Distinct Connectivity Signatures of Hallucinatory Experiences and Neuromelanin Signal in Adolescents

Late adolescence is a critical developmental period that typically precedes psychosis onset, yet the neural correlates of subclinical hallucinatory experiences that may impact psychosis risk are poorly understood. Given evidence from adult psychosis models implicating abnormal "triple network" connectivity among the frontoparietal (FPN), default mode (DMN) and salience/cingulo-opercular (CON) networks, as well as dopaminergic abnormalities, we examined whether hallucinatory experiences in adolescents are associated with altered triple network organization and dopamine-related measures in the midbrain.

We performed a cross-sectional analysis of 171 community adolescents aged 14-17 who underwent resting-state functional magnetic resonance imaging and neuromelanin-sensitive MRI. Hallucinatory experience severity was measured using the Specific Psychotic Experiences Questionnaire. Resting-state functional connectivity was calculated among a priori DMN, FPN, and CON cortical regions; we examined associations between connectivity, hallucinatory experience severity, within-network connectivity, system segregation, and neuromelanin signal in the ventral tegmental area (VTA).

Greater hallucinatory experience severity was associated with stronger connectivity in a subnetwork composed of CON-DMN and CON-FPN edges. Greater hallucinatory experience severity was also associated with lower global network segregation. VTA neuromelanin signal was not directly associated with hallucinatory experience severity, but greater VTA signal predicted lower connectivity in the hallucination-related subnetwork. Greater VTA neuromelanin signal was also associated with a distinct pattern of stronger connectivity within DMN midline regions.

These findings implicate altered triple network organization in hallucinatory experiences during late adolescence and suggest that dopamine-related midbrain signal may reflect broader developmental variation in cortical network organization rather than symptom severity directly.

Hallucinatory experiences during adolescence may signal increased risk for later psychotic disorders, but their brain basis is unclear. We studied 171 adolescents aged 14-17 using resting-state fMRI to measure brain network activity and neuromelanin-sensitive MRI to estimate dopamine-related midbrain signal. More severe hallucinatory experiences were linked to abnormal communication among three brain networks often implicated in psychosis. Dopamine-related signal was not directly related to hallucination severity but was associated with developmentally relevant network organization. Overall, this work serves to improve our understanding of the risk factors that may contribute to psychosis conversion in adulthood.