast-onset, long-acting antidepressant
Anxiolytic and antidepressant properties of ketamine in non-human animals
and further reading
The Abolitionist Project
The Hedonistic Imperative
MDMA: Utopian Pharmacology
Dissociative Anaesthetics: Ketamine
The Good Drug Guide
The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family