# Testing a Synergistic, Neuroplasticity-Based Intervention for Depressive Neurocognition

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2021 · $407,161

## Abstract

Project Summary.
Depression has been described as a problem of impaired neuroplasticity (e.g., prefrontal synaptic depression) at the
molecular level, and decreased cognitive flexibility and prefrontal cortex (PFC) control at the neurocognitive level.
Intravenous ketamine, which displays rapid antidepressant properties, is posited to reverse depression by rapidly
enhancing molecular neuroplasticity; but surprisingly little is known regarding its effects on depressed patients'
neurocognitive processing. We posit that ketamine will rapidly increase cognitive flexibility and the PFC's influence on
affective regions, allowing for rigid, negative biases in cognition to be rapidly reversed. We further expect these
neurocognitive changes will provide a clinical window of opportunity in which to introduce automated cognitive training
techniques, which will consolidate adaptive forms of cognitive processing (specifically, positive implicit representations
of self) while neuroplasticity remains high. Instantiating adaptive forms of processing after first `priming' the brain with
ketamine represents a potentially synergistic treatment approach that could extend the acute effects of a single ketamine
infusion beyond its typical 3-7 day window, efficiently fostering antidepressant effects that are both rapid and enduring. In
this study, 150 patients exhibiting a target profile (self-reported impairments in cognitive flexibility; negative self-
representations; and clinically elevated depression symptoms) will be randomized to receive a single infusion of ketamine
or a psychoactive control (midazolam) and will complete measures designed to capture a proposed neurocognitive
`signature of rapid relief.' This approach will extend molecular models of ketamine's antidepressant mechanisms to novel
cognitive domains, revealing the neurocognitive state that tracks with rapid relief. We hypothesize to see increases in
cognitive flexibility and directed connectivity from PFC to salience network regions, and corresponding decreases in one
of the rigid, negative biases posited to be a key cognitive promoter of depression: negative representations of self
(“depressive self-schemas”)—a cognitive pattern that has shown preliminary sensitivity to ketamine's rapid influence in
our previous studies. In a fully factorial (2x2) design, patients will then be randomized to receive a brief computer-based
cognitive training protocol during the post-infusion “window of opportunity,” designed to implicitly reverse negative self-
representations, instilling positive self-representations in their place, or a sham variant of the same training. Patients will
be followed over 1 month acutely (with 6-month naturalistic follow-up) to assess whether active cognitive training
enhances and/or extends the durability of ketamine's effects on depression and on the neurocognitive `signature of rapid
relief.' After priming brain plasticity with ketamine, we expect that training positive self-represen...

## Key facts

- **NIH application ID:** 10201427
- **Project number:** 5R01MH113857-05
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Rebecca Price
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $407,161
- **Award type:** 5
- **Project period:** 2017-08-15 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10201427

## Citation

> US National Institutes of Health, RePORTER application 10201427, Testing a Synergistic, Neuroplasticity-Based Intervention for Depressive Neurocognition (5R01MH113857-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10201427. Licensed CC0.

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