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

In a small pilot study, psilocybin, compared to diphenhydramine, altered brain activity in people with alcohol use disorder when they viewed alcohol and emotional images. Psilocybin increased activity in the medial and lateral prefrontal cortex and left caudate, and decreased activity in the insular, motor, temporal, parietal, and occipital cortices and cerebellum. For negative cues, psilocybin increased supramarginal gyrus activity; for positive cues, it increased right hippocampus activity and decreased left hippocampus activity. These changes suggest enhanced goal-directed action, improved emotional regulation, and diminished craving, warranting larger studies.

Study at a glance

Abstract

OBJECTIVES/GOALS: This pilot study investigated psilocybin-induced changes in neural reactivity to alcohol and emotional cues in patients with alcohol use disorder (AUD). METHODS/STUDY POPULATION: 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. RESULTS/ANTICIPATED RESULTS: 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. DISCUSSION/SIGNIFICANCE: 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.