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Neuroimaging Correlates of Treatment Response with Psychedelics in Major Depressive Disorder: A Systematic Review

Sarah Kuburi, Anne-Marie Di Passa, Vanessa K. Tassone, Raesham Mahmood, Aleksandra Lalovic, Karim S. Ladha, Katharine Dunlop, Sakina J. Rizvi, Ilya Demchenko, Venkat Bhat

Chronic Stress January 1, 2022 DOI: 10.1177/24705470221115342 via OpenAlex

Summary

AI-generated from the abstract

A systematic review of neuroimaging studies on psychedelics for major depressive disorder found that psilocybin, ayahuasca, and LSD alter brain activity and connectivity in ways linked to antidepressant response. Key changes include amygdala activity and functional connectivity alterations, shifts in medial and ventromedial prefrontal cortex connectivity, and decreased global brain network modularity. One ayahuasca study reported increased limbic activity. The evidence, based on only four datasets, suggests the default mode and limbic networks may be important targets for future research, but more data are needed to confirm these preliminary findings.

Study at a glance

Characteristics Systematic review Peer reviewed
Population Patients with major depressive disorder
Interventions psilocybin ayahuasca lysergic acid diethylamide
Keywords Neuroimaging Clinical psychology Neuroscience Psychiatry
Citations 14
Key finding Psilocybin, ayahuasca, and LSD produce neuroimaging changes—including amygdala and prefrontal cortex connectivity alterations and decreased brain network modularity—that correlate with antidepressant response in major depressive disorder.

Abstract

Preliminary evidence supports the use of psychedelics for major depressive disorder (MDD). However, less attention has been given to the neural mechanisms behind their effects. We conducted a systematic review examining the neuroimaging correlates of antidepressant response following psychedelic interventions for MDD. Through MEDLINE, Embase, and APA PsycINFO, 187 records were identified and 42 articles were screened. Six published studies and one conference abstract were included. Five ongoing trials were included from ClinicalTrials.gov. Our search covered several psychedelics, though included studies were specific to psilocybin, ayahuasca, and lysergic acid diethylamide. Three psilocybin studies noted amygdala activity and functional connectivity (FC) alterations that correlated with treatment response. Two psilocybin studies reported that FC changes in the medial and ventromedial prefrontal cortices correlated with treatment response. Two trials from a single study reported global decreases in brain network modularity which correlated with antidepressant response. One ayahuasca study reported increased activity in the limbic regions following treatment. Preliminary evidence suggests that the default mode and limbic networks may be a target for future research on the neural mechanisms of psychedelics. More data is required to corroborate these initial findings as the evidence summarized in this review is based on four datasets.

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