Psychedelics for recovery from stroke and traumatic brain injury Original paper

Stroke and traumatic brain injury (TBI) are major causes of disability, and current rehabilitation practices often aren’t enough to promote a full recovery. Psychedelics have been investigated for other cognitive and psychological effects; could they help an injured brain recover?

This mini-review collected in vitro, in vivo, and clinical research on classical psychedelics (e.g., psilocybin, LSD, mescaline, DMT) and MDMA to evaluate whether they show any promise for treating brain injury.

The investigators concluded that the substances investigated could potentially benefit brain injury in four major ways:

• Regulating neuroinflammation: Although it is a necessary part of repair after injury, inflammation probably also contributes to damage when blood flow to the brain tissue is restored after a stroke. The receptors that classical psychedelics act on (such as 5-HT2A and S1R) are known to be present in immunomodulatory pathways, and other activators of these receptors have strong immunomodulatory effects in vivo.

• Promoting neurogenesis: Although there isn’t a direct correlation between neurogenesis and recovery from stroke and TBI, neurogenesis is still associated with positive outcomes such as improved cognition and memory. The 5HT receptors are involved in neurogenesis, which means that psychedelics that act on these receptors may be beneficial.

• • Promoting neuroplasticity: * Neuroplasticity is necessary for the recovery of physical function after brain injury, and several strategies for inducing neuroplasticity (such as transcranial magnetic stimulation and deep brain stimulation) show promise for improving stroke recovery. The S1R receptor has been implicated in neuroplasticity, so psychedelics may increase neuroplasticity through their action on this receptor. Additionally, psychedelics can considerably increase brain-derived neurotrophic factor (BDNF), which promotes neuroplasticity. However, it’s worth noting that other drugs that increase BDNF haven’t been able to improve recovery from brain injury.

• Increasing brain activity complexity: The complexity of the activity in the brain has been theorized to reflect the level of consciousness that a person is experiencing, and people with disorders of consciousness (such as experiencing locked-in syndrome or being in a vegetative state or coma) have low levels of brain activity complexity. Psychedelics (as well as ketamine) have been shown to increase brain activity beyond what is seen in normal wakefulness and therefore may benefit people who experience disorders of consciousness after a brain injury.