Brain connectivity changes after psilocybin treatment in body dysmorphic disorder patients

Body dysmorphic disorder (BDD) is a debilitating mental illness characterized by an obsessive preoccupation with perceived flaws in one's physical appearance. Patients with BDD often have distorted self-image, intrusive thoughts, and compulsive behaviors that significantly impair daily functioning and quality of life. Current therapies have limited efficacy, leaving many sufferers without relief.

A new study led by researchers at Columbia University and published in Psychedelics (Genomic Press, New York, USA) provides hope by revealing how the psychedelic drug psilocybin, the active ingredient in "magic mushrooms," may rewire change connectivity of brain circuitry, potentially aiding in the treatment of this debilitating disorder.

In the pilot trial, eight adults with moderate-to-severe BDD that had not responded to standard treatments received a single 25mg oral dose of psilocybin in a supportive setting. Using cutting-edge functional MRI technology, the scientists scanned the participants' brains one day before and one day after the psilocybin session. Sophisticated pattern analysis techniques were then applied to map changes in brain network connectivity and link them to subsequent clinical outcomes.

The results were striking: Just one day after psilocybin administration, the patients exhibited increased connectivity both within a network governing executive functions, and between this network and others involved in processing emotionally salient stimuli and self-referential thinking. Notably, those who showed the greatest strengthening of these neural connections also experienced the most improvement in BDD symptoms one week later.

While preliminary, the findings align with a growing body of evidence indicating that psychedelic compounds like psilocybin can promote mental health by enhancing the brain's capacity for flexibility and integration. By facilitating communication within and between brain networks that are often dysregulated in psychiatric disorders, psilocybin may help restore more adaptive cognitive and emotional functioning.

As the first study of psilocybin in a BDD population, the trial was small and lacked a placebo control. The researchers caution that larger, placebo-controlled studies are needed to verify the efficacy and durability of the treatment. Still, the robust brain-behavior relationships uncovered bode well for the ongoing development of psilocybin therapy.