Triple-network model–based graph theory analysis of the effectiveness of low-dose ketamine in patients with treatment-resistant depression: two resting-state functional MRI clinical trials

作者：Wei-Chen Lin, Li‐Kai Cheng, Tung‐Ping Su, Li‐Fen Chen, Pei-Chi Tu, Cheng‐Ta Li, Ya‐Mei Bai, Shih‐Jen Tsai, Mu‐Hong Chen · 发表于：The British Journal of Psychiatry · 年份：2025 · DOI：10.1192/bjp.2025.14 · 被引用次数：2 · 研究领域：Functional Brain Connectivity Studies、Treatment of Major Depression、Mental Health Research Topics

BACKGROUND: Evidence suggests the crucial role of dysfunctional default mode (DMN), salience and frontoparietal (FPN) networks, collectively termed the triple network model, in the pathophysiology of treatment-resistant depression (TRD). AIMS: Using the graph theory- and seed-based functional connectivity analyses, we attempted to elucidate the role of low-dose ketamine in the triple networks, namely the DMN, salience and FPN. METHOD: Resting-state functional connectivity magnetic resonance imaging (rs-fcMRI) data derived from two previous clinical trials of a single, low-dose ketamine infusion were analysed. In clinical trial 1 (Trial 1), patients with TRD were randomised to either a ketamine or normal saline group, while in clinical trial 2 (Trial 2) those patients with TRD and pronounced suicidal symptoms received a single infusion of either 0.05 mg/kg ketamine or 0.045 mg/kg midazolam. All participants underwent rs-fcMRI pre and post infusion at Day 3. Both graph theory- and seed-based functional connectivity analyses were performed independently. RESULTS: Trial 1 demonstrated significant group-by-time effects on the degree centrality and cluster coefficient in the right posterior cingulate cortex (PCC) cortex ventral 23a and b (DMN) and the cluster coefficient in the right supramarginal gyrus perisylvian language (salience). Trial 2 found a significant group-by-time effect on the characteristic path length in the left PCC 7Am (DMN). In addition, both ketamine and normal ...