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Background: Digital tools and interventions are being increasingly developed in response to the growing mental health crisis, and mental health professionals (MHPs) considerably influence their adoption in client practice. However, how MHPs use digital tools in client interaction is yet to be sufficiently understood, which poses challenges to their design, development, and implementation. Objective: This study aimed to create a contextual understanding of how MHPs use different digital tools in clinical client practice and what characterizes the use across tools. Methods: A total of 19 Finnish MHPs participated in semistructured interviews, and the data were transcribed, coded, and inductively analyzed. Results: We found that MHP digital tool use was characterized by 3 distinct functions: communication, diagnosis and evaluation, and facilitating therapeutic change. The functions were addressed using analog tools, digitized tools that mimic their analog counterparts, and digital tools that use the possibilities native to digital. The MHP-client communication included various media alongside face-to-face meetings, the MHPs increasingly used digitized tools in client evaluation, and the MHPs actively used digitized materials to facilitate therapeutic change. MHP tool use was generally characterized by adaptability—it was negotiated in client interactions. However, there was considerable variance in the breadth of MHPs’ digital toolbox. The existing clinical practices emphasized MHP-client interaction and invited incremental rather than radical developments, which challenged the achievement of the scalability benefits expected from digital tools. Conclusions: MHPs use digitized and digital tools in client practice. Our results contribute to the user-centered research, development, and implementation of new digital solutions in mental health care by classifying them according to their function and medium and describing how MHPs use and do not use them. peerReviewed

Inter-areal synchronization by phase-phase correlations (PPCs) of cortical oscillations mediates many higher neurocognitive functions, which are often affected by prematurity, a globally prominent neurodevelopmental risk factor. Here, we used electroencephalography to examine brain-wide cortical PPC networks at term-equivalent age, comparing human infants after early prematurity to a cohort of healthy controls. We found that prematurity affected these networks in a sleep state-specific manner, and the differences between groups were also frequency-selective, involving brain-wide connections. The strength of synchronization in these networks was predictive of clinical outcomes in the preterm infants. These findings show that prematurity affects PPC networks in a clinically significant manner, suggesting early functional biomarkers of later neurodevelopmental compromise that may be used in clinical or translational studies after early neonatal adversity.

Funding Information: We would like to thank Frances Crabbe, MSc, Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, Scotland for help in the acquisition of MEG/MRI-data. The investigators also acknowledge the support of the Scottish Mental Health Research Network (http://www.smhrn.org.uk), now called the NHS Research Scotland Mental Health Network (http://www.nhsresearchscotland.org.uk/research-areas/mental-health), for providing assistance with participant recruitment, interviews, and cognitive assessments. We thank both the participants and patients who took part in the study and the research assistants of the YouR-study for supporting the recruitment and assessment of CHR participants. The study was supported by the Medical Research Council (MR/L011689/1) and ERANET-Project ?IMBALANCE?. Funding Information: The study was supported by the Medical Research Council (MR/L011689/1) and ERANET-Project “IMBALANCE”. Publisher Copyright: © 2021 The Authors Long-Range Temporal Correlations (LRTCs) index the capacity of the brain to optimally process information. Previous research has shown that patients with chronic schizophrenia present altered LRTCs at alpha and beta oscillations. However, it is currently unclear at which stage of schizophrenia aberrant LRTCs emerge. To address this question, we investigated LRTCs in resting-state magnetoencephalographic (MEG) recordings obtained from patients with affective disorders and substance abuse (clinically at low-risk of psychosis, CHR-N), patients at clinical high-risk of psychosis (CHR-P) (n = 115), as well as patients with a first episode (FEP) (n = 25). Matched healthy controls (n = 47) served as comparison group. LRTCs were obtained for frequencies from 4 to 40 Hz and correlated with clinical and neuropsychological data. In addition, we examined the relationship between LRTCs and transition to psychosis in CHR-P participants, and the relationship between LRTC and antipsychotic medication in FEP participants. Ourresults show that participants from the clinical groups have similar LRTCs to controls. In addition, LRTCs did not correlate with clinical and neurocognitive variables across participants nor did LRTCs predict transition to psychosis. Therefore, impaired LRTCs do not reflect a feature in the clinical trajectory of psychosis. Nevertheless, reduced LRTCs in the beta-band over posterior sensors of medicated FEP participants indicate that altered LRTCs may appear at the onset of the illness. Future studies are needed to elucidate the role of anti-psychotic medication in altered LRTCs.

BACKGROUND:\ud Reproducibility of research findings has been recently questioned in many fields of science, including psychology and neurosciences. One factor influencing reproducibility is the simultaneous testing of multiple hypotheses, which entails false positive findings unless the analyzed p-values are carefully corrected. While this multiple testing problem is well known and studied, it continues to be both a theoretical and practical problem.\ud \ud NEW METHOD:\ud Here we assess reproducibility in simulated experiments in the context of multiple testing. We consider methods that control either the family-wise error rate (FWER) or false discovery rate (FDR), including techniques based on random field theory (RFT), cluster-mass based permutation testing, and adaptive FDR. Several classical methods are also considered. The performance of these methods is investigated under two different models.\ud \ud RESULTS:\ud We found that permutation testing is the most powerful method among the considered approaches to multiple testing, and that grouping hypotheses based on prior knowledge can improve power. We also found that emphasizing primary and follow-up studies equally produced most reproducible outcomes.\ud \ud COMPARISON WITH EXISTING METHOD(S):\ud We have extended the use of two-group and separate-classes models for analyzing reproducibility and provide a new open-source software "MultiPy" for multiple hypothesis testing.\ud \ud CONCLUSIONS:\ud Our simulations suggest that performing strict corrections for multiple testing is not sufficient to improve reproducibility of neuroimaging experiments. The methods are freely available as a Python toolkit "MultiPy" and we aim this study to help in improving statistical data analysis practices and to assist in conducting power and reproducibility analyses for new experiments.

Architecture of phase relationships among neural oscillations is central for their functional significance but has remained theoretically poorly understood. We use phenomenological model of delay-coupled oscillators with increasing degree of topological complexity to identify underlying principles by which the spatio-temporal structure of the brain governs the phase lags between oscillatory activity at distant regions. Phase relations and their regions of stability are derived and numerically confirmed for two oscillators and for networks with randomly distributed or clustered bimodal delays, as a first approximation for the brain structural connectivity. Besides in-phase, clustered delays can induce anti-phase synchronization for certain frequencies, while the sign of the lags is determined by the natural frequencies and by the inhomogeneous network interactions. For in-phase synchronization faster oscillators always phase lead, while stronger connected nodes lag behind the weaker during frequency depression, which consistently arises for in-silico results. If nodes are in anti-phase regime, then a distance π is added to the in-phase trends. The statistics of the phases is calculated from the phase locking values (PLV), as in many empirical studies, and we scrutinize the method's impact. The choice of surrogates do not affects the mean of the observed phase lags, but higher significance levels that are generated by some surrogates, cause decreased variance and might fail to detect the generally weaker coherence of the interhemispheric links. These links are also affected by the non-stationary and intermittent synchronization, which causes multimodal phase lags that can be misleading if averaged. Taken together, the results describe quantitatively the impact of the spatio-temporal connectivity of the brain to the synchronization patterns between brain regions, and to uncover mechanisms through which the spatio-temporal structure of the brain renders phases to be distributed around 0 and π.Trial registrationSouth African Clinical Trials Register: http://www.sanctr.gov.za/SAClinicalbrnbspTrials/tabid/169/Default.aspx, then link to respiratory tract then link to tuberculosis, pulmonary; and TASK Applied Sciences Clinical Trials, AP-TB-201-16 (ALOPEXX): https://task.org.za/clinical-trials/.

Visuospatial attention prioritizes processing of attended visual stimuli. It is characterized by lateralized alpha-band (8-14 Hz) amplitude suppression in visual cortex and increased neuronal activity in a network of frontal and parietal areas. It has remained unknown what mechanisms coordinate neuronal processing among frontoparietal network and visual cortices and implement the attention-related modulations of alpha-band amplitudes and behavior. We investigated whether large-scale network synchronization could be such a mechanism. We recorded human cortical activity with magnetoencephalography (MEG) during a visuospatial attention task. We then identified the frequencies and anatomical networks of inter-areal phase synchronization from source localized MEG data. We found that visuospatial attention is associated with robust and sustained long-range synchronization of cortical oscillations exclusively in the high-alpha (10-14 Hz) frequency band. This synchronization connected frontal, parietal and visual regions and was observed concurrently with amplitude suppression of low-alpha (6-9 Hz) band oscillations in visual cortex. Furthermore, stronger high-alpha phase synchronization was associated with decreased reaction times to attended stimuli and larger suppression of alpha-band amplitudes. These results thus show that high-alpha band phase synchronization is functionally significant and could coordinate the neuronal communication underlying the implementation of visuospatial attention.

Musical expertise is associated with structural and functional changes in the brain that underlie facilitated auditory perception. We investigated whether the phase locking (PL) and amplitude modulations (AM) of neuronal oscillations in response to musical chords are correlated with musical expertise and whether they reflect the prototypicality of chords in Western tonal music. To this aim, we recorded magnetoencephalography (MEG) while musicians and non-musicians were presented with common prototypical major and minor chords, and with uncommon, non-prototypical dissonant and mistuned chords, while watching a silenced movie. We then analyzed the PL and AM of ongoing oscillations in the theta (4–8 Hz) alpha (8–14 Hz), beta- (14–30 Hz) and gamma- (30–80 Hz) bands to these chords. We found that musical expertise was associated with strengthened PL of ongoing oscillations to chords over a wide frequency range during the first 300 ms from stimulus onset, as opposed to increased alpha-band AM to chords over temporal MEG channels. In musicians, the gamma-band PL was strongest to non-prototypical compared to other chords, while in non-musicians PL was strongest to minor chords. In both musicians and non-musicians the long-latency (> 200 ms) gamma-band PL was also sensitive to chord identity, and particularly to the amplitude modulations (beats) of the dissonant chord. These findings suggest that musical expertise modulates oscillation PL to musical chords and that the strength of these modulations is dependent on chord prototypicality.