目的:本研究旨在对健康人和创伤后应激障碍(PTSD)或重度抑郁障碍(MDD)患者中迷幻药的神经认知效应进行药理学研究。
方法:系统审查的首选报告项目(PRISMA)被用作本审查的结构和报告结果的指南。文献检索包括MEDLINE数据库,直至2022年12月。我们纳入了MDMA的随机或开放标签人体研究,psilocybin,mescaline,LSD,DMT,或大麻报告非情绪带电的神经认知结果(“冷认知”)通过验证的神经心理学测试测量。
结果:关于MDMA的全文共43篇(15篇),大麻(12),LSD(6),psilocybin(9),DMT/ayahuasca(1),包括mescaline(0),主要是健康的科目。纳入了一篇关于MDMA对PTSD受试者认知影响的文章;没有关于MDD中迷幻药和神经认知的研究。大多数关于健康受试者的研究报告了在迷幻药的峰值效应期间对认知的有害或中性影响,但有少数例外(例如,MDMA改善精神运动功能)。神经认知维度类型的表现(例如,注意,记忆,执行功能,精神运动)因迷幻类型而异,剂量,和认知测试。
结论:小样本和缺乏统一方法的研究排除了关于迷幻药是否增强的明确结论,减少,或者对认知表现没有显著影响。可以预见,迷幻药将很快成为各种精神疾病的可用治疗方法。应该在未来的研究中评估迷幻药对认知的急性和长期影响。
OBJECTIVE: This study aims to provide an overview of pharmacological trials that examine the neurocognitive effects of psychedelics among healthy individuals and patients with post-traumatic stress disorder (PTSD) or major depressive disorder (MDD).
METHODS: The Preferred Reporting Items for Systematic Reviews (PRISMA) was used as a guide to structure and report the findings for this review. A literature search included the MEDLINE database up until December 2022. We included randomized or open-label human studies of MDMA, psilocybin, mescaline, LSD, DMT, or cannabis reporting non-emotionally charged neurocognitive outcomes (\"cold cognition\") measured through validated neuropsychological tests.
RESULTS: A total of 43 full-text papers on MDMA (15), cannabis (12), LSD (6), psilocybin (9), DMT/ayahuasca (1), and mescaline (0) were included, mostly on healthy subjects. A single article on MDMA\'s effects on cognition in subjects with PTSD was included; there were no studies on psychedelics and neurocognition in MDD. Most of the studies on healthy subjects reported detrimental or neutral effects on cognition during the peak effect of psychedelics with a few exceptions (e.g., MDMA improved psychomotor function). Performance on the type of neurocognitive dimension (e.g., attention, memory, executive function, psychomotor) varies by type of psychedelic, dosage, and cognitive testing.
CONCLUSIONS: Small samples and a lack of uniformed methods across studies preclude unequivocal conclusions on whether psychedelics enhance, decrease, or have no significant effect on cognitive performance. It is foreseen that psychedelics will soon become an available treatment for various psychiatric disorders. The acute and long-term effects on cognition caused by psychedelics should be assessed in future studies.