採用腦影像探討長期K他命使用者認知功能損害與性別差異-第3年計畫

Ketamine use among adolescents and young adults increases rapidly. Chronic ketamine use in adults may lead to uropathy, neurocognitive impairments, including deficits in working memory and executive functions and other social problems. To our knowledge, despite increased physical, psychological and social concerns about ketamine use, no study has systematically documented the effects of ketamine use on prefrontal cortex, cerebral structures and functions, especially in developing, immature brain of teenagers. It is imperative to accumulate more understanding of impacts on brain damage of chronic ketamine use because ketamine influences brain in the ways different from heroin, marijuana and amphetamine. This study aims to examine the ketamine exposure effects to teenagers’ higher cognitive function, brain structural and functional change on imaging studies. Brain network and connectivity change under ketamine exposure will also be explored. In order to differentiate from previous findings on heroin, amphetamine and marijuana, we will recruit 20 teenage ketamine users without using other psychoactive substances and 20 age-, gender-matched healthy controls to receive MRI scan and cognitive evaluation in one year. Besides structural and resting functional imaging, they will also take the stop signal task (SST) and N-back memory test during MRI scan. Besides, we will examine the vulnerability of adolescent developing brain to ketamine effects, for ketamine use became a crucial problem among the youth. This study intends to rescan and re-evaluate the same 20 ketamine use teenagers after another year of ketamine exposure to test differences in cognitive functions, connectivity and structural change. We are implementing this project for another two years. During the first 2 years, we have reviewed more literature related to brain and ketamine use. The influence of onset of using ketamine in adolescence and adults is significantly different in our primary analysis using the first 2-year data. We want to apply for 2 more years to recruit teenagers with ketamine use to answer if ketamine use in teens can influence their developing brains. We have been able to recruit 30 Ketamine and 40 healthy participants at the end of 2017. At the end of 2nd year project, we are confident to have 50 ketamine users and 50 healthy cases. For 2 more years, we want to have 40 teenage participants (20 in each group) for the 2nd 2-year project. For ketamine misuse is a major issue in Asia, it’s quite important to gain more scientific information about the brain effects under chronic ketamine use. Ketamine is currently new antidepressant for refractory depressive patients. Thus understanding the long-term consequences of ketamine use is imperative. The results can be used to develop and design treatment programs, including counseling and psycho-education.