GABA interneurons are the cellular trigger for ketamine's rapid antidepressant actions
Open accessAbstract
A single subanesthetic dose of ketamine, an NMDA receptor (NMDAR) antagonist, produces rapid and sustained antidepressant actions in depressed patients, addressing a major unmet need for the treatment of mood disorders. Ketamine produces a rapid increase in extracellular glutamate and synaptic formation in the prefrontal cortex, but the initial cellular trigger that initiates this increase and ketamine's behavioral actions has not been identified. To address this question, we used a combination of viral shRNA and conditional mutation to produce cell-specific knockdown or deletion of a key NMDAR subunit, GluN2B, implicated in the actions of ketamine. The results demonstrated that the antidepressant actions of ketamine were blocked by GluN2B-NMDAR knockdown on GABA (Gad1) interneurons, as well as subtypes expressing somatostatin (Sst) or parvalbumin (Pvalb), but not glutamate principle neurons in the medial prefrontal cortex (mPFC). Further analysis of GABA subtypes showed that cell-specific knockdown or deletion of GluN2B in Sst interneurons blocked or occluded the antidepressant actions of ketamine and revealed sex-specific differences that are associated with excitatory postsynaptic currents on mPFC principle neurons. These findings demonstrate that GluN2B-NMDARs on GABA interneurons are the initial cellular trigger for the rapid antidepressant actions of ketamine and show sex-specific adaptive mechanisms to GluN2B modulation.
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The behavioral effect of GluN2B loss corresponded to disinhibition of layer 5 mPFC pyramidal neurons, with inhibition of GABA signaling strengthening pyramidal neuron activity.
“This behavioral effect corresponded to a disinhibition of layer 5 mPFC pyramidal neurons whereby inhibition of GABA signaling strengthened pyramidal neuron activity.”
From Mechanisms of ketamine and its metabolites as antidepressants (2022) · cites this paper as Gerhard et al., 2020
The Discussion reports that GluN2B knockdown or deletion in Sst interneurons increased excitatory currents in layer V mPFC pyramidal neurons and was associated with antidepressant-like behavior in male mice. It identifies this as disinhibition, but says the electrophysiological association was not observed in females; the claim omits that limitation. The indexed passages provide a section label but no page number. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe genetic manipulation alone reduced immobility relative to controls to a point where ketamine could not elicit a further reduction.
“The genetic manipulation alone appeared to reduce immobility relative to controls to a point where ketamine could not elicit a further reduction.”
From Mechanisms of ketamine and its metabolites as antidepressants (2022) · cites this paper as Gerhard et al., 2020
The results section reports that GluN2B knockdown in Gad1 interneurons reduced baseline immobility relative to controls and that ketamine produced no further reduction. But the Discussion (p. 1345) reports that another antidepressant reduced immobility in the manipulated mice, ruling out a floor effect. Thus the paper supports the observed lack of further ketamine response, not the suggestion that immobility had fallen to a point where no further reduction was possible. (LLM, conf=0.90)
Experimental — accuracy not yet measuredLoss of GluN2B in medial prefrontal cortex GABAergic interneurons, specifically those expressing somatostatin and parvalbumin, occluded ketamine's antidepressant-like effects in the mouse forced swim test.
“using a genetic knockdown approach in mice found that loss of GluN2B in medial PFC (mPFC GABAergic interneurons, and specifically in those expressing somatostatin (SST) and parvalbumin (PV), occluded the antidepressant-like effects of ketamine in the forced swim test (Gerhard et al., 2020).”
From Mechanisms of ketamine and its metabolites as antidepressants (2022) · cites this paper as Gerhard et al., 2020
Knockdown or deletion of ketamine-sensitive NMDARs from somatostatin- or parvalbumin-expressing interneurons alters baseline forced swim test and other behaviors.
“Furthermore, knock-down and deletion of critical ketaminesensitive NMDARs from either somatostatin-or parvalbuminexpressing interneurons alters baseline behaviors in the FST and other tasks and eliminates the ability of ketamine to change these behaviors in unstressed mice [210].”
From Plasticity of synapses and reward circuit function in the genesis and treatment of depression (2023) · cites this paper as [210]
Deletion of ketamine-sensitive NMDARs from these interneurons eliminates ketamine's ability to change behaviors in unstressed mice.
“Furthermore, knock-down and deletion of critical ketaminesensitive NMDARs from either somatostatin-or parvalbuminexpressing interneurons alters baseline behaviors in the FST and other tasks and eliminates the ability of ketamine to change these behaviors in unstressed mice [210].”
From Plasticity of synapses and reward circuit function in the genesis and treatment of depression (2023) · cites this paper as [210]
Ketamine acutely inhibits interneuron discharge in the prefrontal cortex and reduces spontaneous IPSCs in pyramidal cells.
“As in the hippocampus, ketamine inhibits the discharge of interneurons in the PFC and reduces spontaneous IPSCs in pyramidal cells acutely [210], while restoring inhibition at later timepoints corresponding to its behavioral actions [211].”
From Plasticity of synapses and reward circuit function in the genesis and treatment of depression (2023) · cites this paper as [210]
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- Authors
- Gerhard, D. M., Pothula, S., Liu, R.-J., Wu, M., Li, X.-Y., Girgenti, M. J., Taylor, S. R., Duman, C. H., Delpire, E., Picciotto, M., Wohleb, E. S., & Duman, R. S.
- Affiliations
- Yale University (US)
- Vanderbilt University (US)
- ORCID
- Venue
- Journal of Clinical Investigation
- Published
- 2020-01-27
- Volume
- 130
- Issue
- 3
- Pages
- 1336-1349
- ISSN
- 0021-9738 (ISSN-L)
- 1558-8238
- PMC
- PMC7269589
- OpenAlex
- W2991582092
- Cited by
- 345
- References
- 61
- Citations by year
- 2026: 37 · 2025: 51 · 2024: 51 · 2023: 61 · 2022: 55 · 2021: 44 · 2020: 43
- FWCI
- 22.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH093897, MH105910, MH077681)
- National Institute on Drug Abuse (DA14241)
- National Institute on Alcohol Abuse and Alcoholism (AA013514)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- ketamine, rapid antidepressant effects, GABAergic interneurons, GluN2B, NMDA receptor, somatostatin interneurons, parvalbumin interneurons, medial prefrontal cortex, depression, sex differences, excitatory postsynaptic currents, glutamate release, synaptic plasticity
- MeSH terms
- Animals, Antidepressive Agents, Female, Glutamate Decarboxylase, Interneurons, Ketamine, Male, Mice, Transgenic, Parvalbumins, Sex Characteristics, Somatostatin, Receptors, N-Methyl-D-Aspartate, Mice, Gene Knockout Techniques, GABAergic Neurons
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