TY  - JOUR
PY  - 2017//
TI  - Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms
JO  - Scientific reports
A1  - Carhart-Harris, Robin L.
A1  - Roseman, Leor
A1  - Bolstridge, Mark
A1  - Demetriou, Lysia
A1  - Pannekoek, J. Nienke
A1  - Wall, Matthew B.
A1  - Tanner, Mark
A1  - Kaelen, Mendel
A1  - McGonigle, John
A1  - Murphy, Kevin
A1  - Leech, Robert
A1  - Curran, H. Valerie
A1  - Nutt, David J.
SP  - e13187
EP  - e13187
VL  - 7
IS  - 1
N2  - Psilocybin with psychological support is showing promise as a treatment model in psychiatry but its therapeutic mechanisms are poorly understood. Here, cerebral blood flow (CBF) and blood oxygen-level dependent (BOLD) resting-state functional connectivity (RSFC) were measured with functional magnetic resonance imaging (fMRI) before and after treatment with psilocybin (serotonin agonist) for treatment-resistant depression (TRD). Quality pre and post treatment fMRI data were collected from 16 of 19 patients. Decreased depressive symptoms were observed in all 19 patients at 1-week post-treatment and 47% met criteria for response at 5 weeks. Whole-brain analyses revealed post-treatment decreases in CBF in the temporal cortex, including the amygdala. Decreased amygdala CBF correlated with reduced depressive symptoms. Focusing on a priori selected circuitry for RSFC analyses, increased RSFC was observed within the default-mode network (DMN) post-treatment. Increased ventromedial prefrontal cortex-bilateral inferior lateral parietal cortex RSFC was predictive of treatment response at 5-weeks, as was decreased parahippocampal-prefrontal cortex RSFC. These data fill an important knowledge gap regarding the post-treatment brain effects of psilocybin, and are the first in depressed patients. The post-treatment brain changes are different to previously observed acute effects of psilocybin and other 'psychedelics' yet were related to clinical outcomes. A 'reset' therapeutic mechanism is proposed.<p />  <p>Language: en</p>
LA  - en
SN  - 2045-2322
UR  - http://dx.doi.org/10.1038/s41598-017-13282-7
ID  - ref1
ER  -