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Brain dynamics predictive of response to psilocybin for treatment-resistant depression

Jakub Vohryzek, Joana Cabral, Louis-David Lord, Henrique M. Fernandes, Leor Roseman, David Nutt, Robin Carhart-Harris, Gustavo Deco, Morten L. Kringelbach

Research Square September 20, 2022 preprint DOI: 10.21203/rs.3.rs-2060381/v1 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort
Population Patients with depression receiving psilocybin therapy
Intervention Psilocybin
Dose 10mg and 25mg, 7 days apart
Topics Psilocybin Serotonin Depression
Keywords Anhedonia Depression economics Hallucinogen Receptor
Citations 10
Key findings Brain regions implicated in recovery from depression after psilocybin therapy correlate with serotonin 5-HT2A and 5-HT1A receptor density, providing causal mechanistic evidence for the role of serotonergic transmission.

Abstract

Abstract Psilocybin therapy for depression has started to show promise, yet the underlying causal mechanisms are not currently known. Here we leveraged the differential outcome in responders and non-responders to psilocybin (10mg and 25mg, 7 days apart) therapy for depression - to gain new insights into regions and networks implicated in the restoration of healthy brain dynamics. We used whole-brain modelling to fit the spatiotemporal brain dynamics at rest in both responders and non-responders before treatment. Dynamic sensitivity analysis of systematic perturbation of these models enabled us to identify specific brain regions implicated in a transition from a depressive brain state to a heathy one. Binarizing the sample into treatment responders (> 50% reduction in depressive symptoms) versus non-responders enabled us to identify a subset of regions implicated in this change. Interestingly, these regions correlate with in vivo density maps of serotonin receptors 5-HT2A and 5-HT1A, which psilocin, the active metabolite of psilocybin, has an appreciable affinity for, and where it acts as a full-to-partial agonist. Serotonergic transmission has long been associated with depression and our findings provide causal mechanistic evidence for the role of brain regions in the recovery from depression via psilocybin.

Comparable studies

Other observational and cohort studies on psilocybin for depression, most cited first.

Study Year Design Participants
Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Patients with treatment-resistant depression 2017 Observational cohort n = 19
Psilocybin with psychological support improves emotional face recognition in treatment-resistant depression Patients with treatment-resistant depression and healthy controls 2017 Observational cohort n = 33
More Realistic Forecasting of Future Life Events After Psilocybin for Treatment-Resistant Depression Patients with treatment-resistant depression (TRD) 2018 Observational cohort n = 15
Natural speech algorithm applied to baseline interview data can predict which patients will respond to psilocybin for treatment-resistant depression. 17 patients with treatment-resistant depression and 18 untreated age-matched healthy... 2018 Observational cohort with machine learning classification n = 35
Brain dynamics predictive of response to psilocybin for treatment-resistant depression. Responders and non-responders to psilocybin therapy for depression 2024 Observational cohort

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