1. Functional activity and connectivity signatures of ketamine and lamotrigine during negative emotional processing: a double-blind randomized controlled fMRI study.
- Author
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Meiering MS, Weigner D, Gärtner M, Carstens L, Keicher C, Hertrampf R, Beckmann CF, Mennes M, Wunder A, Weigand A, and Grimm S
- Subjects
- Humans, Double-Blind Method, Male, Adult, Female, Young Adult, Excitatory Amino Acid Antagonists pharmacology, Excitatory Amino Acid Antagonists administration & dosage, Brain drug effects, Brain diagnostic imaging, Hippocampus drug effects, Hippocampus diagnostic imaging, Antidepressive Agents pharmacology, Antidepressive Agents administration & dosage, Ketamine pharmacology, Ketamine administration & dosage, Lamotrigine pharmacology, Lamotrigine administration & dosage, Magnetic Resonance Imaging, Emotions drug effects, Emotions physiology
- Abstract
Ketamine is a highly effective antidepressant (AD) that targets the glutamatergic system and exerts profound effects on brain circuits during negative emotional processing. Interestingly, the effects of ketamine on brain measures are sensitive to modulation by pretreatment with lamotrigine, which inhibits glutamate release. Examining the antagonistic effects of ketamine and lamotrigine on glutamate transmission holds promise to identify effects of ketamine that are mediated through changes in the glutamatergic system. Investigating this modulation in relation to both the acute and sustained effects of ketamine on functional activity and connectivity during negative emotional processing should therefore provide novel insights. 75 healthy subjects were investigated in a double-blind, single-dose, randomized, placebo-controlled, parallel-group study with three treatment conditions (ketamine, lamotrigine pre-treatment, placebo). Participants completed an emotional face viewing task during ketamine infusion and 24 h later. Acute ketamine administration decreased hippocampal and Default Mode Network (DMN) activity and increased fronto-limbic coupling during negative emotional processing. Furthermore, while lamotrigine abolished the ketamine-induced increase in functional connectivity, it had no acute effect on activity. Sustained (24 h later) effects of ketamine were only found for functional activity, with a significant reduction in the posterior DMN. This effect was blocked by pretreatment with lamotrigine. Our results suggest that both the acute increases in fronto-limbic coupling and the delayed decrease in posterior DMN activity, but not the attenuated limbic and DMN recruitment after ketamine, are mediated by altered glutamatergic transmission., (© 2024. The Author(s).)
- Published
- 2024
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