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Frautschi PC, Singh AP, Stowe NA, Yu JPJ. Multimodal Neuroimaging of the Effect of Serotonergic Psychedelics on the Brain. AJNR Am J Neuroradiol 2024; 45:ajnr.A8118. [PMID: 38360790 DOI: 10.3174/ajnr.a8118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/20/2023] [Indexed: 02/17/2024]
Abstract
The neurobiological mechanisms underpinning psychiatric disorders such as treatment-resistant major depression, post-traumatic stress disorder, and substance use disorders, remain unknown. Psychedelic compounds, such as psilocybin, lysergic acid diethylamide, and N,N-dimethyltryptamine, have emerged as potential therapies for these disorders because of their hypothesized ability to induce neuroplastic effects and alter functional networks in the brain. Yet, the mechanisms underpinning the neurobiological treatment response remain obscure. Quantitative neuroimaging is uniquely positioned to provide insight into the neurobiological mechanisms of these emerging therapies and quantify the patient treatment response. This review aims to synthesize our current state-of-the-art understanding of the functional changes occurring in the brain following psilocybin, lysergic acid diethylamide, or N,N-dimethyltryptamine administration in human participants with fMRI and PET. We further aim to disseminate our understanding of psychedelic compounds as they relate to neuroimaging with the goal of improved diagnostics and treatment of neuropsychiatric illness.
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Affiliation(s)
- Paloma C Frautschi
- Department of Radiology (P.C.F., A.P.S., J.-P.J.Y.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ajay P Singh
- Department of Radiology (P.C.F., A.P.S., J.-P.J.Y.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Graduate Program in Cellular and Molecular Biology (A.P.S., J.-P.J.Y.), University of Wisconsin-Madison, Madison, Wisconsin
| | - Nicholas A Stowe
- Neuroscience Training Program, Wisconsin Institutes for Medical Research (N.A.S., J.-P.J.Y.), University of Wisconsin-Madison, Madison, Wisconsin
| | - John-Paul J Yu
- Department of Radiology (P.C.F., A.P.S., J.-P.J.Y.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Neuroscience Training Program, Wisconsin Institutes for Medical Research (N.A.S., J.-P.J.Y.), University of Wisconsin-Madison, Madison, Wisconsin
- Graduate Program in Cellular and Molecular Biology (A.P.S., J.-P.J.Y.), University of Wisconsin-Madison, Madison, Wisconsin
- Department of Biomedical Engineering (J.-P.J.Y.), University of Wisconsin-Madison, Madison, Wisconsin
- Department of Psychiatry (J.-P.J.Y.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Abstract
Cannabis and classic psychedelics are controlled substances with emerging evidence of efficacy in the treatment of a variety of psychiatric illnesses. Cannabis has largely not been regarded as having psychedelic effects in contemporary literature, despite many examples of historical use along with classic psychedelics to attain altered states of consciousness. Research into the "psychedelic" effects of cannabis, and delta-9-tetrahydrocannabinol (THC) in particular, could prove helpful for assessing potential therapeutic indications and elucidating the mechanism of action of both cannabis and classic psychedelics. This review aggregates and evaluates the literature assessing the capacity of cannabis to yield the perceptual changes, aversiveness, and mystical experiences more typically associated with classic psychedelics such as psilocybin. This review also provides a brief contrast of neuroimaging findings associated with the acute effects of cannabis and psychedelics. The available evidence suggests that high-THC cannabis may be able to elicit psychedelic effects, but that these effects may not have been observed in recent controlled research studies due to the doses, set, and settings commonly used. Research is needed to investigate the effects of high doses of THC in the context utilized in therapeutic studies of psychedelics aimed to occasion psychedelic and/or therapeutic experiences. If cannabis can reliably generate psychedelic experiences under these conditions, high-THC dose cannabis treatments should be explored as potential adjunctive treatments for psychiatric disorders and be considered as an active comparator in clinical trials involving traditional psychedelic medications.
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Affiliation(s)
- David Wolinsky
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Frederick Streeter Barrett
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychological & Brain Sciences, Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Ryan Vandrey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Karavallil Achuthan S, Stavrinos D, Argueta P, Vanderburgh C, Holm HB, Kana RK. Thalamic functional connectivity and sensorimotor processing in neurodevelopmental disorders. Front Neurosci 2023; 17:1279909. [PMID: 38161799 PMCID: PMC10755010 DOI: 10.3389/fnins.2023.1279909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/08/2023] [Indexed: 01/03/2024] Open
Abstract
One of the earliest neurobiological findings in autism has been the differences in the thalamocortical pathway connectivity, suggesting the vital role thalamus plays in human experience. The present functional MRI study investigated resting-state functional connectivity of the thalamus in 49 (autistic, ADHD, and neurotypical) young adults. All participants underwent structural MRI and eyes-open resting state functional MRI scans. After preprocessing the imaging data using Conn's connectivity toolbox, a seed-based functional connectivity analysis was conducted using bilateral thalamus as primary seeds. Autistic participants showed stronger thalamic connectivity, relative to ADHD and neurotypical participants, between the right thalamus and right precentral gyrus, right pars opercularis-BA44, right postcentral gyrus, and the right superior parietal lobule (RSPL). Autistic participants also showed significantly increased connectivity between the left thalamus and the right precentral gyrus. Furthermore, regression analyses revealed a significant relationship between autistic traits and left thalamic-precentral connectivity (R2 = 0.1113), as well as between autistic traits and right postcentral gyrus and RSPL connectivity (R2 = 0.1204) in autistic participants compared to ADHD. These findings provide significant insights into the role of thalamus in coordinating neural information processing and its alterations in neurodevelopmental disorders.
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Affiliation(s)
- Smitha Karavallil Achuthan
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Despina Stavrinos
- Department of Psychology and the Institute of Social Science Research, The University of Alabama, Tuscaloosa, AL, United States
| | - Paula Argueta
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Caroline Vanderburgh
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Haley B. Holm
- Children’s Hospital of Atlanta, Atlanta, GA, United States
| | - Rajesh K. Kana
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
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Singleton SP, Wang JB, Mithoefer M, Hanlon C, George MS, Mithoefer A, Mithoefer O, Coker AR, Yazar-Klosinski B, Emerson A, Doblin R, Kuceyeski A. Altered brain activity and functional connectivity after MDMA-assisted therapy for post-traumatic stress disorder. Front Psychiatry 2023; 13:947622. [PMID: 36713926 PMCID: PMC9879604 DOI: 10.3389/fpsyt.2022.947622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction 3,4-methylenedioxymethamphetamine-assisted therapy (MDMA-AT) for post-traumatic stress disorder (PTSD) has demonstrated promise in multiple clinical trials. MDMA is hypothesized to facilitate the therapeutic process, in part, by decreasing fear response during fear memory processing while increasing extinction learning. The acute administration of MDMA in healthy controls modifies recruitment of brain regions involved in the hyperactive fear response in PTSD such as the amygdala, hippocampus, and insula. However, to date there have been no neuroimaging studies aimed at directly elucidating the neural impact of MDMA-AT in PTSD patients. Methods We analyzed brain activity and connectivity via functional MRI during both rest and autobiographical memory (trauma and neutral) response before and two-months after MDMA-AT in nine veterans and first-responders with chronic PTSD of 6 months or more. Results We hypothesized that MDMA-AT would increase amygdala-hippocampus resting-state functional connectivity, however we only found evidence of a trend in the left amygdala-left hippocampus (t = -2.91, uncorrected p = 0.0225, corrected p = 0.0901). We also found reduced activation contrast (trauma > neutral) after MDMA-AT in the cuneus. Finally, the amount of recovery from PTSD after MDMA-AT correlated with changes in four functional connections during autobiographical memory recall: the left amygdala-left posterior cingulate cortex (PCC), left amygdala-right PCC, left amygdala-left insula, and left isthmus cingulate-left posterior hippocampus. Discussion Amygdala-insular functional connectivity is reliably implicated in PTSD and anxiety, and both regions are impacted by MDMA administration. These findings compliment previous research indicating that amygdala, hippocampus, and insula functional connectivity is a potential target of MDMA-AT, and highlights other regions of interest related to memory processes. More research is necessary to determine if these findings are specific to MDMA-AT compared to other types of treatment for PTSD. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT02102802, identifier NCT02102802.
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Affiliation(s)
- S. Parker Singleton
- Department of Computational Biology, Cornell University, Ithaca, NY, United States
| | - Julie B. Wang
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Michael Mithoefer
- MAPS Public Benefit Corporation, San Jose, CA, United States
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Colleen Hanlon
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Mark S. George
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
| | - Annie Mithoefer
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Oliver Mithoefer
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Allison R. Coker
- MAPS Public Benefit Corporation, San Jose, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | | | - Amy Emerson
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Rick Doblin
- Multidisciplinary Association for Psychedelic Studies, San Jose, CA, United States
| | - Amy Kuceyeski
- Department of Computational Biology, Cornell University, Ithaca, NY, United States
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
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Anticevic A, Halassa MM. The thalamus in psychosis spectrum disorder. Front Neurosci 2023; 17:1163600. [PMID: 37123374 PMCID: PMC10133512 DOI: 10.3389/fnins.2023.1163600] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 03/21/2023] [Indexed: 05/02/2023] Open
Abstract
Psychosis spectrum disorder (PSD) affects 1% of the world population and results in a lifetime of chronic disability, causing devastating personal and economic consequences. Developing new treatments for PSD remains a challenge, particularly those that target its core cognitive deficits. A key barrier to progress is the tenuous link between the basic neurobiological understanding of PSD and its clinical phenomenology. In this perspective, we focus on a key opportunity that combines innovations in non-invasive human neuroimaging with basic insights into thalamic regulation of functional cortical connectivity. The thalamus is an evolutionary conserved region that forms forebrain-wide functional loops critical for the transmission of external inputs as well as the construction and update of internal models. We discuss our perspective across four lines of evidence: First, we articulate how PSD symptomatology may arise from a faulty network organization at the macroscopic circuit level with the thalamus playing a central coordinating role. Second, we discuss how recent animal work has mechanistically clarified the properties of thalamic circuits relevant to regulating cortical dynamics and cognitive function more generally. Third, we present human neuroimaging evidence in support of thalamic alterations in PSD, and propose that a similar "thalamocortical dysconnectivity" seen in pharmacological imaging (under ketamine, LSD and THC) in healthy individuals may link this circuit phenotype to the common set of symptoms in idiopathic and drug-induced psychosis. Lastly, we synthesize animal and human work, and lay out a translational path for biomarker and therapeutic development.
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Affiliation(s)
- Alan Anticevic
- School of Medicine, Yale University, New Haven, CT, United States
- *Correspondence: Alan Anticevic,
| | - Michael M. Halassa
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, United States
- Michael M. Halassa,
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Drew L. Your brain on psychedelics. Nature 2022; 609:S92-S94. [PMID: 36171369 DOI: 10.1038/d41586-022-02874-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Arnovitz MD, Spitzberg AJ, Davani AJ, Vadhan NP, Holland J, Kane JM, Michaels TI. MDMA for the Treatment of Negative Symptoms in Schizophrenia. J Clin Med 2022; 11:jcm11123255. [PMID: 35743326 PMCID: PMC9225098 DOI: 10.3390/jcm11123255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 02/05/2023] Open
Abstract
The profound economic burden of schizophrenia is due, in part, to the negative symptoms of the disease, which can severely limit daily functioning. There is much debate in the field regarding their measurement and classification and there are no FDA-approved treatments for negative symptoms despite an abundance of research. 3,4-Methylenedioxy methamphetamine (MDMA) is a schedule I substance that has emerged as a novel therapeutic given its ability to enhance social interactions, generate empathy, and induce a state of metaplasticity in the brain. This review provides a rationale for the use of MDMA in the treatment of negative symptoms by reviewing the literature on negative symptoms, their treatment, MDMA, and MDMA-assisted therapy. It reviews recent evidence that supports the safe and potentially effective use of MDMA to treat negative symptoms and concludes with considerations regarding safety and possible mechanisms of action.
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Affiliation(s)
- Mitchell D. Arnovitz
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
| | - Andrew J. Spitzberg
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
| | - Ashkhan J. Davani
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
| | - Nehal P. Vadhan
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA
| | | | - John M. Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA
| | - Timothy I. Michaels
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
- Correspondence:
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