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Psychedelic modulation of excitation–inhibition balance and the Affective Core Self: A multilevel mechanistic framework

Michael J. Winkelman

Journal of Psychedelic Studies November 6, 2026 DOI: 10.1556/2054.2026.00557 (opens in new tab)

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AI-extracted from the abstract
Characteristics Theoretical or philosophical paper Peer reviewed
Key points Proposes that 5-HT2A receptor activation modulates excitation–inhibition balance, which propagates through vertically coupled levels of a four-level "Affective Core Self" (homeostatic–autonomic, limbic, salience-network, cortical self-referential), and that post-acute plasticity and inhibitory recalibration stabilize some altered regulatory dynamics, linking acute psychedelic effects to enduring changes in affect and self-experience. The authors offer falsifiable predictions involving cortical E-I balance, bottom-up effective connectivity, and autonomic and affective regulation.

Abstract

Abstract: Serotonergic psychedelics reliably alter affective tone, emotional regulation, and self-experience. Prevailing theories emphasize acute changes in neural entropy, default mode network integrity, and large-scale functional connectivity but do not offer a clear mechanism that explains how 5-HT2A receptor pharmacology relates to lasting changes in affect and self-related processing. This article addresses this gap by proposing a testable mechanistic framework in which serotonergic modulation of excitation–inhibition (E-I) balance functions across a hierarchical regulatory architecture of the Affective Core Self, linking molecular, circuit, and network processes to shifts in affective self-dynamics. This theoretical article integrates evidence from neuroimaging and psychopharmacological studies of serotonergic psychedelics to evaluate this proposed mechanism that connects affective neurobiology with changes in self-related processing. Evidence is organized within a hierarchical Affective Core Self framework that includes homeostatic–autonomic, limbic, salience-network, and cortical self-referential regulatory levels. In this model, 5-HT2A receptor activation is proposed to influence E-I dynamics that may propagate across neural circuits and large-scale networks through vertical coupling among Affective Core Self levels. These vertically coupled interactions provide mechanisms through which psychedelic neuromodulation may reorganize affective tone and self-experience within this four-level Affective Core Self regulatory system. Post-acute plasticity and inhibitory recalibration are proposed to stabilize some of these altered regulatory dynamics. This provides a novel model linking acute psychedelic perturbation to enduring changes in affective regulation and self-experience and illustrates how psychedelic neuromodulation can reorganize the affective core of self-processing. This proposal generates falsifiable predictions that can be evaluated through measures of cortical E-I balance, bottom-up effective connectivity dynamics, and autonomic and affective regulation to assess whether psychedelic perturbations propagate across the levels of the Affective Core Self and are correlated with therapeutic outcomes.

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