OPEN Foundation

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Brain imaging reveals the action of LSD on the human brain

Once again researchers from the Psychedelic Research Programme jointly set up by the Beckley Foundation and Imperial College London have published trailblazing research on the effects of psychedelics on the brain. These trendsetting studies are the first to apply multimodal neuroimaging to subjects who were injected with LSD. Dr. Carhart-Harris and his fellow colleagues from Imperial College London have revealed the effects of lysergic acid diethylamide (LSD) on the brain’s network communication, blood flow and electrical activity using fMRI BOLD, arterial spin labelling and magnetoencephalography (Carhart-Harris et al., 2016).

From these neuroimaging studies, researchers have gained an important and novel insight into the basis of ego-dissolution, the way in which closed-eye visuals occur and effects of the combination of LSD and music in the brain. The studies were conducted with 20 subjects who were injected once with 75µg LSD and once with a placebo, at least two weeks apart. All participants had prior experience with psychedelics.

Functional magnetic resonance imaging (fMRI) based on the evaluation of blood oxygen level dependent (BOLD) contrast was applied to evaluate the activity of different brain regions and their interconnection while on LSD. The scans were performed in the resting state, i.e. in the absence of any external stimuli or specific cognitive tasks. Subsequently the levels of (dis)integration/(de)segregation were evaluated, with certain regions of interest (ROI) being picked up to analyse their interaction with the other brain regions.

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LSD - Global FCD
Average functional connectivity density (FCD) in cortical and subcortical regions under the placebo and LSD conditions – Tagliazucchi et al., 2016.

One of the main findings of the study was that LSD facilitates an inflation of globalised communication between various brain regions. Using positron emission tomography (PET), the researchers found that the highest level of such communication occurred in the regions with the highest density of serotonin-2A (5-HT2A) receptors, LSD acting as an agonist to this type of receptors. One interesting aspect of this is that the higher interaction between brain regions corresponded with lower integration within certain networks. All in all, the study identified 12 resting state networks affected by LSD in this way, with the default mode network (DMN) being the most important for the case at study.

Ego dissolution

The DMN is the network of the brain that becomes activated when a person is experiencing resting states such as daydreaming, and becomes inactivated during goal-oriented tasks. According to the present study, the disintegration within the DMN is directly related to the onset of a state of consciousness commonly described as ego dissolution. Ego dissolution is the subjective experience of losing one’s sense of identity. It is sometimes described as unity with the outside world and oneness with the universe resulting from a blurring of the boundaries of the autonomous self. The altered state of consciousness questionnaire used at the end of each scanning day revealed that ego dissolution correlated with the experience of altered meaning, i.e. attaching importance to objects previously deemed unimportant and giving surroundings new, alien meaning. Also correlated with the state of ego dissolution was disintegration in other brain regions such as the salience network and the thalamus.

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LSD - Ego dissolution
Brain regions where a significant correlation between FCD and subjective reports of ego dissolution (LSD minus placebo) was found are colored in red. Brain regions presenting the most selective correlations between FCD increases and ego dissolution scores are colored in green – Tagliazucchi et al., 2016

Disintegration in the DMN and other resting networks was also accompanied by decreased alpha power in regions such as the posterior cingulate cortex (PCC). Regular alpha oscillations are hypothesised to inhibit spontaneous neuronal activity, i.e. that which occurs without exposure to particular stimuli (Tagliazucchi et al., 2016). LSD was found to decrease alpha power and thus trigger spontaneous activity in neurons, an effect that could partially explain the closed-eye imagery associated with the LSD experience.

The mechanisms of closed-eye imagery

Striking results were obtained in the study of closed-eye imagery induced by LSD. The researchers investigated both simple images like geometrical patterns and complex ones including autobiographical scenes occurring under LSD. The study revealed that although there was no visual input, under LSD the visual cortex (VC) behaved as if there was (Carhart-Harris et al., 2016). This observation supports ongoing theories that the appearance of geometrical imagery may be caused by the rendered instability of the VC (Butler et al., 2011).

Apart from the increase in blood flow level, the visual cortex also displayed increased functional connectivity with other brain regions, mainly the parahippocampal cortex (PHC), typically involved in memory retrieval, music-evoked emotion and mental imagery. The researchers used a Dynamic Causal Modelling analysis to reveal increased effective connectivity between the VC and the PHC, where the PHC triggered the activity of the VC. The interconnection of these brain regions can be held responsible for the “colouring” of personal recollections experienced by the subjects under LSD. Apart from the PHC, other brain regions such as those in occipital and inferior frontal lobes also became activated during visuals, leading to the conclusion that a much larger portion of the brain is involved in producing imagery under LSD than in the normal waking state.

The influence of music

The study further revealed the highly important role of music during the psychedelic experience. Mendel Kaelen, a PhD candidate at Imperial College London and board member of the OPEN Foundation, explored the synergistic effects of music during the LSD experience (Kaelen et al., 2016). Three fMRI scans were performed, the first and the third of which were done without the use of music, the second being performed while the subjects listened to music (two excerpts from the album Yearning by the ambient artist Robert Rich and the Indian classical musician Lisa Moscow).

The study showed that the PHC becomes highly activated when subjects are exposed to music and LSD. Furthermore, the increase of interaction between the PHC and the visual cortex corresponded with the intensity of the closed-eye visuals, both simple (geometrical patterns) and complex ones (e.g. based on personal recollections). This certainly underscores the importance of incorporating music into LSD-assisted psychotherapy.

Expanding the knowledge

The findings of the present study with LSD provide firmer ground to the knowledge that has been gathered in experiments using other psychedelics. Psilocybin has been found to have similar effects on brain activity including the disintegration in certain regions such as the default mode network and the emergence of new connections between normally segregated networks. These conclusions emerged from two independent researches, one of which was performed by the authors of the present LSD study (Carhart-Harris et al., 2012, Kometer et al., 2015). Still another research group discovered analogous effects of the Amazonian psychedelic ayahuasca on the human brain (Riba et al., 2002).

The findings of this groundbreaking study have several important implications. First, they hint at a neurological understanding of the therapeutic potential of LSD. Due to its “entropic” effect on the brain – the increase of disintegration within and simultaneous increase of interaction between certain brain regions – LSD may hold the potential for breaking down pathological patterns associated with depression, for instance, and thus increasing the effectiveness of psychotherapy.

The study also demonstrated the potential of LSD in the study of the neurobiology of consciousness, as it seems to put subjects into the so-called primary state of consciousness characteristic of the earlier stages of consciousness development in children, of REM sleep and of early psychosis (Carhart-Harris et al., 2016). This also means that LSD could be applied in psychological research in the study of pathologies (Carhart-Harris et al., 2016).

Apart from the short-term effects of LSD on brain chemistry, more investigation is warranted on the potential of the LSD experience to provoke sustainable changes in personality.

Robin Carhart-Harris and Mendel Kaelen will speak at the OPEN Foundation’s ICPR conference next June.

References:

Butler T. C., Benayoun M., Wallace E., van Drongelen W., Goldenfeld N. and Cowan J. (2012) Evolutionary constraints on visual cortex architecture from the dynamics of hallucinations. Proceedings of the National Academy of Sciences of the United States of America, 606-609. https://dx.doi.org/10.1073/pnas.1118672109

Carhart-Harris R. L., Errizoe D., Williams T., Stone J. M., Reed L. J., Colasanti A., Tyacke R.J., Leech R., Malizia A.L., Murphy K., Hobden P., Evans J., Feilding A., Wise R.G. and Nutt D.J. (2012) Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin. Proc. Natl. Acad. Sci. USA 109, 2138–2143. https://dx.doi.org/10.1073/pnas.1119598109

Carhart-Harris R. L., Muthukumaraswarmy S., Roseman L., Kaelen M., Droog W., Murphy K., Taggliazzuchi E., Schenberg E.E., Nest T., Orban C., Leech R., Williams, L., Williams T., Bolstridge M., Sessa B., McGoniglea J., Sereno M., Nichols D., Hellyer P.J., Hobden P., Evans J., Singh K.D.,  Wise R.G., Curran V., Feilding A. and Nutt D.J. (2016) Neural Correlates of the LSD Experience Revealed by Multimodal Neuroimaging. Proceedings of the National Academy of Sciences of the United States of America, 1-6. https://dx.doi.org/10.1073/pnas.1518377113

Kaelen M., Roseman L., Kahan J., Santos-Ribeiro A., Orban C., Lorenz R., Barett F.S., Bolstridge M., Williams T., Williams L., Wall M.B., Feilding A., Muthukumuraswamy S., Nutt D.J and Carhart-Harris, R. (2016) LSD modulates music-induced imagery via changes in the parahippocampal connectivity. European Neuropsychopharmacology, 1-10. http://dx.doi.org/10.1016/j.euroneuro.2016.03.018

Kometer M., Pokorny T., Seifritz E. and Vollenweider F.X. (2015) Psilocybin-induced spiritual experiences and insightfulness are associated with synchronization of neuronal oscillations. Psychopharmacology (Berl) 232(19):3663–3676. https://dx.doi.org/10.1007/s00213-015-4026-7

Riba J., Anderer P., Morte A., Urbano G., Jané F., Saletu B. and Barbanoj M.J. (2002) Topographic pharmaco-EEG mapping of the effects of the South American psychoactive beverage ayahuasca in healthy volunteers. Br J Clin Pharmacol 53(6):613–628. https://dx.doi.org/10.1046/j.1365-2125.2002.01609

Tagliazucchi E., Roseman L., Kaelen M., Orban C., Muthukumaraswamy S. D., Murphy K., Laufs H., Leech R., McGonigle J., Crossley N., Bullmore E., Williams T., Bolstridge M., Feilding A., Nutt D.J. and Carhart-Harris R. (2016) Increased Global Functional Connectivity Correlates with LSD-Induced Ego Dissolution. Current Biology, 26, 1-8. http://dx.doi.org/10.1016/j.cub.2016.02.010

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Harmine stimulates neurogenesis of human neural cells in vitro

Abstract

Harmine is a β-carboline alkaloid present at highest concentration in the psychotropic plant decoction Ayahuasca. In rodents, classical antidepressants reverse the symptoms of depression by stimulating neuronal proliferation. It has been shown that Ayahuasca presents antidepressant effects in patients with depressive disorder. In the present study, we investigated the effects of harmine in cell cultures containing human neural progenitor cells (hNPCs, 97% nestin-positive) derived from pluripotent stem cells. After 4 days of treatment, the pool of proliferating hNPCs increased by 57%. Harmine has been reported as a potent inhibitor of the dual specificity tyrosine-phosphorylation-regulated kinase (DYRK1A), which regulates cell proliferation and brain development. We tested the effect of analogs of harmine, an inhibitor of DYRK1A (INDY) and an irreversible selective inhibitor of monoamine oxidase (MAO) but not DYRK1A (pargyline). INDY but not pargyline induced proliferation of hNPCs similarly to harmine, suggesting that inhibition of Dyrk1a is a possible mechanism to explain harmine effects upon the proliferation of hNPCs. Harmine also increased dendritic arborization, including total neurite length, number of segments, extremities and nodes in MAP2 positive neurons. Our findings show that harmine enhances neurogenesis of hNPCs in vitro, and suggest a biological activity associated with its antidepressant effects in vivo.

Dakic, V., de Moraes Maciel, R., Drummond, H., Nascimento, J. M., Trindade, P., & Rehen, S. K. (2016). Harmine stimulates neurogenesis of human neural cells in vitro (No. e1957v1). PeerJ Preprints. https://doi.org/10.7287/peerj.preprints.1957v1
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How psychoactive drugs shape human culture: a multi-disciplinary perspective

Abstract

Psychoactive drug use occurs in essentially all human societies. A range of disciplines contribute to our understanding of the influence of drugs upon the human world. For example pharmacology and neuroscience analyse biological responses to drugs, sociology examines social influences upon people’s decisions to use drugs, and anthropology provides rich accounts of use across a variety of cultural contexts. This article reviews work from multiple disciplines to illustrate that drugs influence aspects of culture from social life to religion, politics to trade, while acting as enablers of cultural change throughout human history. This broad view is valuable at a time when the influence not only of traditional drugs but a growing armoury of novel drugs is felt and debated.

Wadley, G. (2016). How psychoactive drugs shape human culture: a multi-disciplinary perspective. Brain Research Bulletin. http://dx.doi.org/10.1016/j.brainresbull.2016.04.008
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Neural correlates of the LSD experience revealed by multimodal neuroimaging

Abstract

Lysergic acid diethylamide (LSD) is the prototypical psychedelic drug, but its effects on the human brain have never been studied before with modern neuroimaging. Here, three complementary neuroimaging techniques: arterial spin labeling (ASL), blood oxygen level-dependent (BOLD) measures, and magnetoencephalography (MEG), implemented during resting state conditions, revealed marked changes in brain activity after LSD that correlated strongly with its characteristic psychological effects. Increased visual cortex cerebral blood flow (CBF), decreased visual cortex alpha power, and a greatly expanded primary visual cortex (V1) functional connectivity profile correlated strongly with ratings of visual hallucinations, implying that intrinsic brain activity exerts greater influence on visual processing in the psychedelic state, thereby defining its hallucinatory quality. LSD’s marked effects on the visual cortex did not significantly correlate with the drug’s other characteristic effects on consciousness, however. Rather, decreased connectivity between the parahippocampus and retrosplenial cortex (RSC) correlated strongly with ratings of “ego-dissolution” and “altered meaning,” implying the importance of this particular circuit for the maintenance of “self” or “ego” and its processing of “meaning.” Strong relationships were also found between the different imaging metrics, enabling firmer inferences to be made about their functional significance. This uniquely comprehensive examination of the LSD state represents an important advance in scientific research with psychedelic drugs at a time of growing interest in their scientific and therapeutic value. The present results contribute important new insights into the characteristic hallucinatory and consciousness-altering properties of psychedelics that inform on how they can model certain pathological states and potentially treat others.

Carhart-Harris, R. L., Muthukumaraswamy, S., Roseman, L., Kaelen, M., Droog, W., Murphy, K., … & Leech, R. (2016). Neural correlates of the LSD experience revealed by multimodal neuroimaging. Proceedings of the National Academy of Sciences, 201518377. http://dx.doi.org/10.1073/pnas.1518377113
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Increased Global Functional Connectivity Correlates with LSD-Induced Ego Dissolution

Abstract

Lysergic acid diethylamide (LSD) is a non-selective serotonin-receptor agonist that was first synthesized in 1938 and identified as (potently) psychoactive in 1943. Psychedelics have been used by indigenous cultures for millennia [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][1]; however, because of LSD’s unique potency and the timing of its discovery (coinciding with a period of major discovery in psychopharmacology), it is generally regarded as the quintessential contemporary psychedelic [2]. LSD has profound modulatory effects on consciousness and was used extensively in psychological research and psychiatric practice in the 1950s and 1960s [3]. In spite of this, however, there have been no modern human imaging studies of its acute effects on the brain. Here we studied the effects of LSD on intrinsic functional connectivity within the human brain using fMRI. High-level association cortices (partially overlapping with the default-mode, salience, and frontoparietal attention networks) and the thalamus showed increased global connectivity under the drug. The cortical areas showing increased global connectivity overlapped significantly with a map of serotonin 2A (5-HT2A) receptor densities (the key site of action of psychedelic drugs [4]). LSD also increased global integration by inflating the level of communication between normally distinct brain networks. The increase in global connectivity observed under LSD correlated with subjective reports of “ego dissolution.” The present results provide the first evidence that LSD selectively expands global connectivity in the brain, compromising the brain’s modular and “rich-club” organization and, simultaneously, the perceptual boundaries between the self and the environment.

Tagliazucchi, E., Roseman, L., Kaelen, M., Orban, C., Muthukumaraswamy, S. D., Murphy, K., … & Bullmore, E. (2016). Increased Global Functional Connectivity Correlates with LSD-Induced Ego Dissolution. Current Biology. http://dx.doi.org/10.1016/j.cub.2016.02.010

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Ketamine for Treatment-Resistant Unipolar and Bipolar Major Depression: Critical Review and Implications for Clinical Practice

Abstract

There is an urgent need for more rapidly effective pharmacotherapies for major depressive disorder and bipolar disorder (BP) that are efficacious and tolerable for depressed patients who respond poorly to conventional treatments. Multiple controlled trials have now demonstrated a rapid, nonsustained antidepressive response to a single intravenous infusion of ketamine. Early controlled studies of intranasal or serial infusion therapy appear promising. The effective dose for depression is lower than the typical anesthetic doses, and side-effects are generally mild and transient. The data investigating the adjunctive use of concurrent ketamine in the course of electroconvulsive therapy (ECT) for depression do not suggest efficacy or tolerability. The therapeutic potential of ketamine has stimulated considerable excitement among clinicians, patients, and industry, and has led to the increasing use of ketamine as an off-label substitute for ECT and other antidepressive treatments. This clinical review of ketamine will assess the evidence-based use of ketamine and initial clinical implications of further development of a potentially novel treatment for rapid reduction of symptoms in depressed patients.

Bobo, W. V., Voort, J. L. V., Croarkin, P. E., Leung, J. G., Tye, S. J., & Frye, M. A. (2016). KETAMINE FOR TREATMENT‐RESISTANT UNIPOLAR AND BIPOLAR MAJOR DEPRESSION: CRITICAL REVIEW AND IMPLICATIONS FOR CLINICAL PRACTICE. Depression and Anxiety. http://dx.doi.org/10.1002/da.22505
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Ketamine for Treatment-Resistant Unipolar and Bipolar Major Depression: Critical Review and Implications for Clinical Practice Read More »

Ketamine for treatment-resistant depression: recent developments and clinical applications

Abstract

Approximately one-third of patients with major depressive disorder (MDD) do not respond to existing antidepressants, and those who do generally take weeks to months to achieve a significant effect. There is a clear unmet need for rapidly acting and more efficacious treatments. We will review recent developments in the study of ketamine, an old anaesthetic agent which has shown significant promise as a rapidly acting antidepressant in treatment-resistant patients with unipolar MDD, focusing on clinically important aspects such as dose, route of administration and duration of effect. Additional evidence suggests ketamine may be efficacious in patients with bipolar depression, post-traumatic stress disorder and acute suicidal ideation. We then discuss the safety of ketamine, in which most neuropsychiatric, neurocognitive and cardiovascular disturbances are short lasting; however, the long-term effects of ketamine are still unclear. We finally conclude with important information about ketamine for primary and secondary physicians as evidence continues to emerge for its potential use in clinical settings, underscoring the need for further investigation of its effects.

Schwartz, J., Murrough, J. W., & Iosifescu, D. V. (2016). Ketamine for treatment-resistant depression: recent developments and clinical applications. Evidence-based mental health. http://dx.doi.org/10.1136/eb-2016-102355

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Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA

Abstract

4-phosphorloxy-N,N-dimethyltryptamine (psilocybin) and methylenedioxymethamfetamine (MDMA), best known for their illegal use as psychedelic drugs, are showing promise as therapeutics in a resurgence of clinical research during the past 10 years. Psilocybin is being tested for alcoholism, smoking cessation, and in patients with advanced cancer with anxiety. MDMA is showing encouraging results as a treatment for refractory post-traumatic stress disorder, social anxiety in autistic adults, and anxiety associated with a life-threatening illness. Both drugs are studied as adjuncts or catalysts to psychotherapy, rather than as stand-alone drug treatments. This model of drug-assisted psychotherapy is a possible alternative to existing pharmacological and psychological treatments in psychiatry. Further research is needed to fully assess the potential of these compounds in the management of these common disorders that are difficult to treat with existing methods.

Mithoefer, M. C., Grob, C. S., & Brewerton, T. D. (2016). Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA. The Lancet Psychiatry. http://dx.doi.org/10.1016/S2215-0366(15)00576-3
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Oral noribogaine shows high brain uptake and anti-withdrawal effects not associated with place preference in rodents

Abstract

This study investigated the effects of noribogaine, the principal metabolite of the drug ibogaine, on substance-related disorders. In the first experiment, mice chronically treated with morphine were subjected to naloxone-precipitated withdrawal two hours after oral administration of noribogaine. Oral noribogaine dose dependently decreased the global opiate withdrawal score by up to 88% of vehicle control with an ED50of 13 mg/kg. In the second experiment, blood and brain levels of noribogaine showed a high brain penetration and a brain/blood ratio of 7±1 across all doses tested. In a third experiment, rats given oral noribogaine up to 100 mg/kg were tested for abuse liability using a standard biased conditioned place paradigm. Noribogaine-treated rats did not display place preference, suggesting that noribogaine is not perceived as a hedonic stimulus in rodents. Retrospective review of published studies assessing the efficacy of ibogaine on morphine withdrawal shows that the most likely cause of the discrepancies in the literature is the different routes of administration and time of testing following ibogaine administration. These results suggest that the metabolite noribogaine rather than the parent compound mediates the effects of ibogaine on blocking naloxone-precipitated withdrawal. Noribogaine may hold promise as a non-addicting alternative to standard opiate replacement therapies to transition patients to opiate abstinence.

Mash, D. C., Ameer, B., Prou, D., Howes, J. F., & Maillet, E. L. (2016). Oral noribogaine shows high brain uptake and anti-withdrawal effects not associated with place preference in rodents. Journal of psychopharmacology (Oxford, England). http://dx.doi.org/10.1177/0269881116641331

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Healing culture and its somewhat humorous discontents - July 22