Evidence map›Paper›PMID 42744905›Full record

ArticleNature neuroscience2026

Intracranial recordings in humans reveal differential contributions of medial and lateral orbitofrontal cortex to approach-avoidance decision-making.

Clara Kwon Starkweather, Ethan H Willbrand, Kristin Sellers, Patrick W Hullett, Andrew D Krystal, A Moses Lee, Kevin S Weiner, Jon T Willie, Peter Brunner, Ming Hsu and 2 more

Abstract read
PubMed Publisher
In one paragraph

Article in Nature neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Clara Kwon StarkweatherDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA. clara.starkweather@ucsf.edu.ORCID http://orcid.org/0000-0002-7772-5363
Ethan H WillbrandSchool of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.ORCID http://orcid.org/0000-0003-4625-5642
Kristin SellersDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0002-0517-2296
Patrick W HullettDepartment of Neurology, University of California, San Francisco, San Francisco, CA, USA.
Andrew D KrystalDepartment of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0002-6702-781X
A Moses LeeDepartment of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
Kevin S WeinerHelen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA.ORCID http://orcid.org/0000-0002-8734-5049
Jon T WillieDepartment of Neurosurgery, University of Texas at Austin, Austin, TX, USA.
Peter BrunnerDepartment of Neurosurgery, Washington University in St. Louis, St. Louis, MO, USA.ORCID http://orcid.org/0000-0002-2588-2754
Ming HsuHelen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA.ORCID http://orcid.org/0000-0001-7195-3579
Edward F ChangDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0003-2480-4700
Robert T KnightDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0001-8686-1685

Funding

U.S. Department of Health & Human Services | National Institutes of Health (NIH) R01MH122431-04U.S. Department of Health & Human Services | National Institutes of Health (NIH) R01NS021135-35U.S. Department of Health & Human Services | National Institutes of Health (NIH) U24NS109103-07U.S. Department of Health & Human Services | National Institutes of Health (NIH) UE5NS070680-15U.S. Department of Health & Human Services | National Institutes of Health (NIH) UH3NS123310-01A1
6 · The paper itself

Abstract

Approach-avoidance refers to the psychological conflict in which deciding to approach a reward also carries potential punishment. The orbitofrontal cortex (OFC) is proposed to arbitrate approach-avoidance decisions, yet little is known about the real-time computations within OFC during these decisions. We conducted intracranial recordings in humans implanted with stereotactic electroencephalography electrodes in the OFC while they played a gamified approach-avoidance task. Here we identified two anatomically distinct signals within the OFC prior to approach: an increase in activity within the medial compartment and a decrease within the lateral compartment. Prior to decisions, these signals rapidly alternated between discrete pro-approach and pro-avoidant states, thus introducing a new functional architecture within the human OFC during decision-making.

Identifiers

PMID42744905

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.