Anterior default mode network and posterior insular connectivity is predictive of depressive symptom reduction following serial ketamine infusion.

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Title: Anterior default mode network and posterior insular connectivity is predictive of depressive symptom reduction following serial ketamine infusion.
Authors: Wade, Benjamin S. C., Loureiro, Joana, Sahib, Ashish, Kubicki, Antoni, Joshi, Shantanu H., Hellemann, Gerhard, Espinoza, Randall T., Woods, Roger P., Congdon, Eliza, Narr, Katherine L.
Source: Psychological Medicine. Sep2022, Vol. 52 Issue 12, p2376-2386. 11p.
Subjects: Intravenous therapy, Functional connectivity, Magnetic resonance imaging, Random forest algorithms, Mental depression, Ketamine, Descriptive statistics, Default mode network, Neuroradiology
Abstract: Background: Ketamine is a rapidly-acting antidepressant treatment with robust response rates. Previous studies have reported that serial ketamine therapy modulates resting state functional connectivity in several large-scale networks, though it remains unknown whether variations in brain structure, function, and connectivity impact subsequent treatment success. We used a data-driven approach to determine whether pretreatment multimodal neuroimaging measures predict changes along symptom dimensions of depression following serial ketamine infusion. Methods: Patients with depression (n = 60) received structural, resting state functional, and diffusion MRI scans before treatment. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HDRS-17), the Inventory of Depressive Symptomatology (IDS-C), and the Rumination Response Scale (RRS) before and 24 h after patients received four (0.5 mg/kg) infusions of racemic ketamine over 2 weeks. Nineteen unaffected controls were assessed at similar timepoints. Random forest regression models predicted symptom changes using pretreatment multimodal neuroimaging and demographic measures. Results: Two HDRS-17 subscales, the HDRS-6 and core mood and anhedonia (CMA) symptoms, and the RRS: reflection (RRSR) scale were predicted significantly with 19, 27, and 1% variance explained, respectively. Increased right medial prefrontal cortex/anterior cingulate and posterior insula (PoI) and lower kurtosis of the superior longitudinal fasciculus predicted reduced HDRS-6 and CMA symptoms following treatment. RRSR change was predicted by global connectivity of the left posterior cingulate, left insula, and right superior parietal lobule. Conclusions: Our findings support that connectivity of the anterior default mode network and PoI may serve as potential biomarkers of antidepressant outcomes for core depressive symptoms. [ABSTRACT FROM AUTHOR]
Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Anterior default mode network and posterior insular connectivity is predictive of depressive symptom reduction following serial ketamine infusion.
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  Data: <searchLink fieldCode="JN" term="%22Psychological+Medicine%22">Psychological Medicine</searchLink>. Sep2022, Vol. 52 Issue 12, p2376-2386. 11p.
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  Data: <searchLink fieldCode="DE" term="%22Intravenous+therapy%22">Intravenous therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Functional+connectivity%22">Functional connectivity</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Random+forest+algorithms%22">Random forest algorithms</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Ketamine%22">Ketamine</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Default+mode+network%22">Default mode network</searchLink><br /><searchLink fieldCode="DE" term="%22Neuroradiology%22">Neuroradiology</searchLink>
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  Data: Background: Ketamine is a rapidly-acting antidepressant treatment with robust response rates. Previous studies have reported that serial ketamine therapy modulates resting state functional connectivity in several large-scale networks, though it remains unknown whether variations in brain structure, function, and connectivity impact subsequent treatment success. We used a data-driven approach to determine whether pretreatment multimodal neuroimaging measures predict changes along symptom dimensions of depression following serial ketamine infusion. Methods: Patients with depression (n = 60) received structural, resting state functional, and diffusion MRI scans before treatment. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HDRS-17), the Inventory of Depressive Symptomatology (IDS-C), and the Rumination Response Scale (RRS) before and 24 h after patients received four (0.5 mg/kg) infusions of racemic ketamine over 2 weeks. Nineteen unaffected controls were assessed at similar timepoints. Random forest regression models predicted symptom changes using pretreatment multimodal neuroimaging and demographic measures. Results: Two HDRS-17 subscales, the HDRS-6 and core mood and anhedonia (CMA) symptoms, and the RRS: reflection (RRSR) scale were predicted significantly with 19, 27, and 1% variance explained, respectively. Increased right medial prefrontal cortex/anterior cingulate and posterior insula (PoI) and lower kurtosis of the superior longitudinal fasciculus predicted reduced HDRS-6 and CMA symptoms following treatment. RRSR change was predicted by global connectivity of the left posterior cingulate, left insula, and right superior parietal lobule. Conclusions: Our findings support that connectivity of the anterior default mode network and PoI may serve as potential biomarkers of antidepressant outcomes for core depressive symptoms. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1017/S0033291722001313
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      – Code: eng
        Text: English
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        PageCount: 11
        StartPage: 2376
    Subjects:
      – SubjectFull: Intravenous therapy
        Type: general
      – SubjectFull: Functional connectivity
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      – SubjectFull: Magnetic resonance imaging
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      – SubjectFull: Random forest algorithms
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      – SubjectFull: Mental depression
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      – SubjectFull: Ketamine
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Default mode network
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      – SubjectFull: Neuroradiology
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              Text: Sep2022
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