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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0809

Clinical, neuropsychological, and neuroimaging profiles of patients with treatment-resistant depression receiving intravenous ketamine treatment: an exploratory multimodal case series

CLINICAL, NEUROPSYCHOLOGICAL, AND NEUROIMAGING PROFILES OF TREATMENT-RESISTANT DEPRESSION IN PATIENTS TREATED WITH INTRAVENOUS KETAMINE: AN EXPLORATORY MULTIMODAL CASE SERIES

A combined mood–executive phenotype characterized by co-occurring clinical severity, executive dysfunction, and disrupted connectivity in large-scale brain networks was identified in patients with treatment-resistant depression who were candidates for intravenous ketamine.

The aim was to describe the clinical, neuropsychological, and neuroimaging profiles of patients with treatment-resistant depression (TRD) before intravenous (IV) ketamine treatment. This retrospective, observational, naturalistic study assessed 8 patients with TRD (4 women, 4 men; mean age 38.5 +/- 10.3 years) at baseline. Clinical assessment used the BDI-II and MADRS; the neuropsychological battery examined executive functions, attention, and episodic memory; resting-state fMRI assessed functional connectivity of the DMN, SN, FP/CEN, and subgenual anterior cingulate cortex (sgACC), while diffusion tensor imaging (DTI) assessed white matter integrity and fractional anisotropy. Findings revealed decoupling between the FP/CEN and SN in 87.5% of patients, hypoconnectivity of the sgACC with prefrontal and salience regions in 75%, DMN fragmentation in 62.5%, and white matter microstructural alterations in 62.5%; the most affected tracts were the arcuate fasciculus, external capsule, and superior longitudinal fasciculus III. Clinical findings included severe depression (BDI-II and MADRS), persistent anhedonia and rumination, substantial functional disability, and moderate impairment in executive functions and attention, with relative preservation of episodic memory. Overall, the findings support a transdiagnostic, multiple-network model of TRD; integrated multimodal assessment may improve patient selection for ketamine, and sgACC, SN, FP/CEN, and DMN markers are proposed as candidates for treatment response prediction models. The authors emphasize the need for longitudinal studies with larger samples.

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