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Psilocybin-induced changes in neural reactivity to alcohol and emotional cues in patients with alcohol use disorder: an fMRI pilot study

Broc A. Pagni, Petros Petridis, Samantha K. Podrebarac, Jack Grinband, Eric D. Claus, Michael P. Bogenschutz

Scientific Reports February 7, 2024 DOI: 10.1038/s41598-024-52967-8 via OpenAlex

Summary

AI-generated from the abstract

In a small pilot study, patients with alcohol use disorder underwent functional magnetic resonance imaging before and after receiving either psilocybin or diphenhydramine. Psilocybin increased activity in the medial and lateral prefrontal cortex and left caudate, while decreasing activity in the insular, motor, temporal, parietal, and occipital cortices, and cerebellum. For negative emotional cues, psilocybin increased supramarginal gyrus activity; for positive cues, it increased right hippocampus activity and decreased left hippocampus activity. These brain changes suggest enhanced goal-directed action, improved emotional regulation, and diminished craving, but larger studies are needed to confirm the neural mechanisms of psilocybin-assisted therapy.

Study at a glance

Characteristics Pilot study; randomized, double-blind, placebo-controlled clinical trial Peer reviewed
Sample size 11
Population Adult patients with alcohol use disorder
Interventions Psilocybin Diphenhydramine
Dose 25 mg of psilocybin, 50 mg of diphenhydramine
Duration fMRI approximately 3 days before and 2 days after intervention
Topics Psilocybin
Keywords Psychology Prefrontal cortex Insular cortex Neuroscience
Citations 30
Registration NCT02061293
Key finding Psilocybin increased prefrontal cortex and caudate activity and decreased insular, motor, and cerebellar activity in response to alcohol and emotional cues, suggesting enhanced goal-directed action and diminished craving.

Abstract

Abstract This pilot study investigated psilocybin-induced changes in neural reactivity to alcohol and emotional cues in patients with alcohol use disorder (AUD). Participants were recruited from a phase II, randomized, double-blind, placebo-controlled clinical trial investigating psilocybin-assisted therapy (PAT) for the treatment of AUD (NCT02061293). Eleven adult patients completed task-based blood oxygen dependent functional magnetic resonance imaging (fMRI) approximately 3 days before and 2 days after receiving 25 mg of psilocybin (n = 5) or 50 mg of diphenhydramine (n = 6). Visual alcohol and emotionally valanced (positive, negative, or neutral) stimuli were presented in block design. Across both alcohol and emotional cues, psilocybin increased activity in the medial and lateral prefrontal cortex (PFC) and left caudate, and decreased activity in the insular, motor, temporal, parietal, and occipital cortices, and cerebellum. Unique to negative cues, psilocybin increased supramarginal gyrus activity; unique to positive cues, psilocybin increased right hippocampus activity and decreased left hippocampus activity. Greater PFC and caudate engagement and concomitant insula, motor, and cerebellar disengagement suggests enhanced goal-directed action, improved emotional regulation, and diminished craving. The robust changes in brain activity observed in this pilot study warrant larger neuroimaging studies to elucidate neural mechanisms of PAT. Trial registration : NCT02061293.

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