The RESILIENT PHENOTYPE INDUCED BY PROphylactic ketamine exposure during adolescence is mediated by the VTA-NAC pathway.

Abstract Background Major depressive disorder (MDD) is prevalent in children and adolescents and is associated with a high degree of morbidity throughout life, with potentially devastating personal consequences and public health impact. Ketamine’s (KET’s) efficacy as an antidepressant has been demonstrated in adolescent rodents; however, the neurobiological mechanisms underlying these effects are unknown. Recent evidence showed that KET reverses stress-induced (i.e., depressive-like) deficits within major mesocorticolimbic regions such as the prefrontal cortex (PFC), nucleus accumbens (NAc), and hippocampus in adult rodents. However, little is known about KET’s effect in the ventral tegmental area (VTA), which provides the majority of dopaminergic input to these brain regions. Methods We characterized behavioral and the biochemical and electrophysiological effects produced by KET treatment in C57BL/6J male mice during adolescence (7-10 per condition) within the VTA and its major projection regions, namely, the NAc and PFC. Subsequently, molecular targets within the VTA-NAc projection were identified for viral gene transfer manipulations to recapitulate the effects of stress or KET treatment. Results Repeated KET treatment produced a robust pro-resilient response to chronic social defeat stress. This effect was largely driven by Akt signaling activity within the VTA and NAc, and it could be blocked or recapitulated through direct Akt-viral-mediated manipulation. Additionally, we found that the KET-induced resilient phenotype is dependent on VTA-NAc, but not VTA-PFC, pathway activity. Conclusions These findings indicate that KET exposure during adolescence produces a pro-resilient phenotype mediated by changes in Akt intracellular signaling and altered neuronal activity within the VTA-NAc pathway.