Bridging the translational neuroscience gap: Development of the ‘shiftability’ paradigm and an exemplar protocol to capture psilocybin-elicited ‘shift’ in neurobiological mechanisms in autism
The paper introduces the "shiftability" paradigm to bridge the translational gap by experimentally manipulating neurotransmitter systems in humans to observe causal effects on brain function in autism. It presents PSILAUT, an exemplar protocol using psilocybin as an in vivo serotonin probe to test whether serotonergic modulation produces different neurobiological “shifts” in autistic versus non‑autistic adults.
Abstract
Clinical trials of pharmacological approaches targeting the core features of autism have failed. This is despite evidence from preclinical studies, genetics, post-mortem studies and correlational analyses linking peripheral and central markers of multiple candidate neurochemical systems to brain function in autism. Whilst this has in part been explained by the heterogeneity of the autistic population, the field has largely relied upon association studies to link brain chemistry to function. The only way to directly establish that a neurotransmitter or neuromodulator is involved in a candidate brain function is to change it and observe a shift in that function. This experimental approach dominates preclinical neuroscience, but not human studies. There is very little direct experimental evidence describing how neurochemical systems modulate information processing in the living human brain. As a result, our understanding of how neurochemical differences contribute to neurodiversity is limited and impedes our ability to translate findings from animal studies into humans. Here, we begin by introducing our “shiftability” paradigm, an approach to bridge the translational gap in autism research. We then provide an overview of the methodologies used and explain our most recent choice of psilocybin as a pharmacological probe of the serotonin system in vivo . Finally, we provide a summary of the protocol for ‘PSILAUT’, an exemplar “shiftability” study which uses psilocybin to directly test the hypothesis that the serotonin system functions differently in autistic and non-autistic adults.
Research Summary of 'Bridging the translational neuroscience gap: Development of the ‘shiftability’ paradigm and an exemplar protocol to capture psilocybin-elicited ‘shift’ in neurobiological mechanisms in autism'
Introduction
Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition characterised by differences in social communication, repetitive or restricted behaviours, and sensory atypicalities. Clinical trials seeking pharmacological treatments for core ASD features have largely failed, a problem the authors attribute not only to diagnostic heterogeneity but also to a lack of experimental paradigms that causally link neurochemical systems to brain function in humans. Most human neuroscience work in this area has relied on correlational approaches that cannot establish whether a given neurotransmitter system actually regulates a candidate brain mechanism. Whelan and colleagues introduce a “shiftability” paradigm intended to bridge this translational gap by deliberately perturbing neurochemical systems in vivo and measuring the resulting ‘shift’ in brain function across multiple organisational levels. The paper outlines the rationale for this experimental medicine approach, summarises methodological options, and presents an exemplar protocol (PSILAUT) that uses low doses of psilocybin as a serotonergic probe to test the hypothesis that 5HT-mediated regulation of sensory processing, local circuits and whole-brain networks differs between autistic and non-autistic adults. The broader goal is to create a pharmacological repository describing how different drugs change (or fail to change) brain mechanisms across individuals, thereby improving stratification for future clinical trials.
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Whelan, T. P., Daly, E., Puts, N. A., Malievskaia, E., Murphy, D. G., & McAlonan, G. M. (2023). Bridging the translational neuroscience gap: Development of the ‘shiftability’ paradigm and an exemplar protocol to capture psilocybin-elicited ‘shift’ in neurobiological mechanisms in autism. https://doi.org/10.1101/2023.05.25.23290521
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