Investigating the Mechanisms of Decision-Making Using Non-Invasive Brain Stimulation

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-40
SponsorWuerzburg University Hospital

About this trial

This study aims to investigate which of two brain regions is important for which decision-making strategy. The investigators suppose that one brain region - the \*striatum\* - is important for repeatedly choosing objects that have previously been paired with rewards (strategy 1). They suppose that a different region - the \*hippocampus\* - is important for extending such reasoning to RELATED objects (strategy 2).

The investigators will repeatedly ask young and healthy subjects to choose between two objects. The two objects are repeatedly drawn from a pool of seven. Relations between the seven objects have been learned on the first day of the experiment. The investigators will record subjects' choices and will use an automated way to assess the extent to which any given subject uses either decision-making strategy.

* On one day, subjects will perform the task while their right hippocampus is being stimulated with non-invasive electrical stimulation ("condition A"). * On another day, subjects will perform the same task but with their striatum being stimulated ("condition B"). * On yet another day, a control stimulation ("condition C") will be applied that looks and feels like the real stimulation but does not influence brain activity.

Which stimulation (A, B, C) happens on which day is assigned by computer code and differs between subjects. Subjects do not know, and investigators mostly do not know, whether real or control stimulation is applied on each day.

The investigators will check whether subjects use strategy 1 more when their striatum is being stimulated and strategy 2 more when their hippocampus is being stimulated, as compared to when the control stimulation is applied.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

No diagnosis of any neurological or psychiatric disease

Disqualifiers

Severe neuropsychiatric or unstable systemic disease

Severe sensory or cognitive impairment or musculoskeletal dysfunction that would prevent subjects from understanding the task instructions or executing the tasks

Implanted medical devices

Diagnosis of epilepsy or history of one or more epileptic seizure(s)

Trial design

Design model

Crossover

Treatments tested in this trial

  • Hippocampal intermittent-theta burst stimulation

    Device

    Transcranial temporal interference stimulation using intermittent theta-burst protocol and targeting right hippocampus. Unlike the striatal set-up, the hippocampal electrode set-up is asymmetrical and can only stimulate unilaterally (Beanato, Moon et al., 2024; Violante et al., 2023). In the present study, \*right\* hippocampus is targeted because it showed cognitive map-compatible activity in a similar task in a previous study (Garvert et al., 2023) and because it has been suggested to be involved in map-based navigation (Iglói et al., 2010).

  • Striatal intermittent-theta burst stimulation

    Device

    Transcranial temporal interference stimulation using intermittent theta-burst protocol and targeting bilateral striatum.

  • High-frequency control stimulation with striatal electrode set-up

    Device

    Analoguous to transcranial temporal interference stimulation except both high-frequency electric fields are oscillating at the exact same frequency, meaning there is no biologically active envelope modulation. This high-frequency stimulation is applied with the striatal electrode set-up in 50 % of the subjects (hippocampal set-up in the other 50 %). No stimulation actually occurs because the stimulation frequency is too high to be biologically active (Grossman et al., 2017).

  • High-frequency control stimulation with hippocampal electrode set-up

    Device

    Analoguous to transcranial temporal interference stimulation except both high-frequency electric fields are oscillating at the exact same frequency, meaning there is no biologically active envelope modulation. This high-frequency stimulation is applied with the hippocampal electrode set-up in 50 % of the subjects (striatal set-up in the other 50 %). No stimulation actually occurs because the stimulation frequency is too high to be biologically active (Grossman et al., 2017).

Treatment groups

36 Participants
are divided into 12 treatment groups

12

Treatment groups

See each treatment group below.

Group A: Striatal tTIS -> Hippocampal tTIS -> Striatal high-frequency controlExperimental treatment 3 interventions
Group B: Striatal tTIS -> Striatal high-frequency control -> Hippocampal tTISExperimental treatment 3 interventions
Group C: Hippocampal tTIS -> Striatal high-frequency control -> Striatal tTISExperimental treatment 3 interventions
Group D: Hippocampal tTIS -> Striatal tTIS -> Striatal high-frequency controlExperimental treatment 3 interventions
Group E: Striatal high-frequency control -> Striatal tTIS -> Hippocampal tTISExperimental treatment 3 interventions
Group F: Striatal high-frequency control -> Hippocampal tTIS -> Striatal tTISExperimental treatment 3 interventions
Group G: Striatal tTIS -> Hippocampal tTIS -> Hippocampal high-frequency controlExperimental treatment 3 interventions
Group H: Striatal tTIS -> Hippocampal high-frequency control -> Hippocampal tTISExperimental treatment 3 interventions
Group I: Hippocampal tTIS -> Hippocampal high-frequency control -> Striatal tTISExperimental treatment 3 interventions
Group J: Hippocampal tTIS -> Striatal tTIS -> Hippocampal high-frequency controlExperimental treatment 3 interventions
Group K: Hippocampal high-frequency control -> Striatal tTIS -> Hippocampal tTISExperimental treatment 3 interventions
Group L: Hippocampal high-frequency control -> Hippocampal tTIS -> Striatal tTISExperimental treatment 3 interventions

Trial outcomes

Primary outcomes

1

Weight between map-based generalization and stimulus-outcome association-based decision-making

"Weight" references a parameter that is extracted from recorded choice behavior by means of computational modeling. Three basic models (one map-based, two stimulus-outcome association-based) are fit to each subject's choice data from each session. Two hybrid models - combining the map-based with either of the stimulus-outcome association-based components - are also fit. The weight parameter will be extracted from the hybrid model that fits most subjects' behavior best under the control condition (high-frequency stimulation). It describes the extent to which the subject relies on the map-based relative to the association-based component/strategy for making their choices. Given the presumed roles of hippocampus in map-based and striatum in association-based decision-making, the investigators expect the weight parameter to increase under hippocampal tTIS and to decrease under striatal tTIS relative to high-frequency control stimulation.

Time frame
Days 2-4.

Secondary outcomes

1

Choice accuracy

Whether, out of two simultaneously presented stimuli, the one associated with the higher reward has been chosen on a given trial. Early after a shift in reward contingencies, using a map-based strategy should increase the probability of choosing correctly. This is because the new reward contingencies may not have been experienced yet (disabling association-based strategies) and so can only be inferred (requiring map-based strategies). Both strategies should be equally successful later after a shift once all new contingencies have been experienced. Averaged across all trials, the investigators therefore expect to observe higher accuracy under hippocampal and lower accuracy under striatal tTIS as compared to control stimulation. The investigators also expect subjects' individual choice accuracies to positively correlate with their map-based weight parameter estimates.

Time frame
Days 2-4.
2

Choice response time

Time between presentation of the two stimuli for the present trial and the subject's choice of one of the two stimuli. The investigators will analyze the effects of hippocampal and striatal tTIS as compared to control stimulation on response time in an exploratory manner.

Time frame
Days 2-4.
3

Proportion of subjects best fit by different computational models

Different candidate models are fit to the recorded choice data, two of which are on the "stimulus-outcome association-based" and one on the "map-based generalization" side. Hybrid models (= weighted sum of one stimulus-outcome association-based element and the map-based generalization element) are also fit. WAIC (Watanabe, 2010) will be used to determine which model fits which subject best under any given stimulation condition. The investigators expect the proportion of subjects best described by the map-based (association-based) model(s) to increase (decrease) under hippocampal tTIS as compared to control stimulation, with the opposite pattern showing under striatal tTIS. Note: Should ≥ 50 % of subjects perform at chance level in the proximity judgments in the first session (last eight blocks), the investigators will use subjects' \*subjective\* representations (as collected at the end of the last choice task session) instead of the objective ones as a basis for the map-based model.

Time frame
Days 2-4.
4

Influence of true and past rewards on choice

The investigators will use (a) the difference in the most recently observed values of the stimuli presented to the subject's left vs. right and (b) the difference between the actual, current values of these stimuli (which may not have been observed yet) to predict whether the subject will have chosen the left vs. right stimulus. Subjects pursuing a stimulus-outcome association-based strategy will exclusively rely on directly experienced reward contingencies (strong regression weight of (a) but not (b)). Subjects generalizing across related stimuli will be able to infer a stimulus' current value even if that one has not been observed recently (strong regression weight of (b) but not (a)). The investigators expect the regression weights of (a) to increase and (b) to decrease under striatal tTIS (opposite under hippocampal tTIS) as compared to control stimulation.

Time frame
Days 2-4.

Other outcomes

1

Gender

Not an outcome variable but a variable that will be collected to characterize the study sample.

Time frame
Day 1.
2

Age

Not an outcome variable but a variable that will be collected to characterize the study sample.

Time frame
Day 1.
3

Center for Epidemiological Studies Depression Scale

German version (Hautzinger \& Bailer, 2003). This is not an outcome measure but a variable that will be collected once at the beginning to characterize the study sample. It will not be analyzed as a function of stimulation condition. Sum scores range from 0 to 60, where higher scores indicate higher depressive symptom load.

Time frame
Day 1.
4

Edinburgh Handedness Inventory

Oldfield (1971). German translation. This is not an outcome measure but a variable that will be collected once at the beginning to characterize the study sample. It will not be analyzed as a function of stimulation condition but will be explored as a potential moderator of stimulation effects. Per side (left and right), between 0 and 20 "+"s can be marked, where a higher number of "+"s indicates stronger use of the respective hand.

Time frame
Day 1.

Sponsors and contacts

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Wuerzburg University Hospital

Lead sponsor

University of Wuerzburg

Collaborator