Electrophysiologic Dynamics of Depression and Antidepressant Response in Epilepsy
Emory University
Summary
This study aims to identify electrophysiologic biomarkers associated with antidepressant response to ketamine in adults with epilepsy undergoing clinically indicated stereo-electroencephalography (sEEG) monitoring who have at least mild depressive symptoms. Participants will receive a single subanesthetic intravenous ketamine infusion (0.5 mg/kg over 40 minutes) during their Epilepsy Monitoring Unit admission. Intracranial neural recordings and behavioral assessments will be collected before and approximately 24 hours after infusion to examine changes in neural circuits associated with rumination and anhedonia.
Description
Depressive symptoms are common among individuals with epilepsy and are associated with reduced quality of life and poorer clinical outcomes. Although neuromodulation therapies have shown promise for treatment-resistant depression, the development of objective biomarkers to guide treatment remains a major challenge. Patients undergoing clinically indicated stereo-electroencephalography (sEEG) monitoring for epilepsy provide a unique opportunity to study human brain circuits with high spatial and temporal resolution. This prospective, single-site, open-label, within-subject mechanistic clinical…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Admitted to the Emory EMU for clinically indicated sEEG monitoring for epilepsy. * At least mild depressive symptoms at baseline, defined as MADRS ≥7 or BDI-II ≥14. * Electrode coverage that includes midline regions sufficient for enrollment and analyses. * Ability to provide informed consent and to complete bedside tasks/questionnaires in English. * Expected to remain under inpatient monitoring through the planned \~24-hour post-infusion follow-up unless clinical needs dictate otherwise. Exclusion Criteria: * Documented IQ \<70, intellectual disability, severe cogniti…
Interventions
- DrugKetamine
Participants will receive one subanesthetic intravenous ketamine infusion administered at a dose of 0.5 mg/kg over 40 minutes during admission to the Epilepsy Monitoring Unit. The infusion will be supervised by a psychiatrist experienced in ketamine administration and conducted under continuous clinical monitoring. Intracranial sEEG recordings, behavioral assessments, and symptom measures collected before and approximately 24 hours after infusion will be used to evaluate electrophysiologic biomarkers associated with antidepressant response
Location
- Emory UniversityAtlanta, Georgia