Hemispheric Complementarity in Hippocampal Theta Dynamics during Mnemonic Decision-Making.

A core function of episodic memory is to distinguish between overlapping experiences by converting similar inputs into distinct, non-overlapping representations-a process termed pattern separation. While anatomical models emphasize the role of specific hippocampal subfields, particularly the dentate gyrus, CA3, and CA1, less is known about how these computations unfold over time and influence memory-based decisions. Here, we use source-localized magnetoencephalography and computational modeling to examine how theta oscillations from the hippocampus as a whole are related to evidence accumulation during mnemonic discrimination. Participants performed the Mnemonic Similarity Task, in which they classified repeat, lure, and foil images as "old," "similar," or "new." We fit a hierarchical Linear Ballistic Accumulator model to behavioral data, estimating trial-by-trial drift rates-a latent index of mnemonic evidence accumulation-and examined whether hippocampal theta power predicted these dynamics. Theta power in the left hippocampus was positively associated with drift toward "new" responses across stimulus conditions, consistent with a novelty-oriented decision bias. In contrast, right hippocampal theta showed negative associations with drift toward familiarity-driven false alarms to foil items, suggesting a complementary mechanism that curtails evidence accumulation based on false familiarity. Both hemispheres showed positive theta-drift associations during correct "similar" responses, implicating bilateral coordination in successful discrimination. Event-related source activity confirmed reliable hippocampal engagement despite the anatomical depth of the source. These findings reveal a dynamic, lateralized mechanism by which hippocampal theta oscillations shape memory-guided decisions, offering new insight into how the brain resolves mnemonic uncertainty in real time.