Classical hallucinogens and neuroimaging: A systematic review of human studies: Hallucinogens and neuroimaging

- Serotonergic hallucinogens induce profound changes in the human mind/brain.
- Hallucinogenic effects are produced by agonism at cortical 5-HT2A receptors.
- 5-HT2A receptors modulate brain activity in fronto-temporo-parieto-occipital areas.
- Agonism at 5-HT2A receptor alters perceptions, memory, emotion, and self-awareness.
- Serotonergic hallucinogens have anxiolytic, antidepressive and antiaddictive effects.

Serotonergic hallucinogens produce alterations of perceptions, mood, and cognition, and have anxiolytic, antidepressant, and antiaddictive properties. These drugs act as agonists of frontocortical 5-HT2A receptors, but the neural basis of their effects are not well understood. Thus, we conducted a systematic review of neuroimaging studies analyzing the effects of serotonergic hallucinogens in man. Studies published in the PubMed, Lilacs, and SciELO databases until 12 April 2016 were included using the following keywords: “ayahuasca”, “DMT”, “psilocybin”, “LSD”, “mescaline” crossed one by one with the terms “mri”, “fmri”, “pet”, “spect”, “imaging” and “neuroimaging”. Of 279 studies identified, 25 were included. Acute effects included excitation of frontolateral/frontomedial cortex, medial temporal lobe, and occipital cortex, and inhibition of the default mode network. Long-term use was associated with thinning of the posterior cingulate cortex, thickening of the anterior cingulate cortex, and decreased neocortical 5-HT2A receptor binding. Despite the high methodological heterogeneity and the small sample sizes, the results suggest that hallucinogens increase introspection and positive mood by modulating brain activity in the fronto-temporo-parieto-occipital cortex.