title: The interactive effects of ketamine and nicotine on human cerebral blood flow.
abstract: OBJECTIVE
  The purpose of this study was to determine if acute nicotine attenuated ketamine-induced regional cerebral blood flow (rCBF).
  
  
  METHODS
  Following 2-4 h of nicotine abstinence, healthy chronic smokers participated in four sets of rCBF studies, H2(15)O positron emission tomography, during a simple sensory motor control task. The four drug conditions studied were placebo, ketamine alone, nicotine alone, and ketamine + nicotine.
  
  
  RESULTS
  Intravenous ketamine increased rCBF in frontal, orbital-frontal, and anterior cingulate areas. Nicotine alone induced marked rCBF elevations in the lateral occipital cortex and rCBF suppressions in the basal ganglia and anterior cingulate cortex. Nicotine added to ketamine attenuated the ketamine-induced elevated rCBF in the anterior cingulate cortex but caused a marked rCBF increase in the orbital frontal region.
  
  
  CONCLUSIONS
  This study illustrates the interactive effects of ketamine, an NMDA receptor antagonist, and nicotine in multiple brain regions. Nicotine substantially ameliorated the effects of ketamine on anterior cingulate rCBF and, when given alone, markedly suppressed anterior cingulate rCBF. The enhanced, synergistic orbitofrontal effects observed with ketamine and nicotine together suggest a marked increase in excitatory neurotransmission in a brain region often linked to psychosis, reward, and addictive behaviors.
authors.affiliation: Department of Psychiatry, Functional Neuroimaging Laboratory, Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Avenue, Baltimore, MD 21228-0247, USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Rowland
authors.forename: Lori
authors.initials: L
authors.lastname: Beason-Held
authors.forename: Carol A
authors.initials: CA
authors.lastname: Tamminga
authors.forename: Henry H
authors.initials: HH
authors.lastname: Holcomb
mesh_terms: D000328:Adult; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D004311:Double-Blind Method; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007649:Ketamine / Q000097:blood / Q000494:pharmacology*; D008297:Male; D009538:Nicotine / Q000097:blood / Q000494:pharmacology*; D010919:Placebos; D049268:Positron-Emission Tomography / Q000379:methods; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000187:drug effects
chemical_list: D010919:Placebos; D007649:Ketamine; D009538:Nicotine