Abstract

Ketamine is a non-competitive N-Methyl-D-aspartate receptor (NMDAR) antagonist used in the clinic to initiate and maintain anaesthesia; it induces dissociative states and has emerged as a breakthrough therapy for major depressive disorder. Using local field potential recordings in freely moving rats, we studied resting state EEG profiles induced by co-administering ketamine with either: clozapine, a highly efficacious antipsychotic; or naltrexone, an opioid receptor antagonist reported to block the acute antidepressant effects of ketamine. As human electroencephalography (EEG) is predominantly recorded in a passive state, head-mounted accelerometers were used with rats to determine active and passive states at a high temporal resolution to offer the highest translatability. In general, pharmacological effects for the three drugs were more pronounced in (or restricted to) the passive state. Specifically, during inactive periods clozapine induced increases in delta (0.1–4 Hz), gamma (30–60 Hz) and higher frequencies (>100 Hz). Importantly, it reversed the ketamine-induced reduction in low beta power (10–20 Hz) and potentiated ketamine-induced increases in gamma and high frequency oscillations (130–160 Hz). Naltrexone inhibited frequencies above 50 Hz and significantly reduced the ketamine-induced increase in high frequency oscillations. However, some frequency band changes, such as clozapine-induced decreases in delta power, were only seen in locomoting rats. These results emphasise the potential in differentiating between activity states to capture drug effects and translate to human resting state EEG. Furthermore, the differential reversal of ketamine-induced EEG effects by clozapine and naltrexone may have implications for the understanding of psychotomimetic as well as rapid antidepressant effects of ketamine.

Highlights

  • Ketamine is a non-competitive N-Methyl-D-aspartate receptor (NMDAR) antagonist investigated for its psychotomimetic properties [1, 2] and has, among other NMDAR antagonists, been used to model positive, negative and cognitive symptoms of schizophrenia (SZ) [3, 4]

  • As neuronal firing increases during movement in response to increased sensory input and processing [37, 92], we hypothesise that the smaller pharmacological deviations in Active vs. Inactive results from 1) circuits modulated by clozapine/ketamine/naltrexone are engaged during locomotion, baseline Active local field potentials (LFP) are closer to physiological maximum and pharmacological enhancement above baseline is limited; or 2) distinct circuits of neurons engaged during Active behaviour generate spectral activity that outweighs LFPs generated by modulation of drug-susceptible circuits

  • Investigation in human subjects and in pre-clinical depression models to characterise the relationship between High frequency oscillations (HFO) amplitudes and rapid-acting antidepressant (RAAD) effects is recommended. This is the first study to investigate differences in locomotor state ketamine LFP induced by the neuroleptic clozapine and the opioid antagonist naltrexone

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Summary

Introduction

Ketamine is a non-competitive N-Methyl-D-aspartate receptor (NMDAR) antagonist investigated for its psychotomimetic properties [1, 2] and has, among other NMDAR antagonists, been used to model positive, negative and cognitive symptoms of schizophrenia (SZ) [3, 4]. Ketamine has gained attention for its robust, long-lasting, rapid-acting antidepressant (RAAD) effects [5, 6]. The mechanism of therapeutic effect remains un-elucidated and understanding RAAD pathways is complicated by ketamine’s affinities to receptors in opioid, norepinephric, dopaminergic and serotonergic systems [1, 7, 8]. Concerns that ketamine RAAD effects are opioid dependent were raised [9,10,11,12,13] after publication of two human studies using naltrexone (opioid antagonist) and ketamine [14, 15]. Williams’ study reported that naltrexone pre-treatment completely prevented ketamine RAAD improvements but left dissociation intact.

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