Evidence map›Paper›PMID 37872291›Full record

Trial reportPsychopharmacology2024

Effects of a dissociative drug on fronto-limbic resting-state functional connectivity in individuals with posttraumatic stress disorder: a randomized controlled pilot study.

Sarah K Danböck, Or Duek, Ziv Ben-Zion, Nachshon Korem, Shelley L Amen, Ben Kelmendi, Frank H Wilhelm, Ifat Levy, Ilan Harpaz-Rotem

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Psychopharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

Sarah K DanböckDepartment of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria. Sarah.Danboeck@uni-mannheim.de.
Or DuekDepartment of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA.
Ziv Ben-ZionDepartment of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA.
Nachshon KoremDepartment of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA.
Shelley L AmenDepartment of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA.
Ben KelmendiDepartment of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA.
Frank H WilhelmDepartment of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria.
Ifat LevyDepartments of Comparative Medicine and Neuroscience, School of Medicine, Yale University, New Haven, CT, USA.
Ilan Harpaz-RotemDepartment of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA.
VA Connecticut Healthcare System · USUniversity of Salzburg · ATUnited States Department of Veterans Affairs · USYale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Austrian Science Fund FWF W 1233NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

rationaleA subanesthetic dose of ketamine, a non-competitive N-methyl-D-aspartate glutamate receptor (NMDAR) antagonist, elicits dissociation in individuals with posttraumatic stress disorder (PTSD), who also often suffer from chronic dissociative symptoms in daily life. These debilitating symptoms have not only been linked to worse PTSD trajectories, but also to increased resting-state functional connectivity (RSFC) between medial prefrontal cortex (mPFC) and amygdala, supporting the conceptualization of dissociation as emotion overmodulation. Yet, as studies were observational, causal evidence is lacking.

objectivesThe present randomized controlled pilot study examines the effect of ketamine, a dissociative drug, on RSFC between mPFC subregions and amygdala in individuals with PTSD.

methodsTwenty-six individuals with PTSD received either ketamine (0.5mg/kg; n = 12) or the control drug midazolam (0.045mg/kg; n = 14) during functional magnetic resonance imaging (fMRI). RSFC between amygdala and mPFC subregions, i.e., ventromedial PFC (vmPFC), dorsomedial PFC (dmPFC) and anterior-medial PFC (amPFC), was assessed at baseline and during intravenous drug infusion.

resultsContrary to pre-registered predictions, ketamine did not promote a greater increase in RSFC between amygdala and mPFC subregions from baseline to infusion compared to midazolam. Instead, ketamine elicited a stronger transient decrease in vmPFC-amygdala RSFC compared to midazolam.

conclusionsA dissociative drug did not increase fronto-limbic RSFC in individuals with PTSD. These preliminary experimental findings contrast with prior correlative findings and call for further exploration and, potentially, a more differentiated view on the neurobiological underpinning of dissociative phenomena in PTSD.

Indexed as

KetamineStress Disorders, Post-TraumaticAmygdalaHumansMagnetic Resonance ImagingMidazolamPilot ProjectsKetamineMidazolamBiomarkerConnectivityDissociationImagingKetaminePTSDTrauma

Identifiers

PMID37872291
PMCPMC10806226
OpenAlexW4387893788

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.