Rebuilding the atrophied brain: 6-month nasal esketamine therapy expands key frontal and hippocampal regions and reduces serum neurofilament levels in patients with major depressive disorder. A proof-of-concept study of the depTesk (DEPression treatment with ESKetamine) study.
Ana Rodríguez Lorente, María Pilar Campos-Navarro, Ángela Gil Montoya, Celia Marín Pérez, María Luisa Maso Navarro, Tomás Orgaz Morales, Nuria López Ramirez, Juan Antonio García-Carmona
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引用次数: 0
Abstract
Objectives: This proof-of-concept study aimed to assess the impact of intranasal esketamine (ESK-IN) in brain volume and neurofilament light chain (sNfL) over 6-months in patients with treatment resistant depression (TDR).
Methods: Seven TRD patients received ESK-IN while continuing oral antidepressants. Clinical evaluations were conducted at baseline, 1, 3, and 6 months, with MRI scans and blood samples taken at baseline and 6 months. Brain volume was assessed using VolBrain2 and DSI studio.
Results: Compared to controls, TRD patients initially showed lower volumes (mm3) in key cortical regions such as the insula (p = 0.0156), the frontal lobe (p = 0.0228) the superior parietal lobe (p = 0.0402), both superior (p = 0.0216) and inferior (p = 0.0437) temporal lobes and subcortical regions such as the nucleus accumbens (p = 0.0056), putamen (p = 0.0083), thalamus (p = 0.0102) and the hippocampus (p = 0.0001). Brain volume increased in the frontal cortex (p = 0.0295), the anterior cingulate (p = 0.0496), and hippocampus (p = 0.0015), as well as in the volume and fiber tracts associated with emotional regulation, such as the frontoparahippocampal (p = 0.0156 and p = 0.0313, respectively), the frontoparietal (p = 0.0496 and p = 0.0156, respectively) and the frontal aslant tract after 6 months on treatment with ESK-IN. In parallel, sNfL levels decreased post-treatment, indicating potential neuroprotective effects.
Conclusions: ESK-IN may promote structural changes in regions associated with mood regulation and neuroplasticity, while also reducing neuronal damage in TRD patients.
期刊介绍：
CNS Spectrums covers all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology, particularly those pertinent to the clinician and clinical investigator. The journal features focused, in-depth reviews, perspectives, and original research articles. New therapeutics of all types in psychiatry, mental health, and neurology are emphasized, especially first in man studies, proof of concept studies, and translational basic neuroscience studies. Subject coverage spans the full spectrum of neuropsychiatry, focusing on those crossing traditional boundaries between neurology and psychiatry.
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