Visual trails: do the doors of perception open periodically?

Unlocking the healing power of psilocybin: an overview of the role of psilocybin therapy in major depressive disorder, obsessive-compulsive disorder and substance use disorder

Resistance to traditional treatment methods is still a major obstacle in modern psychiatry. As a result, several studies are currently being conducted to find effective alternatives to traditional therapies. One of these alternatives is psilocybin, a psychedelic substance that has been tested in clinical trials as an adjunct to psychotherapy. These studies focus on patients with major depressive disorder (MDD), obsessive-compulsive disorder (OCD) and substance use disorder (SUD), particularly alcohol and nicotine dependence. This article looks at the current understanding of psilocybin, including data from clinical trials conducted, psilocybin's mechanism of action, its safety and the level of risk associated with it.

Psychedelic replications in virtual reality and their potential as a therapeutic instrument: an open-label feasibility study

Background

Recent research has shown promising results for the therapeutic benefits of psychedelics. One popular view claims that these benefits are mediated by the subjective experiences induced by these substances. Based on this, we designed a virtual reality experience, Psyrreal, that mimics the phenomenological components of psychedelic experiences.

Aims

We aimed to investigate the therapeutic efficacy of Psyrreal and psychedelic VR experiences in treating depressive symptoms as well as explore the effect of Psyrreal on subjective factors which have been suggested to mediate the therapeutic benefits of psychedelics.

Methods

In this open-label feasibility study, thirteen participants with mild-to-moderate depression underwent a 2-day therapeutic intervention implementing Psyrreal. Depressive symptoms were evaluated by the Emotional State Questionnaire (EST-Q2) at the start of the intervention and 2 weeks after. A thematic analysis of semi-structured interviews after Psyrreal was also conducted as an additional assessment of the method.

Results

A 2-day intervention implementing Psyrreal led to significant decreases in depressive symptoms at the 2-week follow-up (n = 10, p = 0.007, Hedges' g = 1.046) measured by the Emotional State Questionnaire (EST-Q2). The analysis of semi-structured interviews suggests that Psyrreal could lead to insight and alterations in the sense of self in some people.

Conclusion

This work proposes a novel method using virtual reality to augment the treatment of psychological disorders as well as to precisely investigate the mediating subjective factors of the therapeutic effects of psychedelic substances. Our preliminary results suggest that VR experiences combined with psychological support show potential in treating depressive symptoms and further research into similar methods is warranted.

Pharmacological, neural, and psychological mechanisms underlying psychedelics: A critical review

This paper provides a critical review of several possible mechanisms at different levels of analysis underlying the effects and therapeutic potential of psychedelics. At the (1) biochemical level, psychedelics primarily affect the 5-HT_2A receptor, increase neuroplasticity, offer a critical period for social reward learning, and have anti-inflammatory properties. At the (2) neural level, psychedelics have been associated with reduced efficacy of thalamo-cortical filtering, the loosening of top-down predictive signaling and an increased sensitivity to bottom-up prediction errors, and activation of the claustro-cortical-circuit. At the (3) psychological level, psychedelics have been shown to induce altered and affective states, they affect cognition, induce belief change, exert social effects, and can result in lasting changes in behavior. We outline the potential for a unifying account of the mechanisms underlying psychedelics and contrast this with a model of pluralistic causation. Ultimately, a better understanding of the specific mechanisms underlying the effects of psychedelics could allow for a more targeted therapeutic approach. We highlight current challenges for psychedelic research and provide a research agenda to foster insight in the causal-mechanistic pathways underlying the efficacy of psychedelic research and therapy.

Dyskinetopsic Palinopsia: Palinopsia Accompanied by Moving Afterimages

Palinopsia refers to the abnormal persistence, or recurrence, of visual images after a visual stimulus has subsided. We describe here a case of palinopsia accompanied by a visual motion perception disorder as manifested by moving afterimages. A 71-year-old man presented to us after having experienced acute-onset, vivid, visual hallucinations for 1 week. A detailed history revealed that he was hallucinating multiple living and nonliving objects. He also complained of a persistence of afterimages, particularly in the left visual field. He reported that, on a few occasions, while sitting by the window in his room, he had seen a moving car on the road; immediately after the car had disappeared from his sight, he had then seen the same car moving backward at almost the same speed-as if the driver had applied the reverse gear. A neuropsychological assessment did not reveal any deficits in attention, language, or episodic memory. Visual field testing by confrontational perimetry suggested left hemianopia. An MRI of the brain revealed an arteriovenous malformation in the medial part of the right occipital lobe, affecting both the lingual gyrus and the inferior occipital gyrus. Palinopsia has generally been described in reference to static afterimages. In our case, not only was the afterimage that was perceived by the patient in motion, but the direction of the movement was also opposite to that of the actual object. We propose the term dyskinetopsic palinopsia, or simply motion-related palinopsia, for this particular condition.

Discretized Theta-Rhythm Perception Revealed by Moving Stimuli

Despite the subjective continuity of perception over time, increasing evidence suggests that the human nervous system samples sensory information periodically, a finding strongly exemplified by discretized perception in the alpha-rhythm frequency band. More recently, studies have revealed a theta-band cyclic process that manifests itself as periodical fluctuations in behavioral performance. Here, we used a simple stimulus to demonstrate that the theta-cyclic system can produce a vivid experience of slow discrete visual sampling: a Gabor texture pattern appears as a series of flickering snapshots if its spatial window moves continuously over a carrier grating that remains still or drifts continuously in the opposite direction. While the perceptual magnitude of this illusory saltation varied with the speed difference between grating and window components in head-centered coordinates, the perceived rhythm of saltation remained nearly constant (3–8 Hz) over a wide range of stimulus parameters. Results provide further evidence that the slow cyclic neural processes play a critical role not only in attentional task performance but also in conscious perception.

On the Physiological Modulation and Potential Mechanisms Underlying Parieto-Occipital Alpha Oscillations

The parieto-occipital alpha (8–13 Hz) rhythm is by far the strongest spectral fingerprint in the human brain. Almost 90 years later, its physiological origin is still far from clear. In this Research Topic I review human pharmacological studies using electroencephalography (EEG) and magnetoencephalography (MEG) that investigated the physiological mechanisms behind posterior alpha. Based on results from classical and recent experimental studies, I find a wide spectrum of drugs that modulate parieto-occipital alpha power. Alpha frequency is rarely affected, but this might be due to the range of drug dosages employed. Animal and human pharmacological findings suggest that both GABA enhancers and NMDA blockers systematically decrease posterior alpha power. Surprisingly, most of the theoretical frameworks do not seem to embrace these empirical findings and the debate on the functional role of alpha oscillations has been polarized between the inhibition vs. active poles hypotheses. Here, I speculate that the functional role of alpha might depend on physiological excitation as much as on physiological inhibition. This is supported by animal and human pharmacological work showing that GABAergic, glutamatergic, cholinergic, and serotonergic receptors in the thalamus and the cortex play a key role in the regulation of alpha power and frequency. This myriad of physiological modulations fit with the view that the alpha rhythm is a complex rhythm with multiple sources supported by both thalamo-cortical and cortico-cortical loops. Finally, I briefly discuss how future research combining experimental measurements derived from theoretical predictions based of biophysically realistic computational models will be crucial to the reconciliation of these disparate findings.

Is conscious perception a series of discrete temporal frames?

This paper reviews proposals that conscious perception consists, in whole or part, of successive discrete temporal frames on the sub-second time scale, each frame containing information registered as simultaneous or static. Although the idea of discrete frames in conscious perception cannot be regarded as falsified, there are many problems. Evidence does not consistently support any proposed duration or range of durations for frames. EEG waveforms provide evidence of periodicity in brain activity, but not necessarily in conscious perception. Temporal properties of perceptual processes are flexible in response to competing processing demands, which is hard to reconcile with the relative inflexibility of regular frames. There are also problems concerning the definition of frames, the need for informational connections between frames, the means by which boundaries between frames are established, and the apparent requirement for a storage buffer for information awaiting entry to the next frame.

The Experience Elicited by Hallucinogens Presents the Highest Similarity to Dreaming within a Large Database of Psychoactive Substance Reports

Ever since the modern rediscovery of psychedelic substances by Western society, several authors have independently proposed that their effects bear a high resemblance to the dreams and dreamlike experiences occurring naturally during the sleep-wake cycle. Recent studies in humans have provided neurophysiological evidence supporting this hypothesis. However, a rigorous comparative analysis of the phenomenology (“what it feels like” to experience these states) is currently lacking. We investigated the semantic similarity between a large number of subjective reports of psychoactive substances and reports of high/low lucidity dreams, and found that the highest-ranking substance in terms of the similarity to high lucidity dreams was the serotonergic psychedelic lysergic acid diethylamide (LSD), whereas the highest-ranking in terms of the similarity to dreams of low lucidity were plants of the Datura genus, rich in deliriant tropane alkaloids. Conversely, sedatives, stimulants, antipsychotics, and antidepressants comprised most of the lowest-ranking substances. An analysis of the most frequent words in the subjective reports of dreams and hallucinogens revealed that terms associated with perception (“see,” “visual,” “face,” “reality,” “color”), emotion (“fear”), setting (“outside,” “inside,” “street,” “front,” “behind”) and relatives (“mom,” “dad,” “brother,” “parent,” “family”) were the most prevalent across both experiences. In summary, we applied novel quantitative analyses to a large volume of empirical data to confirm the hypothesis that, among all psychoactive substances, hallucinogen drugs elicit experiences with the highest semantic similarity to those of dreams. Our results and the associated methodological developments open the way to study the comparative phenomenology of different altered states of consciousness and its relationship with non-invasive measurements of brain physiology.

Beta oscillations define discrete perceptual cycles in the somatosensory domain

Whether seeing a movie, listening to a song, or feeling a breeze on the skin, we coherently experience these stimuli as continuous, seamless percepts. However, there are rare perceptual phenomena that argue against continuous perception but, instead, suggest discrete processing of sensory input. Empirical evidence supporting such a discrete mechanism, however, remains scarce and comes entirely from the visual domain. Here, we demonstrate compelling evidence for discrete perceptual sampling in the somatosensory domain. Using magnetoencephalography (MEG) and a tactile temporal discrimination task in humans, we find that oscillatory alpha- and low beta-band (8-20 Hz) cycles in primary somatosensory cortex represent neurophysiological correlates of discrete perceptual cycles. Our results agree with several theoretical concepts of discrete perceptual sampling and empirical evidence of perceptual cycles in the visual domain. Critically, these results show that discrete perceptual cycles are not domain-specific, and thus restricted to the visual domain, but extend to the somatosensory domain.

A bidirectional link between brain oscillations and geometric patterns

Like hallucinogenic drugs, full-field flickering visual stimulation produces regular, geometric hallucinations such as radial or spiral patterns. Computational and theoretical models have revealed that the geometry of these hallucinations can be related to functional neuro-anatomy. However, while experimental evidence links both visual flicker and hallucinogenic drugs to upward and downward modulations of brain oscillatory activity, the exact relation between brain oscillations and geometric hallucinations remains a mystery. Here we demonstrate that, in human observers, this link is bidirectional. The same flicker frequencies that preferentially induced radial (<10 Hz) or spiral (10-20 Hz) hallucinations in a behavioral experiment involving full-field uniform flicker without any actual shape displayed, also showed selective oscillatory EEG enhancement when observers viewed a genuine static image of a radial or spiral pattern without any flicker. This bidirectional property constrains the possible neuronal events at the origin of visual hallucinations, and further suggests that brain oscillations, which are strictly temporal in nature, could nonetheless act as preferential channels for spatial information.

Hallucinogen persisting perception disorder and the serotonergic system: a comprehensive review including new MDMA-related clinical cases

Hallucinogen persisting perception disorder (HPPD) is a drug-induced condition associated with inaccurate visual representations. Since the underlying mechanism(s) are largely unknown, this review aims to uncover aspects underlying its etiology. Available evidence on HPPD and drug-related altered visual processing was reviewed and the majority of HPPD cases were attributed to drugs with agonistic effects on serotonergic 5-HT₂A receptors. Moreover, we present 31 new HPPD cases that link HPPD to the use of ecstasy (MDMA), which is known to reverse serotonin reuptake and acts as agonist on 5-HT₂A receptors. The available evidence suggests that HPPD symptoms may be a result from a misbalance of inhibitory-excitatory activity in low-level visual processing and GABA-releasing inhibitory interneurons may be involved. However, high co-morbidities with anxiety, attention problems and derealization symptoms add complexity to the etiology of HPPD. Also, other perceptual disorders that show similarity to HPPD cannot be ruled out in presentations to clinical treatment. Taken together, evidence is still sparse, though low-level visual processing may play an important role. A novel finding of this review study, evidenced by our new cases, is that ecstasy (MDMA) use may also induce symptoms of HPPD.

The flickering wheel illusion: when α rhythms make a static wheel flicker

α oscillations (8-14 Hz) greatly influence brain activity, yet we generally do not experience them consciously: the world does not appear to oscillate. Dedicated strategies must exist in the brain to prevent these oscillations from disrupting normal processing. Could suitable stimuli fool these strategies and lead to the conscious experience of our own brain oscillations? We describe and explore a novel illusion in which the center of a static wheel stimulus (with 30-40 spokes) is experienced as flickering when viewed in the visual periphery. The key feature of this illusion is that the stimulus fluctuations are experienced as a regular and consistent flicker, which our human observers estimated at ~9 Hz during a psychophysical matching task. Correspondingly, the occipital α rhythm of the EEG was the only oscillation that showed a time course compatible with the reported illusion: when α amplitude was strong, the probability of reporting illusory flicker increased. The peak oscillatory frequency for these flicker-induced modulations was significantly correlated, on a subject-by-subject basis, with the individual α frequency measured during rest, in the absence of visual stimulation. Finally, although the effect is strongest during eye movements, we showed that stimulus motion relative to the retina is not necessary to perceive the illusion: the flicker can also be perceived on the afterimage of the wheel, yet by definition this afterimage is stationary on the retina. We conclude that this new flickering illusion is a unique way to experience the α rhythms that constantly occur in the brain but normally remain unnoticed.

Ready steady slow: action preparation slows the subjective passage of time

Professional ball game players report the feeling of the ball 'slowing-down' before hitting it. Because effective motor preparation is critical in achieving such expert motor performance, these anecdotal comments imply that the subjective passage of time may be influenced by preparation for action. Previous reports of temporal illusions associated with action generally emphasize compensation for suppressed sensory signals that accompany motor commands. Here, we show that the time is perceived slowed-down during preparation of a ballistic reaching movement before action, involving enhancement of sensory processing. Preparing for a reaching movement increased perceived duration of a visual stimulus. This effect was tightly linked to action preparation, because the amount of temporal dilation increased with the information about the upcoming movement. Furthermore, we showed a reduction of perceived frequency for flickering stimuli and an enhanced detection of rapidly presented letters during action preparation, suggesting increased temporal resolution of visual perception during action preparation. We propose that the temporal dilation during action preparation reflects the function of the brain to maximize the capacity of sensory information-acquisition prior to execution of a ballistic movement. This strategy might facilitate changing or inhibiting the planned action in response to last-minute changes in the external environment.

Ambiguous figures - what happens in the brain when perception changes but not the stimulus

During observation of ambiguous figures our perception reverses spontaneously although the visual information stays unchanged. Research on this phenomenon so far suffered from the difficulty to determine the instant of the endogenous reversals with sufficient temporal precision. A novel experimental paradigm with discontinuous stimulus presentation improved on previous temporal estimates of the reversal event by a factor of three. It revealed that disambiguation of ambiguous visual information takes roughly 50 ms or two loops of recurrent neural activity. Further, the decision about the perceptual outcome has taken place at least 340 ms before the observer is able to indicate the consciously perceived reversal manually. We provide a short review about physiological studies on multistable perception with a focus on electrophysiological data. We further present a new perspective on multistable perception that can easily integrate previous apparently contradicting explanatory approaches. Finally we propose possible extensions toward other research fields where ambiguous figure perception may be useful as an investigative tool.

Moments in time

It has been suggested that perception and action can be understood as evolving in temporal epochs or sequential processing units. Successive events are fused into units forming a unitary experience or "psychological present." Studies have identified several temporal integration levels on different time scales which are fundamental for our understanding of behavior and subjective experience. In recent literature concerning the philosophy and neuroscience of consciousness these separate temporal processing levels are not always precisely distinguished. Therefore, empirical evidence from psychophysics and neuropsychology on these distinct temporal processing levels is presented and discussed within philosophical conceptualizations of time experience. On an elementary level, one can identify a functional moment, a basic temporal building block of perception in the range of milliseconds that defines simultaneity and succession. Below a certain threshold temporal order is not perceived, individual events are processed as co-temporal. On a second level, an experienced moment, which is based on temporal integration of up to a few seconds, has been reported in many qualitatively different experiments in perception and action. It has been suggested that this segmental processing mechanism creates temporal windows that provide a logistical basis for conscious representation and the experience of nowness. On a third level of integration, continuity of experience is enabled by working memory in the range of multiple seconds allowing the maintenance of cognitive operations and emotional feelings, leading to mental presence, a temporal window of an individual's experienced presence.