Seeking the Psilocybiome: Psychedelics meet the microbiota-gut-brain axis

Moving towards a systems psychiatry paradigm embraces the inherent complex interactions across all levels from micro to macro and necessitates an integrated approach to treatment. Cortical 5-HT2A receptors are key primary targets for the effects of serotonergic psychedelics. However, the therapeutic mechanisms underlying psychedelic therapy are complex and traverse molecular, cellular, and network levels, under the influence of biofeedback signals from the periphery and the environment. At the interface between the individual and the environment, the gut microbiome, via the gut-brain axis, plays an important role in the unconscious parallel processing systems regulating host neurophysiology. While psychedelic and microbial signalling systems operate over different timescales, the microbiota-gut-brain (MGB) axis, as a convergence hub between multiple biofeedback systems may play a role in the preparatory phase, the acute administration phase, and the integration phase of psychedelic therapy. In keeping with an interconnected systems-based approach, this review will discuss the gut microbiome and mycobiome and pathways of the MGB axis, and then explore the potential interaction between psychedelic therapy and the MGB axis and how this might influence mechanism of action and treatment response. Finally, we will discuss the possible implications for a precision medicine-based psychedelic therapy paradigm. (AU)

Seeking the Psilocybiome: Psychedelics meet the microbiota-gut-brain axis.

Moving towards a systems psychiatry paradigm embraces the inherent complex interactions across all levels from micro to macro and necessitates an integrated approach to treatment. Cortical 5-HT2A receptors are key primary targets for the effects of serotonergic psychedelics. However, the therapeutic mechanisms underlying psychedelic therapy are complex and traverse molecular, cellular, and network levels, under the influence of biofeedback signals from the periphery and the environment. At the interface between the individual and the environment, the gut microbiome, via the gut-brain axis, plays an important role in the unconscious parallel processing systems regulating host neurophysiology. While psychedelic and microbial signalling systems operate over different timescales, the microbiota-gut-brain (MGB) axis, as a convergence hub between multiple biofeedback systems may play a role in the preparatory phase, the acute administration phase, and the integration phase of psychedelic therapy. In keeping with an interconnected systems-based approach, this review will discuss the gut microbiome and mycobiome and pathways of the MGB axis, and then explore the potential interaction between psychedelic therapy and the MGB axis and how this might influence mechanism of action and treatment response. Finally, we will discuss the possible implications for a precision medicine-based psychedelic therapy paradigm.

A Dataset for Temporal Semantic Segmentation Dedicated to Smart Mobility of Wheelchairs on Sidewalks.

In smart mobility, the semantic segmentation of images is an important task for a good understanding of the environment. In recent years, many studies have been made on this subject, in the field of Autonomous Vehicles on roads. Some image datasets are available for learning semantic segmentation models, leading to very good performance. However, for other types of autonomous mobile systems like Electric Wheelchairs (EW) on sidewalks, there is no specific dataset. Our contribution presented in this article is twofold: (1) the proposal of a new dataset of short sequences of exterior images of street scenes taken from viewpoints located on sidewalks, in a 3D virtual environment (CARLA); (2) a convolutional neural network (CNN) adapted for temporal processing and including additional techniques to improve its accuracy. Our dataset includes a smaller subset, made of image pairs taken from the same places in the maps of the virtual environment, but from different viewpoints: one located on the road and the other located on the sidewalk. This additional set is aimed at showing the importance of the viewpoint in the result of semantic segmentation.

Self-Supervised Sidewalk Perception Using Fast Video Semantic Segmentation for Robotic Wheelchairs in Smart Mobility.

The real-time segmentation of sidewalk environments is critical to achieving autonomous navigation for robotic wheelchairs in urban territories. A robust and real-time video semantic segmentation offers an apt solution for advanced visual perception in such complex domains. The key to this proposition is to have a method with lightweight flow estimations and reliable feature extractions. We address this by selecting an approach based on recent trends in video segmentation. Although these approaches demonstrate efficient and cost-effective segmentation performance in cross-domain implementations, they require additional procedures to put their striking characteristics into practical use. We use our method for developing a visual perception technique to perform in urban sidewalk environments for the robotic wheelchair. We generate a collection of synthetic scenes in a blending target distribution to train and validate our approach. Experimental results show that our method improves prediction accuracy on our benchmark with tolerable loss of speed and without additional overhead. Overall, our technique serves as a reference to transfer and develop perception algorithms for any cross-domain visual perception applications with less downtime.

Case of paediatric catatonia precipitated by antipsychotic withdrawal in a child with autism spectrum disorder.

A 13-year-old girl with moderate intellectual disability and autism spectrum disorder (ASD) was admitted to the paediatric high-dependency unit following an 8-week history of altered mental status and motor behaviour. Her symptoms emerged followed shortly after discontinuation of risperidone, an atypical antipsychotic previously commenced to manage disruptive behaviour associated with ASD. On physical examination, the patient presented with negativism, grimacing, automatic obedience, waxy flexibility and ambitendency. Blood tests, neuroimaging and lumbar puncture failed to reveal an acute infectious or neurological precipitant. She responded immediately to a trial of intramuscular lorazepam titrated to a total daily dose of 12 mg. This case presents challenges of accurately diagnosing and managing catatonic symptoms in adolescent patients with ASD. We also discuss the potential risk of precipitating catatonia following the discontinuation of antipsychotic treatment that has been prescribed for a prolonged duration.

Mental healthcare interfaces in a regional Irish prison.

PURPOSE: The purpose of this paper is to study the demographic, clinical characteristics and outcomes for those prisoners referred to secondary mental healthcare in a regional Irish prison and the proportion of individuals diverted subsequently from prison to psychiatric settings. DESIGN/METHODOLOGY/APPROACH: The authors conducted a retrospective review of 130 successive psychiatric assessment case records at a regional mixed gender prison serving six southern Irish counties. The authors analysed demographics, clinical characteristics and outcomes. Where diversion out of prison was undertaken, Dangerousness, Understanding, Recovery and Urgency Manual (DUNDRUM) scores were retrospectively completed to assess security need. FINDINGS: In total, 8.6 per cent of all committals from liberty were referred by a general practitioner and 8.1 per cent subsequently assessed by the visiting psychiatrist. Predominantly, these were young males charged with a violent offence. In all, 42.2 per cent of those assessed by secondary care were diagnosed with a substance misuse disorder and 21.1 per cent with a personality disorder. In total, 20.3 per cent suffered from a psychotic disorder and 10.6 per cent with an affective disorder. Of those seen by psychiatric services, 51.2 per cent required psychotropic medication, 29.2 per cent required psychological input and 59.3 per cent required addiction counselling. In all, 10.6 per cent of those assessed were diverted from prison, the majority to approved centres. Mean DUNDRUM-1 scores suggested that those referred to high and medium secure hospitals were appropriately placed, whereas those diverted to open wards would have benefited from a low secure/intensive care setting. ORIGINALITY/VALUE: The multifaceted need set of those referred strengthens the argument for the provision of multidisciplinary mental healthcare into prisons. The analysis of security needs for those diverted from prisons supports the need for Intensive Care Regional Units in Ireland.