Psychometric validation of the French version of the five-dimensional altered states of consciousness questionnaire (5D-ASC) and associated 11 OAV subscales.

Brain-body integromics of the ayahuasca experience.

This micro-phenomenological study examines altered states of consciousness (ASC) during Floatation-REST, a sensory isolation method where individuals lie in a tank filled with Epsom salt-saturated water in complete silence and darkness. Salubrious effects of Floatation-REST have been shown in persons suffering from mental health conditions; these positive outcomes might be related to the experience of ASC. Micro-phenomenological interviews were conducted with fourteen participants who completed a 60-minute Floatation-REST session, to capture the generic structure of ASC. We found that most participants experience four distinct phases during a session (diachronic structure): after an initial acclimatization phase (1), participants experience a transitional phase (2) that prepares them for a subsequent ASC phase (3), followed by a phase of temporal and spatial reorientation (4). The ASC phase is characterized by the experience of positive emotions, deep relaxation, a loss of orientation in space and time, and a reduction in bodily sensations and thoughts (synchronic structure). The characteristics of the ASC phase emerge gradually and progressively intensify. This micro-phenomenological analysis of Floatation-REST sheds new light on the potential of this therapeutic technique. We discuss possible future research and therapeutic applications of Floatation-REST.

EEG reactivity (EEG-R) is currently classified as present, absent, or stimulus-induced rhythmic, periodic, or ictal discharges, per the American Clinical Neurophysiology Society's 2021 Critical Care EEG Terminology. However, our previous study suggested that there may be other forms of EEG-R that warrant distinction, potentially associated with different comorbidities and outcomes. We, therefore, aimed to define "typical" vs "atypical" EEG-R, referring to increased power of arrhythmic alpha/beta frequencies vs delta frequencies after stimulation, respectively, and to identify their associated comorbidities and outcomes. This was a retrospective single-center study, examining adult patients admitted between 2015 and 2022, who underwent continuous EEG (cEEG) as standard-of-care work-up for their illnesses. Univariate testing and logistic regression were performed. The primary patient outcome at hospital discharge was categorized by the modified Rankin Scale (0-2: good; 3-6: poor). The primary independent variable was the presence of typical vs atypical EEG-R. Additional covariates included age, presence of critical illness, and acute intracranial and nonintracranial pathologies. A total of 238 patients with typical EEG-R (median age 54 years, female 50%) and 322 with atypical EEG-R (median age 60 years, female 50%) were identified. Patients with typical EEG-R more commonly underwent cEEG for spell capture of non-neurological episodes (20% vs 0%, Δ20%, 95% CI 15-25, p < 0.0001) or primary seizures (13% vs 2%, Δ11%, 95% CI 7-16, p < 0.0001). Patients with atypical EEG-R were more critically ill (88% vs 32%, Δ56%, 95% CI 49-63, p < 0.0001) with more intracranial (69% vs 45%, Δ24%, 95% CI 15-32, p < 0.0001) and nonintracranial pathologies (92% vs 38%, Δ54%, 95% CI 48-61, p < 0.0001) and concomitant altered mental status (47% vs 30%, Δ17%, 95% CI 9-25, p < 0.0001). These patients were hospitalized longer (median 24.0 vs 7.0 days, Hodges-Lehmann estimator 14 days, 95% CI 12-17, p < 0.0001) with higher rates of poor outcomes (74% vs 22%, Δ52%, 95% CI 45-59, p < 0.0001). In the logistic regression model, the inverse association between atypical EEG-R and good outcome remained significant after adjusting for other covariates (odds ratio 0.20, 95% CI 0.11-0.34, p < 0.0001). Granular, frequency-based assessments of EEG-R, such as the differentiation between typical vs atypical EEG-R, may provide further insight into the potential outcomes of patients with altered states of consciousness. Limitations of this study include the single-center retrospective nature.

Ketamine-induced changes in accumbal glutamate and their association with altered states of consciousness.

Diverging results with converging operations: Implications for the study of consciousness and cognition.

Psychedelics are a broad category of compounds that induce altered states of consciousness. These drugs have shown remarkable promise for the treatment of debilitating disorders ranging from posttraumatic stress disorder to depression and addiction. Although early studies focused on linking binding targets of psychedelics to their therapeutic effects, these pharmacological and biochemical explanations fail to account for the diversity, durability, and context dependence of psychedelics' clinical and acute subjective effects. More recently, neurobiological explanations offer fresh insights and demonstrate that a unifying property of psychedelics is that these compounds reopen critical periods, induce metaplasticity, and reorganize the extracellular matrix. Here we review this evidence and argue that the neurobiological and therapeutic effects of psychedelics challenge the biochemical imbalance model that has dominated translational neuroscience since the 1950s and favor instead a learning model that better accounts for psychedelics' unique therapeutic profile.

General anesthesia (GA) induces reversible unconsciousness for surgery, yet mechanisms underlying bidirectional transitions of states of consciousness during GA remain largely unknown. Here, we focused on states of consciousness rather than contents of consciousness, which reflects the capacity for responsiveness to stimuli. Electroencephalography/electromyography was applied in both male and female mice to investigate states of consciousness during sevoflurane GA. We identified the population activity of glutamatergic neurons in the medial septum (MS) to change synchronously with altered states of consciousness during sevoflurane GA. Activation of glutamatergic MS neurons (MSVglut2) or their projections in the ventral tegmental area (VTA) facilitated behavioral emergence and cortical activation during sevoflurane GA, while their inhibition deepened cortical inhibition. Nevertheless, we further identified anesthetic state-dependent dual control of states of consciousness by monosynaptic innervations from MSVglut2 neurons to heterogeneous downstream VTA neurons. Specifically, optogenetic activation of MS-innervated glutamatergic VTA neurons promoted cortical activation during both continuous steady-state GA (CSSGA) and burst suppression (BS). With current stimulation protocol, optogenetic activation of MS-innervated dopaminergic VTA neurons promoted cortical activation mainly under CSSGA. Optogenetic activation of MS-innervated GABAergic VTA neurons enhanced cortical inhibition mainly under BS. Our findings reveal an anesthetic state-dependent mechanism where MSVglut2 neurons bidirectionally regulate states of consciousness through heterogeneous VTA neurons, providing insights to the complexity in the regulation of states of consciousness under GA.

ABSTRACT In 1868 eminent Australian author Marcus Clarke wrote a gothic tale for his own Colonial Monthly Magazine titled “Cannabis Indica”, purportedly under the influence of hashish. Contemporaneous reviewers discussed this little-known short story as merely a curio, and modern scholars have followed suit. However, the experimental short story is distinguished as one of the first fictional portrayals of altered consciousness and drug use in Australia by an Australian author. Scholars have primarily considered depictions of altered states of consciousness and drug use by European and American writers rather than colonial authors due to the plethora of international fictional and scientific accounts of drug taking. This article argues that Clarke’s story acknowledges and modifies these international understandings, gothicising the experience of drug taking and adapting colonial touchpoints of understanding about the drug, including its oriental origins and link to medical perceptions of insanity, to engage in a literary experiment into colonial consciousness and what it means to be torn by the duality of rational and irrational, of scientific thought and fantastical thinking, and of being both a colonial and part of the empire.

ABSTRACTObjective:Hypovolemia resulting from loss of massive amount of fluids via gastro intestinal tract and causing acute kidney injury (AKI) is seen less in developed countries, while in developing countries we still see large number of such cases. Present study is largest cohort of cases developing hypovolemia from gastro intestinal fluid loss causing AKI and study highlights mortality predictors related to this scenario.Methodology:It is a retrospective cohort where case records of all the patients between January 1990 to December 2024, coming to Sindh Institute of Urology and Transplantation (SIUT), Karachi; who were labelled to have AKI according to KDIGO criteria, were reviewed. Patients developing AKI after acute diarrheal illness, with or without vomiting, were included and the data was analyzed and results are presented here.Results:During the specified time of 35 years, total 1,456 cases of AKI after acute diarrheal illness were seen at this institution, these were 15.2% of total AKI. Mean age was 39.36 ±17.10(range from 18-100 years), male to female ratio was 2.21:1. Non-oliguric AKI was seen in 422 (29%), while 889 (61%) were oliguric and 145 (10%) were anuric. Renal replacement therapy in form of hemodialysis was required in 959 (66%) patients, while 497 (34%) were managed conservatively. Complete renal recovery was seen in 1160 (79.67%), while 125 during (8.58%) died acute phase of illness. Mortality was higher in patients who were hypotensive requiring inotropes, required mechanical ventilation, presented in altered state of consciousness, or developed cardiac arrhythmias with severe electrolyte imbalance. Many of those who died had combination of mentioned insults.Conclusion:While world is moving towards digital and revolutionizing renal diagnosis globally, we face a reality of too many patients suffering from AKI with a preventable cause. We are losing lives with causes where AKI should not occur in first place.

Altered states of consciousness (ASC) involve shifts in perception, cognition, and awareness, offering a unique lens on the nature of consciousness. Across cultures, rhythmic drumming in the theta range (4-7Hz) is often used to induce such states, but it remains unclear whether actively enhancing brain rhythms in this range can cause ASC. We tested whether theta-frequency drumming (4 beats per second) selectively induces ASC compared to rhythms in the delta and alpha ranges. Forty participants listened to ten-minute drumming sessions at each rhythm while EEG was recorded. After each session, they completed an altered experience questionnaire and a time estimation task - an implicit ASC measure. Rhythmic neural tracking at theta was linked to stronger altered experience. Furthermore, participants with stronger theta-band neural tracking to 4-bps drumming tended to report higher ASC across all drumming rhythms, suggesting that neural tracking at this rhythm might serve as a neural marker of susceptibility. These rhythm-specific effects indicate a bidirectional relationship between theta activity and ASC: not only do theta activity accompany ASC, it may actively modulate it. These findings shed new light on the neural dynamics of consciousness and suggest that rhythmic stimulation could serve as a non-pharmacological method for modulating conscious states, with potential applications in cognitive neuroscience and therapeutic contexts.

The literature on psychedelic experiences often highlights their transformative potential. This raises ethical questions about informed consent in psychedelic-assisted therapy: if the altered state of consciousness induced by psychedelic drugs can profoundly alter a person's value system in ways that are epistemically inaccessible to them beforehand, it is unclear whether their informed consent before the experience can be considered valid. I argue that this view stems from a simplistic understanding of psychedelic-mediated transformation, which overemphasises the power of the psychedelic experience in driving change. In most psychedelic-mediated changes, the experience of an altered state of consciousness is only the beginning of the transformative process: a lasting transformation requires patients to undertake a sober, authentic agential process following the psychedelic experience. I suggest that this two-step view of psychedelic transformation alleviates the pressure on informed consent.

Meditation is known to modulate neural activity and enhance cognitive and emotional well-being. While previous studies have largely reported increases in alpha and theta activity, the neurophysiological effects of structured sound-based meditation practices remain underexplored. This study investigated the neurophysiological and subjective effects of rhythmic sound meditation (RSM) compared to a resting state (RS) condition. We aimed to identify EEG spectral patterns and changes in subjective alertness during this meditation protocol. Fifteen healthy adults (mean age = 24.8 ± 3.6 years) participated in two 26-minute sessions (RSM and RS) in a randomised, counterbalanced design. EEG data were recorded using a 64-channel actiCHamp system, and power spectral density was analysed across delta, theta, alpha, beta, and gamma bands. Subjective alertness was assessed before and after the sessions using the Stanford Sleepiness Scale (SSS). Statistical analyses were conducted using Yuen's paired t-test with FDR correction. RSM reduced EEG power across all frequency bands, particularly in prefrontal and frontocentral regions, compared to RS (p < .05, FDR-corrected). Power reductions were observed across delta, theta, alpha, beta, and gamma bands, with the most pronounced effects in frontal areas. SSS scores showed increased alertness post-RSM (93.3% alert) versus decreased alertness post-RS (73.3% alert). RSM induced distinct neurophysiological changes, characterised by widespread EEG power suppression in frontal regions and heightened subjective alertness. These findings support its potential for promoting altered states of consciousness, contributing to the neuroscientific understanding of sound-based meditation.

Adolescence is a period of profound behavioral changes associated with high brain vulnerability to negative stimuli including psychotropic drugs misuse which may contribute to the development of psychiatric disorders. Ketamine, an NMDA receptor antagonist, is an anesthetic agent used in a recreational manner in night clubs and raves, especially by intranasal route. The psychedelic effects of ketamine include euphoria, reward and mood swings, leading to an altered state of consciousness. Ketamine use has increased among adolescents and young adults, becoming a relevant global public health concern. At these events, drug consumption is often episodic but intense, which may disrupt diverse neuromodulation processes leading to behavioral impairments. Here, we investigated the mnemonic consequences of ketamine withdrawal following recreational exposure in adolescent female rats. To mimic weekend recreational use, adolescent female Wistar rats (n = 8 animals per group) received intranasal ketamine or saline (10 mg/kg/day) for three consecutive days. Twenty-four hours after the last ketamine administration, animals were submitted to a battery of behavioral tasks including novel object recognition, social recognition and Y-maze paradigms to assess episodic, social and working memories. Hippocampal and prefrontal cortex samples were collected for neurochemical analysis. Early ketamine withdrawal following acute exposure impaired all memory types evaluated in the current study. Additionally, a significant reduction in serotonin and norepinephrine levels were observed in the hippocampus and prefrontal cortex of ketamine exposure rats. These findings indicated cognitive and monoaminergic impairments in adolescent female rats at early ketamine withdrawal periods following acute exposure.

Mediumistic trance, studied as a cultural phenomenon, is considered an altered state of consciousness with dissociative and non-pathological characteristics. Studies on the effect of this trance state on linguistic performance using electroencephalography (EEG) are still scarce. We investigated the brain electrical activity of mediums using quantitative EEG (qEEG) during writing in waking and trance, and compared them with a matched control group performing simulated mediumistic writing and waking writing (n = 9 per group). EEG power differences exhibited increases across theta, alpha, beta1, and beta2 bands (p < .05) distinguishing activity during trance writing from the simulated mediumistic writing conditions. For the textual evaluations, within-group analyses showed that mediums' trance texts scored higher than their waking texts. In contrast, no significant intergroup differences in overall text quality emerged between mediums and controls. Together, these findings support the view that complex linguistic production is preserved across groups, while trance is associated with distinct spectral dynamics during writing in the mediums' group. Further research is warranted to refine the characterization of neural patterns supporting linguistic production in altered states of consciousness.

Abstract Background and objective Purulent meningitis in children remains a major global public health challenge. In Morocco, despite continuous improvements in disease control, the national case-fatality rate remains high at 11.2%. The present study aimed to describe the epidemiological distribution of pediatric purulent meningitis in Morocco and to identify the determinants influencing its evolution. Methods A retrospective was conducted on suspected cases of purulent meningitis among children from January 2013 to December 2022 in the Marrakech-Safi region, central Morocco. Data were obtained from the Prefectural Epidemiology Unit through the national computerized meningitis surveillance system. Results A total of 199 cases were analyzed, showing a male predominance (68.8%). The most frequent clinical manifestations were vomiting (74.4%), headache (59.3%), and neck stiffness (65.3%). The final diagnosis was purulent meningitis in 47.2% and viral meningitis in 46.7% of cases. Recovery was achieved in 86.4% of patients, while mortality reached 7.5%. The main prognostic risk factors were neurological (coma, altered state of consciousness, seizures) and infectious (purpura, fever), with odds ratios ranging from 2 to 37. The appearance of cerebrospinal fluid also emerged as a significant independent risk factor (OR 6.154; CI 95% 1.853–40.850). In contrast, viral meningitis (OR 0.075; CI 95% 0.013–0.430) and cephalosporin therapy (OR 0.129; CI 95% 0.040–0.422) were identified as protective factors. Conclusion Pediatric purulent meningitis was common among male and younger age. The highest incidence was during spring and in Marrakech-Safi region. Altered consciousness, coma, seizures, fever, and the presence of purpura were identified as major predictors of poor outcomes. These results allow for improved monitoring of the regional distribution of bacterial meningitis and help to better target control measures and improve clinical outcomes.

Understanding the relationship of conscious states to large-scale brain dynamics remains a central challenge in neuroscience. Here, diverse pharmacological and physiological perturbations-including psychedelic states, sleep, and propofol sedation-were used to examine integration-segregation organization of brain networks across altered states of consciousness in humans using functional MRI. Across analyses, psychedelic and sedative states exhibited a robust "mirror-image" pattern of integration and segregation. Psychedelics were characterized by increased large-scale integration and reduced segregation of brain network interactions, whereas sleep and propofol sedation showed the opposite configuration. These opposing integration-segregation patterns were consistently indexed by complementary measures of functional connectivity, network topology, and interaction complexity, capturing non-redundant dimensions of large-scale brain organization. Importantly, this mirror-image organization generalized across multiple spatial levels and reliably differentiated conscious states in an unbiased, data-driven manner. Together, these findings demonstrate that psychedelic and sedated states are characterized by systematic and opposing shifts in large-scale integration and segregation, with implications for mechanisms of consciousness.

The purpose of this study was to identify the ontological and cultural foundations of the shamanic tradition in the Turkic culture of Kazakhstan through the concept of altered states of consciousness (ASC). The research focused on how ASC structured the shamanic worldview, shaped ritual practices, and transformed under post-traditional social conditions. The methodological framework combined philosophical analysis of consciousness, culturological interpretation of mythological and ritual structures, and the analysis of archaeological and ethnographic data. An interdisciplinary synthesis integrating philosophy, ethnology, archaeology, and symbolic analysis was applied, alongside sociocultural analysis and interpretative culturology to examine contemporary transformations of shamanic practice. The study established that ASC functioned as a normative and regulated mode of interaction with a multi-level reality. It operated as a tool of diagnosis, sacred cognition, and social regulation, grounded in stable symbolic forms. The shaman acted as a mediator between sacred and social dimensions, integrating individual experience with collective knowledge. Spatial and material elements of ritual preserved strictly defined symbolism rooted in a mythopoetic worldview. In modern contexts, shamanic tradition has transformed into a more individualized psycho-spiritual practice while retaining core symbolic and ritual codes. Archetypal structures of shamanism continue to persist in folklore, cultural memory, and representations of Kazakh identity. The practical significance of the study lies in its applicability to the interpretation of sacred practices within the Turkic tradition, culturally oriented approaches in ethnopsychology and symbolic anthropology, and the preservation of intangible cultural heritage.

The serotonergic psychedelic psilocybin induces neural plasticity and profoundly alters consciousness. The benzodiazepine midazolam blunts neural plasticity and induces conscious sedation and amnesia at low doses. In our recent open label pilot study, we administered oral psilocybin (25 mg) along with intravenous midazolam at doses allowing a full psychedelic experience while blunting memory for the experience. We previously reported preliminary results from high density scalp electroencephalography (EEG) recorded during the dosing session. Here, we examined changes in EEG band power, normalized Lempel Ziv complexity (LZCn), and spectral exponent. We used linear mixed effects models that incorporated time and the subjective effects of midazolam and psilocybin, measured with the Observer's Assessment of Arousal and Sedation (OAA/S) and selected items from the Altered States of Consciousness (ASC) questionnaire, respectively. At 15-30 min, when midazolam but not psilocybin was at its targeted effect site concentration, we observed increased beta power and decreased spectral exponent. As the subjective effects of psilocybin commenced and over the next six hours, we observed increased LZCn and spectral exponent and decreased broadband power, with the most prominent power reductions in the delta, theta, and alpha frequency bands. OAA/S improved model fits for alpha power while ASC improved model fits for LZCn and spectral exponent. While recognizing limitations inherent to the small sample size and variability in dosages of midazolam, these data are further evidence that the effects of psilocybin are maintained in the presence of midazolam, supporting its utility in mechanistic studies of psilocybin's therapeutic activity.

Baloxavir marboxil (Xofluza™) was initially approved for marketing in Japan and the United States in 2018, which is a first-in-class cap-dependent endonuclease inhibitor of the influenza virus polymerase PA subunit. Despite indicating that Baloxavir marboxil is effective and well-tolerated through a series of clinical trials, studies on its safety in real-world settings are scarce. We conducted a mining analysis of the FDA Adverse Event Reporting System (FAERS) database from Q4 2018 to Q2 2024 to extract adverse events associated with Baloxavir marboxil. Descriptive statistics were first performed to characterize the included reports, covering demographic variables, clinical outcomes, and concomitant medications. We subsequently employed four disproportionality analysis algorithms—ROR, PRR, BCPNN, and MGPS—for signal detection. To verify the robustness of the identified signals, we performed comprehensive subgroup and sensitivity analyses. A total of 1,765 reports comprising 3,624 adverse events with baloxavir marboxil as the primary suspected drug were identified. Most reports originated from the United States (57.98%), followed by Japan (39.58%) and China (1.82%). Over 65% of reports were submitted by non-consumers. Fatal outcomes were reported in 10.89% of cases. In both the overall study population and the deceased subgroup, hypotensive drugs represented the most frequently reported concomitant medications alongside influenza therapeutics. Eight robust safety signals were ultimately detected: altered state of consciousness, anaphylactic reaction, anaphylactic shock, colitis ischaemic, drug eruption, intentional product use issue, melaena, and no adverse event. Among these, “altered state of consciousness” is not listed in the product label. Several labelled adverse reactions with unestablished causality—rash, urticaria, erythema multiforme, vomiting, delirium, abnormal behavior, and hallucinations—disappeared during subgroup and sensitivity analyses. Additionally, the Ω shrinkage measure for the baloxavir marboxil-warfarin interaction yielded Ω₀₂₅ = 1.42. The eight ultimately detected signals represent robust positive findings. Reactions including rash, urticaria, erythema multiforme, vomiting, delirium, abnormal behavior, and hallucinations were determined to be false positives. The most severe outcome, death, primarily reflected the presence of pre-existing cardiovascular conditions. A potential interaction between baloxavir marboxil and warfarin was identified, warranting further investigation.