Disorders of consciousness (DoC) are a challenging and complex group of neurological conditions characterised by absent or impaired awareness. The current range of therapeutic options for DoC patients is limited, offering few non-invasive pharmacological alternatives. This situation has sprung a growing interest in the development of novel treatments, such as the proposal to study the efficacy of 5HT2A receptor agonists (also known as psychedelics) to restore impaired consciousness. Given the ethical implications of exploring novel compounds in non-communicative individuals, we assessed in silico their effects in the whole-brain dynamics of DoC patients. We embedded the whole-brain activity of patients in a low-dimensional space, and then used this representation to visualise the effects of simulated neuromodulation across a range of receptors representing potential drug targets. Our findings show that activation of serotonergic and opioid receptors shifted brain dynamics of DoC patients towards patterns typically seen in conscious and awake individuals, and that this effect was mediated by the brain-wide density of activated receptors. These results showcase the role of whole-brain models in the discovery of novel pharmacological treatments for neuropsychiatric conditions, while also supporting the feasibility of accelerating the recovery of consciousness with serotonergic psychedelics.

During circuit assembly it is essential that neurons connect with their specific synaptic partners. To facilitate this process, a common strategy in many organisms is the organization of brain regions, including the fly visual system, in layers and columns. The atypical-cadherin Flamingo (Fmi) and the receptor Golden Goal (Gogo) were proposed to regulate both the temporary and final layer selection of the R8 photoreceptor, through the cytoplasmic domain of Gogo. Our data suggests that Fmi intracellular signaling is also relevant for R8 final layer selection. The LIM-domain cytoplasmic molecule Espinas (Esn) binds Fmi, and they cooperatively control dendritic self-avoidance in sensory neurons. We observed defects in R8 layer selection in esn mutants with axons overshooting the final target layer, and we demonstrated that the LIM domain is necessary for layer selection. fmi knockdown in photoreceptors results in most R8 axons stalling at the temporary layer, however, we also detected R8 axons projecting past the final-target layer, and showed that fmi and esn genetically interact. Based on the previously described physical and genetic interactions between Fmi/Esn and the findings presented here, we propose that Esn signals downstream of Fmi to stabilize R8 axons in their final target layer.

Linking molecular mechanisms with large-scale brain dynamics remains a fundamental challenge in computational psychiatry. Receptor-informed whole-brain models have provided mechanistic insights into pharmacological interventions, yet they have largely relied on single-receptor topographies that cannot explain the collective response of multiple receptor systems. Here, we combined pharmacological resting-state fMRI with a whole-brain model incorporating cortical expression of adrenergic and dopaminergic receptors to investigate the effects of atomoxetine, a norepinephrine reuptake inhibitor that globally elevates catecholaminergic signaling. Using receptor similarity, we first identified a catecholaminergic chemoarchitecture comprising frontal, posterior and temporal networks, providing the neurochemical scaffold for interpreting atomoxetine-induced brain dynamics. Empirically, atomoxetine selectively stabilized functional connectivity dynamics within the posterior catecholaminergic network. Whole-brain modeling revealed that although individual receptor parameters did not differ between conditions, their collective organization converged toward empirical receptor binding affinities. Remarkably, the simulated atomoxetine state was reconstructed from the placebo configuration through a negative reweighting along this receptor-affinity axis. In silico forward modeling showed that this affinity-driven redistribution gave rise to a cortical modulation pattern aligned with a frontal chemoarchitectural gradient, which was sufficient to simulate the observed dynamical and connectivity changes. Together, these findings suggest receptor binding affinity as a key organizing principle linking molecular receptor organization to brain dynamics, providing a model-based, biologically interpretable computational mechanism through which global catecholaminergic perturbations reshape whole-brain function.

Following a stroke, changes in receptor systems have been observed that may influence the excitability of affected brain regions and drive recovery trajectories. Translating results from animal studies to patients remains a major challenge, and while imaging modalities have provided a wealth of findings, a mechanistic link between local receptor systems and observed imaging data is still missing. To bridge this gap, we built patient-specific digital twins with their own neuromodulatory profiles: we integrated 19 receptor and transporter density maps into a mechanistic whole-brain model, and estimated their influence on cortical excitability for each stroke patient and how these systems subsequently explain recovery trajectories. We found that distinct receptor profiles modulated excitability in perilesional versus non-perilesional tissue. Favourable acute motor outcomes were most strongly explained by increased inhibition mediated by non-perilesional GABA-A receptors, together with enhanced excitability driven by cannabinoid, histaminergic, and noradrenergic systems. For acute language outcomes, we identified receptor signatures that, together with motor findings, formed two cross-domain clusters linking excitability to either better or poorer performance. Remarkably, structurally highly connected hubs played a key role: their acute excitability explained cognitive and language deficits and predicted language recovery at one year. Together, our results establish a mechanistic link between receptor-specific modulation of cortical excitability and behavioural recovery, highlighting potential targets for pharmacological and non-invasive therapeutic interventions.