{"title":"Biomarkers of ketamine's antidepressant effect: a clinical review of genetics, functional connectivity, and neurophysiology.","authors":"Alexandra A Alario, Mark J Niciu","doi":"10.1177/24705470211014210","DOIUrl":null,"url":null,"abstract":"<p><p>Major depressive disorder (MDD) is one of the leading causes of morbidity and all-cause mortality (including suicide) worldwide, and, unfortunately, first-line monoaminergic antidepressants and evidence-based psychotherapies are not effective for all patients. Subanesthetic doses of the N-methyl-D-aspartate receptor antagonists and glutamate modulators ketamine and S-ketamine have rapid and robust antidepressant efficacy in such treatment-resistant depressed patients (TRD). Yet, as with all antidepressant treatments including electroconvulsive therapy (ECT), not all TRD patients adequately respond, and we are presently unable to <i>a priori</i> predict who will respond or not respond to ketamine. Therefore, antidepressant treatment response biomarkers to ketamine have been a major focus of research for over a decade. In this article, we review the evidence in support of treatment response biomarkers, with a particular focus on genetics, functional magnetic resonance imaging, and neurophysiological studies, i.e. electroencephalography and magnetoencephalography. The studies outlined here lay the groundwork for replication and dissemination.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/24705470211014210","citationCount":"16","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chronic Stress","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/24705470211014210","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Psychology","Score":null,"Total":0}
引用次数: 16
Abstract
Major depressive disorder (MDD) is one of the leading causes of morbidity and all-cause mortality (including suicide) worldwide, and, unfortunately, first-line monoaminergic antidepressants and evidence-based psychotherapies are not effective for all patients. Subanesthetic doses of the N-methyl-D-aspartate receptor antagonists and glutamate modulators ketamine and S-ketamine have rapid and robust antidepressant efficacy in such treatment-resistant depressed patients (TRD). Yet, as with all antidepressant treatments including electroconvulsive therapy (ECT), not all TRD patients adequately respond, and we are presently unable to a priori predict who will respond or not respond to ketamine. Therefore, antidepressant treatment response biomarkers to ketamine have been a major focus of research for over a decade. In this article, we review the evidence in support of treatment response biomarkers, with a particular focus on genetics, functional magnetic resonance imaging, and neurophysiological studies, i.e. electroencephalography and magnetoencephalography. The studies outlined here lay the groundwork for replication and dissemination.
重度抑郁症(MDD)是全世界发病率和全因死亡率(包括自杀)的主要原因之一,不幸的是,一线单胺类抗抑郁药和循证心理疗法并非对所有患者都有效。亚麻醉剂量的n -甲基- d -天冬氨酸受体拮抗剂和谷氨酸调节剂氯胺酮和s -氯胺酮对这类难治性抑郁症患者(TRD)具有快速而强大的抗抑郁疗效。然而,与包括电休克疗法(ECT)在内的所有抗抑郁药物治疗一样,并非所有TRD患者都有充分的反应,我们目前无法先验地预测谁对氯胺酮有反应或没有反应。因此,抗抑郁药物治疗对氯胺酮反应的生物标志物已经成为十多年来研究的主要焦点。在本文中,我们回顾了支持治疗反应生物标志物的证据,特别关注遗传学,功能磁共振成像和神经生理学研究,即脑电图和脑磁图。这里概述的研究为复制和传播奠定了基础。