EEG resting state alpha dynamics predict an individual’s vulnerability to auditory hallucinations

Task-free brain activity exhibits spontaneous fluctuations between functional states, characterized by synchronized activation patterns in distributed resting-state (RS) brain networks. The temporal dynamics of the networks’ electrophysiological signatures reflect individual variations in brain activity and connectivity linked to mental states and cognitive functions and can predict or monitor vulnerability to develop psychiatric or neurological disorders. In particular, RS alpha fluctuations modulate perceptual sensitivity, attentional shifts, and cognitive control, and could therefore reflect a neural correlate of increased vulnerability to sensory distortions, including the proneness to hallucinatory experiences. We recorded 5 min of RS EEG from 33 non-clinical individuals varying in hallucination proneness (HP) to investigate links between task-free alpha dynamics and vulnerability to hallucinations. To this end, we used a dynamic brain state allocation method to identify five recurrent alpha states together with their spatiotemporal dynamics and most active brain areas through source reconstruction. The dynamical features of a state marked by activation in somatosensory, auditory, and posterior default-mode network areas predicted auditory and auditory-verbal HP, but not general HP, such that individuals with higher vulnerability to auditory hallucinations spent more time in this state. The temporal dynamics of spontaneous alpha activity might reflect individual differences in attention to internally generated sensory events and altered auditory perceptual sensitivity. Altered RS alpha dynamics could therefore instantiate a neural marker of increased vulnerability to auditory hallucinations

demographic clinical, and service-use characteristics related to the clinician’s recommendation to transition from child to adult mental health services

Purpose: The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians' advice to continue treatment at AMHS. Methods: Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians' transition recommendations. Results: Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psychotic experiences were more likely to be recommended to continue treatment. Among those who had been recommended to continue treatment, young people who used psychotropic medication, who had been in CAMHS for more than a year, and for whom appropriate AMHS were available were more likely to be recommended to continue treatment at AMHS. Young people whose parents indicated a need for ongoing treatment were more likely to be recommended to stay in CAMHS. Conclusion: Although the decision regarding continuity of treatment was mostly determined by a small set of clinical characteristics, the recommendation to continue treatment at AMHS was mostly affected by service-use related characteristics, such as the availability of appropriate service