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Peer-reviewed articleOpen access

A Virtual Clinical Trial of Psychedelics to Treat Patients With Disorders of Consciousness.

Alnagger NLNiD, Cardone PiD, Martial CiD, Perl YSiD, Mindlin IiD, Sitt JDiD, Roseman LiD, Carhart-Harris RiD, Nutt DiD, Mallaroni PiD, Mason NiD, Ramaekers JGiD, Bonhomme V, Laureys SiD, Deco GiD, Gosseries OiD, Núñez PiD, Annen JiD

Advanced science (Weinheim, Baden-Wurttemberg, Germany)Nov 20, 2025License: open accessBelgium, France, Spain, United Kingdom, United States, Netherlands, Canada2 citationsDOI: 10.1002/advs.202511780

Abstract

Disorders of consciousness (DoC), including unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS), have limited treatment options and are characterized by low complexity of brain activity. Recent research suggests that psychedelic drugs, which enhance the complexity of brain activity, could offer promising therapies. Here, individualized whole-brain computational models are developed for patients with DoC, optimized with empirical functional magnetic resonance imaging data and diffusion-weighted imaging data, upon which the administration of lysergic acid diethylamide (LSD) and psilocybin is simulated. An in silico perturbation protocol is applied to assess brain dynamics, first distinguishing between different states of consciousness, including DoC, anesthesia, and the psychedelic state. Then, brain dynamics are assessed before and after a simulation of psychedelic drugs on patients with DoC. Findings indicated that the simulation of LSD and psilocybin shifted the brain activity of patients with DoC closer to criticality (the point at a phase transition between order and chaos), with a greater effect in patients in the MCS. In patients with UWS, the treatment response correlated with structural connectivity, while in patients in the MCS, it aligned with baseline functional connectivity. These results offer a computational foundation for using psychedelics in DoC treatment and highlight the potential future role of computational modeling in drug discovery and personalized medicine.

Topics & conditions

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PsilocybinLSD

Keywords

Functional magnetic resonance imaging (fMRI)CriticalityDisorders Of ConsciousnessPsychedelicsDiffusion‐weighted Imaging (Dwi)Whole‐brain Modeling

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