Increased cortical thickness and decreased brain age among special operations veterans with blast TBI after a magnesium-ibogaine protocol

Ibogaine is a psychoactive alkaloid with therapeutic potential that may promote neuroplasticity. Its effects on human brain morphometry are unknown. Thirty Special Operations Forces veterans with prior blast-induced TBI participated in an observational study in which they received ibogaine co-administered with magnesium. Structural MRIs were collected at baseline (<i>n</i> = 25), initial post-treatment (<i>n</i> = 25), and 1-month post (<i>n</i> = 22). Longitudinal analyses assessed cortical thickness, subcortical volume, and predicted brain age (pBA), estimated from T1 scans. pBA was significantly reduced at 1 month relative to baseline (-1.3 years). Cortical thickness analysis revealed post-treatment increases in 11 regions. Subcortical analyses revealed significant volumetric expansion in 8 regions. Magnesium-ibogaine therapy was associated with increased cortical thickness, subcortical expansion, and reduced pBA at 1 month. Although T1s are sensitive to nonstructural changes, the overall direction of effect is consistent with neuroplastic change.