Eye-state-dependent reorganization of EEG microstates in a pediatric transdiagnostic cohort

Resting electroencephalography (EEG) is sensitive to eye condition, yet the reorganization of pediatric EEG microstates between eyes-closed (EC) and eyes-open (EO) rest remains incompletely characterized. Paired EC and EO recordings from 110 children in the Healthy Brain Network were analyzed using polarity-invariant two-level clustering, backfitting, and within-participant tests of microstate duration, coverage, occurrence, and transition measures. Eye opening shortened A and C segments, increased the occurrence of all four K = 4 classes, and redistributed coverage from C toward B.

All eight significant K = 4 temporal effects retained their direction after participant-wise duration matching and template re-estimation, and broad state sensitivity was also observed at K = 6. Change-score and baseline-adjusted analyses yielded comparable EC-to-EO response profiles among the comparison group without the target diagnoses, ADHD-only group, and ADHD+Anxiety group. The association between posterior alpha reactivity and switching varied in magnitude and direction across segmentation specifications.

A stable fourth K = 4 map showed little correspondence with adult microstate D, whereas a D-like map emerged at K = 6. Pediatric microstate measures reflect both physiological context and analytical definition; eye condition, model order, temporal smoothing, and analyzed duration should therefore be specified explicitly in developmental and clinical studies. This research was supported by the Zhejiang Provincial Health Commission Science and Technology Program Project (Grant No. 2025HY0753).

Hangzhou Childrens Hospital, Hangzhou, China Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China The authors declare no competing interests. The data used in this study were obtained from the Healthy Brain Network (HBN) biobank, an initiative of the Child Mind Institute. The HBN study protocol was approved by the Chesapeake Institutional Review Board (now Advarra, Inc.).

Written informed consent was obtained from all participants and their legal guardians at the time of data collection. The present analysis was performed in accordance with the Child Mind Institute Biobank Data Use Agreement and was exempt from additional IRB review at the authors’ institution because it used de-identified, publicly available data. This manuscript does not contain any individual person’s data in any form (including any individual details, images, or videos).

All data used from the Healthy Brain Network are fully de-identified. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Below is the link to the electronic supplementary material.