Investigating Surprise Signals in the Anterior Insula in Epilepsy Patients With Stereoelectroencephalography Recording

Status: Recruiting
Location: See location...
Intervention Type: Behavioral, Other
Study Type: Observational
SUMMARY

The investigators propose a behavioral experiment with SEEG recording and stimulation, to both confirm the role of a brain region known as the anterior insula in identifying surprise, and disambiguate between competing principles behind adaptation: optimizing and satisficing. Optimizers continue to learn and adapt if performance can be improved, while satisficers are satisfied with a good enough performance and will cease adapting once that is reached. To study surprise signals in the anterior insula, a brain structure where these signals have been very prominent, the investigators will employ an experiment with subjects who are under SEEG (stereoelectroencephalogram) recording, that is, recording from electrodes which have been surgically implanted in the brain. These recordings will be done as patients perform a task where they try to anticipate the movements of a target on a line in two different learning environments (conditions). The experimenters will then determine whether these signals reflect surprise relative to past engagement with the environment, or surprise that reveals that the agent no longer feels in control because uncertainty is not in line with the reference model. If evidence is consistent with the former, adaptation reflects traditional reinforcement and aims at optimizing behavior. If evidence instead is consistent with the latter, behavior is guided by a prior model (a reference model) and behavior is satisficing. An fMRI study by d'Acremont and Bossaerts provides initial evidence that activation in the anterior insula supports the satisficing hypothesis, however it lacks the temporal granularity to completely rule out optimizing. In the current project, the investigators propose to use the higher time resolution of SEEG recordings to confirm these findings and reject the optimizing hypothesis. Additionally, stimulations of the anterior insula during a subset of trials will be used to determine whether insular activation following surprise signals and preceding changes in behavior (learning) is merely correlational or in fact causal. Stimulation will allow us to determine to what extent the subjects' sense of control and subsequent behavior can be influenced in accordance with surprise-based modeling of behavior. The cohort for this study will be patients with drug-resistant, focal epilepsy and who are hospitalized at the Hôpitaux Universitaires de Genève (HUG) for pre-surgical evaluation of their epilepsy using SEEG. The protocol will run in parallel with the patients' clinical procedures.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: t
View:

• 18 years or older

• Fluent in French or English

• Patient who suffers from potentially surgically remediable drug-resistant focal epilepsy

• Patient who requires evaluation with intracranial stereo-EEG electrodes and has them implanted in the anterior insula

• Patient who is able and willing to provide informed consent

Locations
Other Locations
Switzerland
Service de Neurologie, Dpt des Neurosciences cliniques HUG
RECRUITING
Geneva
Contact Information
Primary
Fabienne Picard, MD
Fabienne.Picard@hcuge.ch
+41 22 372 5258
Backup
Nina Sooter
nina.sooter@unige.ch
+41 79 6791 949
Time Frame
Start Date: 2024-01-15
Estimated Completion Date: 2025-12
Participants
Target number of participants: 50
Treatments
Patients
Patients who suffer from potentially surgically remediable drug-resistant focal epilepsy and who require evaluation with intracranial stereo-EEG electrodes and have them implanted in the anterior insula.~N = 10
Subclinical
Healthy individuals who match the clinical population in age and level of education.~N = 40
Related Therapeutic Areas
Sponsors
Leads: University Hospital, Geneva
Collaborators: University of Geneva, Switzerland

This content was sourced from clinicaltrials.gov