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Moujaes F, Rieser NM, Phillips C, de Matos NMP, Brügger M, Dürler P, Smigielski L, Stämpfli P, Seifritz E, Vollenweider FX, Anticevic A, Preller KH. Comparing Neural Correlates of Consciousness: From Psychedelics to Hypnosis and Meditation. Biol Psychiatry Cogn Neurosci Neuroimaging 2024; 9:533-543. [PMID: 37459910 DOI: 10.1016/j.bpsc.2023.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/23/2023] [Accepted: 07/07/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Pharmacological and nonpharmacological methods of inducing altered states of consciousness (ASCs) are becoming increasingly relevant in the treatment of psychiatric disorders. While comparisons between them are often drawn, to date no study has directly compared their neural correlates. METHODS To address this knowledge gap, we directly compared 2 pharmacological methods (psilocybin 0.2 mg/kg orally [n = 23] and lysergic acid diethylamide [LSD] 100 μg orally [n = 25]) and 2 nonpharmacological methods (hypnosis [n = 30] and meditation [n = 29]) using resting-state functional connectivity magnetic resonance imaging and assessed the predictive value of the data using a machine learning approach. RESULTS We found that 1) no network reached significance in all 4 ASC methods; 2) pharmacological and nonpharmacological interventions of inducing ASCs showed distinct connectivity patterns that were predictive at the individual level; 3) hypnosis and meditation showed differences in functional connectivity when compared directly and also drove distinct differences when jointly compared with the pharmacological ASC interventions; and 4) psilocybin and LSD showed no differences in functional connectivity when directly compared with each other, but they did show distinct behavioral-neural relationships. CONCLUSIONS Overall, these results extend our understanding of the mechanisms of action of ASCs and highlight the importance of exploring how these effects can be leveraged in the treatment of psychiatric disorders.
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Affiliation(s)
- Flora Moujaes
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Nathalie M Rieser
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
| | - Christophe Phillips
- GIGA Cyclotron Research Centre in vivo imaging, University of Liège, Liège, Belgium
| | - Nuno M P de Matos
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Mike Brügger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Patricia Dürler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Lukasz Smigielski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; MR Center, Psychiatric University Hospital, University of Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Katrin H Preller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
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2
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Moujaes F, Ji JL, Rahmati M, Burt JB, Schleifer C, Adkinson BD, Savic A, Santamauro N, Tamayo Z, Diehl C, Kolobaric A, Flynn M, Rieser N, Fonteneau C, Camarro T, Xu J, Cho Y, Repovs G, Fineberg SK, Morgan PT, Seifritz E, Vollenweider FX, Krystal JH, Murray JD, Preller KH, Anticevic A. Ketamine induces multiple individually distinct whole-brain functional connectivity signatures. eLife 2024; 13:e84173. [PMID: 38629811 PMCID: PMC11023699 DOI: 10.7554/elife.84173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/15/2024] [Indexed: 04/19/2024] Open
Abstract
Background Ketamine has emerged as one of the most promising therapies for treatment-resistant depression. However, inter-individual variability in response to ketamine is still not well understood and it is unclear how ketamine's molecular mechanisms connect to its neural and behavioral effects. Methods We conducted a single-blind placebo-controlled study, with participants blinded to their treatment condition. 40 healthy participants received acute ketamine (initial bolus 0.23 mg/kg, continuous infusion 0.58 mg/kg/hr). We quantified resting-state functional connectivity via data-driven global brain connectivity and related it to individual ketamine-induced symptom variation and cortical gene expression targets. Results We found that: (i) both the neural and behavioral effects of acute ketamine are multi-dimensional, reflecting robust inter-individual variability; (ii) ketamine's data-driven principal neural gradient effect matched somatostatin (SST) and parvalbumin (PVALB) cortical gene expression patterns in humans, while the mean effect did not; and (iii) behavioral data-driven individual symptom variation mapped onto distinct neural gradients of ketamine, which were resolvable at the single-subject level. Conclusions These results highlight the importance of considering individual behavioral and neural variation in response to ketamine. They also have implications for the development of individually precise pharmacological biomarkers for treatment selection in psychiatry. Funding This study was supported by NIH grants DP5OD012109-01 (A.A.), 1U01MH121766 (A.A.), R01MH112746 (J.D.M.), 5R01MH112189 (A.A.), 5R01MH108590 (A.A.), NIAAA grant 2P50AA012870-11 (A.A.); NSF NeuroNex grant 2015276 (J.D.M.); Brain and Behavior Research Foundation Young Investigator Award (A.A.); SFARI Pilot Award (J.D.M., A.A.); Heffter Research Institute (Grant No. 1-190420) (FXV, KHP); Swiss Neuromatrix Foundation (Grant No. 2016-0111) (FXV, KHP); Swiss National Science Foundation under the framework of Neuron Cofund (Grant No. 01EW1908) (KHP); Usona Institute (2015 - 2056) (FXV). Clinical trial number NCT03842800.
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Affiliation(s)
- Flora Moujaes
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Masih Rahmati
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Joshua B Burt
- Department of Physics, Yale UniversityBostonUnited States
| | - Charles Schleifer
- David Geffen School of Medicine, University of California, Los AngelesLos AngelesUnited States
| | - Brendan D Adkinson
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
| | | | - Nicole Santamauro
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Zailyn Tamayo
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Caroline Diehl
- Department of Psychology, University of California, Los AngelesLos AngelesUnited States
| | | | - Morgan Flynn
- Department of Psychiatry, Vanderbilt University Medical CenterNashvilleUnited States
| | - Nathalie Rieser
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Clara Fonteneau
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Terry Camarro
- Magnetic Resonance Research Center, Yale University School of MedicineNew HavenUnited States
| | - Junqian Xu
- Department of Radiology and Psychiatry, Baylor College of MedicineHoustonUnited States
| | - Youngsun Cho
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Child Study Center, Yale University School of MedicineNew HavenUnited States
| | - Grega Repovs
- Department of Psychology, University of LjubljanaLjubljanaSlovenia
| | - Sarah K Fineberg
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Peter T Morgan
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Psychiatry, Bridgeport HospitalBridgeportUnited States
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - John H Krystal
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - John D Murray
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Physics, Yale UniversityBostonUnited States
- Department of Psychology, Yale UniversityNew HavenUnited States
| | - Katrin H Preller
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
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Preller KH, Scholpp J, Wunder A, Rosenbrock H. Neuroimaging Biomarkers for Drug Discovery and Development in Schizophrenia. Biol Psychiatry 2024:S0006-3223(24)00036-2. [PMID: 38272287 DOI: 10.1016/j.biopsych.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/19/2023] [Accepted: 01/14/2024] [Indexed: 01/27/2024]
Abstract
Schizophrenia is a chronic mental illness that affects up to 1% of the population. While efficacious therapies are available for positive symptoms, effective treatment of cognitive and negative symptoms remains an unmet need after decades of research. New developments in the field of neuroimaging are accelerating our knowledge gain regarding the underlying pathophysiology of symptoms in schizophrenia and psychosis spectrum disorders, inspiring new targets for drug development. However, no validated and qualified biomarkers are currently available to support the development of new therapeutics. This review summarizes the current use of neuroimaging technology in clinical drug development for psychotic disorders. As exemplified by drug development programs that target NMDA receptor hypofunction, neuroimaging results play a critical role in target discovery and establishing target engagement and dose selection. Furthermore, pharmacological neuroimaging may provide response biomarkers that allow for early decision making in proof-of-concept studies that leverage pharmacological challenge models in healthy volunteers. That said, while response and predictive biomarkers are starting to be evaluated in patient populations, they continue to play a limited role. Novel approaches to neuroimaging data acquisition and analysis may aid the establishment of biomarkers that are predictive at the individual level in the future. Nevertheless, various gaps in knowledge need to be addressed and biomarkers need to be validated to establish them as "fit for purpose" in drug development.
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Affiliation(s)
- Katrin H Preller
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany; Boehringer Ingelheim (Schweiz) GmbH, Basel, Switzerland.
| | - Joachim Scholpp
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Andreas Wunder
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Holger Rosenbrock
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
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Stoliker D, Novelli L, Vollenweider FX, Egan GF, Preller KH, Razi A. Neural Mechanisms of Resting-State Networks and the Amygdala Underlying the Cognitive and Emotional Effects of Psilocybin. Biol Psychiatry 2024:S0006-3223(24)00004-0. [PMID: 38185235 DOI: 10.1016/j.biopsych.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
BACKGROUND Serotonergic psychedelics, such as psilocybin, alter perceptual and cognitive systems that are functionally integrated with the amygdala. These changes can alter cognition and emotions that are hypothesized to contribute to their therapeutic utility. However, the neural mechanisms of cognitive and subcortical systems altered by psychedelics are not well understood. METHODS We used resting-state functional magnetic resonance images collected during a randomized, double-blind, placebo-controlled clinical trial of 24 healthy adults under 0.2 mg/kg psilocybin to estimate the directed (i.e., effective) changes between the amygdala and 3 large-scale resting-state networks involved in cognition. These networks are the default mode network, the salience network, and the central executive network. RESULTS We found a pattern of decreased top-down effective connectivity from these resting-state networks to the amygdala. Effective connectivity decreased within the default mode network and salience network but increased within the central executive network. These changes in effective connectivity were statistically associated with behavioral measures of altered cognition and emotion under the influence of psilocybin. CONCLUSIONS Our findings suggest that temporary amygdala signal attenuation is associated with mechanistic changes to resting-state network connectivity. These changes are significant for altered cognition and perception and suggest targets for research investigating the efficacy of psychedelic therapy for internalizing psychiatric disorders. More broadly, our study suggests the value of quantifying the brain's hierarchical organization using effective connectivity to identify important mechanisms for basic cognitive function and how they are integrated to give rise to subjective experiences.
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Affiliation(s)
- Devon Stoliker
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Leonardo Novelli
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy & Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Gary F Egan
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Katrin H Preller
- Department of Psychiatry, Psychotherapy & Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Adeel Razi
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia; Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom; CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, Ontario, Canada.
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Bos E, Preller KH, Kaur G, Malhotra P, Kharawala S, Motti D. Challenges With the Use of Digital Sham: Systematic Review and Recommendations. J Med Internet Res 2023; 25:e44764. [PMID: 37874638 PMCID: PMC10630857 DOI: 10.2196/44764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/26/2023] [Accepted: 07/20/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Digital therapeutics (DTx) are software-based products that prevent, manage, or treat a medical condition and are delivered through a smartphone app, web application, or wearable device. Clinical trials assessing DTx pose challenges, foremost among which is designing appropriate digital shams (or digital placebos), which should ideally mimic DTx (in terms of design, components, and duration of treatment) while omitting the active principle or component. OBJECTIVE The objective of our review was to understand how digital shams are being used in clinical research on DTx in neuroscience, which is the most common therapy area for DTx. METHODS We conducted a systematic literature review of DTx in neuroscience (including neurodevelopmental, neurodegenerative, and psychiatric disorders) with a focus on controlled clinical trials involving digital shams. Studies were identified from trial registries (ClinicalTrials.gov, the European Union Clinical Trials Register, and Trial Trove) and through structured searches in MEDLINE and Embase (both via the Embase website) and were limited to articles in English published from 2010 onward. These were supplemented by keyword-based searches in PubMed, Google, and Google Scholar and bibliographic searches. Studies assessing DTx in neuroscience (including neurodevelopmental, neurodegenerative, and psychiatric disorders) were included. Details related to the publication, DTx, comparator, patient population, and outcomes were extracted and analyzed. RESULTS Our search criteria identified 461 neuroscience studies involving 213 unique DTx. Most DTx were extended reality based (86/213, 40.4%) or mobile device based (56/213, 26.3%); 313 were comparative, of which 68 (21.7%) used shams. The most common therapeutic areas assessed in these studies were stroke (42/213, 19.7%), depression (32/213, 15%), and anxiety (24/213, 11.3%). The most common treatments were cognitive behavioral therapy or behavioral therapy (67/213, 32.4%), physical rehabilitation (60/213, 28.2%), and cognitive training (41/213, 19.2%). We identified the following important issues related to the use of digital shams in neuroscience: shams were not validated before use in studies, they varied widely in design (from being nearly identical to the DTx to using different software programs altogether), and the level of patient engagement or satisfaction with the sham and the impact of the sham on study outcomes were infrequently reported. CONCLUSIONS Digital shams are critical for the clinical development of DTx in neuroscience. Given the importance of sham controls in evaluating DTx efficacy, we provide recommendations on the key information that should be reported in a well-designed DTx trial and propose an algorithm to allow the correct interpretation of DTx study results. Sham-controlled studies should be routinely used in DTx trials-in early-phase studies-to help identify DTx active components and-in late-phase studies-to confirm the efficacy of DTx. The use of shams early in development will ensure that the appropriate sham control is used in later confirmatory trials.
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Affiliation(s)
- Ernst Bos
- F Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Gavneet Kaur
- Bridge Medical Consulting Limited, London, United Kingdom
| | - Pooja Malhotra
- Bridge Medical Consulting Limited, London, United Kingdom
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Kroll SL, Hulka LM, Kexel AK, Vonmoos M, Preller KH, Treyer V, Ametamey SM, Baumgartner MR, Boost C, Pahlisch F, Rohleder C, Leweke FM, Quednow BB. Plasma endocannabinoids in cocaine dependence and their relation to cerebral metabotropic glutamate receptor 5 density. Transl Psychiatry 2023; 13:325. [PMID: 37857616 PMCID: PMC10587180 DOI: 10.1038/s41398-023-02628-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/28/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023] Open
Abstract
Animal models indicate that the endocannabinoid system (ECS) plays a modulatory role in stress and reward processing, both crucially impaired in addictive disorders. Preclinical findings showed endocannabinoid-modulated synaptic plasticity in reward brain networks linked to the metabotropic-glutamate-5 receptor (mGluR5), contributing to drug-reinforcing effects and drug-seeking behavior. Although animal models postulate a link between ECS and cocaine addiction, human translational studies are lacking. Here, we tested previous preclinical findings by investigating plasma endocannabinoids (eCBs) anandamide (AEA), 2-arachidonoylglycerol (2-AG), and the related N-acylethanolamines (NAEs) palmitoylethanolamide (PEA) and oleoylethanolamide (OEA), including their interaction with cerebral mGluR5, in chronic cocaine users (CU). We compared basal plasma concentrations between chronic CU (N = 103; 69 recreational CU and 34 dependent CU) and stimulant-naïve healthy controls (N = 92). Follow-up basal eCB/NAE plasma levels after 12 months were used for reliability and stability check (CU: N = 33; controls: N = 43). In an additional analysis using 11C-ABP688 positron emission tomography (PET) in a male subsample (CU: N = 18; controls: N = 16), we investigated the relationships between eCBs/NAEs and mGluR5 density in the brain. We found higher 2-AG plasma levels in dependent CU compared to controls and recreational CU. 2-AG levels were stable over time across all groups. In the PET-subsample, a positive association between 2-AG and mGluR5 brain density only in CU was found. Our results corroborate animal findings suggesting an alteration of the ECS in cocaine dependence and an association between peripheral 2-AG levels and cerebral mGluR5 in humans. Therefore, the ECS might be a promising pharmaco-therapeutic target for novel treatments of cocaine dependence.
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Affiliation(s)
- Sara L Kroll
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Lea M Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ann-Kathrin Kexel
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Valerie Treyer
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Simon M Ametamey
- Radiopharmaceutical Science, Institute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland
| | - Markus R Baumgartner
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Carola Boost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Franziska Pahlisch
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cathrin Rohleder
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Brain and Mind Centre, Translational Research Collective, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - F Markus Leweke
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Brain and Mind Centre, Translational Research Collective, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
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Rieser NM, Gubser LP, Moujaes F, Duerler P, Lewis CR, Michels L, Vollenweider FX, Preller KH. Psilocybin-induced changes in cerebral blood flow are associated with acute and baseline inter-individual differences. Sci Rep 2023; 13:17475. [PMID: 37838755 PMCID: PMC10576760 DOI: 10.1038/s41598-023-44153-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 10/04/2023] [Indexed: 10/16/2023] Open
Abstract
Research into the use of psilocybin for the treatment of psychiatric disorders is a growing field. Nevertheless, robust brain-behavior relationships linking psilocybin-induced brain changes to subjective drug-induced effects have not been established. Furthermore, it is unclear if the acute neural effects are dependent on individual heterogeneity in baseline characteristics. To address this, we assessed the effects of three oral doses of psilocybin vs. placebo on cerebral blood flow (CBF) using arterial spin labeling in healthy participants (N = 70; n = 31, 0.16 mg/kg; n = 10, 0.2 mg/kg; n = 29, 0.215 mg/kg). First, we quantified psilocybin-induced changes in relative and absolute CBF. Second, in an exploratory analysis, we assessed whether individual baseline characteristics and subjective psychedelic experience are associated with changes in CBF. Psychological and neurobiological baseline characteristics correlated with the psilocybin-induced reduction in relative CBF and the psilocybin-induced subjective experience. Furthermore, the psilocybin-induced subjective experience was associated with acute changes in relative and absolute CBF. The results demonstrated that inter-individual heterogeneity in the neural response to psilocybin is associated with baseline characteristics and shed light on the mechanisms underlying the psychedelic-induced altered state. Overall, these findings help guide the search for biomarkers, paving the way for a personalized medicine approach within the framework of psychedelic-assisted therapy.
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Affiliation(s)
- Nathalie M Rieser
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Lenggstrasse 31, Zurich, Switzerland.
| | - Ladina P Gubser
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Lenggstrasse 31, Zurich, Switzerland
| | - Flora Moujaes
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Lenggstrasse 31, Zurich, Switzerland
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Patricia Duerler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Lenggstrasse 31, Zurich, Switzerland
| | - Candace R Lewis
- School of Life Sciences, Arizona State University, Tempe, AZ, 85281, USA
| | - Lars Michels
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Lenggstrasse 31, Zurich, Switzerland
| | - Katrin H Preller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Lenggstrasse 31, Zurich, Switzerland
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Krystal JH, Preller KH, Corlett PR, Anticevic A, Kaye AP. Psychedelics and the Neurobiology of Meaningfulness. Biol Psychiatry Cogn Neurosci Neuroimaging 2023:S2451-9022(23)00241-0. [PMID: 37730161 DOI: 10.1016/j.bpsc.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Affiliation(s)
- John H Krystal
- Departments of Psychiatry, Neuroscience, and Psychology, Yale University, New Haven, Connecticut; Clinical Neuroscience Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, Connecticut.
| | - Katrin H Preller
- Clinical Neuroscience Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, Connecticut; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Philip R Corlett
- Departments of Psychiatry, Neuroscience, and Psychology, Yale University, New Haven, Connecticut; Abraham Ribicoff Research Laboratories, Connecticut Mental Health Center, New Haven, Connecticut
| | - Alan Anticevic
- Departments of Psychiatry, Neuroscience, and Psychology, Yale University, New Haven, Connecticut; Clinical Neuroscience Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Alfred P Kaye
- Departments of Psychiatry, Neuroscience, and Psychology, Yale University, New Haven, Connecticut; Abraham Ribicoff Research Laboratories, Connecticut Mental Health Center, New Haven, Connecticut
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Engeli EJE, Russo AG, Ponticorvo S, Zoelch N, Hock A, Hulka LM, Kirschner M, Preller KH, Seifritz E, Quednow BB, Esposito F, Herdener M. Accumbal-thalamic connectivity and associated glutamate alterations in human cocaine craving: A state-dependent rs-fMRI and 1H-MRS study. Neuroimage Clin 2023; 39:103490. [PMID: 37639901 PMCID: PMC10474092 DOI: 10.1016/j.nicl.2023.103490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/21/2023] [Accepted: 08/04/2023] [Indexed: 08/31/2023]
Abstract
Craving is a core symptom of cocaine use disorder and a major factor for relapse risk. To date, there is no pharmacological therapy to treat this disease or at least to alleviate cocaine craving as a core symptom. In animal models, impaired prefrontal-striatal signalling leading to altered glutamate release in the nucleus accumbens appear to be the prerequisite for cocaine-seeking. Thus, those network and metabolic changes may constitute the underlying mechanisms for cocaine craving and provide a potential treatment target. In humans, there is recent evidence for corresponding glutamatergic alterations in the nucleus accumbens, however, the underlying network disturbances that lead to this glutamate imbalance remain unknown. In this state-dependent randomized, placebo-controlled, double-blinded, cross-over multimodal study, resting state functional magnetic resonance imaging in combination with small-voxel proton magnetic resonance spectroscopy (voxel size: 9.4 × 18.8 × 8.4 mm3) was applied to assess network-level and associated neurometabolic changes during a non-craving and a craving state, induced by a custom-made cocaine-cue film, in 18 individuals with cocaine use disorder and 23 healthy individuals. Additionally, we assessed the potential impact of a short-term challenge of N-acetylcysteine, known to normalize disturbed glutamate homeostasis and to thereby reduce cocaine-seeking in animal models of addiction, compared to a placebo. We found increased functional connectivity between the nucleus accumbens and the dorsolateral prefrontal cortex during the cue-induced craving state. However, those changes were not linked to alterations in accumbal glutamate levels. Whereas we additionally found increased functional connectivity between the nucleus accumbens and a midline part of the thalamus during the cue-induced craving state. Furthermore, obsessive thinking about cocaine and the actual intensity of cocaine use were predictive of cue-induced functional connectivity changes between the nucleus accumbens and the thalamus. Finally, the increase in accumbal-thalamic connectivity was also coupled with craving-related glutamate rise in the nucleus accumbens. Yet, N-acetylcysteine had no impact on craving-related changes in functional connectivity. Together, these results suggest that connectivity changes within the fronto-accumbal-thalamic loop, in conjunction with impaired glutamatergic transmission, underlie cocaine craving and related clinical symptoms, pinpointing the thalamus as a crucial hub for cocaine craving in humans.
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Affiliation(s)
- Etna J E Engeli
- Centre for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Andrea G Russo
- Department of Advanced Medical and Surgical Sciences, School of Medicine and Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Sara Ponticorvo
- Center for Magnetic Resonance Research, University of Minnesota, Minnesota, United States
| | - Niklaus Zoelch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Zurich, Switzerland
| | - Andreas Hock
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Institute for Biomedical Engineering, University and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Lea M Hulka
- Centre for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Matthias Kirschner
- Transdiagnostic and Multimodal Neuroimaging, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Neuroscience Centre Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Neuroscience Centre Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland; Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Fabrizio Esposito
- Department of Advanced Medical and Surgical Sciences, School of Medicine and Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marcus Herdener
- Centre for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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10
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Avram M, Müller F, Preller KH, Razi A, Rogg H, Korda A, Holze F, Vizeli P, Ley L, Liechti ME, Borgwardt S. Effective Connectivity of Thalamocortical Interactions Following d-Amphetamine, LSD, and MDMA Administration. Biol Psychiatry Cogn Neurosci Neuroimaging 2023:S2451-9022(23)00191-X. [PMID: 37532129 DOI: 10.1016/j.bpsc.2023.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND While the exploration of serotonergic psychedelics as psychiatric medicines deepens, so does the pressure to better understand how these compounds act on the brain. METHODS We used a double-blind, placebo-controlled, crossover design and administered lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (MDMA), and d-amphetamine in 25 healthy participants. By using spectral dynamic causal modeling, we mapped substance-induced changes in effective connectivity between the thalamus and different cortex types (unimodal vs. transmodal) derived from a previous study with resting-state functional magnetic resonance imaging data. Due to the distinct pharmacological modes of action of the 3 substances, we were able to investigate specific effects mainly driven by different neurotransmitter systems on thalamocortical and corticothalamic interactions. RESULTS Compared with placebo, all 3 substances increased the effective connectivity from the thalamus to specific unimodal cortices, whereas the influence of these cortices on the thalamus was reduced. These results indicate increased bottom-up and decreased top-down information flow between the thalamus and some unimodal cortices. However, for the amphetamines, we found the opposite effects when examining the effective connectivity with transmodal cortices, including parts of the salience network. Intriguingly, LSD increased the effective connectivity from the thalamus to both unimodal and transmodal cortices, indicating a breach in the hierarchical organization of ongoing brain activity. CONCLUSIONS The results advance our knowledge about the action of psychedelics on the brain and refine current models aiming to explain the underlying neurobiological processes.
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Affiliation(s)
- Mihai Avram
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany; Center of Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany.
| | - Felix Müller
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | - Adeel Razi
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Helena Rogg
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Alexandra Korda
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany; Center of Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
| | - Friederike Holze
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Patrick Vizeli
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Laura Ley
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Matthias E Liechti
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany; Center of Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
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11
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Ort A, Smallridge JW, Sarasso S, Casarotto S, von Rotz R, Casanova A, Seifritz E, Preller KH, Tononi G, Vollenweider FX. TMS-EEG and resting-state EEG applied to altered states of consciousness: oscillations, complexity, and phenomenology. iScience 2023; 26:106589. [PMID: 37138774 PMCID: PMC10149373 DOI: 10.1016/j.isci.2023.106589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/22/2022] [Accepted: 04/03/2023] [Indexed: 05/05/2023] Open
Abstract
Exploring the neurobiology of the profound changes in consciousness induced by classical psychedelic drugs may require novel neuroimaging methods. Serotonergic psychedelic drugs such as psilocybin produce states of increased sensory-emotional awareness and arousal, accompanied by increased spontaneous electroencephalographic (EEG) signal diversity. By directly stimulating cortical tissue, the altered dynamics and propagation of the evoked EEG activity can reveal drug-induced changes in the overall brain state. We combine Transcranial Magnetic Stimulation (TMS) and EEG to reveal that psilocybin produces a state of increased chaotic brain activity which is not a result of altered complexity in the underlying causal interactions between brain regions. We also map the regional effects of psilocybin on TMS-evoked activity and identify changes in frontal brain structures that may be associated with the phenomenology of psychedelic experiences.
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Affiliation(s)
- Andres Ort
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Corresponding author
| | - John W. Smallridge
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Corresponding author
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Silvia Casarotto
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi Milano, Milan, Italy
| | - Robin von Rotz
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Andrea Casanova
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Katrin H. Preller
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Franz X. Vollenweider
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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12
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Shinn M, Hu A, Turner L, Noble S, Preller KH, Ji JL, Moujaes F, Achard S, Scheinost D, Constable RT, Krystal JH, Vollenweider FX, Lee D, Anticevic A, Bullmore ET, Murray JD. Functional brain networks reflect spatial and temporal autocorrelation. Nat Neurosci 2023; 26:867-878. [PMID: 37095399 DOI: 10.1038/s41593-023-01299-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 03/14/2023] [Indexed: 04/26/2023]
Abstract
High-throughput experimental methods in neuroscience have led to an explosion of techniques for measuring complex interactions and multi-dimensional patterns. However, whether sophisticated measures of emergent phenomena can be traced back to simpler, low-dimensional statistics is largely unknown. To explore this question, we examined resting-state functional magnetic resonance imaging (rs-fMRI) data using complex topology measures from network neuroscience. Here we show that spatial and temporal autocorrelation are reliable statistics that explain numerous measures of network topology. Surrogate time series with subject-matched spatial and temporal autocorrelation capture nearly all reliable individual and regional variation in these topology measures. Network topology changes during aging are driven by spatial autocorrelation, and multiple serotonergic drugs causally induce the same topographic change in temporal autocorrelation. This reductionistic interpretation of widely used complexity measures may help link them to neurobiology.
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Affiliation(s)
- Maxwell Shinn
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Amber Hu
- Yale College, Yale University, New Haven, CT, USA
| | | | - Stephanie Noble
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Katrin H Preller
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich, Switzerland
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Flora Moujaes
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich, Switzerland
| | - Sophie Achard
- University of Grenoble Alpes, CNRS, Inria, Grenoble INP, LJK, Grenoble, France
| | - Dustin Scheinost
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - R Todd Constable
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - John H Krystal
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich, Switzerland
| | - Daeyeol Lee
- Zanvyl Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, MD, USA
- Kavli Discovery Neuroscience Institute, Johns Hopkins University, Baltimore, MD, USA
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, MD, USA
- Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA
| | - Alan Anticevic
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | | | - John D Murray
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA.
- Department of Psychiatry, Yale University, New Haven, CT, USA.
- Department of Physics, Yale University, New Haven, CT, USA.
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13
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von Rotz R, Schindowski EM, Jungwirth J, Schuldt A, Rieser NM, Zahoranszky K, Seifritz E, Nowak A, Nowak P, Jäncke L, Preller KH, Vollenweider FX. Corrigendum to 'Single-dose psilocybin-assisted therapy in major depressive disorder: a placebo-controlled, double-blind, randomised clinical trial'. EClinicalMedicine 2023; 56:101841. [PMID: 36747965 PMCID: PMC9898017 DOI: 10.1016/j.eclinm.2023.101841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
[This corrects the article DOI: 10.1016/j.eclinm.2022.101809.].
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Affiliation(s)
- Robin von Rotz
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
- Corresponding author.
| | - Eva M. Schindowski
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Johannes Jungwirth
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Anna Schuldt
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Nathalie M. Rieser
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Katharina Zahoranszky
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Albina Nowak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Peter Nowak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Lutz Jäncke
- Division Neuropsychology, Department of Psychology, University of Zürich, Zürich, Switzerland
| | - Katrin H. Preller
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Franz X. Vollenweider
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
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14
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von Rotz R, Schindowski EM, Jungwirth J, Schuldt A, Rieser NM, Zahoranszky K, Seifritz E, Nowak A, Nowak P, Jäncke L, Preller KH, Vollenweider FX. Single-dose psilocybin-assisted therapy in major depressive disorder: A placebo-controlled, double-blind, randomised clinical trial. EClinicalMedicine 2023; 56:101809. [PMID: 36636296 PMCID: PMC9830149 DOI: 10.1016/j.eclinm.2022.101809] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Psilocybin has been suggested as a novel, rapid-acting treatment for depression. Two consecutive doses have been shown to markedly decrease symptom severity in an open-label setting or when compared to a waiting list group. To date, to our knowledge, no other trial compared a single, moderate dose of psilocybin to a placebo condition. METHODS In this double-blind, randomised clinical trial, 52 participants diagnosed with major depressive disorder and no unstable somatic conditions were allocated to receive either a single, moderate dose (0.215 mg/kg body weight) of psilocybin or placebo in conjunction with psychological support. MADRS and BDI scores were assessed to estimate depression severity, while changes from baseline to 14 days after the intervention were defined as primary endpoints. The trial took place between April 11th, 2019 and October 12th, 2021 at the psychiatric university hospital in Zürich, Switzerland and was registered with clinicaltrials.gov (NCT03715127). FINDINGS The psilocybin condition showed an absolute decrease in symptom severity of -13.0 points compared to baseline and were significantly larger than those in the placebo condition (95% CI -15.0 to -1.3; Cohens' d = 0.97; P = 0.0011; MADRS) and -13.2 points (95% CI; -13.4 to -1.3; Cohens' d = 0.67; P = 0.019; BDI) 14 days after the intervention. 14/26 (54%) participants met the MADRS remission criteria in the psilocybin condition. INTERPRETATION These results suggest that a single, moderate dose of psilocybin significantly reduces depressive symptoms compared to a placebo condition for at least two weeks. No serious adverse events were recorded. Larger, multi-centric trials with longer follow-up periods are needed to inform further optimisation of this novel treatment paradigm. FUNDING The study was funded by the Swiss National Science Foundation, Crowdfunding, the Swiss Neuromatrix Foundation, and the Heffter Research Institute.
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Affiliation(s)
- Robin von Rotz
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
- Corresponding author.
| | - Eva M. Schindowski
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Johannes Jungwirth
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Anna Schuldt
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Nathalie M. Rieser
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Katharina Zahoranszky
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Albina Nowak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Peter Nowak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Lutz Jäncke
- Division Neuropsychology, Department of Psychology, University of Zürich, Zürich, Switzerland
| | - Katrin H. Preller
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - Franz X. Vollenweider
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
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15
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Stoliker D, Novelli L, Vollenweider FX, Egan GF, Preller KH, Razi A. Effective Connectivity of Functionally Anticorrelated Networks Under Lysergic Acid Diethylamide. Biol Psychiatry 2023; 93:224-232. [PMID: 36270812 DOI: 10.1016/j.biopsych.2022.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Classic psychedelic-induced ego dissolution involves a shift in the sense of self and a blurring of the boundary between the self and the world. A similar phenomenon is identified in psychopathology and is associated with the balance of anticorrelated activity between the default mode network, which directs attention inward, and the salience network, which recruits the dorsal attention network to direct attention outward. METHODS To test whether changes in anticorrelated networks underlie the peak effects of lysergic acid diethylamide (LSD), we applied dynamic causal modeling to infer effective connectivity of resting-state functional magnetic resonance imaging scans from a study of 25 healthy adults who were administered 100 μg of LSD or placebo. RESULTS We found that inhibitory effective connectivity from the salience network to the default mode network became excitatory, and inhibitory effective connectivity from the default mode network to the dorsal attention network decreased under the peak effect of LSD. CONCLUSIONS The effective connectivity changes we identified may reflect diminution of the functional anticorrelation between resting-state networks that may be a key neural mechanism of LSD and underlie ego dissolution. Our findings suggest that changes to the sense of self and subject-object boundaries across different states of consciousness may depend upon the organized balance of effective connectivity of resting-state networks.
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Affiliation(s)
- Devon Stoliker
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia.
| | - Leonardo Novelli
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy & Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Gary F Egan
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Katrin H Preller
- Department of Psychiatry, Psychotherapy & Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Adeel Razi
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia; Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom; CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, Ontario, Canada
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16
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Moujaes F, Preller KH, Ji JL, Murray JD, Berkovitch L, Vollenweider FX, Anticevic A. Towards mapping neuro-behavioral heterogeneity of psychedelic neurobiology in humans. Biol Psychiatry 2022:S0006-3223(22)01805-4. [PMID: 36715317 DOI: 10.1016/j.biopsych.2022.10.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022]
Abstract
Precision psychiatry aims to identify markers of inter-individual variability that allow predicting the right treatment for each patient. However, bridging the gap between molecular-level manipulations and neural systems-level functional alterations remains an unsolved problem in psychiatry. After decades of low success rates in pharmaceutical R&D for psychiatric drugs, multiple studies now point to the potential of psychedelics as a promising fast-acting and long-lasting treatment for some psychiatric symptoms. Yet, given the highly psychoactive nature of these substances, a precision medicine approach is essential to map the neural signals related to clinical efficacy in order to identify patients who can maximally benefit from this treatment. Recent studies have shown that bridging the gap between pharmacology, systems-level neural response in humans and individual experience is possible for psychedelic substances, therefore paving the way for a precision neuropsychiatric therapeutic development. Specifically, it has been shown that the integration of brain-wide PET or transcriptomic data, i.e. receptor distribution for the serotonin 2A receptor, with computational neuroimaging methods can simulate the effect of psychedelics on the human brain. These novel 'computational psychiatry' approaches allow for modeling inter-individual differences in neural as well as subjective effects of psychedelic substances. Collectively, this review provides a deep dive into psychedelic pharmaco-neuroimaging studies with a core focus on how recent computational psychiatry advances in biophysically based circuit modeling can be leveraged to predict individual responses. Finally, we emphasize the importance of human pharmacological neuroimaging for the continued precision therapeutic development of psychedelics.
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Affiliation(s)
- Flora Moujaes
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, 8032 Zurich, Switzerland; Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States
| | - Katrin H Preller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, 8032 Zurich, Switzerland; Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States; Department of Physics, Yale University, New Haven, CT, 06511, United States; Interdepartmental Neuroscience Program, Yale University, New Haven, CT, 06511, United States
| | - Lucie Berkovitch
- Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States; Université de Paris, 15 Rue de l'École de Médecine, F-75006 Paris, France; Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, 1 rue Cabanis, F-75014, Paris, France
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, 8032 Zurich, Switzerland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States; Interdepartmental Neuroscience Program, Yale University, New Haven, CT, 06511, United States.
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17
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Abstract
Psychedelics are serotonin 2A receptor agonists that can lead to profound changes in perception, cognition and mood. In this review, we focus on the basic neurobiology underlying the action of psychedelic drugs. We first discuss chemistry, highlighting the diversity of psychoactive molecules and the principles that govern their potency and pharmacokinetics. We describe the roles of serotonin receptors and their downstream molecular signaling pathways, emphasizing key elements for drug discovery. We consider the impact of psychedelics on neuronal spiking dynamics in several cortical and subcortical regions, along with transcriptional changes and sustained effects on structural plasticity. Finally, we summarize neuroimaging results that pinpoint effects on association cortices and thalamocortical functional connectivity, which inform current theories of psychedelic action. By synthesizing knowledge across the chemical, molecular, neuronal, and network levels, we hope to provide an integrative perspective on the neural mechanisms responsible for the acute and enduring effects of psychedelics on behavior.
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Affiliation(s)
- Alex C. Kwan
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA,Correspondence: ; ; ;
| | - David E. Olson
- Department of Chemistry, University of California, Davis, Davis, CA, USA,Department of Biochemistry & Molecular Medicine, School of Medicine, University of California, Davis, Sacramento, CA, USA,Center for Neuroscience, University of California, Davis, Davis, CA, USA,Correspondence: ; ; ;
| | - Katrin H. Preller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland.,Correspondence: ; ; ;
| | - Bryan L. Roth
- Department of Pharmacology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA.,Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA.,Psychoactive Drug Screening Program, National Institute of Mental Health, School of Medicine, University of North Carolina, Chapel Hill, NC, USA.,Correspondence: ; ; ;
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18
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Roseman L, Preller KH, Fotiou E, Winkelman MJ. Editorial: Psychedelic sociality: Pharmacological and extrapharmacological perspectives. Front Pharmacol 2022; 13:979764. [PMID: 35935854 PMCID: PMC9355415 DOI: 10.3389/fphar.2022.979764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Leor Roseman
- Centre for Psychedelic Research, Faculty of Medicine, Imperial College London, London, United Kingdom
- *Correspondence: Leor Roseman,
| | - Katrin H. Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | | | - Michael J. Winkelman
- Retired, School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, United States
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19
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McCulloch DEW, Knudsen GM, Barrett FS, Doss MK, Carhart-Harris RL, Rosas FE, Deco G, Kringelbach ML, Preller KH, Ramaekers JG, Mason NL, Müller F, Fisher PM. Psychedelic resting-state neuroimaging: A review and perspective on balancing replication and novel analyses. Neurosci Biobehav Rev 2022; 138:104689. [PMID: 35588933 DOI: 10.1016/j.neubiorev.2022.104689] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 12/20/2022]
Abstract
Clinical research into serotonergic psychedelics is expanding rapidly, showing promising efficacy across myriad disorders. Resting-state functional magnetic resonance imaging (rs-fMRI) is a commonly used strategy to identify psychedelic-induced changes in neural pathways in clinical and healthy populations. Here we, a large group of psychedelic imaging researchers, review the 42 research articles published to date, based on the 17 unique studies evaluating psychedelic effects on rs-fMRI, focusing on methodological variation. Prominently, we observe that nearly all studies vary in data processing and analysis methodology, two datasets are the foundation of over half of the published literature, and there is lexical ambiguity in common outcome metric terminology. We offer guidelines for future studies that encourage coherence in the field. Psychedelic rs-fMRI will benefit from the development of novel methods that expand our understanding of the brain mechanisms mediating its intriguing effects; yet, this field is at a crossroads where we must also consider the critical importance of consistency and replicability to effectively converge on stable representations of the neural effects of psychedelics.
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Affiliation(s)
| | - Gitte Moos Knudsen
- Neurobiology Research Unit and NeuroPharm, Rigshospitalet, Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Frederick Streeter Barrett
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neuroscience and Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Manoj K Doss
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robin Lester Carhart-Harris
- Neuroscape, Weill Institute for Neurosciences, University of California San Francisco, CA, USA; Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK
| | - Fernando E Rosas
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK; Data Science Institute, Imperial College London, London, UK; Centre for Complexity Science, Imperial College London, London, UK
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu Fabra, Barcelona, Spain; Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain; Institució Catalana de la Recerca i Estudis Avançats (ICREA), Barcelona, Spain; Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Morten L Kringelbach
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Denmark
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Natasha L Mason
- Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Felix Müller
- University of Basel, Department of Psychiatry (UPK), Basel, Switzerland
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20
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Ji JL, Helmer M, Fonteneau C, Burt JB, Tamayo Z, Demšar J, Adkinson BD, Savić A, Preller KH, Moujaes F, Vollenweider FX, Martin WJ, Repovš G, Cho YT, Pittenger C, Murray JD, Anticevic A. Correction: Mapping brain-behavior space relationships along the psychosis spectrum. eLife 2022; 11:79129. [PMID: 35380951 PMCID: PMC8983038 DOI: 10.7554/elife.79129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 11/18/2022] Open
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21
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Duerler P, Vollenweider FX, Preller KH. A neurobiological perspective on social influence: Serotonin and social adaptation. J Neurochem 2022; 162:60-79. [PMID: 35274296 PMCID: PMC9322456 DOI: 10.1111/jnc.15607] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 01/09/2023]
Abstract
Humans are inherently social beings. Being suggestible to each other's expectations enables pro-social skills that are crucial for social learning and adaptation. Despite its high relevance for psychiatry, the neurobiological mechanisms underlying social adaptation are still not well understood. This review therefore provides a conceptual framework covering various distinct mechanisms underlying social adaptation and explores the neuropharmacology - in particular the role of the serotonin (5-HT) system - modulating these mechanisms. This article therefore reviews empirical results on social influence processing and reconciles them with recent findings from psychedelic research on social processing to elucidate neurobiological and neuropharmacological underpinnings of social adaptation. Various computational, neurobiological, and neurochemical processes are involved in distinct mechanisms underlying social adaptation such as the multisensory process of social information integration that is crucial for the forming of self-representation and representations of social norms. This is again associated with self- and other-perception during social interactions as well as value-based decision making that guides our behaviour in daily interactions. We highlight the critical role of 5-HT in these processes and suggest that 5-HT can facilitate social learning and may represent an important target for treating psychiatric disorders characterized by impairments in social functioning. This framework also has important implications for psychedelic-assisted therapy as well as for the development of novel treatment approaches and future research directions.
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Affiliation(s)
- Patricia Duerler
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, Zurich, Switzerland
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, Zurich, Switzerland
| | - Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, Zurich, Switzerland
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22
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Abstract
Substance use disorders (SUD) represent a significant public health issue with a high need for novel and efficacious treatment options. In light of this high unmet need, recent results reporting beneficial outcomes of psychedelic-assisted therapy in SUD are particularly relevant. However, several questions remain with regard to this treatment approach. The clinical mechanisms of action of psychedelic substances in the treatment of SUD are not well understood. Closing this knowledge gap is critical to inform and optimize the psychotherapeutic embedding of the acute substance administration. In this chapter, we discuss potential mechanisms that have implications on psychotherapeutic approaches including induced neuroplasticity, alterations in brain network connectivity, reward and emotion processing, social connectedness, insight, and mystical experiences. Furthermore, we outline considerations and approaches that leverage these mechanisms in order to optimize the therapeutic embedding by maximizing synergy between substance effects and psychotherapy. Understanding the mechanisms of action, developing psychotherapeutic approaches accordingly, and evaluating their synergistic efficacy in scientific studies will be critical to advance the framework of psychedelic-assisted therapy for addiction, create evidence-based approaches, and achieve the best treatment outcome for patients with SUD.
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Affiliation(s)
- Nathalie M Rieser
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Psychiatric University Hospital Zurich, Zurich, Switzerland.
| | - Marcus Herdener
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Psychiatric University Hospital Zurich, Zurich, Switzerland
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23
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Burt JB, Preller KH, Demirtas M, Ji JL, Krystal JH, Vollenweider FX, Anticevic A, Murray JD. Transcriptomics-informed large-scale cortical model captures topography of pharmacological neuroimaging effects of LSD. eLife 2021; 10:e69320. [PMID: 34313217 PMCID: PMC8315798 DOI: 10.7554/elife.69320] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
Psychoactive drugs can transiently perturb brain physiology while preserving brain structure. The role of physiological state in shaping neural function can therefore be investigated through neuroimaging of pharmacologically induced effects. Previously, using pharmacological neuroimaging, we found that neural and experiential effects of lysergic acid diethylamide (LSD) are attributable to agonism of the serotonin-2A receptor (Preller et al., 2018). Here, we integrate brain-wide transcriptomics with biophysically based circuit modeling to simulate acute neuromodulatory effects of LSD on human cortical large-scale spatiotemporal dynamics. Our model captures the inter-areal topography of LSD-induced changes in cortical blood oxygen level-dependent (BOLD) functional connectivity. These findings suggest that serotonin-2A-mediated modulation of pyramidal-neuronal gain is a circuit mechanism through which LSD alters cortical functional topography. Individual-subject model fitting captures patterns of individual neural differences in pharmacological response related to altered states of consciousness. This work establishes a framework for linking molecular-level manipulations to systems-level functional alterations, with implications for precision medicine.
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Affiliation(s)
- Joshua B Burt
- Department of Psychiatry, Yale UniversityNew HavenUnited States
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Murat Demirtas
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Jie Lisa Ji
- Department of Psychiatry, Yale UniversityNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
| | - John H Krystal
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry ZurichZurichSwitzerland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
| | - John D Murray
- Department of Psychiatry, Yale UniversityNew HavenUnited States
- Department of Psychiatry, Yale University School of MedicineNew HavenUnited States
- Interdepartmental Neuroscience Program, Yale UniversityNew HavenUnited States
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24
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Ji JL, Helmer M, Fonteneau C, Burt JB, Tamayo Z, Demšar J, Adkinson BD, Savić A, Preller KH, Moujaes F, Vollenweider FX, Martin WJ, Repovš G, Murray JD, Anticevic A. Mapping brain-behavior space relationships along the psychosis spectrum. eLife 2021; 10:66968. [PMID: 34313219 PMCID: PMC8315806 DOI: 10.7554/elife.66968] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/14/2021] [Indexed: 12/29/2022] Open
Abstract
Difficulties in advancing effective patient-specific therapies for psychiatric disorders highlight a need to develop a stable neurobiologically grounded mapping between neural and symptom variation. This gap is particularly acute for psychosis-spectrum disorders (PSD). Here, in a sample of 436 PSD patients spanning several diagnoses, we derived and replicated a dimensionality-reduced symptom space across hallmark psychopathology symptoms and cognitive deficits. In turn, these symptom axes mapped onto distinct, reproducible brain maps. Critically, we found that multivariate brain-behavior mapping techniques (e.g. canonical correlation analysis) do not produce stable results with current sample sizes. However, we show that a univariate brain-behavioral space (BBS) can resolve stable individualized prediction. Finally, we show a proof-of-principle framework for relating personalized BBS metrics with molecular targets via serotonin and glutamate receptor manipulations and neural gene expression maps derived from the Allen Human Brain Atlas. Collectively, these results highlight a stable and data-driven BBS mapping across PSD, which offers an actionable path that can be iteratively optimized for personalized clinical biomarker endpoints.
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Affiliation(s)
- Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States.,Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, United States
| | - Markus Helmer
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
| | - Clara Fonteneau
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
| | | | - Zailyn Tamayo
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
| | - Jure Demšar
- Department of Psychology, University of Ljubljana, Ljubljana, Slovenia.,Faculty of Computer and Information Science, University of Ljubljana, Ljubljana, Slovenia
| | - Brendan D Adkinson
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States.,Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, United States
| | | | - Katrin H Preller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Flora Moujaes
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - William J Martin
- The Janssen Pharmaceutical Companies of Johnson and Johnson, San Francisco, United States
| | - Grega Repovš
- Department of Psychiatry, University of Zagreb, Zagreb, Croatia
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States.,Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, United States.,Department of Physics, Yale University, New Haven, United States
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States.,Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, United States.,Department of Psychology, Yale University School of Medicine, New Haven, United States
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25
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Duerler P, Brem S, Fraga-González G, Neef T, Allen M, Zeidman P, Stämpfli P, Vollenweider FX, Preller KH. Psilocybin Induces Aberrant Prediction Error Processing of Tactile Mismatch Responses-A Simultaneous EEG-FMRI Study. Cereb Cortex 2021; 32:186-196. [PMID: 34255821 DOI: 10.1093/cercor/bhab202] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/27/2021] [Accepted: 06/07/2021] [Indexed: 12/20/2022] Open
Abstract
As source of sensory information, the body provides a sense of agency and self/non-self-discrimination. The integration of bodily states and sensory inputs with prior beliefs has been linked to the generation of bodily self-consciousness. The ability to detect surprising tactile stimuli is essential for the survival of an organism and for the formation of mental body representations. Despite the relevance for a variety of psychiatric disorders characterized by altered body and self-perception, the neurobiology of these processes is poorly understood. We therefore investigated the effect of psilocybin (Psi), known to induce alterations in self-experience, on tactile mismatch responses by combining pharmacological manipulations with simultaneous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) recording. Psi reduced activity in response to tactile surprising stimuli in frontal regions, the visual cortex, and the cerebellum. Furthermore, Psi reduced tactile mismatch negativity EEG responses at frontal electrodes, associated with alterations of body- and self-experience. This study provides first evidence that Psi alters the integration of tactile sensory inputs through aberrant prediction error processing and highlights the importance of the 5-HT2A system in tactile deviancy processing as well as in the integration of bodily and self-related stimuli. These findings may have important implications for the treatment of psychiatric disorders characterized by aberrant bodily self-awareness.
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Affiliation(s)
- Patricia Duerler
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich 8032, Switzerland
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital for Psychiatry, University of Zurich, Zurich 8032, Switzerland
| | - Gorka Fraga-González
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital for Psychiatry, University of Zurich, Zurich 8032, Switzerland
| | - Tiffany Neef
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich 8032, Switzerland
| | - Micah Allen
- Aarhus Institute of Advanced Studies, Aarhus University, 8000 Aarhus C, Denmark.,Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University Hospital, 8000 Aarhus C, Denmark.,Cambridge Psychiatry, University of Cambridge, Cambridge CB2 8AH, United Kingdom
| | - Peter Zeidman
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, United Kingdom
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich 8032, Switzerland
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich 8032, Switzerland
| | - Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich 8032, Switzerland
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26
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Olbrich S, Preller KH, Vollenweider FX. LSD and ketanserin and their impact on the human autonomic nervous system. Psychophysiology 2021; 58:e13822. [PMID: 33772794 DOI: 10.1111/psyp.13822] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/23/2021] [Accepted: 02/15/2021] [Indexed: 12/25/2022]
Abstract
The interest in lysergic acid diethylamide (LSD) has sparked again due to its supposed positive effects on psychopathological conditions. Yet, most research focuses on the actions of LSD on the central nervous system. The interaction with the autonomic nervous system (ANS) has been neglected so far. Therefore, the aim was to assess the effects of LSD and the serotonin 2A receptor antagonist ketanserin on the ANS as assessed by heart rate variability (HRV) measures and their correlation with subjective drug-induced effects in a randomized, placebo-controlled crossover trial. Thus, ANS activity was derived from electrocardiogram recordings after intake of placebo, LSD or ketanserin, and LSD by calculating R-peak-based measures of sympathetic and parasympathetic activity. Repeated measure ANOVA and partial correlation for HRV measures and subjective experience questionnaires were performed. LSD predominantly increased sympathetic activity, while ketanserin counteracted this effect on the ANS via an increase of parasympathetic tone. Sympathetic activity was positively and parasympathetic activity negatively associated with psychedelic effects of LSD. Furthermore, Placebo HRV measures predicted subjective experiences after LSD intake. The association between trait ANS activity and LSD-induced subjective experiences may serve as a candidate biomarker set for the effectiveness of LSD in the treatment of psychopathological conditions.
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Affiliation(s)
- Sebastian Olbrich
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Zurich, Zurich, Switzerland
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Zurich, Zurich, Switzerland
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27
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De Gregorio D, Aguilar-Valles A, Preller KH, Heifets BD, Hibicke M, Mitchell J, Gobbi G. Hallucinogens in Mental Health: Preclinical and Clinical Studies on LSD, Psilocybin, MDMA, and Ketamine. J Neurosci 2021; 41:891-900. [PMID: 33257322 PMCID: PMC7880300 DOI: 10.1523/jneurosci.1659-20.2020] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/29/2020] [Accepted: 10/09/2020] [Indexed: 12/24/2022] Open
Abstract
A revamped interest in the study of hallucinogens has recently emerged, especially with regard to their potential application in the treatment of psychiatric disorders. In the last decade, a plethora of preclinical and clinical studies have confirmed the efficacy of ketamine in the treatment of depression. More recently, emerging evidence has pointed out the potential therapeutic properties of psilocybin and LSD, as well as their ability to modulate functional brain connectivity. Moreover, MDMA, a compound belonging to the family of entactogens, has been demonstrated to be useful to treat post-traumatic stress disorders. In this review, the pharmacology of hallucinogenic compounds is summarized by underscoring the differences between psychedelic and nonpsychedelic hallucinogens as well as entactogens, and their behavioral effects in both animals and humans are described. Together, these data substantiate the potentials of these compounds in treating mental diseases.
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Affiliation(s)
- Danilo De Gregorio
- Department of Psychiatry, McGill University, Montreal, Quebec H3A 1A1, Canada
| | - Argel Aguilar-Valles
- Department of Neuroscience, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - Katrin H Preller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, CH-8032 Zurich, Switzerland
| | - Boris Dov Heifets
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305
| | - Meghan Hibicke
- Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112
| | - Jennifer Mitchell
- Department of Neurology, University of California San Francisco, San Francisco, California 94158
| | - Gabriella Gobbi
- Department of Psychiatry, McGill University, Montreal, Quebec H3A 1A1, Canada
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28
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Mertens LJ, Preller KH. Classical Psychedelics as Therapeutics in Psychiatry - Current Clinical Evidence and Potential Therapeutic Mechanisms in Substance Use and Mood Disorders. Pharmacopsychiatry 2021; 54:176-190. [PMID: 33472250 DOI: 10.1055/a-1341-1907] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Classical psychedelics, primarily psilocybin and lysergic acid diethylamide (LSD), have been used and extensively studied in Western medicine as part of substance-assisted psychotherapy in the 1950s and 1960s. Modern clinical research is currently gaining momentum and provides new evidence for the safety and efficacy of classical psychedelics (primarily psilocybin, but also LSD and ayahuasca) in the treatment of different psychiatric conditions, including substance use and mood disorders.In this review article, we outline common pathological mechanisms of substance use disorders (SUD) and unipolar depression. Next, the current literature on the effects of psychedelics is summarized in order to generate hypotheses regarding their potential therapeutic mechanisms of action in treating these psychiatric conditions. Finally, we review and discuss clinical trials published since 2011 investigating the effects of psychedelics in SUD and depression.While results from those modern clinical trials are promising, most of them do not meet the methodological requirements to allow firm conclusions on the clinical efficacy of psychedelics. Larger, blinded, randomized controlled trials (RCT) with clearly defined patient groups and well-defined primary endpoints are needed. Additionally, the therapeutic mechanisms of classical psychedelics are currently unknown. This review presents hypotheses derived from preclinical and human studies that need to be tested in future trials to better understand the clinical potential of psychedelic substances in modern psychiatry.
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Affiliation(s)
- Lea J Mertens
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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Leptourgos P, Fortier-Davy M, Carhart-Harris R, Corlett PR, Dupuis D, Halberstadt AL, Kometer M, Kozakova E, LarØi F, Noorani TN, Preller KH, Waters F, Zaytseva Y, Jardri R. Hallucinations Under Psychedelics and in the Schizophrenia Spectrum: An Interdisciplinary and Multiscale Comparison. Schizophr Bull 2020; 46:1396-1408. [PMID: 32944778 PMCID: PMC7707069 DOI: 10.1093/schbul/sbaa117] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The recent renaissance of psychedelic science has reignited interest in the similarity of drug-induced experiences to those more commonly observed in psychiatric contexts such as the schizophrenia-spectrum. This report from a multidisciplinary working group of the International Consortium on Hallucinations Research (ICHR) addresses this issue, putting special emphasis on hallucinatory experiences. We review evidence collected at different scales of understanding, from pharmacology to brain-imaging, phenomenology and anthropology, highlighting similarities and differences between hallucinations under psychedelics and in the schizophrenia-spectrum disorders. Finally, we attempt to integrate these findings using computational approaches and conclude with recommendations for future research.
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Affiliation(s)
- Pantelis Leptourgos
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT
| | - Martin Fortier-Davy
- Institut Jean Nicod, École des Hautes Études en Sciences Sociales, École Normale Supérieure, PSL Research University, Paris France
| | | | - Philip R Corlett
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT
| | - David Dupuis
- Department of Anthropology, University of Durham, Durham, UK
| | - Adam L Halberstadt
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Research Service, VA San Diego Healthcare System, San Diego, CA
| | - Michael Kometer
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Eva Kozakova
- Department of Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czechia
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czechia
| | - Frank LarØi
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
- Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway
| | | | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Flavie Waters
- School of Psychological Sciences, The University of Western Australia, Perth, Western Australia
| | - Yuliya Zaytseva
- Department of Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czechia
- Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Renaud Jardri
- Univ. Lille, INSERM U1172, CHU Lille, Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY team, Lille, France
- Laboratoire de Neurosciences Cognitives et Computationnelles, ENS, INSERM U960, PSL Research University, Paris, France
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Pokorny T, Duerler P, Seifritz E, Vollenweider FX, Preller KH. LSD acutely impairs working memory, executive functions, and cognitive flexibility, but not risk-based decision-making. Psychol Med 2020; 50:2255-2264. [PMID: 31500679 DOI: 10.1017/s0033291719002393] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Psychiatric and neurodegenerative illnesses are characterized by cognitive impairments, in particular deficits in working memory, decision-making, and executive functions including cognitive flexibility. However, the neuropharmacology of these cognitive functions is poorly understood. The serotonin (5-HT) 2A receptor might be a promising candidate for the modulation of cognitive processes. However, pharmacological studies investigating the role of this receptor system in humans are rare. Recent evidence demonstrates that the effects of Lysergic acid diethylamide (LSD) are mediated via agonistic action at the 5-HT2A receptor. Yet, the effects of LSD on specific cognitive domains using standardized neuropsychological test have not been studied. METHODS We examined the acute effects of LSD (100 µg) alone and in combination with the 5-HT2A antagonist ketanserin (40 mg) on cognition, employing a double-blind, randomized, placebo-controlled, within-subject design in 25 healthy participants. Executive functions, cognitive flexibility, spatial working memory, and risk-based decision-making were examined by the Intra/Extra-Dimensional shift task (IED), Spatial Working Memory task (SWM), and Cambridge Gambling Task (CGT) of the Cambridge Neuropsychological Test Automated Battery. RESULTS Compared to placebo, LSD significantly impaired executive functions, cognitive flexibility, and working memory on the IED and SWM, but did not influence the quality of decision-making and risk taking on the CGT. Pretreatment with the 5-HT2A antagonist ketanserin normalized all LSD-induced cognitive deficits. CONCLUSIONS The present findings highlight the role of the 5-HT2A receptor system in executive functions and working memory and suggest that specific 5-HT2A antagonists may be relevant for improving cognitive dysfunctions in psychiatric disorders.
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Affiliation(s)
- Thomas Pokorny
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Heffter Research Center Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Patricia Duerler
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Heffter Research Center Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Heffter Research Center Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Heffter Research Center Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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Smigielski L, Kometer M, Scheidegger M, Stress C, Preller KH, Koenig T, Vollenweider FX. P300-mediated modulations in self-other processing under psychedelic psilocybin are related to connectedness and changed meaning: A window into the self-other overlap. Hum Brain Mapp 2020; 41:4982-4996. [PMID: 32820851 PMCID: PMC7643385 DOI: 10.1002/hbm.25174] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/27/2020] [Accepted: 08/04/2020] [Indexed: 01/06/2023] Open
Abstract
The concept of self and self‐referential processing has a growing explanatory value in psychiatry and neuroscience, referring to the cognitive organization and perceptual differentiation of self‐stimuli in health and disease. Conditions in which selfhood loses its natural coherence offer a unique opportunity for elucidating the mechanisms underlying self‐disturbances. We assessed the psychoactive effects of psilocybin (230 μg/kg p.o.), a preferential 5‐HT1A/2A agonist known to induce shifts in self‐perception. Our placebo‐controlled, double‐blind, within‐subject crossover experiment (n = 17) implemented a verbal self‐monitoring task involving vocalizations and participant identification of real‐time auditory source‐ (self/other) and pitch‐modulating feedback. Subjective experience and task performance were analyzed, with time‐point‐by‐time‐point assumption‐free multivariate randomization statistics applied to the spatiotemporal dynamics of event‐related potentials. Psilocybin‐modulated self‐experience, interacted with source to affect task accuracy, and altered the late phase of self‐stimuli encoding by abolishing the distinctiveness of self‐ and other‐related electric field configurations during the P300 timeframe. This last effect was driven by current source density changes within the supragenual anterior cingulate and right insular cortex. The extent of the P300 effect was associated with the intensity of psilocybin‐induced feelings of unity and changed meaning of percepts. Modulations of late encoding and their underlying neural generators in self‐referential processing networks via 5‐HT signaling may be key for understanding self‐disorders. This mechanism may reflect a neural instantiation of altered self–other and relational meaning processing in a stimulus‐locked time domain. The study elucidates the neuropharmacological foundation of subjectivity, with implications for therapy, underscoring the concept of connectedness.
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Affiliation(s)
- Lukasz Smigielski
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Michael Kometer
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Milan Scheidegger
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Cornelia Stress
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Thomas Koenig
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
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Duerler P, Schilbach L, Stämpfli P, Vollenweider FX, Preller KH. LSD-induced increases in social adaptation to opinions similar to one's own are associated with stimulation of serotonin receptors. Sci Rep 2020; 10:12181. [PMID: 32699231 PMCID: PMC7376162 DOI: 10.1038/s41598-020-68899-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 07/02/2020] [Indexed: 11/09/2022] Open
Abstract
Adapting one's attitudes and behaviors to group norms is essential for successful social interaction and, thus, participation in society. Yet, despite its importance for societal and individual functioning, the underlying neuropharmacology is poorly understood. We therefore investigated its neurochemical and neural correlates in a pharmacological functional magnetic resonance imaging study. Lysergic acid diethylamide (LSD) has been shown to alter social processing and therefore provides the unique opportunity to investigate the role of the 5-HT2A receptor in social influence processing. Twenty-four healthy human volunteers received either (1) placebo + placebo, (2) placebo + LSD (100 µg), or (3) the 5-HT2A receptor antagonist ketanserin (40 mg) + LSD (100 µg) at three different occasions in a double-blind, randomized, counterbalanced, cross-over design. LSD increases social adaptation but only if the opinions of others are similar to the individual's own. These increases were associated with increased activity in the medial prefrontal cortex while participants received social feedback. Furthermore, pretreatment with the 5-HT2A antagonist ketanserin fully blocked LSD-induced changes during feedback processing, indicating a key role of the 5-HT2A system in social feedback processing. Our results highlight the crucial role of the 5-HT-system in social influence and, thus, provide important insight into the neuropharmacological basis of social cognition and behavior.
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Affiliation(s)
- Patricia Duerler
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstrasse 31, 8032, Zürich, Switzerland.
| | - Leonhard Schilbach
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804, Munich, Germany.,Department of Psychiatry, Ludwig-Maximilians-Universität, Munich, Germany.,Clinic for Disorders of Social Interaction, LVR Klinikum Düsseldorf/Kliniken der Heinrich-Heine-Universität Düsseldorf, Bergische Landstr. 2, 40629, Düsseldorf, Germany
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, 8032, Zurich, Switzerland
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstrasse 31, 8032, Zürich, Switzerland
| | - Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstrasse 31, 8032, Zürich, Switzerland
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Preller KH, Duerler P, Burt JB, Ji JL, Adkinson B, Stämpfli P, Seifritz E, Repovš G, Krystal JH, Murray JD, Anticevic A, Vollenweider FX. Psilocybin Induces Time-Dependent Changes in Global Functional Connectivity. Biol Psychiatry 2020; 88:197-207. [PMID: 32111343 DOI: 10.1016/j.biopsych.2019.12.027] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/23/2019] [Accepted: 12/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The use of psilocybin in scientific and experimental clinical contexts has triggered renewed interest in the mechanism of action of psychedelics. However, its time-dependent systems-level neurobiology remains sparsely investigated in humans. METHODS We conducted a double-blind, randomized, counterbalanced, crossover study comprising 23 healthy human participants who received placebo and 0.2 mg/kg of psilocybin orally on 2 different test days. Participants underwent magnetic resonance imaging at 3 time points between administration and peak effects: 20 minutes, 40 minutes, and 70 minutes after administration. Resting-state functional connectivity was quantified via a data-driven global brain connectivity method and compared with cortical gene expression maps. RESULTS Psilocybin reduced associative, but concurrently increased sensory, brain-wide connectivity. This pattern emerged over time from administration to peak effects. Furthermore, we showed that baseline connectivity is associated with the extent of psilocybin-induced changes in functional connectivity. Lastly, psilocybin-induced changes correlated in a time-dependent manner with spatial gene expression patterns of the 5-HT2A (5-hydroxytryptamine 2A) and 5-HT1A (5-hydroxytryptamine 1A) receptors. CONCLUSIONS These results suggest that the integration of functional connectivity in sensory regions and the disintegration in associative regions may underlie the psychedelic state and pinpoint the critical role of the serotonin 2A and 1A receptor systems. Furthermore, baseline connectivity may represent a predictive marker of the magnitude of changes induced by psilocybin and may therefore contribute to a personalized medicine approach within the potential framework of psychedelic treatment.
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Affiliation(s)
- Katrin H Preller
- Neuropsychopharmacology and Brain Imaging Unit, University Hospital for Psychiatry Zurich, Zurich, Switzerland; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
| | - Patricia Duerler
- Neuropsychopharmacology and Brain Imaging Unit, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Joshua B Burt
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Physics, Yale University, New Haven, Connecticut
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Brendan Adkinson
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Grega Repovš
- Mind and Brain Laboratory, Department of Psychology, University of Ljubljana, Ljubljana, Slovenia
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut; Department of Physics, Yale University, New Haven, Connecticut
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging Unit, University Hospital for Psychiatry Zurich, Zurich, Switzerland
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Bershad AK, Preller KH, Lee R, Keedy S, Wren-Jarvis J, Bremmer MP, de Wit H. Preliminary Report on the Effects of a Low Dose of LSD on Resting-State Amygdala Functional Connectivity. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 5:461-467. [PMID: 32033922 PMCID: PMC7150630 DOI: 10.1016/j.bpsc.2019.12.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND The practice of "microdosing," or the use of repeated, very low doses of lysergic acid diethylamide (LSD) to improve mood or cognition, has received considerable public attention, but empirical studies are lacking. Controlled studies are needed to investigate both the therapeutic potential and the neurobiological underpinnings of this pharmacologic treatment. METHODS The present study was designed to examine the effects of a single low dose of LSD (13 μg) versus placebo on resting-state functional connectivity and cerebral blood flow in healthy young adults. Twenty men and women, 18 to 35 years old, participated in 2 functional magnetic resonance imaging scanning sessions in which they received placebo or LSD under double-blind conditions. During each session, the participants completed drug effect and mood questionnaires, and physiological measures were recorded. During expected peak drug effect, they underwent resting-state blood oxygen level-dependent and arterial spin labeling scans. Cerebral blood flow as well as amygdala and thalamic connectivity were analyzed. RESULTS LSD increased amygdala seed-based connectivity with the right angular gyrus, right middle frontal gyrus, and the cerebellum, and decreased amygdala connectivity with the left and right postcentral gyrus and the superior temporal gyrus. This low dose of LSD had weak and variable effects on mood, but its effects on positive mood were positively correlated with the increase in amygdala-middle frontal gyrus connectivity strength. CONCLUSIONS These preliminary findings show that a very low dose of LSD, which produces negligible subjective changes, alters brain connectivity in limbic circuits. Additional studies, especially with repeated dosing, will reveal whether these neural changes are related to the drug's purported antidepressant effect.
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Affiliation(s)
- Anya K Bershad
- Department of Psychiatry, University of California Los Angeles, Los Angeles, California
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Sarah Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Jamie Wren-Jarvis
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Michael P Bremmer
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois.
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Lewis CR, Preller KH, Braden BB, Riecken C, Vollenweider FX. Rostral Anterior Cingulate Thickness Predicts the Emotional Psilocybin Experience. Biomedicines 2020; 8:biomedicines8020034. [PMID: 32085521 PMCID: PMC7168190 DOI: 10.3390/biomedicines8020034] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 01/02/2023] Open
Abstract
Psilocybin is the psychoactive compound of mushrooms in the psilocybe species. Psilocybin directly affects a number of serotonin receptors, with highest affinity for the serotonin 2A receptor (5HT-2Ar). Generally, the effects of psilocybin, and its active metabolite psilocin, are well established and include a range of cognitive, emotional, and perceptual perturbations. Despite the generality of these effects, there is a high degree of inter-individual variability in subjective psilocybin experiences that are not well understood. Others have shown brain morphology metrics derived from magnetic resonance imaging (MRI) can predict individual drug response. Due to high expression of serotonin 2A receptors (5HT-2Ar) in the cingulate cortex, and its prior associations with psilocybin, we investigate if cortical thickness of this structure predicts the psilocybin experience in healthy adults. We hypothesized that greater cingulate thickness would predict higher subjective ratings in sub-scales of the Five-Dimensional Altered State of Consciousness (5D-ASC) with high emotionality in healthy participants (n = 55) who received oral psilocybin (either low dose: 0.160 mg/kg or high dose: 0.215 mg/kg). After controlling for sex, age, and using false discovery rate (FDR) correction, we found the rostral anterior cingulate predicted all four emotional sub-scales, whereas the caudal and posterior cingulate did not. How classic psychedelic compounds induce such large inter-individual variability in subjective states has been a long-standing question in serotonergic research. These results extend the traditional set and setting hypothesis of the psychedelic experience to include brain structure metrics.
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Affiliation(s)
- Candace R. Lewis
- Translational Genomics Research Institute, Neurogenomics Division, Phoenix, AZ 85004, USA
- Neuropsychopharamacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich 8032, Switzerland; (K.H.P.); (F.X.V.)
- Correspondence: ; Tel.: +1-602-343-8400
| | - Katrin H. Preller
- Neuropsychopharamacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich 8032, Switzerland; (K.H.P.); (F.X.V.)
| | - B. Blair Braden
- Arizona State University, College of Health Solutions, Tempe 85281, AZ 85004, USA; (B.B.B.); (C.R.)
| | - Cory Riecken
- Arizona State University, College of Health Solutions, Tempe 85281, AZ 85004, USA; (B.B.B.); (C.R.)
| | - Franz X. Vollenweider
- Neuropsychopharamacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich 8032, Switzerland; (K.H.P.); (F.X.V.)
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Kluwe-Schiavon B, Schote AB, Vonmoos M, Hulka LM, Preller KH, Meyer J, Baumgartner MR, Grünblatt E, Quednow BB. Psychiatric symptoms and expression of glucocorticoid receptor gene in cocaine users: A longitudinal study. J Psychiatr Res 2020; 121:126-134. [PMID: 31812111 DOI: 10.1016/j.jpsychires.2019.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Chronic cocaine users (CU) display reduced peripheral expression of the glucocorticoid receptor gene (NR3C1), which is potentially involved in stress-related psychiatric symptoms frequently occurring in CU. However, it is unknown whether psychiatric symptoms and lower NR3C1 expression are related to each other and whether reduction of drug consumption reverse them. METHOD At baseline, NR3C1 mRNA expression was measured in 68 recreational CU, 30 dependent CU, and 68 stimulant-naïve controls. Additionally, the Revised Symptom Checklist (SCL-90R) and the Barratt Impulsiveness Scale (BIS) were assessed. At a one-year follow-up, the association between change in NR3C1 expression and psychiatric symptoms was examined in 48 stimulant-naïve controls, 19 CU who increased and 19 CU who decreased their consumption. At both test sessions, cocaine concentrations in hair samples were determined. Mixed-effects models were used to investigate how changes in drug use intensity affect severity of psychiatric symptoms and NR3C1 expression over time. RESULTS At baseline, recreational and dependent CU displayed elevated impulsivity and considerable symptom burden across most of the SCL-90R subscales. Time-group interaction effects were found for several impulsivity scores, SCL-90R Global Severity Index, Paranoid Thoughts, and Depression subscales as well as for NR3C1 expression. Pairwise comparisons showed that decreasing CU specifically improved in these SCL-90R subscales, while their NR3C1 expression was adapted. Finally, changes in NR3C1 expression were negatively correlated with changes in impulsivity but not SCL-90R scores. CONCLUSION Our findings suggest that NR3C1 expression changes and some psychiatric symptoms are reversible upon reduction of cocaine intake, thus favouring abstinence-oriented treatment approaches.
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Affiliation(s)
- B Kluwe-Schiavon
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - A B Schote
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - M Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - L M Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - K H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - J Meyer
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - M R Baumgartner
- Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Switzerland
| | - E Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland
| | - B B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland.
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Kexel AK, Vonmoos M, Preller KH, Hulka LM, Seifritz E, Quednow BB. Social and Non-Social Cognitive Enhancement in Cocaine Users-A Closer Look on Enhancement Motives for Cocaine Consumption. Front Psychiatry 2020; 11:618. [PMID: 32695032 PMCID: PMC7338788 DOI: 10.3389/fpsyt.2020.00618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cognitive disturbances of chronic cocaine users (CU) have been repeatedly investigated. However, it is yet unknown how CU using cocaine for cognitive or social enhancement differ from stimulant-naïve controls and CU that do not have these motives. More precisely, we assumed that CU with an enhancement motive self-medicate deficits in specific cognitive abilities, i.e., they use cocaine to enhance their performance in either social (social motive) or non-social cognitive situations (cognitive motive). METHODS Forty-two CU were categorized according to their motives for cocaine consumption into social and non-social motive groups as well as cognitive and non-cognitive motive groups, respectively. Subsequently, CU motive groups were compared to 48 stimulant-naïve controls in their social and non-social cognitive functioning applying a comprehensive neuropsychological test battery. RESULTS The social motive group showed deficits in cognitive empathy compared to controls (Cohen's d = 0.65) and the non-social motive group (d = 0.60). No mentionable effects were found for emotional empathy and Theory-of-Mind. Cognitive and non-cognitive motive groups both showed general cognitive deficits but with different patterns of impairments compared to controls: the cognitive motive group had deficits mainly in working memory (d = 0.84) and declarative memory (d = 0.60), whereas the non-cognitive motive group also had deficits in working memory (d = 0.61) but additionally in executive functions (d = 0.67). For the domains declarative memory and executive functions, the respective other CU group displayed intermediate performance. CONCLUSIONS This study demonstrates that cocaine is partially instrumentalized by CU with specific enhancement motives to counteract related cognitive impairments.
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Affiliation(s)
- Ann-Kathrin Kexel
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Lea M Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
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Ho JT, Preller KH, Lenggenhager B. Neuropharmacological modulation of the aberrant bodily self through psychedelics. Neurosci Biobehav Rev 2020; 108:526-541. [DOI: 10.1016/j.neubiorev.2019.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 11/18/2019] [Accepted: 12/04/2019] [Indexed: 12/13/2022]
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Barrett FS, Preller KH, Herdener M, Janata P, Vollenweider FX. Serotonin 2A Receptor Signaling Underlies LSD-induced Alteration of the Neural Response to Dynamic Changes in Music. Cereb Cortex 2019; 28:3939-3950. [PMID: 29028939 DOI: 10.1093/cercor/bhx257] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 09/12/2017] [Indexed: 11/12/2022] Open
Abstract
Classic psychedelic drugs (serotonin 2A, or 5HT2A, receptor agonists) have notable effects on music listening. In the current report, blood oxygen level-dependent (BOLD) signal was collected during music listening in 25 healthy adults after administration of placebo, lysergic acid diethylamide (LSD), and LSD pretreated with the 5HT2A antagonist ketanserin, to investigate the role of 5HT2A receptor signaling in the neural response to the time-varying tonal structure of music. Tonality-tracking analysis of BOLD data revealed that 5HT2A receptor signaling alters the neural response to music in brain regions supporting basic and higher-level musical and auditory processing, and areas involved in memory, emotion, and self-referential processing. This suggests a critical role of 5HT2A receptor signaling in supporting the neural tracking of dynamic tonal structure in music, as well as in supporting the associated increases in emotionality, connectedness, and meaningfulness in response to music that are commonly observed after the administration of LSD and other psychedelics. Together, these findings inform the neuropsychopharmacology of music perception and cognition, meaningful music listening experiences, and altered perception of music during psychedelic experiences.
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Affiliation(s)
- Frederick S Barrett
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr, Baltimore, MD, USA
| | - Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, Zurich, Switzerland
| | - Marcus Herdener
- Department of Psychiatry, Psychotherapy and Psychosomatics, Center for Addictive Disorders,University Hospital for Psychiatry Zurich, Lenggstr. 31, Zurich, Switzerland
| | - Petr Janata
- Department of Psychology, University of California, Davis, 1 Shields Dr, Davis, CA, USA.,Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA, USA
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, Zurich, Switzerland
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Preller KH. The Effects of Low Doses of Lysergic Acid Diethylamide in Healthy Humans: Demystifying the Microdosing of Psychedelics. Biol Psychiatry 2019; 86:736-737. [PMID: 31648681 DOI: 10.1016/j.biopsych.2019.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
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Schote AB, Jäger K, Kroll SL, Vonmoos M, Hulka LM, Preller KH, Meyer J, Grünblatt E, Quednow BB. Glucocorticoid receptor gene variants and lower expression of NR3C1 are associated with cocaine use. Addict Biol 2019; 24:730-742. [PMID: 29761890 DOI: 10.1111/adb.12632] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 12/22/2022]
Abstract
Animal and cross-sectional human studies suggest that chronic cocaine use is associated with altered responsivity of the hypothalamic-pituitary-adrenal axis to stress. Moreover, increased susceptibility to stress has been proposed as an important factor for development, maintenance and relapse of cocaine addiction. As the glucocorticoid receptor gene (NR3C1) mediates genomic effects of the stress hormone cortisol, we investigated NR3C1 expression and the association of NR3C1 genotypes with cocaine use, addiction and comorbid psychiatric symptoms in 126 chronic cocaine users and 98 stimulant-naïve healthy controls. A comprehensive psychiatric assessment was performed including severity of depressive symptoms and current psychological distress. Whole blood NR3C1 mRNA levels were determined and six NR3C1 polymorphisms (rs10482605, rs41423247, rs10052957, rs6189, rs56149945 and rs6198) were genotyped. Compared to controls, cocaine users showed significantly lower NR3C1 expression (P < 0.001), which was not affected by NR3C1 genotypes. In controls, rs41423247 [P < 0.01, false discovery rate (FDR)-corrected], haplotype 2 and haplotype 3 (both P < 0.05, FDR-corrected) were associated with altered NR3C1 gene expression. Haplotype 3 (including minor alleles of rs10052957 and rs41423247) was associated with an increased risk for cocaine addiction (odds ratio = 2.74, P < 0.05, uncorrected). Moreover, addicted cocaine users carrying haplotype 3 showed higher depression scores (P < 0.01, FDR-corrected) than noncarriers. Considering possible confounding effects of alcohol and/or depression, we conclude that chronic cocaine use is associated with lower NR3C1 gene expression suggesting possible direct effects of the drug on the biological adaptation of stress-related genes. Finally, we postulate that haplotype 3 of NR3C1 might serve as a potential risk factor for stimulant addiction and associated psychiatric symptoms.
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Affiliation(s)
- Andrea B. Schote
- Department of Neurobehavioral Genetics, Institute of PsychobiologyUniversity of Trier Germany
| | - Kristina Jäger
- Department of Neurobehavioral Genetics, Institute of PsychobiologyUniversity of Trier Germany
| | - Sara L. Kroll
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric HospitalUniversity of Zurich Switzerland
| | - Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric HospitalUniversity of Zurich Switzerland
| | - Lea M. Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric HospitalUniversity of Zurich Switzerland
| | - Katrin H. Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric HospitalUniversity of Zurich Switzerland
| | - Jobst Meyer
- Department of Neurobehavioral Genetics, Institute of PsychobiologyUniversity of Trier Germany
| | - Edna Grünblatt
- University Clinic for Child and Adolescent PsychiatryUniversity of Zurich Switzerland
- NeuroscienceCenter ZurichUniversity and ETH Zurich Switzerland
| | - Boris B. Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric HospitalUniversity of Zurich Switzerland
- NeuroscienceCenter ZurichUniversity and ETH Zurich Switzerland
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Hirsiger S, Hänggi J, Germann J, Vonmoos M, Preller KH, Engeli EJE, Kirschner M, Reinhard C, Hulka LM, Baumgartner MR, Chakravarty MM, Seifritz E, Herdener M, Quednow BB. Longitudinal changes in cocaine intake and cognition are linked to cortical thickness adaptations in cocaine users. Neuroimage Clin 2019; 21:101652. [PMID: 30639181 PMCID: PMC6412021 DOI: 10.1016/j.nicl.2019.101652] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 12/04/2018] [Accepted: 01/02/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cocaine use has been consistently associated with decreased gray matter volumes in the prefrontal cortex. However, it is unclear if such neuroanatomical abnormalities depict either pre-existing vulnerability markers or drug-induced consequences. Thus, this longitudinal MRI study investigated neuroplasticity and cognitive changes in relation to altered cocaine intake. METHODS Surface-based morphometry, cocaine hair concentration, and cognitive performance were measured in 29 cocaine users (CU) and 38 matched controls at baseline and follow-up. Based on changes in hair cocaine concentration, CU were classified either as Decreasers (n = 15) or Sustained Users (n = 14). Surface-based morphometry measures did not include regional tissue volumes. RESULTS At baseline, CU displayed reduced cortical thickness (CT) in lateral frontal regions, and smaller cortical surface area (CSA) in the anterior cingulate cortex, compared to controls. In Decreasers, CT of the lateral frontal cortex increased whereas CT within the same regions tended to further decrease in Sustained Users. In contrast, no changes were found for CSA and subcortical structures. Changes in CT were linked to cognitive performance changes and amount of cocaine consumed over the study period. CONCLUSIONS These results suggest that frontal abnormalities in CU are partially drug-induced and can recover with decreased substance use. Moreover, recovery of frontal CT is accompanied by improved cognitive performance confirming that cognitive decline associated with cocaine use is potentially reversible.
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Affiliation(s)
- Sarah Hirsiger
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Jürgen Hänggi
- Division Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Jürgen Germann
- Cerebral Imaging Center, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Etna J E Engeli
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Matthias Kirschner
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Caroline Reinhard
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Lea M Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Markus R Baumgartner
- Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Mallar M Chakravarty
- Cerebral Imaging Center, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; Departments of Psychiatry and Biomedical and Biological Engineering, McGill University, Montreal, QC, Canada
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Marcus Herdener
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
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Abstract
Social cognition is a fundamental ability in human everyday lives. Deficits in social functioning also represent a core aspect of many psychiatric disorders. Yet, despite its significance, deficits in social cognition skills are insufficiently targeted by current treatments. Hallucinogens and entactogens have been shown to have the potential to modulate social processing. This article reviews the literature on the influence of hallucinogens and entactogens on social processing in controlled experimental studies in humans and elucidates the underlying neurobiological and neuropharmacological mechanisms. Furthermore, it identifies current knowledge gaps and derives implications for hallucinogen-assisted treatment approaches as well as the development of novel medication for trans-diagnostic impairments in social cognition.
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Affiliation(s)
- Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
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Vonmoos M, Eisenegger C, Bosch OG, Preller KH, Hulka LM, Baumgartner M, Seifritz E, Quednow BB. Improvement of Emotional Empathy and Cluster B Personality Disorder Symptoms Associated With Decreased Cocaine Use Severity. Front Psychiatry 2019; 10:213. [PMID: 31024365 PMCID: PMC6459943 DOI: 10.3389/fpsyt.2019.00213] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/25/2019] [Indexed: 12/24/2022] Open
Abstract
Aims: Chronic cocaine users display impaired social cognitive abilities, reduced prosocial behavior, and pronounced cluster B personality disorder (PD) symptoms all contributing to their social dysfunctions in daily life. These social dysfunctions have been proposed as a major factor for maintenance and relapse of stimulant use disorders in general. However, little is known about the reversibility of social cognitive deficits and socially problematic personality facets when stimulant use is reduced or ceased. Therefore, we examined the relation between changing intensity of cocaine use and the development of sociocognitive functioning and cluster B PD symptomatology over the course of 1 year. Methods: Social cognition, social decision-making, and cluster B PD symptoms were assessed in 38 cocaine users (19 with increased and 19 with decreased use) and 48 stimulant-naive healthy controls at baseline and at 1-year follow-up. Cocaine use severity was objectively determined by quantitative 6-month hair analyses. The categorization of the two cocaine user groups was based on a combination of absolute (± 0.5 ng/mg) and relative (± 10%) changes in the cocaine hair concentration between baseline and the 1-year follow-up. Social cognition was assessed using the Multifaceted Empathy Test (MET) and the Movie for the Assessment of Social Cognition (MASC). A combined Distribution/Dictator Game was applied for assessing social decision-making. Cluster B PD symptoms were measured by a Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) PD questionnaire according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Results: Increased cocaine use was linked to worsened empathy, while decreased cocaine use went along with improved emotional empathy. Moreover, whereas decreased cocaine use was associated with reduced severity of self-reported cluster B PD symptoms, these symptoms remained largely stable in increasers. In contrast to a significant reduction of prosocial behavior at baseline in the combined cocaine user group, specifically decreasers were not statistically distinguishable from controls at the follow-up. Conclusions: Sociocognitive deficits and cluster B PD symptoms of chronic cocaine users are adaptable over time as they covary with the increase or decrease in cocaine use. Hence, abstinence orientation and training of social cognition and interaction might improve social functioning, and should therefore be important therapeutic elements in cocaine addiction treatment.
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Affiliation(s)
- Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Christoph Eisenegger
- Neuropsychopharmacology and Biopsychology Unit, Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Oliver G Bosch
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Lea M Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Markus Baumgartner
- Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
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Vonmoos M, Hirsiger S, Preller KH, Hulka LM, Allemann D, Herdener M, Baumgartner MR, Quednow BB. Cognitive and neuroanatomical impairments associated with chronic exposure to levamisole-contaminated cocaine. Transl Psychiatry 2018; 8:235. [PMID: 30368522 PMCID: PMC6204136 DOI: 10.1038/s41398-018-0279-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/29/2018] [Accepted: 09/10/2018] [Indexed: 01/07/2023] Open
Abstract
Currently, levamisole is the most common cocaine adulterant worldwide and it is known to induce a variety of adverse side effects. Animal studies and human case reports suggest potential neurotoxicity of the compound but neither neuroanatomical nor cognitive effects of levamisole have been systematically investigated in cocaine users so far. We examined cognitive performance and cortical structural differences between chronic cocaine users with low and high recent exposure to levamisole objectively determined by quantitative toxicological hair analyses. In Study 1, we compared 26 chronic cocaine users with low levamisole exposure (lowLevCU), 49 matched cocaine users with high levamisole exposure (highLevCU), and 78 matched stimulant-naive controls regarding cognitive functioning employing a comprehensive neuropsychological test battery. In Study 2, we investigated cortical thickness by use of T1-weighted MRI in a subgroup of 12 lowLevCU, 17 highLevCU, and 38 stimulant-naive controls. In Study 1, both cocaine user groups showed significant impairments in the cognitive domains of attention and working memory as well as in the global cognitive index. However, highLevCU showed significantly worse executive functions compared to lowLevCU although both groups did not differ in severity of cocaine consumption and other clinical dimensions. Study 2 revealed that highLevCU, displayed reduced cortical thickness specifically in the middle frontal gyrus compared to both controls and lowLevCU. Our results suggest that levamisole exposure during the last months in cocaine users is associated with increased executive function impairments and pronounced thinning of the lateral prefrontal cortex. Consequently, prevention and drug policy-making should aim to reduce levamisole contamination of street cocaine.
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Affiliation(s)
- Matthias Vonmoos
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, Experimental and Clinical Pharmacopsychology, University of Zurich, Zurich, Switzerland.
| | - Sarah Hirsiger
- 0000 0004 1937 0650grid.7400.3Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, Experimental and Clinical Pharmacopsychology, University of Zurich, Zurich, Switzerland
| | - Katrin H. Preller
- 0000 0004 1937 0650grid.7400.3Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, Experimental and Clinical Pharmacopsychology, University of Zurich, Zurich, Switzerland
| | - Lea M. Hulka
- 0000 0004 1937 0650grid.7400.3Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, Experimental and Clinical Pharmacopsychology, University of Zurich, Zurich, Switzerland ,0000 0004 1937 0650grid.7400.3Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, Center for Addictive Disorders, University of Zurich, Zurich, Switzerland
| | - Daniel Allemann
- Health & Social Welfare Department State of Berne, Office of the Cantonal Pharmacist, Zurich, Switzerland
| | - Marcus Herdener
- 0000 0004 1937 0650grid.7400.3Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, Center for Addictive Disorders, University of Zurich, Zurich, Switzerland
| | - Markus R. Baumgartner
- 0000 0004 1937 0650grid.7400.3Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Boris B. Quednow
- 0000 0004 1937 0650grid.7400.3Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, Experimental and Clinical Pharmacopsychology, University of Zurich, Zurich, Switzerland ,0000 0001 2156 2780grid.5801.cNeuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
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Preller KH, Burt JB, Ji JL, Schleifer CH, Adkinson BD, Stämpfli P, Seifritz E, Repovs G, Krystal JH, Murray JD, Vollenweider FX, Anticevic A. Changes in global and thalamic brain connectivity in LSD-induced altered states of consciousness are attributable to the 5-HT2A receptor. eLife 2018; 7:35082. [PMID: 30355445 PMCID: PMC6202055 DOI: 10.7554/elife.35082] [Citation(s) in RCA: 195] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 09/09/2018] [Indexed: 12/15/2022] Open
Abstract
Background: Lysergic acid diethylamide (LSD) has agonist activity at various serotonin (5-HT) and dopamine receptors. Despite the therapeutic and scientific interest in LSD, specific receptor contributions to its neurobiological effects remain unknown. Methods: We therefore conducted a double-blind, randomized, counterbalanced, cross-over studyduring which 24 healthy human participants received either (i) placebo+placebo, (ii) placebo+LSD (100 µg po), or (iii) Ketanserin, a selective 5-HT2A receptor antagonist,+LSD. We quantified resting-state functional connectivity via a data-driven global brain connectivity method and compared it to cortical gene expression maps. Results: LSD reduced associative, but concurrently increased sensory-somatomotor brain-wide and thalamic connectivity. Ketanserin fully blocked the subjective and neural LSD effects. Whole-brain spatial patterns of LSD effects matched 5-HT2A receptor cortical gene expression in humans. Conclusions: Together, these results strongly implicate the 5-HT2A receptor in LSD’s neuropharmacology. This study therefore pinpoints the critical role of 5-HT2A in LSD’s mechanism, which informs its neurobiology and guides rational development of psychedelic-based therapeutics. Funding: Funded by the Swiss National Science Foundation, the Swiss Neuromatrix Foundation, the Usona Institute, the NIH, the NIAA, the NARSAD Independent Investigator Grant, the Yale CTSA grant, and the Slovenian Research Agency. Clinical trial number: NCT02451072. The psychedelic drug LSD alters thinking and perception. Users can experience hallucinations, in which they, for example, see things that are not there. Colors, sounds and objects can appear distorted, and time can seem to speed up or slow down. These changes bear some resemblance to the changes in thinking and perception that occur in certain psychiatric disorders, such as schizophrenia. Studying how LSD affects the brain could thus offer insights into the mechanisms underlying these conditions. There is also evidence that LSD itself could help to reduce the symptoms of depression and anxiety disorders. Preller et al. have now used brain imaging to explore the effects of LSD on the brains of healthy volunteers. This revealed that LSD reduced communication among brain areas involved in planning and decision-making, but it increased communication between areas involved in sensation and movement. Volunteers whose brains showed the most communication between sensory and movement areas also reported the strongest effects of LSD on their thinking and perception. Preller et al. also found that another drug called Ketanserin prevented LSD from altering how different brain regions communicate. It also prevented LSD from inducing changes in thinking and perception. Ketanserin blocks a protein called the serotonin 2A receptor, which is activated by a brain chemical called serotonin that, amongst other roles, helps to regulate mood. By mapping the location of the gene that produces the serotonin 2A receptor, Preller et al. showed that the receptor is present in brain regions that show altered communication after LSD intake, therefore pinpointing the importance of this receptor in the effects of LSD. Psychiatric disorders that produce psychotic symptoms affect vast numbers of people worldwide. Further research into how LSD affects the brain could help us to better understand how such symptoms arise, and may also lead to the development of more effective treatments for a range of mental health conditions.
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Affiliation(s)
- Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland.,Department of Psychiatry, Yale University School of Medicine, New Haven, United States
| | - Joshua B Burt
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States.,Department of Physics, Yale University, New Haven, United States
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
| | - Charles H Schleifer
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
| | - Brendan D Adkinson
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Grega Repovs
- Mind and Brain Lab, Department of Psychology, University of Ljubljana, Ljubljana, Slovenia
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States.,Department of Physics, Yale University, New Haven, United States.,Department of Neuroscience, Yale University School of Medicine, New Haven, United States
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
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Kroll SL, Wunderli MD, Vonmoos M, Hulka LM, Preller KH, Bosch OG, Baumgartner MR, Quednow BB. Socio-cognitive functioning in stimulant polysubstance users. Drug Alcohol Depend 2018; 190:94-103. [PMID: 30005311 DOI: 10.1016/j.drugalcdep.2018.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 05/09/2018] [Accepted: 06/01/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Using more than one psychotropic substance is accompanied by increased risks for psychiatric and physical disorders. Accordingly, deficits in basal cognitive functions have been consistently associated with polysubstance use (PSU), whereas little is known about potential impairments in more complex socio-cognitive skills, which are relevant for daily-life functioning. Therefore, we investigated the effects of toxicological validated stimulant PSU on social cognition under consideration of potential cumulative effects. METHODS We compared socio-cognitive performances of 47 individuals with stimulant PSU with 59 matched stimulant-naïve controls using the Multifaceted Empathy Test (MET) and the Movie for the Assessment of Social Cognition (MASC). Additionally, social network size was assessed by the Social Network Questionnaire (SNQ). Hair and urine testing was employed to categorize three PSU subgroups (3, 4, and ≥5 substances used) and to ensure drug abstinence in controls. RESULTS Individuals with stimulant PSU showed lower emotional empathy (MET) and a smaller social network (SNQ) compared to controls (both with linear trends for increasing number of used substances: p < .05). In contrast, cognitive empathy (MET and MASC) was largely unaffected by PSU. Additional linear regression analyses within PSU individuals revealed number of used substances as the best predictor for inferior performance in emotional empathy (p < .01), while severity of the use of single substances or substance-classes did not show a significant impact. CONCLUSION These findings demonstrate cumulative adverse effects of stimulant PSU on an important facet of socio-cognitive functioning. Therefore, emotional empathy deficits should be targeted in future interventions and rehabilitations for individuals with PSU.
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Affiliation(s)
- Sara L Kroll
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Michael D Wunderli
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Lea M Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Katrin H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Oliver G Bosch
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Markus R Baumgartner
- Center for Forensic Hair Analysis, Institute of Forensic Medicine, University of Zurich, Kurvenstrasse 17, 8006 Zurich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
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Abstract
From the beginning of therapeutic research with psychedelics, music listening has been consistently used as a method to guide or support therapeutic experiences during the acute effects of psychedelic drugs. Recent findings point to the potential of music to support meaning-making, emotionality, and mental imagery after the administration of psychedelics, and suggest that music plays an important role in facilitating positive clinical outcomes of psychedelic therapy. This review explores the history of, contemporary research on, and future directions regarding the use of music in psychedelic research and therapy, and argues for more detailed and rigorous investigation of the contribution of music to the treatment of psychiatric disorders within the novel framework of psychedelic therapy.
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Affiliation(s)
- Frederick S Barrett
- a Department of Psychiatry and Behavioral Sciences, Behavioral Pharmacology Research Unit , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Katrin H Preller
- b Neuropsychopharmacology and Brain Imaging, Department of Psychiatry Psychotherapy and Psychosomatics , University Hospital for Psychiatry Zurich , Zurich , Switzerland.,c Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA
| | - Mendel Kaelen
- d Psychedelic Research Group, Department of Medicine , Imperial College London , London , UK.,e Wavepaths Ltd , London , UK
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49
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Grimm O, Kraehenmann R, Preller KH, Seifritz E, Vollenweider FX. Psilocybin modulates functional connectivity of the amygdala during emotional face discrimination. Eur Neuropsychopharmacol 2018; 28:691-700. [PMID: 29703645 DOI: 10.1016/j.euroneuro.2018.03.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/28/2017] [Accepted: 03/22/2018] [Indexed: 11/26/2022]
Abstract
Recent studies suggest that the antidepressant effects of the psychedelic 5-HT2A receptor agonist psilocybin are mediated through its modulatory properties on prefrontal and limbic brain regions including the amygdala. To further investigate the effects of psilocybin on emotion processing networks, we studied for the first-time psilocybin's acute effects on amygdala seed-to-voxel connectivity in an event-related face discrimination task in 18 healthy volunteers who received psilocybin and placebo in a double-blind balanced cross-over design. The amygdala has been implicated as a salience detector especially involved in the immediate response to emotional face content. We used beta-series amygdala seed-to-voxel connectivity during an emotional face discrimination task to elucidate the connectivity pattern of the amygdala over the entire brain. When we compared psilocybin to placebo, an increase in reaction time for all three categories of affective stimuli was found. Psilocybin decreased the connectivity between amygdala and the striatum during angry face discrimination. During happy face discrimination, the connectivity between the amygdala and the frontal pole was decreased. No effect was seen during discrimination of fearful faces. Thus, we show psilocybin's effect as a modulator of major connectivity hubs of the amygdala. Psilocybin decreases the connectivity between important nodes linked to emotion processing like the frontal pole or the striatum. Future studies are needed to clarify whether connectivity changes predict therapeutic effects in psychiatric patients.
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Affiliation(s)
- O Grimm
- University Hospital Frankfurt, Departement of Psychiatry, Psychosomatics and Psychotherapy, Frankfurt am Main, Germany; Psychiatric Hospital Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich, Switzerland.
| | - R Kraehenmann
- Psychiatric Hospital Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich, Switzerland
| | - K H Preller
- Psychiatric Hospital Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich, Switzerland
| | - E Seifritz
- Psychiatric Hospital Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich, Switzerland
| | - F X Vollenweider
- Psychiatric Hospital Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich, Switzerland
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50
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Abstract
Classic serotonergic hallucinogens or psychedelics produce an altered states of consciousness (ASC) that is characterized by profound alterations in sensory perception, mood, thought including the perception of reality, and the sense of self. Over the past years, there has been considerable progress in the search for invariant and common features of psychedelic states. In the first part of this review, we outline contemporary approaches to characterize the structure of ASCs by means of three primary etiology-independent dimensions including oceanic boundlessness, anxious ego-dissolution, and visionary restructuralization as well as by 11 lower-order factors, all of which can be reliably measured by the altered state of consciousness questionnaire (APZ-OAV). The second part sheds light on the dynamic nature of psychedelic experiences. Frequently, psychedelic subjects progress through different stages over time and levels of changes along a perception-hallucination continuum of increasing arousal and ego-dissolution. We then review in detail the acute effects of psychedelics on sensory perception, emotion, cognition, creativity, and time perception along with possible neural mechanisms underlying them. The next part of this review outlines the influence of non-pharmacological factors (predictors) on the acute psychedelic experience, such as demographics, genetics, personality, mood, and setting, and also discusses some long-term effects succeeding the acute experience. The last part presents some recent concepts and models attempting to understand different facets of psychedelic states of consciousness from a neuroscientific perspective.
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Affiliation(s)
- Katrin H Preller
- Neuropsychopharmacology and Brain Imaging Unit, Heffter Research Center Zurich Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland.
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging Unit, Heffter Research Center Zurich Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland.
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