Predictors of responsiveness to ketamine: An updated systematic review of neuroimaging findings.
Journal of affective disorders July 15, 2026 Iman Kiani, Giulia Cattarinussi, Fabio Sambataro et al.
A systematic review of fifteen neuroimaging studies identifies potential brain-based markers that could predict which patients with major depressive disorder will respond to ketamine. The anterior cingulate cortex and amygdala, along with their connections to other brain regions, frequently predicted better response. Higher fractional anisotropy in the cingulum, larger hippocampus volume, and a higher Glx/glutamate ratio in the dorsomedial prefrontal cortex also correlated with response. Task-based imaging showed that anterior cingulate cortex activity predicted antidepressant response. The review notes limitations due to differences in assessments, follow-up times, ketamine doses, and imaging methods across studies.