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The central role of the Thalamus in psychosis, lessons from neurodegenerative diseases and psychedelics

Summary

This paper explores how the thalamus, a key brain structure controlling attention and perception, malfunctions in Parkinson’s disease and similar neurological conditions, causing hallucinations and delusions. Interestingly, these symptoms resemble the altered mental states produced by psychedelic drugs like LSD and psilocybin. By studying both conditions together, researchers found that a common mechanism called thalamocortical dysrhythmia disrupts how the brain filters information and processes reality, offering new insights for treating psychotic symptoms.

Background

The thalamus plays a critical role in modulating consciousness and perception. Psychotic symptoms in Parkinson’s disease (PD) and Dementia with Lewy Bodies (DLB) share phenomenological similarities with altered states induced by psychedelic compounds, suggesting common underlying neurobiological mechanisms.

Objective

To propose that thalamocortical dysrhythmia (TCD) is a central mechanism linking psychosis in neurodegenerative diseases with altered states of consciousness induced by psychedelics, and to establish a conceptual bridge between neurology and psychiatry.

Results

Evidence demonstrates that TCD dysregulates thalamic filtering and impairs default mode network (DMN) coupling with task-positive networks, occurring in both PD-DLB psychosis and psychedelic-induced states. Serotonergic 5-HT2A receptor modulation and cholinergic system dysfunction emerge as key pathways in both conditions.

Conclusion

ThalamoCortical dysrhythmia provides a unifying pathophysiological framework for understanding psychosis in neurodegenerative diseases and psychedelic-induced altered states, offering new therapeutic insights and bridging neurology-psychiatry conceptual divide.
  • Published in:Translational Psychiatry,
  • Study Type:Review,
  • Source: PMC10719401, PMID: 38092757
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