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Two Tiny Orbitofrontal Patches Tug at Risky Choices, Study Finds

The pattern of rapid, opposing activity may point to circuit-level targets for more precise brain stimulation but the finding is preliminary and needs larger studies

Overview

  • Researchers reported on Tuesday that intracranial recordings in six patients revealed two neighboring orbitofrontal cortex sites that push in opposite directions to drive approach versus avoidance choices.
  • The team used electrodes already implanted for clinical monitoring and an immersive video game to record millisecond-scale signals from the medial orbital sulcus and a lateral patch while participants weighed bombs versus treasure.
  • Those two sites oscillated like a see-saw instead of gradually accumulating evidence, and the pattern of their opposition predicted a person’s choice roughly half a second before movement.
  • The mapping suggests a measurable neural signature that could guide more spatially precise neuromodulation for disorders of excessive avoidance or risk‑taking, and related UCSF trials are testing stimulation of fibers linked to the avoidance region.
  • Because the result comes from six clinical patients, researchers stress the need for replication in larger, more diverse samples and for work to show that targeting these microcircuits improves symptoms in real patients.