Single and repeated ketamine treatment induces perfusion changes in sensory and limbic networks in major depressive disorder

Ketamine infusion therapy is now well-replicated to produce fast-acting antidepressant effects in patients with major depressive disorder (MDD). However, brain systems-level hemodynamic changes in response to single and repeated ketamine treatment remain uncharacterized. Using advanced MB pCASL MRI we examined CBF changes occurring with single and repeated ketamine treatment. Initial changes in blood flow were observed in the posterior cingulate and precuneus and primary and higher order visual areas. However, repeated exposure to ketamine engaged deeper limbic structures and the insula. Findings demonstrate that ketamine treatment perturbs distinct functional networks including sensory and limbic regions