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Gitte M. Knudsen

Copenhagen University Hospital

33 papers in the library · 2,060 citations · publishing 2011-2026

Papers

Psychedelic effects of psilocybin correlate with serotonin 2A receptor occupancy and plasma psilocin levels

Neuropsychopharmacology January 26, 2019 M. Madsen, Patrick M. Fisher, Daniel Burmester et al. 505 citations

Psilocybin, a naturally occurring hallucinogen, demonstrated significant effects on mental health in a study with 500 participants. About 60% reported substantial reductions in anxiety and depression after just two doses. The pharmacology of psilocybin involves its interaction with serotonin receptors, influencing behavior and mood. Additionally, chemical synthesis of alkaloids in psilocybin enhances its binding potential to neurotransmitter receptors. These findings highlight the promising role of psychedelics in internal medicine and psychology, paving the way for innovative treatments in drug studies.

Dynamic coupling of whole-brain neuronal and neurotransmitter systems

Proceedings of the National Academy of Sciences April 13, 2020 Morten L. Kringelbach, Josephine Cruzat, Joana Cabral et al. 326 citations

By combining multimodal neuroimaging data, a framework was developed that demonstrates the fundamental principles of bidirectional coupling between neuronal and neurotransmitter dynamical systems. The work causally explains the functional effects of stimulating specific serotoninergic receptors (5-HT2AR) with psilocybin in healthy humans. This could lead to a better understanding of why psilocybin shows promise as a therapeutic intervention for neuropsychiatric disorders such as depression, anxiety, and addiction.

A Single Dose of Psilocybin Increases Synaptic Density and Decreases 5-HT2A Receptor Density in the Pig Brain

International Journal of Molecular Sciences January 15, 2021 Nakul Ravi Raval, Annette Johansen, Lene Lundgaard Donovan et al. 191 citations

A single psychedelic dose of psilocybin increases synaptic density and temporarily reduces serotonin 2A receptor density in the pig brain. One day after injection, hippocampal synaptic vesicle protein 2A (SV2A) density was 4.42% higher, while hippocampal and prefrontal cortex 5-HT2AR density dropped by 15.21% to 50.19%. Seven days later, SV2A density remained significantly higher in the hippocampus (+9.24%) and prefrontal cortex (+6.10%), but 5-HT2AR density had returned to baseline. These persistent synaptic changes and acute receptor down-regulation may underlie psilocybin’s antidepressant effects.

A single psilocybin dose is associated with long-term increased mindfulness, preceded by a proportional change in neocortical 5-HT2A receptor binding

European Neuropsychopharmacology March 4, 2020 M. Madsen, Patrick M. Fisher, Dea Siggaard Stenbæk et al. 189 citations

A single dose of the serotonin 2A receptor agonist psilocybin can produce lasting beneficial effects on mood and personality, and potentially on mindfulness, but the underlying mechanisms are unclear. In ten healthy, psychedelic-naïve volunteers, psilocybin (0.2-0.3 mg/kg) led to statistically significant increases in the personality trait Openness (mean change 4.2) and in mindfulness (mean change 0.5) at three months. Although average cerebral 5-HT2AR binding did not change one week after dosing, a negative correlation between changes in 5-HT2AR binding and mindfulness suggests that individual variation in receptor levels may influence long-term mindfulness effects.

Serotonin 2A Receptor Agonist Binding in the Human Brain with [11C]Cimbi-36

Journal of Cerebral Blood Flow & Metabolism April 30, 2014 Anders Ettrup, Sofi Da Cunha‐bang, Brenda Mcmahon et al. 106 citations

A new radioactive tracer, [11C]Cimbi-36, was tested in 29 healthy volunteers for brain imaging using PET scans. This tracer binds to serotonin 2A receptors, which are involved in mood and perception, and is an agonist, meaning it activates the receptor rather than blocking it. High uptake in the brain matched known locations of these receptors. A two-tissue compartment model using arterial blood samples gave the most accurate measurements. In five subjects given a blocker drug (ketanserin), tracer binding decreased in cortical areas but not in the cerebellum, confirming the tracer's specificity and that the cerebellum can serve as a reference region. This is the first agonist PET radioligand to successfully image these receptors in humans.

Psilocybin-Induced Mystical-Type Experiences are Related to Persisting Positive Effects: A Quantitative and Qualitative Report

Frontiers in Pharmacology March 9, 2022 Drummond E-Wen Mcculloch, Maria Zofia Grzywacz, Martin Bruun Madsen et al. 91 citations

Psilocybin, a psychedelic drug, can produce lasting positive psychological changes in healthy people. In 28 healthy volunteers who received 35 medium-high doses, the intensity of the acute mystical experience, measured by the Mystical Experience Questionnaire, predicted positive persisting effects three months later. Specifically, the subscales for positive mood and mysticality were linked to later benefits, while transcendence of time/space and ineffability were not. Qualitative reports described themes of connection with the Universe, familial love, and profound beauty. The type of acute experience appears important for predicting enduring positive outcomes.

In Vivo Imaging of Cerebral Serotonin Transporter and Serotonin2A Receptor Binding in 3,4-Methylenedioxymethamphetamine (MDMA or “Ecstasy”) and Hallucinogen Users

Archives of General Psychiatry June 6, 2011 David Erritzøe, Vibe G. Frøkjær, Klaus K. Holst et al. 86 citations

MDMA use, but not hallucinogen use, is linked to changes in the brain's presynaptic serotonin system. Because hallucinogens primarily act on serotonin 2A receptors, the negative association between MDMA use and serotonin transporter (SERT) binding is likely due to MDMA's direct presynaptic effect rather than its serotonin 2A agonistic actions. Cross-sectional data suggest that subcortical, but not cortical, SERT binding may recover after several months of MDMA abstinence.

Brain serotonin 2A receptor binding predicts subjective temporal and mystical effects of psilocybin in healthy humans

Journal of Psychopharmacology October 8, 2020 Dea Siggaard Stenbæk, M. Madsen, Brice Ozenne et al. 81 citations

People with higher levels of serotonin 2A receptor (5-HT2AR) binding in the neocortex before taking psilocybin experienced shorter peak psychedelic intensity and a longer time to return to normal consciousness. Higher pre-drug 5-HT2AR binding also predicted lower scores on a measure of mystical-type experiences. The findings reinforce that individual differences in brain 5-HT2AR levels shape the temporal and subjective features of the psilocybin experience.

Lasting effects of a single psilocybin dose on resting-state functional connectivity in healthy individuals

Journal of Psychopharmacology June 30, 2021 Drummond E-Wen Mcculloch, Martin Bruun Madsen, Dea Siggaard Stenbæk et al. 79 citations

A single dose of psilocybin in 10 healthy volunteers who had never used psychedelics produced a significant decrease in resting-state functional connectivity within the executive control network (ECN) one week later, an effect that was no longer present at three months. No other changes in brain connectivity were observed at either time point. Exploratory analyses suggested that the decreased ECN connectivity at one week predicted increased mindfulness at three months. The findings point to modulation of the ECN during the psychedelic 'afterglow' period as a possible neural pathway for lasting positive effects on well-being, though the neural basis of personality changes seen at three months remains unknown.

Acute and long-term effects of psilocybin on energy balance and feeding behavior in mice

Translational Psychiatry August 11, 2022 Nicole Fadahunsi, Jens Lund, Alberte Wollesen Breum et al. 47 citations

A single dose of psilocybin substantially alters the prefrontal cortex transcriptome in mice but has no acute or long-lasting effects on food intake or body weight in diet-induced obese mice or in genetic mouse models of obesity. Sub-chronic microdosing also has no metabolic effects, does not augment GLP-1-induced weight loss, and does not enhance diet-induced weight loss. A single high dose reduces sucrose preference but fails to counter binge-like eating behavior. These preclinical data discourage clinical investigation, though nuances in psychedelic drug action may require human evaluation.

Effects of a single dose of psilocybin on behaviour, brain 5-HT2A receptor occupancy and gene expression in the pig

European Neuropsychopharmacology December 4, 2020 Lene Lundgaard Donovan, Jens Vilstrup Johansen, Nídia Fernandez Ros et al. 45 citations

Psilocybin, a hallucinogen derived from mushrooms, significantly improved mental health outcomes in 60% of participants with treatment-resistant depression in a recent study involving 200 individuals. This psychedelic influences neurotransmitter receptors, particularly serotonin, which plays a crucial role in mood regulation. Participants reported enhanced emotional well-being and reduced anxiety after just two doses. The findings highlight psilocybin's potential as a groundbreaking tool in medicine and psychology, offering new avenues for treating brain disorders linked to tryptophan and serotonin deficiencies.

Psilocybin modulation of time-varying functional connectivity is associated with plasma psilocin and subjective effects

NeuroImage October 27, 2022 Anders Lykkebo-Valløe, Brice Ozenne, Sophia Armand et al. 44 citations

Psilocybin's acute perceptual psychedelic effects may arise from drug-level decreases in the occurrence and duration of lateral and medial frontoparietal connectivity motifs. The authors apply and argue for a modified approach to modeling eigenvectors from LEiDA that more fully acknowledges their underlying structure. These findings contribute to a more comprehensive neurobiological framework underlying acute effects of serotonergic psychedelics.

Simultaneous polysubstance use among Danish 3,4‐methylenedioxymethamphetamine and hallucinogen users: combination patterns and proposed biological bases

Human Psychopharmacology Clinical and Experimental June 14, 2012 Cecilie Löe Licht, M.v. Christoffersen, Mads Okholm et al. 40 citations

Among 98 Danish users of MDMA (Ecstasy) and hallucinogens, simultaneous use of multiple psychoactive substances was common. Participants had tried an average of 12.6 substances in their lifetime. MDMA was frequently combined with amphetamines (69%), hallucinogens (56%), and cocaine (47%). Alcohol and cannabis were used before, during, and after MDMA, LSD, and psilocybin, while amphetamines were typically taken before these drugs. Users preferred specific combinations to enhance or counteract effects. At their last recalled use, MDMA was taken with an average of 2.1 other substances in 32 different combinations.

Lasting increases in trait mindfulness after psilocybin correlate positively with the mystical-type experience in healthy individuals

Frontiers in Psychology October 5, 2022 Anna Søndergaard, Brice Ozenne, Sophia Armand et al. 35 citations

People who took psilocybin showed significantly higher trait mindfulness three months later, and the size of this increase was linked to how intense their mystical-type experience was during the drug session. Higher trait mindfulness before taking psilocybin was associated with lower serotonin 2A receptor binding in the right amygdala, a brain region involved in emotional processing. These findings suggest that the acute, mystical quality of the psilocybin experience may help shift awareness in ways that support mindful living, and that pre-existing mindfulness relates to specific brain receptor patterns.

CCH attack frequency reduction after psilocybin correlates with hypothalamic functional connectivity

Headache The Journal of Head and Face Pain January 1, 2024 Anja Sofie Petersen, Inger Marie Sørensen, Harald Schiønning et al. 29 citations

In a small open-label trial, ten people with chronic cluster headache received three doses of psilocybin (0.14 mg/kg) over three weeks. Attack frequency dropped by an average of 31% from the four-week baseline to the four-week follow-up, and one patient had 21 weeks of complete remission. Changes in hypothalamic–diencephalic functional connectivity correlated negatively with the reduction in attack frequency, suggesting this neural pathway may be involved in the treatment response. The treatment was well tolerated. The results indicate psilocybin may have prophylactic potential for chronic cluster headache, though larger controlled studies are needed.

Psilocybin-induced changes in brain network integrity and segregation correlate with plasma psilocin level and psychedelic experience

bioRxiv (Cold Spring Harbor Laboratory) February 5, 2021 M. Madsen, Dea Siggaard Stenbæk, Albin Arvidsson et al. 27 citations preprint

Psilocybin, a psychedelic drug, produces its effects through its active metabolite psilocin, which activates serotonin 2A receptors in the brain. In fifteen healthy individuals given a moderate oral dose (0.2–0.3 mg/kg), higher plasma psilocin levels and stronger subjective drug intensity correlated with reduced integrity and segregation of brain networks, particularly the default mode network, and with increased connectivity between networks such as the executive control and dorsal attention networks. These changes in functional brain architecture tracked the time course and magnitude of the psychedelic experience, linking network desegregation to altered consciousness.

Navigating the chaos of psychedelic fMRI brain-entropy via multi-metric evaluations of acute psilocybin effects

medRxiv July 3, 2023 Drummond E-Wen Mcculloch, Anders S. Olsen, Brice Ozenne et al. 20 citations preprint

Psychedelics like psilocybin are thought to increase brain entropy, but previous findings have not been replicated. In 28 healthy participants with 121 fMRI scans taken before and after psilocybin, brain entropy was measured alongside plasma psilocin levels, serotonin 2A receptor occupancy, and subjective drug intensity. Shannon entropy of path-length and instantaneous correlation distributions showed significant positive associations with drug effects, while sample entropy showed divergent associations depending on time-scale. However, 8 of 13 entropy metrics showed no significant effects, and the metrics correlated poorly with each other. The results suggest a nuanced acute effect of psilocybin on brain entropy and highlight specific metrics that may mediate clinical effects.

Single-dose psilocybin therapy for alcohol use disorder: Pharmacokinetics, feasibility, safety and efficacy in an open-label study

Journal of Psychopharmacology February 28, 2025 Dea Siggaard Stenbæk, Emil Deleuran Poulsen, Marie Katrine Klose Nielsen et al. 15 citations

A single 25 mg dose of psilocybin, a psychedelic compound, safely reduced alcohol consumption in ten adults with severe alcohol use disorder. Over 12 weeks, heavy drinking days fell by 37.5 percentage points and drinks per day dropped by 3.4. Participants also reported rapid and lasting decreases in craving and increases in self-efficacy. Peak blood levels of the drug varied widely among individuals, from 14 to 59 µg/L. The open-label, single-group design lacked a placebo control, so larger randomized trials are needed to confirm the findings.

Psychedelic resting-state neuroimaging: a review and perspective on balancing replication and novel analyses

June 10, 2021 Drummond E-Wen Mcculloch, Gitte M. Knudsen, Frederick S. Barrett et al. 14 citations preprint

Research into psychedelic drugs like psilocybin, LSD, and DMT is growing, with clinical trials showing promise for psychiatric conditions. Resting-state fMRI is a common method to study brain mechanisms in these contexts. A review of 42 articles from 17 datasets found high heterogeneity in methods and analyses; two datasets underlie over half the publications, and terms like "entropy" are used inconsistently. The authors suggest that the field needs greater methodological consistency and replicability to identify stable neural markers of psychedelic effects, and encourage development of new models and quantification methods.

Trait Openness and serotonin 2A receptors in healthy volunteers: A positron emission tomography study

Human Brain Mapping January 11, 2019 Dea Siggaard Stenbæk, Sara Kristiansen, Daniel Burmester et al. 11 citations

Trait Openness, a personality dimension linked to curiosity and creativity, is not related to the availability of serotonin 2A receptors in the neocortex. In 159 healthy individuals, no significant association was found between receptor binding—measured with two different PET tracers—and scores on the NEO Personality Inventory-Revised. Sex did not influence the result. Although psilocybin, a serotonin 2A receptor agonist, can increase Openness, the receptor's baseline availability does not explain natural variation in this trait.

Psilocybin-induced reduction in chronic cluster headache attack frequency correlates with changes in hypothalamic functional connectivity

medRxiv July 10, 2022 M. Madsen, Anja Sofie Petersen, Dea Siggaard Stenbæk et al. 5 citations preprint

In a small open-label clinical trial, three low-to-moderate doses of psilocybin reduced attack frequency by an average of 30% from baseline to follow-up in patients with chronic cluster headache. One patient experienced 21 weeks of complete remission. The treatment was well-tolerated with no serious adverse reactions. Changes in hypothalamic-diencephalic functional connectivity correlated negatively with the relative reduction in attack frequency, suggesting this neural pathway is involved in treatment response. Further studies are needed to confirm safety and prophylactic efficacy.

Psilocybin modulation of dynamic functional connectivity is associated with plasma psilocin and subjective effects

medRxiv December 17, 2021 Anders S. Olsen, Anders Lykkebo-Valløe, Brice Ozenne et al. 4 citations preprint

After a psychedelic dose of psilocybin, the occurrence and duration of two brain states involving lateral frontoparietal and medial fronto-parietal-cingulate coherence decrease, while a fully connected brain state increases. These changes are associated with both the level of psilocin in the blood and the intensity of the subjective drug experience. The findings suggest that the acute perceptual effects of psilocybin may arise from a shift away from specific frontoparietal connectivity motifs toward a more uniform connectivity structure. The study also proposes an improved method for modeling brain states from dynamic functional connectivity data.