Behavioral and Electrophysiological Effects of Ketamine in Treatment-Resistant Depression

Brief Summary

The overarching goal of the present study is to evaluate the effect of a subanesthetic dose of ketamine 24-hour post-injection on resting state functional connectivity, cognitive control, and reward learning.

Intervention / Treatment

Condition or Disease

  • Major Depressive Disorder

Phase

Study Design

Study type: OBSERVATIONAL
Status: Recruiting
Study results: No Results Available
Age: 18 Years to 70 Years
Enrollment: 60 (ESTIMATED)
Funded by: Other
Time Perspective: Cross-Sectional
Observational Model: Case-Control

Masking

Clinical Trial Dates

Start date: Aug 17, 2020 ACTUAL
Primary Completion: Jun 01, 2023 ESTIMATED
Completion Date: Mar 31, 2024 ESTIMATED
Study First Posted: Jan 27, 2020 ACTUAL
Results First Posted: Aug 31, 2020
Last Updated: Mar 31, 2023

Sponsors / Collaborators

Lead Sponsor: N/A
Responsible Party: N/A

Major Depressive Disorder (MDD) participants with treatment-resistant depression (TRD) will be recruited from McLean's Ketamine clinic. Suitability for Ketamine treatment will be determined as typically done by the service - through evaluation by the clinicians on the staff of the Ketamine Service who perform psychiatric consultations and assessments for Ketamine suitability. Potential subjects will be informed about the study only after they have received a positive consultation at the clinic and have already agreed to receive the treatment.

This study consists of a set of questionnaires, urine drug screen, and electroencephalogram (EEG) recordings.

Eligibility Criteria

Sex: All
Minimum Age: 18
Maximum Age: 70
Healthy Volunteers: Yes

Inclusion Criteria (MDD Subjects):

* All genders, races, and ethnic origins, aged between 18 and 70;
* DSM-5 diagnostic criteria for MDD (diagnosed with the use of the Structured Clinical Interview for DSM-5 (SCID-5));
* A score of ≥32 on the Inventory of Depressive Symptomatology-Clinician Rated (IDS-C30).
* Capable of providing written informed consent, and fluent in English;
* Right-handed;
* Treatment Resistant (as assessed using the MGH Antidepressant Response Questionnaire)
* Have already decided to receive ketamine treatment as part of their standard clinical care

Inclusion Criteria (Control Subjects):

* All genders, races, and ethnic origins, aged between 18 and 70;
* Absence of medical, neurological, and psychiatric illness (including alcohol and substance abuse), as assessed by subject history and a structured clinical interview (SCID-I/NP);
* A baseline Quick Inventory of Depressive Symptomatology (QIDS) score ≤ 5;
* A baseline Hamilton Depression Rating Scale (HDRS) score ≤ 7;
* Capable of providing written informed consent, and fluent in English;
* Right-handed;
* No first-degree relative with mood or psychotic disorder.

Exclusion Criteria (All Subjects):

* Serious or unstable medical illness, including cardiovascular, hepatic, renal, respiratory, endocrine, neurologic or hematologic disease;
* History of seizure disorder;
* History or current diagnosis of any of the following DSM-5 psychiatric illnesses: schizophrenia, schizoaffective disorder, delusional disorder, psychotic disorders not otherwise specified, substance abuse disorder;
* Clinical or laboratory evidence of hypothyroidism, hyperthyroidism, or other thyroid disorder that is not controlled by medication;
* Substance use assessed by physician as dangerous for ketamine treatment;
* Untreated glaucoma;
* Complex post-traumatic stress disorder (PTSD) with dissociation;
* Patients with a lifetime history of electroconvulsive therapy (ECT).
* Participants with a lifetime history of ketamine use.

This clinical trial is recruiting

Are you interested in participating in this trial or others? We'd love to help.

Primary Outcomes
  • Relative FRP response is the primary outcome measure for the probabilistic reward task (PRT).

  • Relative ERN response is the primary outcome measure for the flanker task.

  • The Probablilistic Reward Task operationalizes positive reinforcement learning

  • The Flanker Task is a cognitive task that measures response inhibition to assess the ability to suppress responses that are inappropriate in a particular context.

  • Severity of rumination will be assessed using the Rumination Response Scale (RRS). The RRS has a minimum score of 22 and a maximum score of 88. Higher scores indicate higher degrees of ruminative symptoms.

More Details

NCT Number: NCT04239963
Other IDs: 2019P003371
Study URL: https://clinicaltrials.gov/study/NCT04239963
Last updated: Sep 29, 2023