Single-dose psilocybin alters resting state functional networks in patients with body dysmorphic disorder
Xi Zhu, Chen Zhang, David J Hellerstein, Jamie D. Feusner, Michael G. Wheaton, Gloria J. Gomez, Franklin R. Schneier
Psychedelics September 24, 2024 DOI: 10.61373/pp024r.0028 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Open-label pilot study Peer reviewed |
|---|---|
| Sample size | 8 |
| Population | Adults with moderate-to-severe nondelusional body dysmorphic disorder |
| Intervention | Psilocybin |
| Dose | 25 mg |
| Duration | 12-week follow-up |
| Topics | Default mode network Psilocybin |
| Keywords | Body dysmorphic disorder Resting State FMRI Dosing Precuneus Insula |
| Citations | 6 |
| Registration | NCT04656301 |
| Key points | Increased resting state functional connectivity within the Executive Control Network and between the Executive Control Network, Default Mode Network, and Salience Network one day after psilocybin dosing predicted improvement in BDD symptoms at one week. |
Abstract
Body dysmorphic disorder (BDD) is a severe psychiatric condition characterized by preoccupation with perceived flaws in one's appearance, which the individual views as defective or ugly. Psilocybin, a serotonin 2A receptor agonist with psychedelic properties, has emerged as a potential therapeutic agent for depression and other psychiatric disorders. This study aimed to identify subacute neural changes predicting symptomatic response to psilocybin treatment in adults with BDD. Eight adults with moderate-to-severe nondelusional BDD were administered a single oral 25 mg dose of psilocybin, accompanied by psychological support, and underwent resting state functional magnetic resonance imaging assessments 1 day before and 1 day after the dosing. Both a region of interest (ROI)-to-ROI analysis and multivariate pattern analysis (MVPA) were used to identify changes in resting state functional connectivity (rsFC) at day 1 after dosing that predicted treatment response at week 1, measured by change in Yale-Brown Obsessive Compulsive Disorder Scale Modified for BDD (BDD-YBOCS) score. All participants completed the dosing and follow-up assessments over 12 weeks. BDD-YBOCS scores decreased at week 1 and week 12 after dosing ( p <0.001 for both). MVPA revealed a significant increase in rsFC within the Executive Control Network (ECN) at day 1. Increased rsFC within the ECN (dlPFC – Superior Parietal Lobule [FPL]), between the ECN and Default Mode Network (dlPFC – Precuneus), and between the ECN and the Salience Network (dlPFC – insula) were predictive of improvement in BDD symptoms at week 1. These findings are the first report of subacute brain effects of psilocybin in patients with BDD. Given the small sample size and uncontrolled design of the study, larger controlled studies are necessary to validate these observations. Clinical Trials Registration: Clinicaltrials.gov ID: NCT04656301
Comparable studies
Other non-randomized and open-label trials on psilocybin, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. Patients with moderate-to-severe, unipolar, treatment-resistant major depression | 2016 | Open-label feasibility trial | n = 12 |
| Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Patients with severe, unipolar, treatment-resistant major depression | 2017 | Open-label trial | n = 20 |
| Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction Psychiatrically healthy nicotine-dependent smokers | 2014 | Open-label pilot study | n = 15 |
| Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression Patients with treatment-resistant depression | 2018 | Clinical trial | n = 20 |
| Safety, Tolerability, and Efficacy of Psilocybin in 9 Patients With Obsessive-Compulsive Disorder Subjects with obsessive-compulsive disorder (OCD) | 2006 | Controlled clinical trial |
Citations in the library
Cited by 5
- Why psychedelic-assisted therapy studies in eating disorders risk missing the mark on outcomes: a phenomenological psychopathology perspective. Journal of Eating Disorders September 2, 2025
- Psilocybin-assisted psychotherapy for treatment-resistant obsessive–compulsive disorder: protocol for an open-label pilot study BJPsych Open December 15, 2025
- Psychedelics and the Serotonin Hypothesis of Eating Disorders Brain Sciences August 21, 2025
- Psilocybin Treatment as an Adjunct to Cognitive Behavioral Therapy for Eating Disorders: Therapeutic Rationale & Considerations for Protocol Development. Behavioral Sciences March 6, 2026
- Psilocybin as a Transdiagnostic Treatment for Eating Disorders and Comorbid Psychopathology: Implications for Clinical Nosology and Research Directions International Journal of Eating Disorders July 2, 2026
Cites 16
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
- Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Scientific Reports October 13, 2017
- Increased global integration in the brain after psilocybin therapy for depression. Nature Medicine April 11, 2022
- Emotions and brain function are altered up to one month after a single high dose of psilocybin. Scientific Reports February 10, 2020
and 11 more in the library