Post-acute psychological effects of classical serotonergic psychedelics: a systematic review and meta-analysis.

BACKGROUND: Scientific interest in the therapeutic effects of classical psychedelics has increased in the past two decades. The psychological effects of these substances outside the period of acute intoxication have not been fully characterized. This study aimed to: (1) quantify the effects of psilocybin, ayahuasca, and lysergic acid diethylamide (LSD) on psychological outcomes in the post-acute period; (2) test moderators of these effects; and (3) evaluate adverse effects and risk of bias. METHODS: We conducted a systematic review and meta-analysis of experimental studies (single-group pre-post or randomized controlled trials) that involved administration of psilocybin, ayahuasca, or LSD to clinical or non-clinical samples and assessed psychological outcomes ⩾24 h post-administration. Effects were summarized by study design, timepoint, and outcome domain. RESULTS: A total of 34 studies (24 unique samples, n = 549, mean longest follow-up = 55.34 weeks) were included. Classical psychedelics showed significant within-group pre-post and between-group placebo-controlled effects on a range of outcomes including targeted symptoms within psychiatric samples, negative and positive affect-related measures, social outcomes, and existential/spiritual outcomes, with large between-group effect in these domains (Hedges' gs = 0.84 to 1.08). Moderator tests suggest some effects may be larger in clinical samples. Evidence of effects on big five personality traits and mindfulness was weak. There was no evidence of post-acute adverse effects. CONCLUSIONS: High risk of bias in several domains, heterogeneity across studies, and indications of publication bias for some models highlight the need for careful, large-scale, placebo-controlled randomized trials.

Age-Related Changes in Temporal Processing of Rapidly-Presented Sound Sequences in the Macaque Auditory Cortex.

The mammalian auditory cortex is necessary to resolve temporal features in rapidly-changing sound streams. This capability is crucial for speech comprehension in humans and declines with normal aging. Nonhuman primate studies have revealed detrimental effects of normal aging on the auditory nervous system, and yet the underlying influence on temporal processing remains less well-defined. Therefore, we recorded from the core and lateral belt areas of auditory cortex when awake young and old monkeys listened to tone-pip and noise-burst sound sequences. Elevated spontaneous and stimulus-driven activity were the hallmark characteristics in old monkeys. These old neurons showed isomorphic-like discharge patterns to stimulus envelopes, though their phase-locking was less precise. Functional preference in temporal coding between the core and belt existed in the young monkeys but was mostly absent in the old monkeys, in which old belt neurons showed core-like response profiles. Finally, the analysis of population activity patterns indicated that the aged auditory cortex demonstrated a homogenous, distributed coding strategy, compared to the selective, sparse coding strategy observed in the young monkeys. Degraded temporal fidelity and highly-responsive, broadly-tuned cortical responses could underlie how aged humans have difficulties to resolve and track dynamic sounds leading to speech processing deficits.

Nonspatial sequence coding varies along the CA1 transverse axis.

The hippocampus plays a critical role in the memory for sequences of events, a defining feature of episodic memory. To shed light on the fundamental mechanisms supporting this capacity, we recently recorded neural activity in CA1 as rats performed a nonspatial odor sequence memory task. Our main finding was that, while the animals' location and behavior remained constant, a proportion of CA1 neurons fired differentially to odors depending on whether they were presented in or out of sequence (sequence cells). Here, we further examined if such sequence coding varied along the distal-to-proximal axis of the dorsal CA1 region (distal: toward subiculum; proximal: toward CA3). Differences in information processing along this axis have been suggested by recent anatomical and electrophysiological evidence that odor information may be more strongly represented in the distal segment, whereas spatial information may be more strongly represented in the proximal segment. Recorded neurons were grouped into four arbitrary sections of dorsal CA1, ranging from distal to proximal. We found that, although sequence cell coding was observed across the distal-to-proximal extent of CA1 from which we recorded, it was significantly higher in intermediate CA1, a region with more balanced anatomical input from lateral and medial entorhinal regions. More specifically, in that particular segment of CA1, we observed a significant increase in the magnitude of sequence coding of all cells, as well as in the sequential information content of sequence cells. Importantly, a different pattern was observed when examining the distribution of spatial coding from the same electrodes. Consistent with previous reports, our results suggest that spatial information was more strongly represented in the proximal section of CA1 (higher proportion of cells with place fields). These findings indicate that nonspatial sequence memory coding is not uniformly distributed along the transverse axis of CA1, and that this distribution does not simply follow the expected gradient based on the stimulus modality or the degree of spatial selectivity. Instead, the observed distribution suggests this form of sequence coding may be associated with convergent input from lateral and medial entorhinal regions, which is present throughout the proximodistal axis but greater in intermediate CA1.

Local field potential correlates of auditory working memory in primate dorsal temporal pole.

Dorsal temporal pole (dTP) is a cortical region at the rostral end of the superior temporal gyrus that forms part of the ventral auditory object processing pathway. Anatomical connections with frontal and medial temporal areas, as well as a recent single-unit recording study, suggest this area may be an important part of the network underlying auditory working memory (WM). To further elucidate the role of dTP in auditory WM, local field potentials (LFPs) were recorded from the left dTP region of two rhesus macaques during an auditory delayed matching-to-sample (DMS) task. Sample and test sounds were separated by a 5-s retention interval, and a behavioral response was required only if the sounds were identical (match trials). Sensitivity of auditory evoked responses in dTP to behavioral significance and context was further tested by passively presenting the sounds used as auditory WM memoranda both before and after the DMS task. Average evoked potentials (AEPs) for all cue types and phases of the experiment comprised two small-amplitude early onset components (N20, P40), followed by two broad, large-amplitude components occupying the remainder of the stimulus period (N120, P300), after which a final set of components were observed following stimulus offset (N80OFF, P170OFF). During the DMS task, the peak amplitude and/or latency of several of these components depended on whether the sound was presented as the sample or test, and whether the test matched the sample. Significant differences were also observed among the DMS task and passive exposure conditions. Comparing memory-related effects in the LFP signal with those obtained in the spiking data raises the possibility some memory-related activity in dTP may be locally produced and actively generated. The results highlight the involvement of dTP in auditory stimulus identification and recognition and its sensitivity to the behavioral significance of sounds in different contexts. This article is part of a Special Issue entitled SI: Auditory working memory.

Age-related changes of auditory brainstem responses in nonhuman primates.

Nonhuman primates, compared with humans and rodents, have historically been far less used for studies of age-related hearing loss, primarily because of their long life span and high cost of maintenance. Strong similarities in genetics, anatomy, and neurophysiology of the auditory nervous system between humans and monkeys, however, could provide fruitful opportunities to enhance our understanding of hearing loss. The present study used a common, noninvasive technique for testing hearing sensitivity in humans, the auditory brainstem response (ABR), to assess the hearing of 48 rhesus macaques from 6 to 35 yr of age to clicks and tone stimuli between 0.5 and 16.0 kHz. Old monkeys, particularly those above 21.5 yr of age, had missing ABR waveforms at high frequencies. Regression analyses revealed that ABR threshold increased as a function of age at peaks II and IV simultaneously. In the suprathreshold hearing condition (70 dB peak sound pressure level), ABR-based audiograms similarly varied as a function of age such that old monkeys had smaller peak amplitudes and delayed latencies at low, middle, and high frequencies. Peripheral hearing differences remained a major influence associated with age-related changes in audiometric functions of old monkeys at a comparable sensation level across animals. The present findings suggest that hearing loss occurs in old monkeys across a wide range of frequencies and that these deficits increase in severity with age. Parallel to prior studies in monkeys, we found weak effects of sex on hearing, and future investigations are necessary to clarify its role in age-related hearing loss.

Neural correlates of auditory recognition memory in the primate dorsal temporal pole.

Temporal pole (TP) cortex is associated with higher-order sensory perception and/or recognition memory, as human patients with damage in this region show impaired performance during some tasks requiring recognition memory (Olson et al. 2007). The underlying mechanisms of TP processing are largely based on examination of the visual nervous system in humans and monkeys, while little is known about neuronal activity patterns in the auditory portion of this region, dorsal TP (dTP; Poremba et al. 2003). The present study examines single-unit activity of dTP in rhesus monkeys performing a delayed matching-to-sample task utilizing auditory stimuli, wherein two sounds are determined to be the same or different. Neurons of dTP encode several task-relevant events during the delayed matching-to-sample task, and encoding of auditory cues in this region is associated with accurate recognition performance. Population activity in dTP shows a match suppression mechanism to identical, repeated sound stimuli similar to that observed in the visual object identification pathway located ventral to dTP (Desimone 1996; Nakamura and Kubota 1996). However, in contrast to sustained visual delay-related activity in nearby analogous regions, auditory delay-related activity in dTP is transient and limited. Neurons in dTP respond selectively to different sound stimuli and often change their sound response preferences between experimental contexts. Current findings suggest a significant role for dTP in auditory recognition memory similar in many respects to the visual nervous system, while delay memory firing patterns are not prominent, which may relate to monkeys' shorter forgetting thresholds for auditory vs. visual objects.

Primate auditory recognition memory performance varies with sound type.

Neural correlates of auditory processing, including for species-specific vocalizations that convey biological and ethological significance (e.g., social status, kinship, environment), have been identified in a wide variety of areas including the temporal and frontal cortices. However, few studies elucidate how non-human primates interact with these vocalization signals when they are challenged by tasks requiring auditory discrimination, recognition and/or memory. The present study employs a delayed matching-to-sample task with auditory stimuli to examine auditory memory performance of rhesus macaques (Macaca mulatta), wherein two sounds are determined to be the same or different. Rhesus macaques seem to have relatively poor short-term memory with auditory stimuli, and we examine if particular sound types are more favorable for memory performance. Experiment 1 suggests memory performance with vocalization sound types (particularly monkey), are significantly better than when using non-vocalization sound types, and male monkeys outperform female monkeys overall. Experiment 2, controlling for number of sound exemplars and presentation pairings across types, replicates Experiment 1, demonstrating better performance or decreased response latencies, depending on trial type, to species-specific monkey vocalizations. The findings cannot be explained by acoustic differences between monkey vocalizations and the other sound types, suggesting the biological, and/or ethological meaning of these sounds are more effective for auditory memory.

Scopolamine impairs auditory delayed matching-to-sample performance in monkeys.

Information concerning the major neurotransmitters critical for auditory memory is sparse. One possibility is the cholinergic system, important for performance in some tasks requiring visual short-term memory and attention [T.G. Aigner, M. Mishkin, The effects of physostigmine and scopolamine on recognition memory in monkeys, Behav. Neural. Biol. 45 (1986) 81-87; N. Hironaka, K. Ando, Effects of cholinergic drugs on scopolamine-induced memory impairment in rhesus monkeys, Jpn. J. Psychopharmacol. 16 (1996) 103-108; T.M. Myers, G. Galbicka, M.L. Sipos, S. Varadi, J.L. Oubre, M.G. Clark, Effects of anticholinergics on serial-probe recognition accuracy of rhesus macaques (Macaca mulatta), Pharmacol. Biochem. Behav. 73 (2002) 829-834; H. Ogura, T.G. Aigner, MK-801 Impairs recognition memory in rhesus monkeys: comparison with cholinergic drugs, J. Pharmacol. Exp. Ther. 266 (1993) 60-64; D.M. Penetar, J.H. McDonough Jr., Effects of cholinergic drugs on delayed match-to-sample performance of rhesus monkeys, Pharmacol. Biochem. Behav. 19 (1983) 963-967; M.A. Taffe, M.R. Weed, L.H. Gold, Scopolamine alters rhesus monkey performance on a novel neuropsychological test battery, Cogn. Brain Res. 8 (1999) 203-212]. Five rhesus monkeys were trained to perform an auditory go/no-go delayed matching-to-sample (DMTS) task wherein two acoustic stimuli (500ms), separated by variable memory delays (500ms, 2500ms, or 5000ms), were either identical sound presentations, i.e., match trials, or two different sound presentations, i.e., nonmatch trials. Sound stimuli were chosen semi-randomly from a large set sound set ( approximately 900). After reaching a criterion of 80% correct on the behavioral task, monkeys were injected with saline or doses of scopolamine hydrochloride mixed in saline (3 microg, 5 microg, and 10 microg per 1kg of weight), 30 min before training. Scopolamine impaired performance accuracy on match trials in a dose-dependent manner. Blocking muscarinic receptors with scopolamine did not significantly impair motor responses, food motivation, or responses to rewarded sound. These findings support the hypothesis that the cholinergic system is important for auditory short-term memory.

Double dissociation of attentional resources: prefrontal versus cingulate cortices.

Efficient attention to our environment facilitates the decisions that need to be executed in daily life. Filtering critical from noncritical information may require the neural organization of multiple brain regions. Combining lesion techniques and the rodent version of the Wisconsin card sorting task in humans, we show at least two types of attentional processing systems reside in the cingulate and prefrontal cortices depending on task demands requiring shifts of attention within or between sets of meaningful cues, respectively. This neural organization for shifting attention either within or between perceptual dimensions is task dependent, and this type of organization provides evidence of attentional systems that transcend separate modality processing systems while subdividing executive control of attention. The results suggest that the anterior and posterior cingulate cortices are critical when shifting attention to closely related meaningful cues (i.e., within a perceptual dimension or attentional set) by suppressing interference of irrelevant background information, whereas the prefrontal cortex is critical when shifting attention between disparate sets of meaningful cues (i.e., between perceptual dimensions or attentional sets) (Dias et al., 1996a,b; Birrell and Brown, 2000). Based on the theories of Mackintosh (1965, 1975; Sutherland and Mackintosh, 1971), it is suggested that the cingulate cortex may be important for decreasing attention to irrelevant information. In general, attention deficit disorders affect both children and adults, and current medications may affect the prefrontal and associated parietal cortical systems more or less than the cingulate cortical system.