Healthy VolunteersNeuroimaging & Brain MeasuresDepressive DisordersAnxiety DisordersLSDPsilocybin

Molecular, haemodynamic, and functional effects of LSD in the human brain

Using simultaneous PET–MRI in healthy volunteers, this first integrated molecular and functional neuroimaging study quantifies LSD occupancy at cerebral serotonin 2A receptors and establishes a dose–occupancy relationship while revealing an anticlockwise hysteresis between plasma levels and subjective effects. LSD produced distinct haemodynamic and functional changes — increasing global cerebral and internal carotid artery flow without altering artery diameter and reducing global connectivity (GCOR), with GCOR changes negatively correlated with CBF and differing from effects of psilocybin — findings relevant to clinical development.

Authors

  • Gitte Knudsen
  • Patrick Fisher
  • Friederike Holze

Published

MedRvix
individual Study

Abstract

In this study, we provide the first study to integrate molecular and functional neuroimaging during psychedelic drug effects in humans. Using simultaneous PET-MRI technology, we describe multiple brain actions of lysergic acid diethylamide (LSD) in healthy volunteers. We quantify the occupancy of LSD at cerebral serotonin 2A receptors and show that LSD increases global cerebral blood flow and internal carotid artery flow without affecting the diameter of the internal carotid artery, opposite effects to those observed In this study, we provide the fi rst study to integrate molecular and functional neuroimaging during psychedelic drug eff ects in humans. Using simultaneous PET-MRI technology, we describe multiple brain actions of lysergic acid diethylamide (LSD) in seven healthy volunteers blinded to LSD dose received. We quantify the occupancy of LSD at cerebral serotonin 2A receptors and show that LSD increases global cerebral blood fl ow (CBF) and internal carotid artery fl ow without aff ecting the diameter of the internal carotid artery, opposite eff ects to those observed following psilocybin. Functional connectivity analyses show decreases in global connectivity (GCOR). Change in GCOR is negatively correlated with change in CBF. We observe an anticlockwise hysteresis loop between plasma drug levels and subjective eff ects, suggesting atypical pharmacodynamic mechanisms. We contrast our CBF and GCOR fi ndings and their relation in a separate cohort of 25 participants administered psilocybin, highlighting key consistencies and diff erences in their neural eff ects. By establishing the dose-occupancy relation of LSD in humans, our fi ndings provide critical insights for the clinical development of psychedelic compounds and demonstrate unique neurophysiological eff ects that distinguish LSD from related psychedelics.

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Research Summary of 'Molecular, haemodynamic, and functional effects of LSD in the human brain'

Introduction

Lysergic acid diethylamide (LSD) is a potent serotonergic psychedelic drug that has recently entered phase 3 clinical trials for the treatment of anxiety and depressive disorders following promising phase 1 and 2a safety and efficacy data. LSD exerts its principal effects through high-affinity agonism at the 5-HT2A receptor, but in vivo receptor occupancy data and the relationship between receptor binding, cerebrovascular physiology, and functional brain changes have not previously been characterised simultaneously in humans. Such multimodal data are critical for establishing dose-occupancy relationships that can inform rational clinical dose selection. The present study conducted the first simultaneous molecular and functional neuroimaging investigation of LSD in humans, combining positron emission tomography (PET) with the 5-HT2A receptor radioligand [11C]Cimbi-36, functional MRI, and haemodynamic measurements to characterise LSD's effects on cerebral 5-HT2AR occupancy, cerebral blood flow (CBF), and whole-brain functional activity and connectivity across a range of doses.

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Study Details

References (32)

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