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Consistent evidence that brain serotonin 2A receptor binding is positively associated with personality-based risk markers of depression

Emma S Høgsted, Vincent Beliveau, Brice Ozenne, Martin K Madsen, Claus Svarer, Vibeke H Dam, Annette Johansen, Patrick M. Fisher, Gitte M. Knudsen, Vibe G. Frøkjær, Anjali Sankar

The British Journal of Psychiatry December 5, 2024 DOI: 10.1192/bjp.2024.143 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort Peer reviewed
Sample size 80
Population Healthy volunteers
Topics Depression Serotonin
Keywords Personality research Neuroimaging Serotonin 2a receptor Cortisol Latent variable modelling Neuroticism Positron-emission tomography Mental health Brain chemistry
Citations 4
Key findings Serotonin 2A receptor binding is positively associated with inward facets of neuroticism, and this association is not moderated by cortisol awakening response.

Abstract

Background: Using [ 18 F]altanserin, a serotonin 2A receptor (5-HT 2A R) antagonist Positron Emission Tomography (PET) tracer, a positive association between cortical 5-HT 2A R binding and the inward-directed facets of neuroticism has been demonstrated in healthy individuals. Psilocybin, a 5-HT 2A R agonist, shows promise for the treatment of depression, reducing neuroticism and mood symptoms potentially via hypothalamic-pituitary-adrenal (HPA) modulation. 5-HT 2A R and neuroticism are both modulated by HPA axis function.

Aims: In this study, we examined whether the association between 5-HT 2A R binding and the inward facets of neuroticism can be replicated in an independent healthy cohort using the new 5-HT 2A R agonist tracer [ 11 C]Cimbi-36, and if their association is moderated by cortisol awakening response (CAR), an index of HPA axis function. If so, this could advance mechanistic insights into interventions that target the 5-HT 2A R and reduce neuroticism.

Method: Eighty healthy volunteers underwent [ 11 C]Cimbi-36 PET scans and completed the NEO personality inventory (NEO-PI-R) for the assessment of neuroticism. Salivary samples were available for determination of CAR in 70 of the participants. Using linear latent variable models, we evaluated the association between 5-HT 2A R binding and inward facets of neuroticism, namely depression, anxiety, self-consciousness and vulnerability to stress, and whether CAR moderated this association.

Results: The study confirms the positive association between 5-HT 2A R binding and the inward facets of neuroticism ( β = 0.01, 95% CI = [0.0005: 0.02], P = 0.04), and this association is independent of CAR ( P = 0.33).

Conclusions: The findings prompt consideration of whether novel interventions such as psilocybin that actively targets 5-HT 2A R and causes changes in personality could be particularly beneficial if implemented as a targeted approach based on neuroticism profiles.