ArticleJournal of psychopharmacology (Oxford, England)2021
Brain entropy and neurotrophic molecular markers accompanying clinical improvement after ketamine: Preliminary evidence in adolescents with treatment-resistant depression.
Article in Journal of psychopharmacology (Oxford, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Ketamine/esketamine treatment for resistant depression in children and adolescents: a PRISMA systematic review.European child & adolescent psychiatry · 2026Pooled it
- Psychedelics and ketamine/esketamine in depressive disorders: biological mechanisms and associated neuroimaging and clinical changes.Translational psychiatry · 2025Pooled it
- Ketamine for mood disorders, anxiety, and suicidality in children and adolescents: a systematic review.European child & adolescent psychiatry · 2025Pooled it
- Single dose IV ketamine for adolescent suicidal ideation in the emergency department: a pilot randomized trial.BMC psychiatry · 2026Trial
- ATP bioenergetics and fatigue in young adults with and without major depression.Translational psychiatry · 2026Article
- A longitudinal analysis of the clinical practice of ketamine assisted psychotherapy with adolescents and young adults.Frontiers in psychiatry · 2026Article
- Neuroimaging as a Tool for Advancing Pediatric Psychopharmacology.Paediatric drugs · 2025Review
- The different impacts of functional network centrality and connectivity on the complexity of brain signals in healthy control and first-episode drug-naïve patients with major depressive disorder.Brain imaging and behavior · 2025Article
- A Systematic Review on Ketamine and Esketamine for Treatment-Resistant Depression and Suicidality in Adolescents: A New Hope?Children (Basel, Switzerland) · 2024Review
- Intranasal esketamine as therapeutic option: a case report of an adolescent with treatment resistant depression.Frontiers in psychiatry · 2023Article
- Ketamine-assisted psychotherapy in adolescents with multiple psychiatric diagnoses.Frontiers in psychiatry · 2023Article
- The trilateral interactions between mammalian target of rapamycin (mTOR) signaling, the circadian clock, and psychiatric disorders: an emerging model.Translational psychiatry · 2022Review
- Novel drug developmental strategies for treatment-resistant depression.British journal of pharmacology · 2022Review
- Intrinsic Connectivity Networks of Glutamate-Mediated Antidepressant Response: A Neuroimaging Review.Frontiers in psychiatry · 2022Review
- Biomarkers of ketamine's antidepressant effect: a clinical review of genetics, functional connectivity, and neurophysiology.Chronic stress (Thousand Oaks, Calif.)Review
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundCurrent theory suggests that treatment-resistant depression (TRD) involves impaired neuroplasticity resulting in cognitive and neural rigidity, and that clinical improvement may require increasing brain flexibility and adaptability.
aimsIn this hypothesis-generating study, we sought to identify preliminary evidence of brain flexibility correlates of clinical change within the context of an open-label ketamine trial in adolescents with TRD, focusing on two promising candidate markers of neural flexibility: (a) entropy of resting-state functional magnetic resonance imaging (fMRI) signals; and (b) insulin-stimulated phosphorylation of mammalian target of rapamycin (mTOR) and glycogen synthase-3-beta (GSK3β) in peripheral blood mononuclear cells.
methodsWe collected resting-state functional magnetic resonance imaging data and blood samples from 13 adolescents with TRD before and after a series of six ketamine infusions over 2 weeks. Usable pre/post ketamine data were available from 11 adolescents for imaging and from 10 adolescents for molecular signaling. We examined correlations between treatment response and changes in the central and peripheral flexibility markers.
resultsDepression reduction correlated with increased nucleus accumbens entropy. Follow-up analyses suggested that physiological changes were associated with treatment response. In contrast to treatment non-responders (
conclusionsThese data provide preliminary evidence that changes in neural flexibility may underlie symptom relief in adolescents with TRD following ketamine. Future research with adequately powered samples is needed to confirm resting-state entropy and insulin-stimulated mTOR and GSK3β as brain flexibility markers and candidate targets for future clinical trials. CLINICAL TRIAL NAME: Ketamine in adolescents with treatment-resistant depression
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