Brain functional network correlates and predictors of the perioperative antidepressant effect of esketamine in breast cancer patients: a double-blind randomized controlled trial using resting-state fMRI and graph theory.
Transl Psychiatry March 6, 2026 Huimin Zhu, Qingfeng Wei, Shuang Xu et al. 1 citation
In breast cancer patients, a single preoperative dose of esketamine produced a greater reduction in depressive symptoms 24 hours after surgery compared to placebo, as measured by the Montgomery-Åsberg Depression Rating Scale. The antidepressant effect was associated with increased functional connectivity in the left superior frontal gyrus and changes in brain network properties, including reduced clustering coefficient and increased global efficiency in the default mode network. Baseline functional connectivity in the left superior frontal gyrus predicted the magnitude of the antidepressant response. The findings suggest that esketamine's rapid antidepressant action involves modulation of brain functional networks.