Lucie Berkovitch, MD, PhD. September 2022
November 28, 2022Title: Psychedelics in the brain: An overview of neuroimaging studies
Description: This talk provides an exhaustive overview of neuroimaging data on psychedelics. It is divided in three parts: 1) from receptors to brain effects, 2) from brain to cognition, 3) from neurobehavioural effects to theoretical models.
In a first part, we describe psychedelic effects on brain networks, brain oscillations, signal complexity/entropy and on some specific functions such as emotional processing, social processing, surprise processing.
In the second part, we try to predict their cognitive effects based on their brain effects and compare those predictions to actual findings.
In the third part, we summarize existing models to explain psychedelic effects and propose another angle of description of their effects based on the theoretical models of consciousness.
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- 00:00Right. That was less difficulty with the
- 00:03technical aspects than I was expecting.
- 00:05So it's great to see everyone this is our.
- 00:11Restarted sent monthly seminar
- 00:14in psychedelic science,
- 00:17which we plan to continue to have
- 00:20every third Friday at 3:30 PM.
- 00:23We're going to do it hybrid as we are today.
- 00:25We've got a small number of people here
- 00:27in the room and a lot more on zoom,
- 00:29so it's great to see such a large group,
- 00:31and we'll continue to have it available
- 00:32in both formats if we can continue
- 00:34to make the technical stuff work.
- 00:36We do promise coffee and cookies
- 00:37if you come in person, so. Umm.
- 00:39So our presenter today is Lucy Berkovich,
- 00:43who's a postdoc in Allen Antiche lab.
- 00:46And she's in the early stages of
- 00:49putting together a very exciting
- 00:50study looking at the brain effects
- 00:53of psilocybin and ketamine.
- 00:54But what I've asked you to do
- 00:56is sort of a broader overview.
- 00:57I hope you'll talk about some of
- 00:58your own plans in your own work,
- 00:59but also a broader overview of the effects
- 01:01that the brain imaging literature and
- 01:04the effects of these substances on the brain.
- 01:07So Lucy,
- 01:08thank you so much for being here.
- 01:09It's great to have you join us and
- 01:10really looking forward to learn.
- 01:13Hi. Yeah, I'm very, I'm very glad
- 01:15to have been invited and I'm,
- 01:17I'm really happy in fact to
- 01:19to give this presentation. So
- 01:22I'm sorry, I did just realize,
- 01:24so just two housekeeping things.
- 01:26First of all, this is being
- 01:28recorded and eventually our
- 01:29plan is to post on the website.
- 01:31So just be aware that that that this
- 01:33is being recorded and second of all,
- 01:35in order to avoid the feedback we've
- 01:37turned off the speakers, which means
- 01:39we cannot hear people who are here.
- 01:43With this virtually we can
- 01:44try to figure out how to,
- 01:45I'll see if I can figure out
- 01:47how to make that work better.
- 01:48But yeah, if you're here virtually
- 01:49and you want to contribute,
- 01:51please raise your hand and
- 01:53or right into that.
- 01:54And I will try to keep an eye on the
- 01:55chat as the conference is going along.
- 01:57But if you just call out,
- 01:58I don't think we're going to hear you.
- 02:00All right.
- 02:01That's the last housekeeping I can think of.
- 02:02So go ahead.
- 02:05Well, so yes, so thank you
- 02:07for for this invitation.
- 02:08So in fact, I really try to provide
- 02:10an overview of the neuroimaging
- 02:13studies about psychedelics.
- 02:14So I decided not to focus
- 02:16on on psychedelic process.
- 02:18So I will not really address the
- 02:19ketamine aspect, but I would be
- 02:20really happy to talk about it too.
- 02:22And and I mean I can have a couple
- 02:24of slides on that also if you need.
- 02:26So just to provide like first,
- 02:29first of all maybe a few definitions,
- 02:31so everybody here I guess I
- 02:34know what it's like.
- 02:35But anyway,
- 02:36So what what I will talk about is
- 02:38uh psylocybe which is the the active
- 02:41compound of matching magic mushrooms,
- 02:43LSD DMT which is one of the chemical
- 02:47compound of iasca and also mescaline.
- 02:50But you will see that there
- 02:51is not in fact many studies,
- 02:53many neural imaging study about the Muslim.
- 02:56So all these molecules are
- 03:00serotonergic agonists,
- 03:01in particular in the vestibular
- 03:03receptors of the serotonin,
- 03:05but also on other receptors.
- 03:08And they have several subjective effects.
- 03:10And in fact This is why they are famous.
- 03:13And in particular they give a
- 03:16visual distortion that like you
- 03:18can see that are kind of moving,
- 03:21moving distortion or the impression
- 03:23that things are breathing or
- 03:26volute things like that.
- 03:27There is also time and
- 03:30space filling alterations,
- 03:31just academics and mystical spiritual
- 03:34experiences that are reported by users.
- 03:39And for all these effects,
- 03:43I've I've shown to also provide
- 03:45kind of promising results in
- 03:47different psychiatric disorders,
- 03:49and in particular in depression,
- 03:51anxiety and addiction.
- 03:53So all of this brings the question
- 03:56about brain mechanism and in fact how
- 04:00this brain mechanism can account for
- 04:02both these changes in perception,
- 04:04but also the therapeutic effects
- 04:07of these molecules.
- 04:08So first I will try to travel from
- 04:11the receptors to the brain effect
- 04:12and then to the cognitive and the
- 04:15theoretical aspects of the psychedelics.
- 04:17So regarding the receptors,
- 04:19maybe the first question is where
- 04:22are the 5-2 receptors in the brain?
- 04:24And in fact, as you can see here,
- 04:27I don't know if you can see my my mind,
- 04:28so I don't, I'm not sure.
- 04:30But you can see that they are quite
- 04:33broadly distributed across the brain
- 04:36and in particular they are located in.
- 04:39Region that corresponds to
- 04:41some important networks and in
- 04:43particular the default mode network
- 04:46and the task positive network.
- 04:49And these two networks are
- 04:52supposedly anticorrelated.
- 04:53The first one activate when you're
- 04:55doing nothing and the other one will
- 04:57activate when you are involved in the task.
- 05:00I just also highlighted on the
- 05:02left the five HT 1A receptor
- 05:04that is located more on the the
- 05:07the medial temporal lobe.
- 05:09And particularly the hippocampus,
- 05:10because there is more a kind of
- 05:13inhibitory effect of this receptor that
- 05:15is also activated by psychedelics.
- 05:20So what happens now when we activate
- 05:23this literary receptors in the brain?
- 05:26So here you can see a kind of schematic
- 05:28of different action of the psychedelic
- 05:31and we're going to review this
- 05:33progressively because it's kind of a
- 05:36complex complicated schematic, right.
- 05:38So here you can see the LSD on the
- 05:41left and on like the red receptors
- 05:44are the furnishings where receptors,
- 05:46so this LSD, but it's supposed
- 05:48to be the same with the others.
- 05:50Catholics will activate these
- 05:52pyramidal neurons that you can see
- 05:55here in layer 5 and layer six of the
- 05:58preferred the prefrontal cortex.
- 06:00So there will be a huge activation of
- 06:03these neuron just by a direct effect
- 06:06on the fiber structure receptors.
- 06:08There will be also an activation of
- 06:11these neurons through the appearance
- 06:13from other brain areas and in particular
- 06:17the telemus that also have these
- 06:19village tutorial receptors and this
- 06:22will result in a glutamate release
- 06:24in the prefrontal cortex still and
- 06:28an increased synaptic plasticity
- 06:30and you will see that.
- 06:32This is also a very important mechanism.
- 06:36But the father states where
- 06:38receptors are not only located on.
- 06:41Excitatory neurons,
- 06:42but also on inhibitory neurons and in
- 06:45particular these Gabaergic neurons here.
- 06:48And this will inhibit the pyramidal neuron.
- 06:51So there is a kind of balance
- 06:54between excitation and inhibition
- 06:55and there are also internal ones in
- 06:58the prefrontal cortex that would be
- 07:00activated and that will also inhibit,
- 07:03inhibit the the parent domains.
- 07:06But All in all,
- 07:08there is a neural activation
- 07:10of these pyramidal neurons,
- 07:12in particular in the layer of five,
- 07:14the prefrontal cortex,
- 07:16and this will lead to what has been
- 07:20observed as an hyper frontality or hyper
- 07:23activity in the prefrontal cortex.
- 07:27OK, so now if we turn to like
- 07:29the the brain effect of the
- 07:31psychedelics and what what we can
- 07:34observe with neuroimaging study.
- 07:36First of all there is a new
- 07:39state of connectivity at first.
- 07:41And this is characterized by a
- 07:44decreased within network connectivity.
- 07:46So it means that in several network
- 07:48you will have less connectivity of
- 07:50different parts of this network
- 07:51and this is particularly the case
- 07:53in the development network and
- 07:55here in this study also in the
- 07:57auditory network for the silo sibin.
- 08:00But we can see pretty much similar effect
- 08:03in the different network with LSD here.
- 08:06So what is in yellow is just the
- 08:08mapping of the the network and in
- 08:11blue-green it's the the decrease of
- 08:13the within network connectivity.
- 08:15You can see here also that in the
- 08:17visual network you have decreased
- 08:19connectivity and other networks can have
- 08:21this decrease within network connectivity.
- 08:24And we with AOS here we also have
- 08:27this decrease within connectivity
- 08:29within the in the different network.
- 08:32And you have another result that is not
- 08:35really observed with other psychedelics,
- 08:37which is an increase this time of
- 08:39the within network connectivity
- 08:41in the salience network.
- 08:43And we'll see that this is this
- 08:45belongs to some discrepancies that
- 08:47exist between the different molecules.
- 08:52On the other hand, there is an
- 08:54increased between network connectivity,
- 08:56which means that the network one
- 08:58with another will be more connected.
- 09:01And this can be seen here in this kind
- 09:04of metrics that shows the differences
- 09:07in fact between silybin and placebo.
- 09:09And what you can see in red is all
- 09:11the combination of networks that
- 09:13are more connected one to another.
- 09:16So there is really a kind of huge
- 09:18increase across the brain of this.
- 09:20Between network and activity.
- 09:23And this is also the case under LSD.
- 09:26Here in green we can see how these networks
- 09:28would be more connected to to each other.
- 09:33Yeah. Are these two effects
- 09:35consistent with just an increase in noise?
- 09:39So if you just simply increase the noise,
- 09:41you're going to decrease the
- 09:42coherence within any given network
- 09:44that was coherent and baseline.
- 09:45You inject noise different less
- 09:47code and across networks if the
- 09:49networks are distinct in their
- 09:51patterns or even anti correlated
- 09:52because how we find them through ICA,
- 09:54then you're going to lose the anticorrelation
- 09:57which may read out as enhanced
- 09:59correlation or loss of anticorrelation.
- 10:02So all right,
- 10:02all it it's easy for me to see how the
- 10:05loss of within network connectivity
- 10:07could simply be the injection of noise.
- 10:09It's less obvious to me whether the
- 10:10second fight be increased in between.
- 10:12Never could be explained
- 10:13by just the injection.
- 10:18I I think that the fact that we
- 10:20find opposite pattern is like, yeah,
- 10:23less incoherence with the idea that
- 10:25we will have only a single like
- 10:28these are both relative to base.
- 10:31Find the different networks are non
- 10:33correlated or anticorrelated if not.
- 10:36It depends. For example,
- 10:37the different network and the
- 10:38science or the executive network.
- 10:40They are anticorrelated naturally.
- 10:41So the fact that
- 10:42there is a correlation between increased.
- 10:47This is the like this is the shortcut
- 10:48that is made in many studies.
- 10:50That diagram, what we called a
- 10:52loss of anticorrelation is an
- 10:54increasing connectivity between them,
- 10:56right? Yeah, but that's not true
- 10:57with all of these patterns.
- 11:00So what you can see here is that for
- 11:02between some networks you will have
- 11:04an increase but with between some
- 11:06other you will have like a decrease.
- 11:07I did not detail everything
- 11:09because like to cover everything.
- 11:11I could not go in every details.
- 11:13But indeed in fact the what you
- 11:16mentioned is a very important point
- 11:18and you will see and we will see for
- 11:21instance that what was taken as an
- 11:23hyper frontality or an increase in
- 11:25general activity in the brain could
- 11:27be in fact just related to the.
- 11:29Is the child rescue effect of the
- 11:31of the drugs and that when you
- 11:33when you correct that with for
- 11:35example global signal regression,
- 11:37you have very different pattern
- 11:39of activation.
- 11:42Is the increase within salience network
- 11:47effect that you showed on the last slide?
- 11:51Since that. By itself like generally
- 11:55to this increasing between network
- 11:56connectivity or is that like an outlier?
- 12:00Yeah, it's uh, something different.
- 12:01It's really the reason connectivity in the
- 12:04salience network and not just because it's
- 12:06connected to all the other. Like, yeah,
- 12:09it's just like an individual pattern.
- 12:13Umm. And so yes, so we're like this
- 12:17is what I was just saying like there
- 12:20is more coupling between the DMN
- 12:22and the task positive network under
- 12:24service saving and under iOS gas.
- 12:26So what you can see here in
- 12:29particular on the.
- 12:31On the bottom right is that when
- 12:33you choose a seed that belong
- 12:34to one of the two networks,
- 12:36you will see like a burst of
- 12:38activity on the other network.
- 12:40So it's also probably region
- 12:42dependent and some some parts
- 12:44of each of these network can
- 12:46be more connected to another.
- 12:48Yeah.
- 12:51Umm. So what we can see also during
- 12:54rest is a reduced associative but an
- 12:57increased sensory brain wide connectivity
- 12:59and this is what I was mentioning
- 13:01after our global senior regression.
- 13:03So you can see that for sale saving
- 13:06in this study with this increase in
- 13:10the particularity of capital area.
- 13:12And a decrease in the frontal area
- 13:14and you can and you have kind of
- 13:16a similar pattern that is quite
- 13:18striking how these two are are are
- 13:20really close to another with the very
- 13:23same increasing the exhibitor area,
- 13:25decrease in frontal and in this case
- 13:27also the somatomotor cortex that
- 13:29is also that has also an increased
- 13:31connectivity with the rest of the brain.
- 13:35Umm, the telem, the Telemus is also
- 13:38more connected to other areas and
- 13:41in particular to sensory areas.
- 13:43So there is a bit small,
- 13:45but what you can see here is that in
- 13:48this kind of ring graph is all the
- 13:51red lines corresponds to an increase
- 13:54in connectivity and it's and there
- 13:57is an increase that is kind of
- 13:59specific to the to the sensory areas
- 14:01compared to the associated areas.
- 14:05And finally, under iOS card,
- 14:08there is an increase of coupling
- 14:10between the visual area and
- 14:12the development network.
- 14:13But interestingly,
- 14:14I mean even if it's also like a
- 14:17correlate of what I presented before,
- 14:20there is a decreased coupling between
- 14:22the visual and the task positive network.
- 14:24And in this study the salience network
- 14:26has an increased within connectivity.
- 14:28So it may be related.
- 14:32So under Iowa schedule,
- 14:33I think that are quite specific
- 14:35and in particular there are there,
- 14:37there are changes in visual areas that
- 14:40really look like visual stimulation even
- 14:42if participants have their eyes closed.
- 14:46So this is what you can see here.
- 14:48So in fact there are like 4 condition
- 14:51like I close before and after iOS
- 14:54which on the blue and the red and the
- 14:58sorry yes before and after and and.
- 15:00Natural image which means visual
- 15:02stimulation before and after in
- 15:04in white and green and what you
- 15:05can see that there is a decrease.
- 15:07So this is the Brodmann areas
- 15:09corresponding to the visual cortex.
- 15:11There is a decrease in fact only.
- 15:15That was before I was camp.
- 15:16So in other words,
- 15:17after I was scared,
- 15:18you have the the I closed all the eyes open.
- 15:21You have the same activity
- 15:23in the visual areas,
- 15:25which is like kind of striking and you also
- 15:31relative to. Single track
- 15:34within trial baseline.
- 15:36So that's not comparing across conditions,
- 15:39just comparing each trajectory in
- 15:40each condition to its own, yeah?
- 15:44Then you can have also.
- 15:47So there is also an I I
- 15:48will go back to that later,
- 15:50a decreased feedback and an
- 15:52increased feed forward under iasca
- 15:54in eyes closed condition and this
- 15:57looks like a visual stimulation.
- 16:00So in fact you have like this increase
- 16:03that you can see of the blue line
- 16:05and the decrease of the red line.
- 16:06So it's like in a way visual eyes close.
- 16:13You have like similar pattern to.
- 16:15Uh, to visual estimation, the iOS can.
- 16:18Under LSD it's a bit different,
- 16:20but there isn't.
- 16:21It was observed that there was an
- 16:23increased activity in the visual cortex.
- 16:26And also an increased coordination between
- 16:29several subparts of the visual cortex.
- 16:33So this can be correlated to
- 16:35the visual imagery under LSD.
- 16:38But it's quite difficult in
- 16:39fact to compare because it's
- 16:41all these studies are different,
- 16:42are not necessarily using the same methods.
- 16:48Another effect that is uh quite
- 16:51reproducibly observed under psychedelic is
- 16:54a decrease of low frequency bands power.
- 16:58So you know that the different association
- 17:01carried like the vector of synchronization
- 17:04and information transfer across the brain.
- 17:07And what you can see on the second
- 17:09delic here for LG Stylo savings,
- 17:11that there is really a important
- 17:13decrease of alpha and beta bands.
- 17:16And for LS you have also decreased
- 17:18in Delta and data and also in gamma.
- 17:20So for LSD you have basically a decrease
- 17:23of all broadband decrease whereas for solo
- 17:26Sabine it would be more for alpha and beta.
- 17:30This is another way and from another
- 17:33study that confirms this results.
- 17:34And what you can see that yes indeed
- 17:37the decrease is higher under LSD
- 17:39and there is also a shift of alpha
- 17:42frequency toward higher frequency
- 17:43that you can see on the bottom left.
- 17:47And a decrease that is more specific
- 17:51to alpha and beta than under siding.
- 17:56For the,
- 17:56you also have a decrease of alpha
- 17:59and beta band that you can see here,
- 18:02but we'll see that there are different
- 18:04pattern and in particular that the
- 18:06feed forward or the Yammer bands
- 18:08are increased on the iOS and this
- 18:11is not something that is observed
- 18:13on the silo siding.
- 18:16For a decrease and so saving is more
- 18:19like no effect or really very light
- 18:23changes for this for this frequency.
- 18:26And I was scared.
- 18:28There are other accused that.
- 18:30Um,
- 18:31the there is a change in the
- 18:34feedforward connectivity and
- 18:35in particular there is here.
- 18:38So this study focused on information
- 18:40transfer and what you can see is
- 18:42that there is an increased postural
- 18:44entire information transfer,
- 18:45so from sensory areas to higher level areas,
- 18:49whereas there is a decrease in
- 18:51terrible posterior information from so.
- 18:52And this is the,
- 18:53the graph I just showed you before about
- 18:56the the mimicking of visual stimulation
- 18:58when eyes are closed and this is the same.
- 19:00Do that for a while.
- 19:01The previous increasing backlog is decreased.
- 19:04Lucy,
- 19:05I don't understand these
- 19:06data and that's my failing.
- 19:08Are you able to explain?
- 19:10Succinctly, how this the the data that
- 19:13you're showing the EEG connectivity data?
- 19:16Correspond to feedforward versus
- 19:18feedback information transfer or is
- 19:20that like a whole lecture by itself?
- 19:23So no like gamma was like regarding the
- 19:26association so it's a bit the shortcut.
- 19:29Alpha and beta were more associated with
- 19:32top down processing while gamma was more
- 19:35associated with both of our processing.
- 19:37OK. So these are inferences from
- 19:39relative power from changes in power
- 19:41in the different frequency bands
- 19:43like the. So this is for
- 19:45the gamma versus alpha beta,
- 19:47but for the like the study
- 19:49that is on the bottom left,
- 19:51it's really like the the
- 19:53measure the information transfer
- 19:55between different areas so.
- 19:59I think there's
- 20:00like a time 15 cross correlation.
- 20:03Yeah, they do like the I.
- 20:06They do a Granger causality,
- 20:08I think in this study.
- 20:10But in the earlier study,
- 20:11there wasn't featured personality.
- 20:13It's just based on an assumption
- 20:15based on what's been observed in
- 20:17visual processing for example,
- 20:19or something like that
- 20:20in the previous one with I like.
- 20:25Alpha represents top down ohh,
- 20:29so the alpha and the like.
- 20:31The correspondence between alpha and
- 20:33top down is more related to like other
- 20:36studies that they did not present here.
- 20:38It's like several studies showed that.
- 20:43You have like like object
- 20:44recognition for example is held by
- 20:46half hours and things like that.
- 20:47But it's a different feature.
- 20:48It's visual processing exactly, yeah, yeah.
- 20:56OK. And the last,
- 20:59the last part of the literature isn't?
- 21:04Interested about signal complexity or entry?
- 21:08So it's basically corresponds to the
- 21:11quantity of information in the brain
- 21:14and how how much this information
- 21:17is unpredictable in space and time.
- 21:20So this is an example for cytosine
- 21:22and how you can measure that.
- 21:24So you take the activity in different
- 21:27region and you can see how these
- 21:30different region are correlated and have
- 21:33connectivity at different time points.
- 21:35And you can measure I don't know what
- 21:39it is and you can measure the entropy
- 21:42by looking at the probability of
- 21:44changing of this pattern of connectivity
- 21:47in the across the run inference.
- 21:50And what it was found is that
- 21:52there is an increase of entropy.
- 21:55Leaving.
- 21:57And there are other way to
- 21:59measure the complexity,
- 22:00so these diversity of information
- 22:02in the brain and the diversity of
- 22:05pattern in the brain, for example.
- 22:09Complexity and you can see also that
- 22:12there is an increase in complexity
- 22:15under saving and LSD and that
- 22:18under LSD like it's a very general
- 22:22complexity that interest pretty
- 22:23much like all the posterior part
- 22:26of the brain, whether for like.
- 22:30The solar savings? More India.
- 22:34And this increase of Lymphoseek
- 22:36complexity was also observed and
- 22:38of Shannon entropy under iOS cap.
- 22:41So this is something that is quite.
- 22:45Like that seems to be shared
- 22:47between the different molecules.
- 22:50Lucy sorry again my my ignorance
- 22:52of some of the techniques.
- 22:55I have an intuition for what increased
- 22:57entropy means that's rough crudely
- 22:58analogous to more noise right?
- 23:00Injecting noise. What is?
- 23:01What is complexity?
- 23:02Does this measure of
- 23:04Flexity getting in is it on?
- 23:06The complexity and entropy are both
- 23:08going in the same direction and I
- 23:10think of complexity sort of amid a
- 23:12happy medium between between, you know,
- 23:14crystalline purity and total noise and.
- 23:16Like somewhere in the middle but.
- 23:19So, so complexity will be
- 23:20so I will just jump like.
- 23:22So this was more the title,
- 23:23but this slide is more about entropy.
- 23:25But the next slide will
- 23:26show about complexity.
- 23:27But complexity is basically like
- 23:32the diversity of information
- 23:34you can have in the brain.
- 23:36So it's like.
- 23:39I don't know exactly how to
- 23:40explain better than that,
- 23:41but it's not like with entropy.
- 23:43We have also the idea of
- 23:44a kind of a disorder,
- 23:46so also like a lot of changes across
- 23:48time and the complexity will be for
- 23:51example a more enhanced repertoire,
- 23:54like more diverse patterns of activation.
- 23:59Does it make sense?
- 23:59Yes. So they don't have to go in
- 24:01the same direction, but it's not
- 24:03contradictory that they do OK.
- 24:08So unless there is also more occurrence
- 24:12of global coherence phase log states, so.
- 24:15So here what the authors did is that
- 24:19so they took the the brain activity
- 24:23and they try to slice it according
- 24:26to like to define kind of phase lock
- 24:29states that corresponds in fact to
- 24:31activation patterns of activation and
- 24:34of connectivity between different areas.
- 24:36So this is not very obvious.
- 24:39Here but in fact so you have states
- 24:42where some region are connected one to
- 24:44the other and the first states that
- 24:46is that you can see the more frequent
- 24:48than this is in fact increased under
- 24:50sale siding is in fact a state where
- 24:52everything is connected to another.
- 24:54So there is no difference and not
- 24:56sub support that are more connected
- 24:58than other and that can corresponds
- 25:00to a specific network.
- 25:02And what is observed is that
- 25:04in fact on the same savings.
- 25:06So not only this Facebook state is.
- 25:09More frequent, but also there is uh,
- 25:11more probability to switch from any
- 25:13other states to this state of coherence,
- 25:16whereas like this frontoparietal state,
- 25:19the state three is less probable
- 25:21and there is less transition toward
- 25:24the states after something.
- 25:27Is this with global signal
- 25:28regression in the data?
- 25:31I'm not sure just state one is
- 25:34global signal, right? So it's state.
- 25:37So if you do it without global signal
- 25:39regression and the prominent state is global.
- 25:43If you if you did global signal
- 25:45regression and still saw that,
- 25:47that would mean something quite different.
- 25:49I think the control for that, but I
- 25:52cannot like yeah when I'm not 100% sure.
- 25:58And finally, you can also slice
- 26:02the like decompose the brain
- 26:04activity into harmonic states.
- 26:06So this is a bit tricky and
- 26:08I'm not an expert about that,
- 26:11but basically you will use the connectome
- 26:13and the structural connectivity
- 26:15of the brain and you will check
- 26:18how like the different harmonies,
- 26:21the different frequency of
- 26:24oscillation of this structural
- 26:26connectivity and you can then map.
- 26:28And analyze brain imaging according
- 26:31to a combination of these different
- 26:36patterns of connectome harmonics.
- 26:38So this is what these authors
- 26:41like developed and used for
- 26:44studying cellular Sabine and LSD.
- 26:46And basically what they find for
- 26:49silo sybian is that here the
- 26:51representation of the different
- 26:53energy like the different the
- 26:55probability of this harmonic pattern.
- 26:58And there is some changes where some
- 27:00of them will be more represented
- 27:03under and some of them will be less
- 27:06represented and interestingly when
- 27:07you plot the overall probability.
- 27:09You have different states.
- 27:10What you can see is that the more
- 27:12probable state will be a bit less
- 27:14probable underside of siding,
- 27:15while some states that are usually
- 27:18less represented in those possible
- 27:20will be more representative under
- 27:22set of sibling and they're the
- 27:24same pattern with LSD.
- 27:26So the main idea here is to say
- 27:28that in fact you will push some
- 27:30state that are usually quite rare
- 27:32and you will decrease maybe state
- 27:35that are more frequent.
- 27:38The brain when taking psychedelic
- 27:41and that that's qualitatively consistent
- 27:43with the increased complexity,
- 27:44right, because you have more,
- 27:46more states are being represented so
- 27:47there's a larger repertories, OK.
- 27:51And like there were also other,
- 27:53uh, quite technical studies using
- 27:55the fractal dimension in spatial
- 27:58or temporal dimensions or the
- 28:01directed international connectivity.
- 28:03But the main idea was that you
- 28:05have less constraints in the brain
- 28:07and more diverse and fluctuates
- 28:09fluctuation in the brain connectivity
- 28:12patterns under psychedelics.
- 28:17Different religions.
- 28:20So that's a very good question. In fact I I
- 28:24I think the people on zoom since we're
- 28:27hearing from from Luby's microphone.
- 28:29So I think they're having I loud
- 28:30and I'm close but I think they're
- 28:32having a little trouble hearing.
- 28:33So the question was how does this
- 28:35compare these these complexity
- 28:36findings compared to what might be
- 28:38seen with other psychoactive drugs.
- 28:40Are these unique to the psychedelic.
- 28:42So I did not see other study doing
- 28:46that for example for Kittanning so.
- 28:50Which is maybe one of the things that has
- 28:52the more closest pharmacological pattern
- 28:54by activating the neurons and algorithm.
- 28:58Or even just a more land drug likeness
- 29:01SSRI or some other drug, yeah,
- 29:03he's going to have some monoamines
- 29:04and compared the network. So
- 29:08I will go to that later.
- 29:09But there is like this,
- 29:11this study by character is team
- 29:15that compared for example the
- 29:17integration between different
- 29:18networks and we can think that
- 29:20this is also linked to this between
- 29:23connectivity across the brain and
- 29:25there is not a change in modularity.
- 29:28This is not exactly the same, but.
- 29:30We can imagine that this is a right not
- 29:34to put all these effects and also an
- 29:37important thing is that these effects
- 29:39are correlated to acute effects.
- 29:41So I mean it's,
- 29:42it's it could be quite specific in
- 29:45fact to the subjective effect but for
- 29:47ketamine it's a very good question.
- 29:48I mean yeah,
- 29:49because even if the subjective I'll be
- 29:52different maybe there are like just.
- 29:55As far as I know,
- 29:57it hasn't been explored so much,
- 29:59but these analysis could be done
- 30:00in the resting state F MRI datasets
- 30:02that exist, right? But yeah.
- 30:06This is so
- 30:06someone needs to figure out what
- 30:08it means and then do it, yeah?
- 30:14There are other important changes
- 30:16in those acrylic about emotion,
- 30:19social and software processing so.
- 30:23And there is overall decreased response,
- 30:25brain response during emotional processing.
- 30:28So what you can see here is
- 30:30that on the side of saving,
- 30:31there is a decrease for of the
- 30:34amygdala activity that is more
- 30:37important for negative emotion
- 30:39compared to neutral emotion.
- 30:41Here uh is uh under again like the
- 30:45network and small yellow you have
- 30:48the increase to shuffle places.
- 30:52And here and here is a ninja.
- 30:58Measure of the N 170 and which you can see
- 31:02is that there is a specific increase of.
- 31:05Of this wave this is associated with.
- 31:09I've just been thinking
- 31:10that you don't see at all,
- 31:11for it's important for neutral emotion.
- 31:16Question are they under the influence of?
- 31:20Yeah, for this, for this,
- 31:22it says it's, it's during the, the,
- 31:24it's during the acute effects.
- 31:31But this decrease of the and 170
- 31:34was also fined for neutral steam in
- 31:36another study and also for organiza
- 31:38steam that you know are these
- 31:40kind of triangle that you can see
- 31:42with the using visual integration.
- 31:44So maybe they are not very specific
- 31:47emotional processing. Umm.
- 31:49This is not observed under iowaska really,
- 31:53but there is less study for Iowa Aska.
- 31:54In fact, there was an increase of
- 31:58different region pertaining to the to
- 32:01the medial temporal lobe and increase
- 32:04connectivity again between the and the right.
- 32:08This confirms that the same
- 32:10study that they presented before,
- 32:11so it's difficult to generalize.
- 32:15And they'll say there is,
- 32:17there is also an increased interaction
- 32:19with the environment and in particular
- 32:22so there there were several studies
- 32:24using LSD during music listening.
- 32:27And what you can see is that there
- 32:29is an increased coupling between
- 32:31visual cortex and cortex and more
- 32:34particularly there is more influence of.
- 32:38Over the visual context.
- 32:39That can be linked to the visual imagery
- 32:42that you have when listening to music under.
- 32:46Because.
- 32:47That contrast there is listening
- 32:49to music without psychedelics,
- 32:51yes. In this case it's with and without.
- 32:53And they did also before,
- 32:55so this is the same on the right.
- 32:57This is the same alcohol
- 32:59that they did also before,
- 33:00during and after. So they compare,
- 33:02but they're always listening to music.
- 33:05No. Before listening to music,
- 33:07under secondary, before music,
- 33:08during and after music.
- 33:10So there is like 2
- 33:12crossover there is possible.
- 33:15These three moments before,
- 33:16during and after listening to me.
- 33:18So only one can only listen
- 33:20to music during one.
- 33:22And what they showed this couple in
- 33:24finding is the interactive effect.
- 33:25Exactly. Music and psychedelic. Yeah.
- 33:28Thank you. And there is also so.
- 33:32And an increase of um,
- 33:34um diversity under music that
- 33:37is more important than in the
- 33:39condition before and after music.
- 33:42So in the middle you have during music
- 33:44and so it's increased everywhere.
- 33:46But you have any direction between
- 33:48music and non music in this case.
- 33:54Then there is a music.
- 33:56Is there any differences?
- 33:58Also are there like
- 33:59connections between other?
- 34:03No there there is a like the
- 34:06it's mostly between like this
- 34:08visual cortex like hyper complex.
- 34:11I mean the rights against
- 34:13like the change in, yeah,
- 34:16of the global density of the brain,
- 34:18but it's not very like pop up.
- 34:24On those saving,
- 34:26there is a processing of social
- 34:28exclusion that you can see on the cortex.
- 34:31And on the reduced distinction
- 34:34between self and other and the
- 34:37posterior singulate cortex.
- 34:39So I put that all together.
- 34:40It's not exactly the same topic,
- 34:42but just to say that it can
- 34:45corresponds to this feeling of like
- 34:48connectedness with the environment.
- 34:50Yeah, ours.
- 34:52Like you think that
- 34:53was sort of like the?
- 34:58Like potentially like the
- 34:59Pro social effect vaccine.
- 35:01Yeah. So yeah.
- 35:02So I would I would talk about like the
- 35:05like the link between behavior and.
- 35:07So, but in fact it's not so easy to
- 35:09find the neural correlate of the solution,
- 35:12probably because it's a big entity that's
- 35:14very different aspect of the experience of.
- 35:19Business. So for social inclusion,
- 35:21what do they use?
- 35:22So the user, you know,
- 35:24this disable paradigm whereby people were
- 35:27and there we have a question in the
- 35:29chat, what kind of music was it?
- 35:31Oh, and general.
- 35:32So in this case exactly, I don't know.
- 35:35But they use a playlist
- 35:37that is quite control.
- 35:38So in the playlist there is Electro music,
- 35:40classic music and it's like,
- 35:42but it's a kind of control.
- 35:45In the clinical trials,
- 35:46the same the Hopkins playlist,
- 35:48the same one they use.
- 35:49I I'm not 100% sure that they use
- 35:52this very playlist in in this case,
- 35:54but this is a very good question.
- 35:56But I think it's the same.
- 35:57It's the same team, so it's
- 35:59probably the same kind of right? But
- 36:01it's not words and it's not.
- 36:05I don't know if there is no,
- 36:07maybe the place somewhere on the on
- 36:09the supplementary information that I
- 36:11don't have like the the lyrics. Sorry.
- 36:16There is also a decreased
- 36:18surprise processing,
- 36:19so a decreased mismatch negativity,
- 36:22that is this wave that appears when you
- 36:25have a sequence and and when you are
- 36:28processing a deviant team within a sequence.
- 36:31So this is decreased on the sybian
- 36:34and quite intriguingly, it's.
- 36:36It's even like it seems to be more pronounced
- 36:38for standard than deviant stimuli here,
- 36:41but it's only for tactile and it
- 36:44was not found for. Auditory system.
- 36:47Whereas for LSD it was finding
- 36:49the very classical overall,
- 36:51uh, paradigm, uh,
- 36:52where you are just a different tone
- 36:54and you can see that there is this
- 36:56decrease in mismatch negativity
- 36:58with the rain red red line that
- 37:00is not showing this since it's.
- 37:05OK. So I would just.
- 37:09Just shows a few data showing that it's
- 37:11it's it's probably all these effects
- 37:14probably depend on the five receptors
- 37:16because it could be also independent.
- 37:18But in fact Ketanserin,
- 37:20which is an antagonist of a further 2A,
- 37:25blocks many neural and behavioral
- 37:27effects of psychedelics.
- 37:29So here you can see that the
- 37:32contrast between LSD and placebo.
- 37:35Show pretty much the same
- 37:37pattern of differences as the
- 37:40contrast between LSD and LSD.
- 37:44Here it's the same ID, so uh,
- 37:46with ketanserin plus iOS call you,
- 37:48you have no more the decrease in the alpha
- 37:51that you could see with iOS scalone.
- 37:53And this has been shown in several
- 37:55studies that I will not list here,
- 37:57but it was regularly used and showed that
- 38:00it antagonized pretty much all the effects.
- 38:03Another way to check that.
- 38:06Involved in the effects of the
- 38:08of the psychedelic is to use the
- 38:11gene expression map and to see
- 38:14whether this gene expression map
- 38:16corresponds to the subjective,
- 38:17sorry to the to the neural
- 38:20effects in this case.
- 38:21So that is so.
- 38:22What you can see is there is kind of
- 38:25similarity in the expression map and
- 38:27the change in global brain connectivity
- 38:30observed under LSD and you can also
- 38:34correlate these maps across the time.
- 38:36So this is what the this thing did uh,
- 38:39with silybin on the right.
- 38:41And what you can see is that there is
- 38:43an increase of correlation between
- 38:45the neural effects of silybin
- 38:47and the 5H2 receptor gene map,
- 38:50whereas there is an inspiration
- 38:52for the 1A receptor map which is
- 38:55supposedly like as an opposite effect.
- 38:59There's a comment in the chat that gets
- 39:01answered isn't fully selected for two,
- 39:02and there is a more selective 1 available,
- 39:07MDL 100907. You know if anyone is
- 39:10following up with the more selective and
- 39:12I didn't see a study using
- 39:15a different antagonist,
- 39:16this is the one that is mostly used,
- 39:17but maybe there are like.
- 39:20Yeah. And and finally,
- 39:23you can also simulate what would be an
- 39:27excitatory gain modulation obtained by 5.
- 39:31Activation and you can reproduce
- 39:33again the empirical data.
- 39:35So you can see that there is
- 39:37a nice correlation between
- 39:38empirical change in global brain
- 39:40connectivity and the model changes.
- 39:44OK. So now I returned from rent
- 39:48recognition and So what I will try,
- 39:51but it's more hypothetical is to
- 39:54predict how what kind of cognitive
- 39:56effects we can have by the brain effects
- 39:59that we just have seen together.
- 40:01So the first part is about the
- 40:04reduction of the the the connectivity
- 40:07in the default mode network.
- 40:10And indeed what we can bet is that
- 40:13this change in connectivity can give
- 40:16the so-called equity solution or maybe
- 40:17you will be less self focused and
- 40:20more available to process external
- 40:21information because you have a
- 40:23deactivation of the of the default
- 40:25mode network that will be disrupted.
- 40:28The increased connectivity between
- 40:30network and the increased complexity
- 40:32slash diversity slash repertoire may
- 40:34corresponds to a more information
- 40:37sharing across the brain and also
- 40:40more fluctuation and more update
- 40:42of the content of the brain.
- 40:45What has been interpreted by several
- 40:47authors at a possible enhanced
- 40:49state of consciousness because
- 40:52information sharing and complexity
- 40:54has been also linked to different
- 40:56states of consciousness.
- 40:58And we can also think that the
- 41:00connectivity between different
- 41:01sensory areas can lead to the seizure,
- 41:04which is an effect that is regularly
- 41:07observed under psychedelic.
- 41:11On the other hand,
- 41:13so the reduced connectivity in
- 41:15associative several region but
- 41:17increased in sensory areas and the
- 41:20change in this alpha band or feedback.
- 41:22And for some molecules in particular
- 41:24they always get increased forward
- 41:27or the exchange in telemetry
- 41:29collectivity change from the LSD.
- 41:31All this may lead to so cognitive impairment
- 41:33is a really like broad prediction,
- 41:35but in fact it has been observed
- 41:37under secondary but more maybe
- 41:39more specifically to an increased
- 41:41sensory processing and maybe to
- 41:43less constraints that would be
- 41:44applied on this sensory processing.
- 41:49So now let's check whether this
- 41:51prediction can be observed in the data.
- 41:54So first of all,
- 41:55not all the neuroimaging studies
- 41:57explored the the correlation with
- 42:00subjective effect and it's quite
- 42:02difficult to prove that all together.
- 42:04But many of them explored
- 42:06whether a visual experience was
- 42:08correlated with several patterns,
- 42:11and in particular it has been found
- 42:13that the decrease of the N 170 was
- 42:15correlated with visual experience.
- 42:17So maybe there is less integration
- 42:21of visual information.
- 42:22That it was correlated to an increased
- 42:25activity in visual cortex increased
- 42:27connective connectivity between visual
- 42:28cortex and the rest of the brain.
- 42:31The decrease of alpha
- 42:32notably in posterior region,
- 42:34so notably those are pertaining
- 42:36to the visual cortex of the
- 42:40posterior different network.
- 42:42The connectivity between the
- 42:44telemus and the fusiform gyrus.
- 42:47And as I said earlier,
- 42:49like more influence of the parade book
- 42:51and book Cortex on the visual cortex.
- 42:53So all this data is kind of difficult
- 42:57to summarize in just one aspect.
- 43:00What we can see is that.
- 43:02Let's say generally like the change
- 43:04in visual cortex and disconnectivity
- 43:06seems to be associated with the the
- 43:09visual experience under psychedelic.
- 43:11The DMT,
- 43:12uh,
- 43:12there is a decrease of alpha and the
- 43:15increase of complexity that was also
- 43:17associated with visual experience and
- 43:20this change in feedforward feedback.
- 43:22And again like in this case,
- 43:24it's quite natural to think that
- 43:26the increase it corresponds to an
- 43:27increase of sensory processing.
- 43:31I got the solution so.
- 43:33What was found in several studies that
- 43:36it was correlated with the decreased
- 43:38alpha regulatory activity, and notably
- 43:40in the posterior cingulate cortex,
- 43:42which is part of the default network.
- 43:44So This is why it makes sense.
- 43:48But there were also, like many other
- 43:50correlate of the euro dissolution that
- 43:52are quite difficult to put together.
- 43:54So, for example,
- 43:55a disintegration of the salience network,
- 43:58a disconnection between the parietal
- 43:59lobes and the medial temporal lobes,
- 44:01decreased connectivity between parapro
- 44:03campus and retrosplenial cortex,
- 44:05change of increase of salience
- 44:07network connectivity.
- 44:08So many, many correlates that are not
- 44:13obviously a linkable to these effects.
- 44:16And regarding the overall subjective effects,
- 44:21the decreased network integrity
- 44:22and segregation was correlated
- 44:24to that and also connectivity
- 44:27with the somatomotor region, so.
- 44:30This is also quite, let's say,
- 44:33natural to think that's OK.
- 44:35When you when you change the the the
- 44:37integration of information across the brain,
- 44:39you will have this subjective effect.
- 44:42But they they could simply be correlated
- 44:45with the intensity effect specifically
- 44:47exactly in this in this study, it was
- 44:49not correlated to specific substrate.
- 44:54I mean it would be interested to, yeah,
- 44:56yeah, it would be interesting to have to
- 44:57have something that is more specific,
- 44:59but also all these phenomena are
- 45:01probably correlated one to another,
- 45:02so it's difficult to to separate them.
- 45:07Regarding emotions and mood.
- 45:10So we saw this decreased brain response to
- 45:15negative emotional stimuli and and this
- 45:18could lead to a bias toward positive emotion.
- 45:21And in fact it was not.
- 45:24It was found, but maybe not as expected.
- 45:27So here you can see that the decrease.
- 45:29So there is this decrease in the
- 45:32amygdala for negative that is more
- 45:34important than for neutral.
- 45:36Uh stimuli and and uh the reaction time
- 45:40that you can see uh uh under is increased,
- 45:44but it seems to be increased for everything.
- 45:46So negative, neutral and shapes.
- 45:47That is the control in these studies.
- 45:49So not very specific to an emotional aspect.
- 45:54Unfortunately,
- 45:54let's say or in other study,
- 45:56there is some specific bias
- 45:59toward positive emotion.
- 46:00So in this case it's like the the error
- 46:05rate in recognizing emotional faces.
- 46:07So what you can see is that there
- 46:10is more error for negative,
- 46:11so it's negative emotion is less recognized.
- 46:15And in this study also you can see that
- 46:17there is less recognition for fearful faces.
- 46:20You don't have it for other,
- 46:22it's not significant for the other emotions.
- 46:24And in this study they used 2 doses
- 46:27of LSD and there is not apparently
- 46:30a dose effect for this aspect.
- 46:35And what we may be interested in in
- 46:37particular as as psychiatrist as I
- 46:39am is the positive effect on mood.
- 46:42And for that even in the first study we
- 46:45have a significant positive effect on mood.
- 46:48And in the second one too that is
- 46:51like associated with stellar sibling
- 46:53index or in Africa controls here.
- 46:56And what you can see is that
- 46:58this positive effect change is
- 47:00correlated to the enterable change.
- 47:02So this is quite a.
- 47:04Grievance and are quite nice to see that
- 47:06it could be a like one of the neural
- 47:09substrates of this of this improvement.
- 47:12There's a comment in the chat.
- 47:16That the. Pointing out that these
- 47:18are all in healthy controls exactly,
- 47:21or perhaps general population.
- 47:22So it's possible that these would
- 47:24be qualitatively different findings
- 47:25into test subjects or in another.
- 47:27Thank you for this transition.
- 47:30So I'm going to the to the
- 47:33antidepressant effect.
- 47:34And uh, overall, uh,
- 47:35what was found is that the
- 47:37changes in magnitude were
- 47:39also alleviating depression in
- 47:41participant with depression.
- 47:44Just another comment please.
- 47:45Are acute effects.
- 47:49There's a bit of
- 47:50yeah, everything is acute I so
- 47:52there are several studies showing
- 47:55studying effects after one week,
- 47:57but I did not detail by
- 47:59mean I have like with time,
- 48:00so I did not detail everything.
- 48:02So this is really for acute effects.
- 48:06So for participants with depression,
- 48:09so quite strangely, there is an increased
- 48:12animal activity during phase processing.
- 48:15So this was interpreted by the others as
- 48:18being a moment where you are confronted,
- 48:21confronted to negative emotion and that it
- 48:24could be still positive for the people.
- 48:27But during rest there is a decreased
- 48:30amygdala activity that was in
- 48:32this study correlated with the
- 48:34improvement that was subsequently.
- 48:36Observed after service.
- 48:41There is also a decreased amygdala.
- 48:45Even from the personal cortex
- 48:48connectivity that was correlated
- 48:50with a decrease in ruminations and
- 48:53overall what is observed in this study
- 48:56where subjects with depression at the
- 49:00received signal savings that there
- 49:01is a better emotion recognition after
- 49:03the the the intake that is correlated
- 49:05with the improvement of the mood.
- 49:08When you say after is this.
- 49:11During these days, uh,
- 49:12in it's one week after I think I'm, yeah.
- 49:15Well beyond the period. It's.
- 49:17Yeah. It's their ability to
- 49:19recognize after the treatment.
- 49:20Yes, it's not during the treatment.
- 49:25So there there are two studies
- 49:28exploring how network integration
- 49:30changes the sailor saving could play a
- 49:34role in this antidepressant effects.
- 49:37So the first one we showed that there
- 49:39was a an increased connectivity between
- 49:42the entire single singular cortex and
- 49:44the posterior singulate cortex that
- 49:46are part of the respectively that's
- 49:49positive network and different network,
- 49:52so there is a better integration.
- 49:55Between these two regions pertaining
- 49:57to two different networks and they also
- 49:59studied like the cognitive flexibility,
- 50:01they found that both of them were increased.
- 50:03But quite strangely,
- 50:05these two measures were articulated,
- 50:07so the more changing in the connectivity
- 50:09and the less improvement in flexibility.
- 50:12So it was difficult to understand this
- 50:16result. And there is, uh, another um.
- 50:21Study uh where uh you can see that the
- 50:23higher integration between different
- 50:25networks, so the default network,
- 50:27executive network,
- 50:28salience network that you can see
- 50:30in this bar plot and the decrease
- 50:32recruitment of the default mode
- 50:35network was associated with a better
- 50:37outcome of of the depressive symptoms.
- 50:40And this seems to be specific to
- 50:42the Silo saving treatment because
- 50:44in this study they compared with
- 50:46the stellar prime and they did not
- 50:49observe this change of modularity.
- 50:50So what they called.
- 50:52If you like to use the inverse
- 50:55of integration.
- 50:56No,
- 50:56I mean yeah you understand so the
- 50:59when the network are correlated
- 51:02there is a less modularity and
- 51:06they find that it was correlated
- 51:08to the to the to the outcome.
- 51:11OK.
- 51:12Yeah, yeah. In the chat.
- 51:14Sharif so. These are. Let's see.
- 51:18Well, the comment is it's hard
- 51:20to have a placebo control.
- 51:25The changes are you know,
- 51:26they're, they're,
- 51:26they're changes in many of these cases.
- 51:29How much of that is attributable
- 51:31to suicide and versus other aspects
- 51:33of the experience that the patient,
- 51:35which I think is a an incredibly
- 51:37incredible challenge for this entire field,
- 51:41not in clinical outcome
- 51:43studies as well as study.
- 51:46It's also like I I'm not sure
- 51:48that the the rule is necessary to
- 51:51distinguish the like the subjective
- 51:53effects or let's say like I'm not
- 51:56sure if it's possible to have a
- 51:58very good placebo condition indeed.
- 52:01And I don't know like let's say
- 52:03my practical part is more like OK,
- 52:05it's like what you're interested
- 52:07in is the is the improvement.
- 52:09So of course you don't want to to
- 52:11put your patient with the like a
- 52:13risk that will be that's correlated
- 52:15to these improvements.
- 52:16But um, yeah and this is also one of
- 52:19the strong attack with to microdosing.
- 52:23But in fact yes,
- 52:24in all these studies of course people
- 52:26knows that they that they were they
- 52:28have psychedelic and not a placebo.
- 52:30So
- 52:31in this case these are
- 52:33within subject comparisons.
- 52:34So placebo question doesn't arise
- 52:35but it does for some of the other
- 52:38literature that you've reviewed.
- 52:40Think of this as the cordless
- 52:41of the overall experience. Yeah.
- 52:43Yeah. Significant component.
- 52:44Exactly. Yeah. Yeah.
- 52:46But I mean, the experience is
- 52:48also treated by the component.
- 52:49So I don't know if it's
- 52:50realistically satisfied.
- 52:52Yeah, yeah, exactly.
- 52:59So my last thought, if I have time,
- 53:01is to talk a bit about the
- 53:02theoretical models. It's fine.
- 53:03So, so there are few of them right now.
- 53:06The consequence theory,
- 53:09the relaxed belief under psychedelics,
- 53:12and the cortical posterior cortical models.
- 53:15So we will start with the the
- 53:19corticostriatal dynamic particle theory.
- 53:21So the main idea is that the
- 53:23teams will play a very important
- 53:25role in the psychedelic effects,
- 53:27and in particular it will.
- 53:32It, like the telemus,
- 53:33normally filter information and other
- 53:36psychedelic it will be less able
- 53:38to filter information, intercepts,
- 53:40even exceptive information.
- 53:42And um this uh will lead to um,
- 53:46uh kind of flooded uh information
- 53:48coming from the the sensory areas
- 53:50and it was shown also and I showed
- 53:53that before that there was an
- 53:56increased connectivity between the
- 53:57telemus and the sensory areas whereas
- 54:00there is a decreased connectivity
- 54:02probably with the associative areas.
- 54:05So overall this will the terms will
- 54:07be at the origin of this pattern that
- 54:10I already showed 2 whereby there is.
- 54:12The decreased connectivity for
- 54:15the associative areas,
- 54:17whereas there is an increased
- 54:19connectivity for the sensory
- 54:20cortices with the rest of the brain.
- 54:21So there will be a kind of switch from
- 54:25like a balance where you will have a
- 54:27lot of sensory processing and really
- 54:31degraded integrative processing.
- 54:33And this was fine,
- 54:35like with these two maps that
- 54:37are quite similar to each other,
- 54:39what is
- 54:39that gap in the middle
- 54:41lateral prefrontal cortex?
- 54:42There's an area of prefrontal there.
- 54:44It is not reduced.
- 54:47Still. Where? I'm sorry.
- 54:51So you've got this global reduction scroll
- 54:53this association protects. Except there.
- 54:58Uh, I like no,
- 55:00I don't know what it is exactly that,
- 55:01but this, so this study were also
- 55:04correlated with global signal regulation.
- 55:07So I mean this is the map of statistical.
- 55:11So it's it's maybe just a threshold effect
- 55:13and not necessarily something that is
- 55:15particularly not affected by this one.
- 55:17Yeah. Yeah, it's really, yeah.
- 55:21Freeze up and.
- 55:26So the second model.
- 55:29So the the main claim is that there is
- 55:31the under psychedelic there will be
- 55:33decreased prior and increased bottom up.
- 55:35So it starts from the irregular excitation
- 55:38of the of the layer 5 pyramidal neurons
- 55:41because of the receptor activation.
- 55:43According to the others,
- 55:45this is the cause of the decreased power.
- 55:49Because there is this kind of
- 55:51desynchronization and thereby less like
- 55:53the low frequency rhythm would be less
- 55:56synchronized and therefore decreased.
- 55:59And this is what is observed,
- 56:00of course, in the in the literature.
- 56:02And both of these will lead
- 56:05to disruption of integrity.
- 56:07Of last last scale networks and what
- 56:09we have seen about like this increased
- 56:13entropy diversity during rest.
- 56:16And this is also corroborated
- 56:19by empirical data.
- 56:20Uh, the other thing that all these
- 56:23corresponds to a decreased precision of
- 56:25high level priors or decrease in belief,
- 56:28because for them like this alpha
- 56:31rhythm and parameter neuron encodes
- 56:33the precision of the priors.
- 56:36So like it's not very easy to to
- 56:38to to fill this gap between like
- 56:41the computational aspect and the
- 56:43like the physical aspects.
- 56:45But this is what they propose and
- 56:47the consequence of that would be
- 56:49that there will be a liberation.
- 56:51The bottom up information that will slow
- 56:54and so and also a more as sensibility,
- 56:58sensitivity to updates and
- 57:00to prediction error.
- 57:01So you will have you will be more open to
- 57:04new information and update your models.
- 57:07And they propose that this is
- 57:08one of the crucial aspects of the
- 57:11therapeutical aspect of this molecule
- 57:12that you are able to update some rich,
- 57:15very rigid model,
- 57:16pathologically rigid model,
- 57:17for example in depression,
- 57:19anxiety or addictions.
- 57:23And finally there is the classic the
- 57:25cortical cluster cortical model.
- 57:27So. So this is the classroom,
- 57:31and what we know about it is that it is
- 57:34that it received input from the corpus.
- 57:37It expresses itself also 5H3 receptors.
- 57:42And uh, the role of the claustrum is to
- 57:45um to allow cortical synchronization and
- 57:47also it is activated during task switching.
- 57:51So it's a kind of.
- 57:53Then leader of different cortical network.
- 57:58So you should activate through receptors
- 58:00at these two location like the clustering
- 58:03directly and also in the prefrontal cortex.
- 58:05So the others think that it
- 58:07results in a decoupling.
- 58:09So it will not be synchronized because
- 58:10there will not be like this harmony
- 58:12between the two but they will work a bit
- 58:15separately and this will lead to aberrant
- 58:17cognitive control on network states.
- 58:19And in fact overall the the the customer
- 58:22will not be able to no more to to do
- 58:24these cortical synchronization and
- 58:25it will lead to a disruption and.
- 58:28And that's simulation of different
- 58:30cortical networks that are crucial
- 58:32for brain functioning.
- 58:33So in particular the different
- 58:35network by the continued work.
- 58:37And all this is supported by one study.
- 58:40So of course the recognizer
- 58:43techniques like further replication,
- 58:45but in this study,
- 58:46so there is a change of connectivity
- 58:49between the classroom and
- 58:51different different networks,
- 58:53in particular the development
- 58:55network and the frontal.
- 58:58Control, uh,
- 58:59network and there is also like change
- 59:02per se in the activity of the classroom.
- 59:05This isn't healthy.
- 59:07Yes,
- 59:08yes.
- 59:10And how well I know the
- 59:12classrooms like 1 voxel thing.
- 59:14Like how good is the site
- 59:15with modern methods?
- 59:16How good is imaging
- 59:17imaging in the classroom?
- 59:22OK, I would like to finish and I I
- 59:24hope that we may discuss about that.
- 59:26So I'm coming from the consciousness
- 59:28field of cognitive science and and I I
- 59:31get interested in psychedelic because for
- 59:33me it was quite obvious that subjectively
- 59:36there will be a strong impact of
- 59:38psychedelic and conscious perception.
- 59:39I just want to propose a link between
- 59:41what I know of conscious perception
- 59:43and the effect of psychedelic and
- 59:46like it's also a way to describe maybe
- 59:48the Rebus a bit differently because.
- 59:50Many of the premises of this will be common.
- 59:54So this is the model that I used a lot
- 59:57to to all my studies on consciousness.
- 01:00:00And this is the the model of the
- 01:00:02global neuronal workspace.
- 01:00:03So the main idea is that consciousness
- 01:00:06rely on the activation of a specific
- 01:00:08network that corresponds to like the
- 01:00:12connection between different brain
- 01:00:15area through a long distance neurons.
- 01:00:18And the main idea is that.
- 01:00:20So all the time you will have,
- 01:00:21you will unconsciously process
- 01:00:23information and few information will
- 01:00:25be amplified in particular by top
- 01:00:27down processing to enter this network
- 01:00:29and being shared and broadcasted
- 01:00:31across the brain.
- 01:00:32So it will bring like a kind of huge
- 01:00:34activation and this encoding of
- 01:00:36information shared by different brain
- 01:00:38areas would really corresponds to
- 01:00:40conscious perception of this information.
- 01:00:43Umm,
- 01:00:43and this top down could be linked
- 01:00:47to this alpha band or beta band.
- 01:00:49And as I said before,
- 01:00:51some studies showed that perception
- 01:00:54was helped by this particular vendor.
- 01:00:58Oscillations.
- 01:00:58And so there will be this kind
- 01:01:02of broadcasting in this network,
- 01:01:04but also filtering.
- 01:01:05So there are two roles of this
- 01:01:07amplification and of this top
- 01:01:08down processing.
- 01:01:09First of all to amplify so that you
- 01:01:11can perceive and you know that your
- 01:01:13attention plays a very important
- 01:01:14role in conscious perception,
- 01:01:15but also to determine and to
- 01:01:19disambiguate what you are exposed to.
- 01:01:22And of course,
- 01:01:24like this sharing of information
- 01:01:26really and like with the pyramidal
- 01:01:28neurons and also like just global
- 01:01:30connectivity across the brain.
- 01:01:34So if we start with the
- 01:01:37same idea as the Rebus,
- 01:01:39so the activity of the pyramidal neuron
- 01:01:42decrease low frequency rhythm and
- 01:01:45increased inter network connectivity.
- 01:01:47So let's see how this plays a
- 01:01:50role in consciousness.
- 01:01:51So the pyramid on the run have
- 01:01:54been shown to support information
- 01:01:57integration so and to allow
- 01:02:00coincidence detection between external
- 01:02:02data and internal prediction so.
- 01:02:05In fact, the computation between
- 01:02:07priors and and sensory input
- 01:02:09can can also occur directly
- 01:02:11injecting these neurons and not
- 01:02:13necessarily in a in a video area,
- 01:02:15but already at the neural level.
- 01:02:18But it has also been involved
- 01:02:20in conscious computations.
- 01:02:21And indeed there was a study
- 01:02:23showing that if you change the
- 01:02:25calcium activity in the dendrites,
- 01:02:27you can modulate threshold for
- 01:02:29perceptual detection and also that
- 01:02:31anesthesia decouples these neurons.
- 01:02:34And that's it can be one of the
- 01:02:36mechanism through which you lose
- 01:02:38consciousness during anesthesia.
- 01:02:42So as I said, like uh, alpha situation,
- 01:02:44we're shown to carry a part of the
- 01:02:47top down sensory prediction and this
- 01:02:50prediction will change your orientation
- 01:02:52of attention on the external world and
- 01:02:55also help to disambiguate sensor inputs.
- 01:02:58So This is why, for example,
- 01:03:00you can see that this you will have the
- 01:03:02impression that the left circle is convex,
- 01:03:05is convex while the right one is concave.
- 01:03:07And you will be pretty sure about that
- 01:03:09even if there is no like it could.
- 01:03:12Also be like uh the the opposite,
- 01:03:14but just because in general the light
- 01:03:16comes from the from the from the
- 01:03:19sky and not from the ground. Umm.
- 01:03:22And in fact it has been shown in several
- 01:03:24studies that the expectation correspond
- 01:03:26to kind of template of activation that
- 01:03:29you can decode in the brain and that is
- 01:03:31much to a sensory incoming evidence.
- 01:03:34So in fact you have a kind of ghost
- 01:03:37activation that corresponds to what
- 01:03:38you're expecting and there is a matching
- 01:03:41and this really sharpened perception by
- 01:03:43increasing the the signal to noise ratio.
- 01:03:49And finally like of course connectivity is
- 01:03:53crucial so that cortical region of high
- 01:03:57level region can constraint and like sensory
- 01:04:00region according to this expectation.
- 01:04:03And it was shown in this study that
- 01:04:07like the top down effects rely on
- 01:04:09recurrent and enhanced connectivity
- 01:04:11within some different areas and
- 01:04:13more broadly like the long distance
- 01:04:15connectivity has been shown to be.
- 01:04:18Related to contraception,
- 01:04:20uh threshold and information sharing too.
- 01:04:23So what I would like to propose here is that.
- 01:04:26So if we take this hypothesis of global
- 01:04:29neuronal workspace with this top down
- 01:04:32that is very crucial to amplify and and
- 01:04:34let's information enter this workspace,
- 01:04:37the decrease of alpha band will
- 01:04:39impair this top down processing
- 01:04:41and you will have therefore less
- 01:04:43selectivity on your sensory input.
- 01:04:46So this is quite close to what
- 01:04:48is proposed by characterized and
- 01:04:51and also in the talamo particles.
- 01:04:53Well, a looper proposal proposal.
- 01:04:56So what are the consequences of that is that
- 01:04:59you will have less filtering of information.
- 01:05:03But also because there is this increase
- 01:05:05in their network connectivity,
- 01:05:06you will have an amplification of the,
- 01:05:10we can say the neural vector
- 01:05:12encoding conscious percept.
- 01:05:13So we can imagine that there will
- 01:05:15be more amplification inside the
- 01:05:17workspace because there is a lot
- 01:05:19of sharing of information and this
- 01:05:21will lead to this may lead to.
- 01:05:23Maybe there is less information
- 01:05:25inside the workspace,
- 01:05:26but this seems to be
- 01:05:28subjectively very amplified.
- 01:05:29And it was also interesting he showed that
- 01:05:31when you were missing some information,
- 01:05:34you never you never detect that
- 01:05:35you're missing some information,
- 01:05:37you just complete with information.
- 01:05:39And generally you have the illusion
- 01:05:40to perceive everything.
- 01:05:41So the less you perceive and the
- 01:05:43more you can have the impression
- 01:05:44that you perceive correctly,
- 01:05:45and in fact you are just missing the
- 01:05:48gap with your own representation.
- 01:05:50Also,
- 01:05:50this can be linked to the temporal
- 01:05:53dilatation that was regularly
- 01:05:55described under a psychedelic.
- 01:05:59Japan, activity of pyramidal neurons.
- 01:06:02So I said that they were like
- 01:06:04kind of coincidence detectors.
- 01:06:05So maybe the feeling of epiphany or the
- 01:06:08feeling of coincidence is linked to this
- 01:06:10hyperactivity of these pyramidal neurons.
- 01:06:12And um,
- 01:06:13because you have less um uh,
- 01:06:16uh, prediction and you have
- 01:06:18less low uh frequency reason,
- 01:06:19you are less able to give a unique
- 01:06:21interpretation of your sensory input.
- 01:06:23So there is something that is
- 01:06:25maybe that can be more moving
- 01:06:27and maybe unstable in the way
- 01:06:29you represent the external world.
- 01:06:31But because you have this activity
- 01:06:33of the pyramidal neuron,
- 01:06:34maybe you will just match some
- 01:06:36available templates that are here with
- 01:06:38perception because they are activated
- 01:06:40and they are all used to integrate
- 01:06:43external information with prediction.
- 01:06:44So this may explain why why you
- 01:06:47match your sensory input with for
- 01:06:49example geometrical forms of faces
- 01:06:51are very like common patterns of
- 01:06:53activation that may be available
- 01:06:56and and and will be just hyper
- 01:06:58matched with this sensory inputs.
- 01:07:01And finally,
- 01:07:02but this is a more general statement,
- 01:07:04the increase of the uncertainty and the
- 01:07:07change in perception they have shown
- 01:07:09to be linked to like to to favor jumps
- 01:07:12to conclusion and delusional ideas.
- 01:07:15And there may be also, of course involved
- 01:07:18in the mental flexibility that have
- 01:07:21potential therapeutical effects. Yes.
- 01:07:27So that's the part that talks about.
- 01:07:29So less ability to give unique
- 01:07:31interpretation of sensory input.
- 01:07:33And I wonder if it is related with
- 01:07:36the sort of we have to decrease
- 01:07:39connectivity within networks.
- 01:07:41And I wonder if that also applies
- 01:07:43in terms of those interpretations
- 01:07:46that are so ingrained in different
- 01:07:48conditions or those associations that
- 01:07:50are ingrained in different conditions
- 01:07:53like making an association between one.
- 01:07:55Do you like and I'll draw on something
- 01:07:58in the environment and like having
- 01:08:00an obsessive thought or I wonder if
- 01:08:02part of the what we see with imagine
- 01:08:05like with less network connectivity,
- 01:08:08also more complexities is related
- 01:08:11with having that wider?
- 01:08:13Repertory in terms of associations
- 01:08:16or interpretation.
- 01:08:18Yeah, yeah,
- 01:08:19yeah. Yeah. So you write that this
- 01:08:22diffuse ability to to interpret
- 01:08:24uniquely and sensory input and we
- 01:08:26also due to like the disintegration
- 01:08:28of the network or the the increased
- 01:08:30connectivity of Internet work that can
- 01:08:32interfere with basically with the like
- 01:08:35like their regular functioning and
- 01:08:37and and their role to to distinguish
- 01:08:40between one thing and another.
- 01:08:42But what I like is in this idea
- 01:08:44and it's and and I didn't say
- 01:08:46but it's of course absolutely.
- 01:08:48Uh, compatible with the telemetry?
- 01:08:49Uh, hypothesis because the telemetry,
- 01:08:53the telemus also filtering information
- 01:08:54and allowed to to to choose between
- 01:08:57several interpretations too.
- 01:08:58So I think it's just another
- 01:09:01level of description.
- 01:09:02But yeah,
- 01:09:03because it's what I know it's,
- 01:09:04I feel more comfortable with this
- 01:09:06way of describing things.
- 01:09:07But of course it's it's not anemic
- 01:09:09with the the other proposals.
- 01:09:14I'm almost done I think I have
- 01:09:16two slides so please slide.
- 01:09:18So the limitation all of these studies
- 01:09:22so I took this summary that only
- 01:09:26talk about resting state of moral
- 01:09:28literature but I think it's it's
- 01:09:30quite obvious what are the problem
- 01:09:31with all this second indicator.
- 01:09:33So first of all what you can see is
- 01:09:36that there is many many reanalysis
- 01:09:39of few cohorts of data and.
- 01:09:42This is striking,
- 01:09:43like it's almost like half of
- 01:09:44the articles are in fact coming
- 01:09:46from the same data.
- 01:09:48So this is of course a
- 01:09:50problem for reproducibility.
- 01:09:52And I I, I mean,
- 01:09:53I also totally admit that it's very
- 01:09:55difficult to build such studies and
- 01:09:57I I know what I'm talking about.
- 01:09:59But of course this is a problem for
- 01:10:02interpretation and generalization.
- 01:10:04Second,
- 01:10:04so there are not so many participants
- 01:10:06in the study and we would like
- 01:10:08to have more important study,
- 01:10:09even if in cognitive psychology generally,
- 01:10:11like with.
- 01:10:1225 people you are you already have
- 01:10:14like substantial results, of course.
- 01:10:16So here are only resting state literature,
- 01:10:19but in fact it's like most of the
- 01:10:21literature in your imaging literature
- 01:10:22and psychedelic is using resting state.
- 01:10:24And this is a like kind of an
- 01:10:27issue because in fact we don't know
- 01:10:29exactly what people are doing during
- 01:10:31resting state and in particular
- 01:10:32during secret experience there
- 01:10:34may be totally attractive and
- 01:10:36fascinated by something and just
- 01:10:37processing one thing for a while.
- 01:10:39And we don't know if what we are analyzing
- 01:10:41is like really demanding resting or
- 01:10:44just focalizing on something special that.
- 01:10:47And the difference across participants.
- 01:10:49So I think that we really need to have
- 01:10:52more tasks because it's more constraining.
- 01:10:55So of course it also have its limits
- 01:10:57and but it it helps to compare
- 01:11:00different condition maybe in a
- 01:11:02more constrained manner.
- 01:11:03So as I said,
- 01:11:04so I did not mention there is just one.
- 01:11:09Study with muslin, but uh,
- 01:11:11so many of the study involved the
- 01:11:14SILYBIN and LSD a bit less for iasca.
- 01:11:18And what would be,
- 01:11:19I think really interesting is to
- 01:11:21compare the drug one to another and
- 01:11:24in particular with getting into
- 01:11:26because I did not highlight it.
- 01:11:28So yeah, yeah, someone should do that.
- 01:11:31So because as you can see,
- 01:11:33there are several aspects
- 01:11:35that are a bit different,
- 01:11:36in particular for the feed
- 01:11:38forward we talked about already.
- 01:11:40But also the condition are generally
- 01:11:42different and even in the use of
- 01:11:44people like I generally taken
- 01:11:45in a ritual way and things like
- 01:11:47that and we we really want to
- 01:11:49compare and to see what are the
- 01:11:52pharmacological difference and the
- 01:11:54the neuroimaging differences between
- 01:11:56several drugs in the very same.
- 01:12:00But I'm experimental paradigm.
- 01:12:03So we would also be very interested in
- 01:12:06comparing these different population
- 01:12:07because in general the study were either
- 01:12:10in control or in patient with depression.
- 01:12:13But there is not really comparison between
- 01:12:15the two for neuroimaging studies at least.
- 01:12:18Um, we talked about it also,
- 01:12:20but uh it would be quite interesting
- 01:12:22to see uh the long lasting effects or
- 01:12:25at least just some study explored the
- 01:12:27time dependent effect in the session.
- 01:12:29So they did several scan in the
- 01:12:31in the very same session.
- 01:12:32But it could be also interesting to
- 01:12:34see what is left after a session
- 01:12:37of psychedelic and also maybe
- 01:12:39to explore the different doses.
- 01:12:40So there are several study with Microdose,
- 01:12:42but it could be interesting within
- 01:12:44us the same study and within the same
- 01:12:46experimental guidance to have several doses.
- 01:12:48So to compare and to see what is
- 01:12:50dose dependent or not.
- 01:12:53OK, so as I should like psychedelic
- 01:12:56drastically change a brain state of
- 01:12:58activity and connectivity during rests,
- 01:13:00decreased within connectivity,
- 01:13:02increase entropy and
- 01:13:04internetwork connectivity,
- 01:13:05in particular in sensory areas.
- 01:13:08This decrease of low frequency problems
- 01:13:12that are probably involved in feedback.
- 01:13:15Some effects are quite consistently
- 01:13:17associated with subjective effects,
- 01:13:19and in particular the effect of Magdala,
- 01:13:21which showed that it were quite linked to the
- 01:13:25increased positive effects under psychedelic.
- 01:13:29But some of the branches are
- 01:13:31changes are more difficult to link,
- 01:13:33or are maybe inconsistent across
- 01:13:36studies or across psychedelics,
- 01:13:38so it's difficult to really know what
- 01:13:41what are their subjective correlates.
- 01:13:45And finally the the current
- 01:13:47theoretical models agree on a
- 01:13:48decrease of filtering prior control.
- 01:13:50So there are different terms,
- 01:13:51but basically the idea is that there is
- 01:13:54less constraint on sensory processing
- 01:13:56and they kind of disagree on what is
- 01:14:00the main mechanism or stable region
- 01:14:02that is involved in in this effect.
- 01:14:07So the future direction,
- 01:14:08so for me like on top of all the proposal
- 01:14:12I made for having more maybe reliable or
- 01:14:16generalizable data for second imaging.
- 01:14:19I think that the two direction
- 01:14:22that we have is on the first
- 01:14:25hand like a better description,
- 01:14:27better description of the subjective
- 01:14:29effects and maybe one also of the aspect is
- 01:14:32that there is inter individual variation.
- 01:14:33So it will be very interesting and it's.
- 01:14:36It's in fact something that's our
- 01:14:38lab do to map the subjective effects
- 01:14:41to a neural individual map and not
- 01:14:44only to put everybody in the same.
- 01:14:49In the same group and it's important
- 01:14:53because if we if we are working on
- 01:14:57this individual neural effects,
- 01:14:59we will probably have more power to link
- 01:15:02the the subjective and the neural and
- 01:15:04the maybe the receptor also and better
- 01:15:07better understanding of the mechanistic.
- 01:15:10On the other hand,
- 01:15:11it will also be helpful to see
- 01:15:13what of these subjective effect
- 01:15:15may be helpful for patients.
- 01:15:18And once they see your addiction?
- 01:15:20And the second as aspect is in
- 01:15:25fact the using the psychedelic as a
- 01:15:29pharmacological model of psychosis.
- 01:15:31So in this case what we would like
- 01:15:33to do is rather to see what is the
- 01:15:36neural dysfunction in patients.
- 01:15:38So without taking them you can
- 01:15:40just doing brain imaging when they
- 01:15:42have like specific symptoms and
- 01:15:43try to link these symptoms to what
- 01:15:46we can observe under psychedelic
- 01:15:47and again if possible in the.
- 01:15:50Individual manner because in this case
- 01:15:52we may think for example that when
- 01:15:54patient is as a cerebral exhibition
- 01:15:56that is close to LSU response map
- 01:15:58and therefore that is mechanism is
- 01:16:00more a certain energetic logic.
- 01:16:04Yeah.
- 01:16:05Dysfunction,
- 01:16:05whereas another one may have for
- 01:16:07example a neural response map that is
- 01:16:09closer to look at anyone would have
- 01:16:12maybe more dissociative effects and
- 01:16:14things like that and the mechanistic
- 01:16:16of possible therapeutic drug may be
- 01:16:19different and this will really open
- 01:16:22the the field of individualized medicine.
- 01:16:24I finished.
- 01:16:25So thank you for your attention
- 01:16:29and of course I yeah,
- 01:16:31I see that there were so
- 01:16:32many questions in the chat.
- 01:16:33Sorry I could not do at the same time,
- 01:16:35but of course I would be happy to have
- 01:16:38your feedback and to answer your questions.
- 01:16:41Thank you, Lucy.
- 01:16:42That was a wonderful day.
- 01:16:44Thank you. We do have a couple of
- 01:16:47questions dangling in the chat.
- 01:16:49One thing for me to do,
- 01:16:50the collective findings, this is a big.
- 01:16:53Reconcile the phenomenon of a bad trip.
- 01:16:58And because, you know,
- 01:16:59to the extent that they did,
- 01:17:00the group data all looked pretty positive.
- 01:17:02So how do we understand the
- 01:17:03phenomenon of a bad trip?
- 01:17:04And relatedly,
- 01:17:05do we understand how or why
- 01:17:07some depressed individuals
- 01:17:08may be non responders despite
- 01:17:11having the second experience?
- 01:17:12It's not quite the same question,
- 01:17:14but both around how this negative affect.
- 01:17:16Yes, so. So there is one study exploring.
- 01:17:21So the difference between, but in fact
- 01:17:23it's not really the goal of the study,
- 01:17:25but they were exploring the level of
- 01:17:28glutamate in the brain and they find
- 01:17:30that the increasing glutamate in the
- 01:17:32prefrontal cortex was associated with bad
- 01:17:35trip and in the hippocampus was associated
- 01:17:37with good trip if my memory are good.
- 01:17:40So in fact there was a regional good trip or
- 01:17:43bad trip levels of mutants in this study,
- 01:17:46but otherwise it's.
- 01:17:47Yeah, I think there is a general bias
- 01:17:50from a researcher in psychedelic towards
- 01:17:52the good trip and a very good setting.
- 01:17:54So many people in fact in this in this study.
- 01:17:58Did not experience such a bad trip
- 01:18:01and so we don't have, I think,
- 01:18:03enough cases to really have the
- 01:18:06neural correlates of battrick.
- 01:18:08But this is a very interesting question,
- 01:18:10of course, because we. She started.
- 01:18:14Yeah, yeah. I'm sure you would
- 01:18:17have improvement for that, but
- 01:18:19can be interesting and at least, yeah.
- 01:18:24Risk benefit ratio. You know, like.
- 01:18:29To protect patients from that, we have
- 01:18:32to know what it is.
- 01:18:34Worked for a couple of days,
- 01:18:35but I think like anyways we do,
- 01:18:38if there's more and more study,
- 01:18:40we will have more. Yeah. I mean,
- 01:18:42yeah, it could turn into, yeah,
- 01:18:44if you start, you can evaluate
- 01:18:45exactly. And the second one was why?
- 01:18:49Depression do not respond.
- 01:18:51So yeah, I mean this is even a broader
- 01:18:53question like for for psychiatrists like
- 01:18:55why in some case you give a medicine it
- 01:18:58works and sometimes it doesn't work.
- 01:18:59So it's a very difficult question.
- 01:19:02Probably there is heterogeneity in
- 01:19:04patients with depression first of all.
- 01:19:06So of course they may not have the the
- 01:19:08same neural mechanisms of depression and
- 01:19:10and thereby not the same like a response
- 01:19:14to to treatment after like I can say
- 01:19:18from my experience with ketamine because.
- 01:19:20We were using a lot of ketamine to
- 01:19:23help people with a resistant depression
- 01:19:25and I don't know you manage afterward
- 01:19:28to to know a bit which patient will
- 01:19:31be will have a good trip or bad
- 01:19:33trip or will have a response.
- 01:19:34And in in particular I think one of
- 01:19:36the main aspect is really to accept
- 01:19:39the condition of the drug and to
- 01:19:41accept also to be high during a while.
- 01:19:43And this is something that is absolutely
- 01:19:45not easy to accept for many people and
- 01:19:48in particular patient because they are.
- 01:19:50Really afraid.
- 01:19:51And one of the questions for example
- 01:19:53is for people with trauma like whether
- 01:19:57the dissociative experience that they
- 01:19:59can really experience during during
- 01:20:02ketamine or I don't know exactly
- 01:20:04with psychedelic,
- 01:20:04we don't have a lot of data on that,
- 01:20:06but how it can be managed and will
- 01:20:08it be positive or negative for them.
- 01:20:11And also there is a decorrelation between
- 01:20:14the acute effect and the beneficial effects,
- 01:20:16OK.
- 01:20:17I mean it's quite striking straightening
- 01:20:18like some some of them will have very.
- 01:20:20Kind of battery backfilling,
- 01:20:21but afterward they will feel really
- 01:20:23good and some other will really
- 01:20:25enjoy the trip and they will have
- 01:20:26no room blasting with the effects.
- 01:20:28So there are several layers of
- 01:20:31response to that question, I think.
- 01:20:33Yeah.
- 01:20:36So it's still bad?
- 01:20:37Yeah. See this. Thanks.
- 01:20:40And measured by MRI like do you
- 01:20:43know approximately, I don't,
- 01:20:44I don't think the last and the reason
- 01:20:46I ask the question is thinking
- 01:20:48logistically in terms of but we
- 01:20:49have the best imaging as another
- 01:20:51tool not being able to measure.
- 01:20:53The occupancy of the party still
- 01:20:55do every sector and then getting
- 01:20:57a sense of how that occupancy
- 01:20:59in a specific area is related
- 01:21:01to what we see with the MRI.
- 01:21:03But I don't know if that's gonna
- 01:21:05be like along those effects last,
- 01:21:08is that something that we can
- 01:21:10see like 24 hours later or
- 01:21:11yeah, so most of the study that's
- 01:21:14explored the long lasting effect
- 01:21:16like they explored one week
- 01:21:18after or something like that.
- 01:21:20But I cannot remember something
- 01:21:22really long term in general the
- 01:21:25safety between two doses is so for
- 01:21:28study for example that are crossover.
- 01:21:31So for the clinical trial they
- 01:21:32really tried to have.
- 01:21:33Long time between the two,
- 01:21:35but for like from dental study
- 01:21:38usually they manage at least two
- 01:21:40weeks between 2 intake to be sure that
- 01:21:43they will not like the long lasting
- 01:21:45effect for the placebo or condition.
- 01:21:47But yeah it's I mean this question
- 01:21:49is not solved like we don't know
- 01:21:52exactly and we don't have enough
- 01:21:54data to to really answer how long
- 01:21:56does it last because you have like
- 01:21:58just the effect of the drug staying
- 01:22:00in the brain but also like I did not
- 01:22:02mention the effect on on synaptic.
- 01:22:04But it's probably also very important in
- 01:22:07particular for the beneficial effects,
- 01:22:09and this may be long lasting effects.
- 01:22:13We have a couple
- 01:22:14more questions in the chat,
- 01:22:15but we are at 5:00 o'clock.
- 01:22:18It was a wonderful presentation.
- 01:22:20I really covered a lot of ground.
- 01:22:21Thank you. Thank you.
- 01:22:30I mean people can send me
- 01:22:32emails and have discussion.
- 01:22:34I would be very happy to.
- 01:22:38Yeah. Qualitative
- 01:22:40analysis of different narratives
- 01:22:41in our seeking treatment study, OK.
- 01:22:45Say. You know. And the model.