Yousefi P, Lietz Morten P, O'Higgins F J, Rippe R C A, Hasler G, van Elk M, Enriquez-Geppert S
Cognitive Psychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands.
Molecular Psychiatry Lab, Faculty of Science and Medicine, University of Freiburg, Villars-sur-Glâne, Switzerland.
Psychopharmacology (Berl). 2025 Jun;242(6):1171-1196. doi: 10.1007/s00213-024-06742-2. Epub 2025 Jan 23.
Psilocybin shows promise for treating neuropsychiatric disorders. However, insight into its acute effects on cognition is lacking. Given the significant role of executive functions in daily life and treatment efficacy, it is crucial to evaluate how psilocybin influences these cognitive domains.
This meta-analysis aims to quantify the acute effects of psilocybin on executive functions and attention, while examining how dosage, timing of administration, cognitive domain, and task characteristics moderate these effects.
A systematic review and multilevel meta-analysis were conducted on empirical studies assessing psilocybin's acute effects on working memory, conflict monitoring, response inhibition, cognitive flexibility, and attention. Effect sizes for reaction time (RT) and accuracy (ACC) were calculated, exploring the effects of timing (on-peak defined as 90-180 min post-administration), dosage, cognitive function categories, and task sensitivity to executive functions as potential moderators.
Thirteen studies (42 effect sizes) were included. In the acute phase, psilocybin increased RTs (Hedges' g = 1.13, 95% CI [0.57, 1.7]) and did not affect ACC (Hedges' g = -0.45, 95% CI [-0.93, 0.034]). Effects on RT were dose dependent. Significant between-study heterogeneity was found for both RT and ACC. Task sensitivity to executive functions moderated RT effects. Publication bias was evident, but the overall effect remained significant after adjustment for this.
Our meta-analysis shows that psilocybin impairs executive functions and results in a slowing down of RT. We discuss potential neurochemical mechanisms underlying the observed effects as well as implications for the safe use of psilocybin in clinical and experimental contexts.
裸盖菇素在治疗神经精神疾病方面显示出前景。然而，目前缺乏对其对认知的急性影响的深入了解。鉴于执行功能在日常生活和治疗效果中的重要作用，评估裸盖菇素如何影响这些认知领域至关重要。
本荟萃分析旨在量化裸盖菇素对执行功能和注意力的急性影响，同时研究剂量、给药时间、认知领域和任务特征如何调节这些影响。
对评估裸盖菇素对工作记忆、冲突监测、反应抑制、认知灵活性和注意力的急性影响的实证研究进行了系统综述和多层次荟萃分析。计算了反应时间（RT）和准确性（ACC）的效应量，探讨了时间（给药后90 - 180分钟定义为峰值）、剂量、认知功能类别以及任务对执行功能的敏感性作为潜在调节因素的影响。
纳入了13项研究（42个效应量）。在急性期，裸盖菇素增加了反应时间（Hedges' g = 1.13，95% CI [0.57, 1.7]），但不影响准确性（Hedges' g = -0.45，95% CI [-0.93, 0.034]）。对反应时间的影响呈剂量依赖性。在反应时间和准确性方面均发现了显著的研究间异质性。任务对执行功能的敏感性调节了反应时间的影响。存在明显的发表偏倚，但调整后总体效应仍然显著。
我们的荟萃分析表明，裸盖菇素会损害执行功能并导致反应时间减慢。我们讨论了观察到的效应背后的潜在神经化学机制以及裸盖菇素在临床和实验环境中安全使用的意义。
