Overview
- Researchers at UCSF and UC Berkeley published peer-reviewed findings on Tuesday, September 15, 2026, showing two adjacent orbitofrontal cortex patches—medial and lateral—drive approach and avoidance decisions.
- The team recorded directly from intracranial electrodes while six clinical patients played an immersive, gamified task and found the medial patch rose before risky 'go' choices while a lateral patch rose before 'avoid' choices.
- The two signals alternated rapidly like a see-saw rather than building steadily, and this tug-of-war forecasted a participant’s choice about 500 milliseconds before movement.
- Because the orbitofrontal cortex is hard to image with fMRI, these millisecond intracranial readings provide a more precise readout that researchers say could serve as a biomarker to refine neuromodulation targeting.
- Clinical translation remains early since the result rests on six patients; authors and UCSF teams are pursuing replication and targeted stimulation trials to test whether the signal can guide treatment for OCD, depression, addiction, and related disorders.