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

• Published in: Scientific reports Vol. 14; no. 1; p. 3159
• Main Authors: Pagni, B. A., Petridis, P. D., Podrebarac, S. K., Grinband, J., Claus, E. D., Bogenschutz, M. P.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 07.02.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 631/1647/245/1627; 631/378/3920; 692/308/2779/777; Alcohol use; Alcohols; Brain mapping; Cerebellum; Clinical trials; Cortex (parietal); Diphenhydramine; Emotions; Functional magnetic resonance imaging; Hippocampus; Humanities and Social Sciences; Magnetic resonance imaging; multidisciplinary; NCT; NCT02061293; Neuroimaging; Occipital lobe; Patients; Pilot projects; Prefrontal cortex; Psilocybin; Science; Science (multidisciplinary); Temporal lobe
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-52967-8

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.