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Ketamine Clinical Trials

How the Brain Encodes Beliefs: A Functional Magnetic Resonance Imaging Study of the Belief Updating in Treatment Resistant Depression.

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Id: NCT05577247

Organisation Name: Assistance Publique - Hôpitaux de Paris

Overal Status: Not yet recruiting

Start Date: December 15, 2022

Last Update: October 13, 2022

Lead Sponsor: Assistance Publique - Hôpitaux de Paris

Brief Summary: Major depressive disorder (MDD) is characterized by a cognitive triad of negative beliefs about oneself, the future and the world. For example, depressed patients hold persistently negative expectations about the future, despite contradictory evidence, and these strong negative beliefs are thought to play an important role in the maintenance of depressive symptoms and potentially in treatment resistance. Indeed, one out of three patients with major depressive disorder does not respond to conventional, monoaminergic treatments, which has led to the concept of treatment resistant depression (TRD). It is unknown how the brain encodes the strong negative beliefs that are insensitive to positive disconfirming information in TRD patients, and how these neural underpinnings of maladaptive belief updating are altered by antidepressant treatment.

The principal objective of this study is to gain insight into the brain mechanisms of belief updating about the future in TRD patients before and after starting ketamine treatment. We will combine behavioral testing of cognitive biases in belief updating with functional magnetic resonance imaging and a pharmacological challenge comparing ketamine to conventional, monoaminergic antidepressants.

The results of this study are expected to provide a better understanding of the neurocognitive mechanisms of belief-updating in depressed patients, and how these mechanisms contribute to clinical improvement following antidepressant treatment.

  • Treatment Resistant Depression

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