EEG correlates of dissociation during ketamine treatment

  • Research type

    Research Study

  • Full title

    Electroencephalographic (EEG) correlates of dissociation during ketamine treatment

  • IRAS ID

    306474

  • Contact name

    Rupert McShane

  • Contact email

    rupert.mcshane@oxfordhealth.nhs.uk

  • Sponsor organisation

    Oxford Health NHS Foundation Trust

  • Duration of Study in the UK

    0 years, 11 months, 17 days

  • Research summary

    Research Summary

    Low dose ketamine is a potent but unlicensed antidepressant. A version of it, esketamine, has been licensed as an antidepressant but is not NICE approved. The Oxford Health NHS Foundation Trust Ketamine Clinic treats both NHS and self-pay (private) patients and has treated over 340 patients with 3,100 infusions and over 9,000 oral doses. Some patients have been treated regularly for up to 10 years.
    This is a single-site, cohort observational study sponsored by Oxford Health NHS Foundation Trust. We will recruit N=30 patients with treatment-resistant depression who are offered ketamine as part of the Interventional Psychiatry service at Oxford Health, from study approval date until August 2023.

    We wish to explore whether the dissociation that patients with depression experience during ketamine treatment has electroencephalographic (brain electrical activity) correlates and whether these change with repeated use of ketamine. Understanding this may eventually help us to understand the brain mechanisms of ‘dissociation’ – the sense that one’s mind and body are separate.

    Summary of Results

    Depression is one of the leading causes of disability worldwide. For around one in three people with depression, standard treatments such as antidepressants and talking therapies are not effective. This is known as treatment-resistant depression (TRD). In recent years, ketamine - a medicine originally used as an anaesthetic - has been found to work quickly in relieving symptoms for some people with TRD.

    However, at the moment, doctors have no reliable way of measuring how ketamine is affecting the brain during treatment. This study explored whether brain activity monitoring using a low-cost device could help.

    We used a portable electroencephalogram (EEG) headset to measure brain waves in patients receiving intravenous ketamine at a specialist NHS clinic. EEG measures the brain’s electrical activity through sensors placed on the scalp. We recorded this activity before, during, and after the ketamine infusion.

    The results so far have showed a drop in specific types of brain waves, known as alpha and theta waves, particularly in areas near the sides of the head (called the temporal regions). These changes were seen during the ketamine infusion and returned towards baseline afterwards.

    This suggests that it is possible to detect brain changes during ketamine treatment using a simple, wearable EEG device. More research is needed to understand whether this type of monitoring could help guide or personalise treatment for people with depression in the future.

  • REC name

    East Midlands - Nottingham 1 Research Ethics Committee

  • REC reference

    22/EM/0226

  • Date of REC Opinion

    14 Oct 2022

  • REC opinion

    Favourable Opinion