Investigation of Intranasal Ketamine Related Changes in Attentional Brain Networks With Functional and Structural MRI

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

33 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-06-01

Study Completion Date

2023-06-21

Brief Summary

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Subanesthetic ketamine is currently used as a rapid-acting antidepressant. It is an antagonist of the N-methyl-d-aspartate (NMDA) receptor, but former results indicate that its action also depends on the noradrenaline system and the locus coeruleus (LC).

Based on this known impact of ketamine on the sympathetic nervous system the aim of this study is to investigate the effects of intranasal esketamine on LC related attentional brain networks in task based functional MRI, to relate those attention network changes to behavioural measures and to predict ketamine related attention network changes by brain structure.

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Detailed Description

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Conditions

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Ketamine Treatment

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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first 56mg esketamine (2x Spravato® 28 mg nasal spray), then placebo

Group Type EXPERIMENTAL

56mg esketamine (2x Spravato® 28 mg nasal spray)

Intervention Type DRUG

56mg esketamine (2x Spravato® 28 mg nasal spray)

0.9% saline solution nasal spray

Intervention Type DRUG

0.9% saline solution nasal spray

first placebo (0.9% saline solution nasal spray), then ketamine

Group Type EXPERIMENTAL

56mg esketamine (2x Spravato® 28 mg nasal spray)

Intervention Type DRUG

56mg esketamine (2x Spravato® 28 mg nasal spray)

0.9% saline solution nasal spray

Intervention Type DRUG

0.9% saline solution nasal spray

Interventions

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56mg esketamine (2x Spravato® 28 mg nasal spray)

Intervention Type DRUG

0.9% saline solution nasal spray

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* General health (no serious internal or neurologic pre-existing conditions) based on medical history, physical examination and structured clinical interview for DSM-IV (SCID)
* Age 18 to 55 years
* Right-handedness (due to potential lateralization effects of left-handed subjects)
* Willingness and competence to sign the informed consent form

Exclusion Criteria

* Current or history of psychiatric or neurological disease
* Current medical illness requiring treatment
* Current or former substance abuse
* Pregnancy or current breastfeeding
* Diagnosis of an Axis-1 psychotic disorder in a first-degree relative
* Known aneurysmal vascular disease based on medical history (including intracranial, thoracic, or abdominal aorta, or peripheral arterial vessels), history of intracerebral haemorrhage, recent (within 6weeks) cardiovascular event, including myocardial infarction (MI)
* Significant pulmonary insufficiency, including COPD; sleep apnoea with morbid obesity (BMI ≥35), uncontrolled brady- or tachyarrhythmias that lead to haemodynamic instability; history of an MI, haemodynamically significant valvular heart disease or heart failure (NYHA Class III-IV)
* Hyperthyroidism that has not been sufficiently treated
* History of brain injury, hypertensive encephalopathy, intrathecal therapy with ventricular shunts, or any other condition associated with increased intracranial pressure
* Child-Pugh class C (severe) hepatic impairment
* Any contraindication for MRI (e.g., MR incompatible implants, etc.) including dental implants causing signal artifacts
* Failure to comply with the study protocol or to follow the instruction of the investigating team

Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes