Findings of effects for minimally conscious woman with Traumatic Brain Injury

A Dose of Psilocybin Sparked Brain Activity in a Minimally Conscious Woman

A barely conscious woman showed surprising brain activity and movement after psilocybin administration, raising questions about psychedelics and consciousness.

In a first-of-its-kind case study, researchers observed brain activity and spontaneous movements after administering psilocybin, the psychoactive compound in psychedelic mushrooms, to a woman in a minimally conscious state. While she didn’t regain full awareness, her brain showed signstypically seen in healthy individuals while under the influence of psychedelics.

The 41-year-old woman had been diagnosed with minimally conscious state plus (MCS+), a condition where patients show limited signs of awareness but remain largely unresponsive. The patient has been in this state for over a year after experiencing a traumatic brain injury. During that time, her caregiver (who’s also her husband) tried various interventions without success. He then administered a psilocybin tincture via a gastric tube while at home in Colorado, where psilocybin is decriminalized. He observed leg movements and then contacted researchers in Belgium to let them know what happened. A formal observation session was then organized, wherein a full 2.5-gram dose of psilocybin was given. The researchers didn’t administer the drug themselves, but they recorded EEG data before and after the session to monitor how her brain responded.

“We observed a striking increase in brain signal complexity,” said Olivia Gosseries, one of the case study’s authors, to DoubleBlind. “This is usually seen in healthy subjects [who have consumed] psychedelics, not in patients with impaired consciousness.”

That complexity, measured by something called Lempel-Ziv complexity, suggests a richer, more variable brain signal. Post-dose, her EEG also showed a drop in slower brain waves, such as delta waves, and a boost in faster ones, like gamma; these patterns are associated with the psychedelic state.

While her clinical assessments didn’t improve, her body reacted in new ways. She lifted both legs, held them aloft, and visibly shivered her right leg, a side that hadn’t moved at rest before. Her eyes and mouth opened with unusual alertness. 

“The leg movements had previously been reported by the patient’s husband at lower doses of psilocybin, so their reoccurrence was anticipated,” Gosseries said. “However, given that these were spontaneous and unprompted movements, they cannot be interpreted as definitive evidence of increased consciousness.”

Gosseries believes the psilocybin may have induced what’s known as a disconnected state of consciousness. “Psilocybin increased brain signal complexity, which may parallel an increase in the richness of internal experience,” she said. “However, since we did not observe improved behavioral signs of consciousness at the bedside, we think that she may have entered a disconnected state of consciousness, similar to dreaming or a psychedelic ‘trip.’”

One curious outcome was that before the dose, the woman grimaced at a pain stimulus. Afterward, there was no response. “We noticed a clear absence of pain responses after psilocybin,” Gosseries said. “This could suggest an analgesic effect.”

The woman had only tried psilocybin once prior to her injury. Could that earlier exposure have influenced her response? 

“There is currently no empirical evidence demonstrating that prior exposure to psilocybin creates a form of ‘neurobiological recognition’ that would influence responses after severe brain injury,” Gosseries said. “While receptor-level adaptations such as desensitization or upregulation are known to occur with repeated exposure to some psychoactive substances, these mechanisms have not been clearly established for psilocybin, particularly after a single or limited number of exposures.”

This wasn’t a clinical trial, so there was no placebo control. “We did not design the experiment as this was an observational study,” Gosseries said. “Like all the interventions we propose, none of our patients are able to provide consent themselves. Together with the families, we carefully consider what might be in the patient’s best interest, based also on their prior wishes.”

It’s unclear whether her movements reflected a psychedelic experience or if they were a result of neurological noise. While more research is needed, the implications of this case study are staggering.

“Double Blind Magazine”