Altered network hub connectivity after acute LSD administration
This study (n=20) found that LSD decreased functional connectivity (FC) within visual, sensorimotor, and auditory networks and the default-mode network (DMN), and increased functional connectivity between networks.
Authors
- Stefan Borgwardt
- Patrick C. Dolder
Published
Abstract
LSD is an ambiguous substance, said to mimic psychosis and to improve mental health in people suffering from anxiety and depression. Little is known about the neuronal correlates of altered states of consciousness induced by this substance. Limited previous studies indicated profound changes in functional connectivity of resting state networks after the administration of LSD. The current investigation attempts to replicate and extend those findings in an independent sample. In a double-blind, randomized, cross-over study, 100 μg LSD and placebo were orally administered to 20 healthy participants. Resting state brain activity was assessed by functional magnetic resonance imaging. Within-network and between-network connectivity measures of ten established resting state networks were compared between drug conditions. Complementary analysis were conducted using resting state networks as sources in seed-to-voxel analyses. Acute LSD administration significantly decreased functional connectivity within visual, sensorimotor and auditory networks and the default mode network. While between-network connectivity was widely increased and all investigated networks were affected to some extent, seed-to-voxel analyses consistently indicated increased connectivity between networks and subcortical (thalamus, striatum) and cortical (precuneus, anterior cingulate cortex) hub structures. These latter observations are consistent with findings on the importance of hubs in psychopathological states, especially in psychosis, and could underlay therapeutic effects of hallucinogens as proposed by a recent model.
Research Summary of 'Altered network hub connectivity after acute LSD administration'
Introduction
Research interest in classic hallucinogens such as psilocybin, DMT and LSD has increased because their acute effects resemble some features of psychosis and because single or few administrations have shown promising, sometimes long-lasting, therapeutic effects in conditions such as anxiety and depression. Functional magnetic resonance imaging (fMRI) studies have begun to probe the neuronal correlates of these altered states by assessing functional connectivity (FC) within and between resting state networks (RSNs). Earlier reports found that LSD and psilocybin reduce coactivation within several RSNs while increasing connectivity between networks, but those studies were limited by small samples, differences in head motion between conditions, and a lack of independent replications. Müller and colleagues set out to replicate and extend prior findings by testing the acute effects of oral LSD (100 μg) versus placebo on resting-state FC in a double-blind, randomized, cross-over sample of healthy volunteers. The study used independent component analysis (ICA) to identify ten well-established RSNs and compared within-network and between-network connectivity across drug conditions. Exploratory seed-to-voxel analyses probed whole-brain changes in RSN connectivity, with particular attention to whether hub structures (for example thalamus and striatum) showed altered coupling. The investigators also explored associations between FC changes, subjective drug effects (5D-ASC), plasma LSD levels and physiological measures.
Methods
This was a randomized, placebo-controlled, double-blind, cross-over fMRI study. Each participant received 100 μg LSD in one session and placebo in the other, with at least seven days washout between sessions. Twenty healthy participants (10 male, 10 female; mean age 32 ± 11 years, range 25–60) were included in the analysed sample after exclusion of four datasets for excessive head motion. Exclusion criteria included major psychiatric disorder (personal or first-degree relative), significant medical conditions, recent or heavy illicit drug use, and pregnancy; only two participants had previously used a hallucinogen on a single occasion. Resting-state fMRI was acquired on a 3 T scanner (Magnetom Prisma). Participants kept their eyes closed; 300 volumes were collected (repetition time 1.8 s). Anatomical T1-weighted images were also obtained. Physiological measures (blood pressure, heart rate, body temperature) and venous blood for plasma LSD were taken two and three hours after administration; subjective effects were assessed three hours after dosing using the 5D-ASC questionnaire. Preprocessing combined FSL and SPM procedures: brain extraction, realignment, slice-timing correction, co-registration to T1, segmentation, normalization to MNI space and 5 mm smoothing. ICA-specific preprocessing included high-pass filtering (0.01 Hz) and dimension reduction to 20 components using PCA. Data quality steps for network and seed analyses included scrubbing (global signal z > 3 or composite motion > 0.5 mm), regression of six motion parameters, CompCor removal of five principal components from white matter and CSF, and band-pass filtering (0.008–0.09 Hz). Probabilistic ICA (MELODIC) was constrained to 20 components; after visual inspection eight components judged artifactual were removed, leaving 12 components that were matched to ten canonical RSN templates (visual networks 1–3, DMN, cerebellum, sensorimotor, auditory, executive control, frontoparietal 1–2). Within-network FC differences were tested using dual regression and paired permutation tests (Randomise) with threshold-free cluster enhancement (TFCE); a Bonferroni-adjusted family-wise error rate of p < 0.005 was used to account for testing ten networks. Between-network FC was assessed by extracting weighted ROI time series from the unthresholded ICA-derived RSNs and computing bivariate correlations between all network pairs, with paired t-tests and false discovery rate (FDR) correction across comparisons (significance at FDR p < 0.05). Seed-to-voxel analyses correlated each RSN time course with every brain voxel and used paired t-tests with cluster-level FDR correction (cluster-forming p < 0.001, cluster FDR p < 0.005). Exploratory Pearson correlations tested relationships between FC changes (Δ parameter estimates) and 5D-ASC total and subscale scores, the specific ego-dissolution item, plasma LSD at 2 h (immediately before scanning), and changes in physiological parameters. Multiple-comparison corrections were applied (FDR) where reported.
Results
Sample and network identification: Of 20 ICA components retained after artifact removal, ten matched canonical RSN templates (visual 1–3, DMN, cerebellum, sensorimotor, auditory, executive control, frontoparietal 1–2). The final analysed sample comprised 20 subjects after excluding four for head motion; no significant motion differences between conditions were reported. Within-network connectivity: Compared with placebo, LSD acutely decreased coactivation within several RSNs. Significant reductions were observed in visual networks 1 and 3 (covering large extents of those networks), extensive portions of the sensorimotor network, the medial–posterior portion of the DMN, and a small cluster in the right inferior frontal gyrus within the auditory network. Small pockets of increased coactivation under LSD were noted outside some network masks (visual networks 2 and 3 in right superior parietal lobe and precuneus, and frontoparietal network 1 in left inferior frontal gyrus). Between-network connectivity: LSD produced widespread increases in FC between RSNs; no decreases were detected. All investigated networks showed some increase in between-network coupling, most prominently visual network 1, the cerebellum and the executive network. Seed-to-voxel and hub overlap: Seed-to-voxel analyses confirmed broad increases in RSN-to-voxel FC under LSD. Regions repeatedly implicated across seeds included cerebellar and occipital areas (lingual gyrus, intracalcarine cortex, precuneus), medial frontal areas (frontal medial cortex, frontal pole, anterior cingulate cortex) and subcortical structures (bilateral thalamus, putamen, pallidum, caudate). Overlap maps showed maximal convergence (>6 networks) in bilateral thalamus and caudate. When all ten RSNs were entered together to assess common effects, significant drug-related increases were observed in putative hub regions: thalamus, putamen, caudate, cerebellum, precuneus, anterior cingulate cortex and frontal pole/middle frontal gyrus. Associations with subjective effects, plasma and physiology: Two uncorrected correlations were reported between decreased FC within the auditory network and 5D-ASC dimensions (visionary restructuralization r = -0.53, p = 0.02; auditory alterations r = -0.49, p = 0.03), but these did not survive FDR correction. No other significant associations between within-network FC and subjective ratings were found; specifically, there was no relationship between DMN integrity and the ego-dissolution item (r = 0.06, p = 0.81). Plasma LSD levels at 2 h did not show significant correlations with FC measures. Some uncorrected correlations arose between changes in physiological measures (systolic and diastolic blood pressure, body temperature) and particular between-network connections, but none remained significant after multiple-comparison correction and there was no evidence for a systematic physiological confound.
Discussion
Müller and colleagues interpret their findings as a replication and extension of prior work showing that acute LSD decreases coactivation within several RSNs while increasing connectivity between networks on a global scale. The within-network reductions observed here—particularly in visual, sensorimotor and medial–posterior DMN regions—align with some earlier LSD and psilocybin reports, although exact network-level overlap across studies was inconsistent. The investigators note that similar within-network decreases have also been reported after administration of the SSRI sertraline, which raises questions about the specificity of these within-network alterations to the subjective, hallucinogenic effects of LSD and suggests they could reflect nonspecific serotonergic modulation. A central novel emphasis of the present study is that seed-to-voxel and overlap analyses consistently implicated hub structures—notably bilateral thalamus and striatum (caudate, putamen, pallidum), plus precuneus and anterior cingulate—increased in their connectivity with multiple RSNs under LSD. The authors highlight that thalamocortical and corticostriato-thalamo-cortical circuitry alterations resemble patterns repeatedly reported in schizophrenia research, suggesting a possible mechanistic link for why hallucinogens can transiently induce psychosis-like phenomena in vulnerable individuals. At the same time, the authors refer to a recent model proposing that acute destabilisation of hub connectivity by hallucinogens could underlie their therapeutic effects, by allowing the emergence and later stabilisation of new connectivity patterns. The study's limitations as acknowledged by the authors include a relatively small sample size and a single moderately high oral dose of LSD, the indirect nature of fMRI as a measure of neuronal activity (with potential drug effects on neurovascular coupling), and physiological confounds that were measured at only one pre-scan time point. The fMRI environment itself might have influenced subjective experiences. Methodological choices—such as constraining ICA to 20 components to match prior templates—could also affect results. Finally, the authors stress that although some network perturbations mirror features of schizophrenia, hallucinogen-induced states and schizophrenia differ in symptom profile and phenomenology. Overall, the investigators conclude that while decreased within-RSN coactivation and broadly increased between-network connectivity are reproducible group-level effects of LSD, the lack of consistent associations with subjective measures and discrepancies across studies make it doubtful that any single FC metric is a reliable, characteristic neural signature of hallucinogen action. The consistent involvement of subcortical and cortical hub regions, however, provides a plausible neurobiological substrate linking acute psychedelic effects, psychosis models and hypotheses about therapeutic mechanisms.
Conclusion
The authors conclude that acute oral LSD reproduces previous observations of decreased functional connectivity within several RSNs and broadly increased connectivity between networks. However, they caution that these within- and between-network measures lack clear and specific associations with subjective drug effects and can resemble changes produced by non-hallucinogenic serotonergic drugs, calling into question their specificity as biomarkers of psychedelic states. Importantly, increased coupling between networks and cortical/subcortical hub structures (notably thalamus and striatum) was a robust finding and is consistent with patterns reported in psychosis and with theoretical models positing that transient alterations in hub connectivity may both produce psychotomimetic effects and enable therapeutic reorganisation of brain networks.
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METHODS
This study was a randomized, placebo-controlled, double-blind, cross-over trial. Each participant received 100 μg LSD and placebo in a cross-over manner. The washout period between sessions was at least seven days. Functional MRI data was acquired for each condition, resulting in two data sets (active drug and placebo) for each participant (repeated measures design). Conditions were compared using paired ttests. The study was approved by the Ethics Committee for Northwest/ Central Switzerland (EKNZ) and by the Federal Office of Public Health. All subjects provided written consent prior to participating and received monetary compensation. This study was registered at clinicaltrials.gov prior to study start (NCT02308969).
CONCLUSION
This study investigated the acute effects of LSD on network connectivity in healthy subjects. We found that acute LSD administration decreased FC within the DMN, the auditory and sensorimotor networks and visual networks 1 and 3. Between-network FC was widely increased; all RSNs were affected to some degree, particularly the cerebellum and the executive network. Seed-to-voxel analysis indicated that increased FC of RSNs on a whole-brain level consistently involved hub structures (specifically thalamus and striatum). Below, we discuss our findings in the context of previous observations obtained after the administration of LSDand the related hallucinogenic drug psilocybin. Like LSD, psilocybin exerts its effects mainly through agonism at the 5-HT 2A -receptor. Our results on alterations in within-network connectivity closely resemble those previously reported in LSD, where decreases in coactivation within the DMN, the sensorimotor network and the visual networks 1 and 3 were reported. Additionally, Carhart-Harris et al. reported decreases in the right frontoparietal network and the parietal cortex network and found no alterations within the auditory network. We did not investigate the parietal network in our study and the frontoparietal network was not affected in our analysis. The functional relevance of decreased withinnetwork FC to subjective drug effects is largely unknown. No significant associations were described in previous studies with psilocybin. For LSD, decreased coactivation within the DMN was significantly associated with feelings of "ego dissolution", a finding that could not be replicated in our studyalthough ego dissolution varied markedly across subjects and correlated with exposure to LSD. Within this context, it should be noted, that very similar alterations in within-network connectivity were reported after the administration of sertraline, a selective serotonin reuptake inhibitor.studied the effects of sertraline on connectivity using the same RSN templates and similar methods of analysis; they pinpointed exactly the same networks as in our study (DMN, visual networks 1-3, sensorimotor and auditory network). These findings also overlapped with regions identified in a previous study with LSD. These effects of sertraline, a drug causing no major subjective effects, call into question the specificity of these alterations and their significance for subjective drug effects. It is possible that they represent an epiphenomen of unspecific serotonergic stimulation. Between-network connectivity was examined in two previous studies after administration of either psilocybinor LSD. With psilocybin, FC between an anterior DMN and nine other RSNs was investigated; FC was increased between the anterior DMN and dorsal attention, salience, right frontoparietal, and auditory networks. Broader analyses of FC between several networks indicated widespread increases in between-network FC under psilocybinandto a considerably lesser extentunder LSD. Fig.shows a comparison of these findings of these studies with our results. In general, there was no good accordance within the results of previous studiesor between those studies and our findings. It does not seem very likely that these widely divergent findings simply reflect different effects of psilocybin and LSD, as their mechanism of action at the 5HT 2A -receptor is very similar, as are probably the subjective effects. Furthermore, our results differed considerably from those recently reported for LSD. These differences might be due to significant differences in movement between conditions present in those studies and different methods of analysis, differences in regions covered by RSNs, or the slightly larger sample size in our study. Moreover, routes of administration (i.v. and oral administration) or the previous experiences of participants with hallucinogenic drugs might have affected the results. Seed-to-voxel analyses indicated increased FC between RSNs and several structures known as hubs (precuneus, anterior cingulate cortex, striatum and thalamus). Hubs are thought to be of importance for overall brain functioning by serving integration and large-scale interaction (van den. Using functional connectivity density analysis, a previous study has already reported significantly increased global connectivity in several regions after the administration of LSD and psilocybin, including the precuneus and thalamus. In the present study, it was found that FC between the great majority of RSNs and striatum and thalamus was increased after administration of LSD, compared with placebo. Both structures (striatum and thalamus) show widespread structural connections to other brain regionsand are part of the so called "rich club", a set of highly connected regions that are densely connected among themselves (van den. The striatum (comprised of caudate and putamen) is the main input structure of the basal gangliaand is connected to numerous cortical regions via loopswhich pass through the basal ganglia, to the thalamus and back to the cortex (cortico-striato-thalamo-cortical loops). We have already investigated thalamocortical FC after administration of LSD in the same sample in more detail. Among others, we found increased global FC of striato-thalamic structures after LSD compared with placebo. This could indicate that these regions are specifically influenced by LSD. It is interesting to note that the thalamic and striatal projections for the DMN, sensorimotor and frontoparietal networks observed in this study were relatively similar to the topography of cortical projections on these regions observed in several fMRI studies. However, the visual networks 1-3 and the auditory network did not follow this pattern, and occupied large portions of these subcortical structures. The importance of hub lesions in brain disorders has recently been emphasized. Alterations in thalamocortical FC have long been suspected to be involved in the pathophysiology of schizophreniaand have been one of the few neuroimaging findings that have been repeatedly replicated in the search of the neural correlates of schizophrenia. Several studies indicated that FC between thalamus and frontal regions is decreased while FC between thalamus and sensorimotor areas is increased (for an overview see (Giraldo-Chica and Woodward, 2017)). It is remarkable that data-driven FC analysis in one of the biggest samples to date has identified alterations in thalamocortical FC as an outstanding characteristic of schizophrenia. The findings reported by those authors very closely resemble those found in our data set (see Fig.) and, additionally to the thalamus, also comprise the pallidum and striatum. These observations might indicate that not only the thalamus but also the whole corticostriato-thalamo-cortical circuitry is involved in altered brain functioning in schizophrenia as well as in altered states of consciousness induced by LSD, as has already suspected. Maybe these similarities could also explain why hallucinogenic drugs can induce psychotic episodes in vulnerable subjects, rather than in the general populationas they might act on a system that is already impaired in patients in at-risk states of psychosis. On the other side, a recent model proposed that altered hub connectivity induced by hallucinogens might also explain their therapeutic effects. Various studies have indicated that these Asterisks indicate significant differences between drug and placebo condition (green:. Black indicates networks which were not investigated. Roseman et al. reported separate results for two representation of the DMN, which were combined in this presentation. (For interpretation of the references to color in this figure legend, the reader is referred to the online version of this chapter.) substances might have beneficial effects in distinct mental disorders like depression, anxiety, and addiction. It is an interesting question, how a single mechanism of action can exert positive effects in heterogeneous diseases.hypothesize that this link can be found in altered hub connectivity induced by these drugs. According to this model, pathological connectivity patterns associated with diverse mental diseases are acutely altered through destabilization of hub functions with subsequent changes in FC between various brain regions. These events somehow give rise to the development of new connectivity patterns which are stabilized after the acute effects have subsided, possibly through anti-inflammatory effects. This study is limited by a relatively small sample size and the use of a moderately high dose of LSD. Functional MRI is only an indirect measure for neuronal activity and relies on neurovascular coupling. LSD might alter neurovascular coupling, as already reported for the related serotonergic drug psilocin. This might result in biased FC results. LSD-induced alterations in physiological parameters such as heart rate and blood pressure might also affect FC. We found no evidence for a systematic relationship between alterations in physiological parameters and functional connectivity in our data set. However, these measures were taken only at one time point before the fMRI scan and nuisance regression of continuously recorded parameters might have been preferable. Furthermore, the fMRI environment might have negatively influenced subjective drug effects. Although hallucinogenic drugs seem to mimic some symptoms present in schizophrenia, there are presumably also important differences. Firstly, negative symptoms as commonly seen in schizophrenia are probably not present to this extent with hallucinogens, which mainly induce effects similar to positive symptoms. Secondly, there are also important differences among the positive symptoms, such as the predominance of visual hallucinations in hallucinogens compared to mainly auditory hallucinations in schizophrenia. ICA results are influenced by the prespecified dimensionality (i.e. the prespecified number of components). However, we restricted ICA to 20 components in order to allow direct comparison with established templates byand with results from previous studies using LSDand psilocybin.
Study Details
- Study Typeindividual
- Populationhumans
- Characteristicsbrain measuresplacebo controlleddouble blindrandomized
- Journal
- Compounds
- Topics
- Authors