Abstract and Effector-Selective Decision Signals Exhibit Qualitatively Distinct Dynamics before Delayed Perceptual Reports

Prioritized neural processing of social threats during perceptual decision-making

Emotional signals, notably those signaling threat, benefit from prioritized processing in the human brain. Yet, it remains unclear whether perceptual decisions about the emotional, threat-related aspects of stimuli involve specific or similar neural computations compared to decisions about their non-threatening/non-emotional components. We developed a novel behavioral paradigm in which participants performed two different detection tasks (emotion vs. color) on the same, two-dimensional visual stimuli. First, electroencephalographic (EEG) activity in a cluster of central electrodes reflected the amount of perceptual evidence around 100 ms following stimulus onset, when the decision concerned emotion, not color. Second, participants' choice could be predicted earlier for emotion (240 ms) than for color (380 ms) by the mu (10 Hz) rhythm, which reflects motor preparation. Taken together, these findings indicate that perceptual decisions about threat-signaling dimensions of facial displays are associated with prioritized neural coding in action-related brain regions, supporting the motivational value of socially relevant signals.

A Neural Decision Signal during Internal Sampling from Working Memory in Humans

How humans transform sensory information into decisions that steer purposeful behavior is a central question in psychology and neuroscience that is traditionally investigated during the sampling of external environmental signals. The decision-making framework of gradual information sampling toward a decision has also been proposed to apply when sampling internal sensory evidence from working memory. However, neural evidence for this proposal remains scarce. Here we show (using scalp EEG in male and female human volunteers) that sampling internal visual representations from working memory elicits a scalp EEG potential associated with gradual evidence accumulation-the central parietal positivity. Consistent with an evolving decision process, we show how this signal (1) scales with the time participants require to reach a decision about the cued memory content and (2) is amplified when having to decide among multiple contents in working memory. These results bring the electrophysiology of decision-making into the domain of working memory and suggest that variability in memory-guided behavior may be driven (at least in part) by variations in the sampling of our inner mental contents.

Prior probability cues bias sensory encoding with increasing task exposure

When observers have prior knowledge about the likely outcome of their perceptual decisions, they exhibit robust behavioural biases in reaction time and choice accuracy. Computational modelling typically attributes these effects to strategic adjustments in the criterion amount of evidence required to commit to a choice alternative - usually implemented by a starting point shift - but recent work suggests that expectations may also fundamentally bias the encoding of the sensory evidence itself. Here, we recorded neural activity with EEG while participants performed a contrast discrimination task with valid, invalid, or neutral probabilistic cues across multiple testing sessions. We measured sensory evidence encoding via contrast-dependent steady-state visual-evoked potentials (SSVEP), while a read-out of criterion adjustments was provided by effector-selective mu-beta band activity over motor cortex. In keeping with prior modelling and neural recording studies, cues evoked substantial biases in motor preparation consistent with criterion adjustments, but we additionally found that the cues produced a significant modulation of the SSVEP during evidence presentation. While motor preparation adjustments were observed in the earliest trials, the sensory-level effects only emerged with extended task exposure. Our results suggest that, in addition to strategic adjustments to the decision process, probabilistic information can also induce subtle biases in the encoding of the evidence itself.

Intracranial electroencephalography reveals effector-independent evidence accumulation dynamics in multiple human brain regions

Neural representations of perceptual decision formation that are abstracted from specific motor requirements have previously been identified in humans using non-invasive electrophysiology; however, it is currently unclear where these originate in the brain. Here we capitalized on the high spatiotemporal precision of intracranial EEG to localize such abstract decision signals. Participants undergoing invasive electrophysiological monitoring for epilepsy were asked to judge the direction of random-dot stimuli and respond either with a speeded button press (N = 24), or vocally, after a randomized delay (N = 12). We found a widely distributed motor-independent network of regions where high-frequency activity exhibited key characteristics consistent with evidence accumulation, including a gradual buildup that was modulated by the strength of the sensory evidence, and an amplitude that predicted participants' choice accuracy and response time. Our findings offer a new view on the brain networks governing human decision-making.

Interpersonal alignment of neural evidence accumulation to social exchange of confidence

Private, subjective beliefs about uncertainty have been found to have idiosyncratic computational and neural substrates yet, humans share such beliefs seamlessly and cooperate successfully. Bringing together decision making under uncertainty and interpersonal alignment in communication, in a discovery plus pre-registered replication design, we examined the neuro-computational basis of the relationship between privately held and socially shared uncertainty. Examining confidence-speed-accuracy trade-off in uncertainty-ridden perceptual decisions under social vs isolated context, we found that shared (i.e. reported confidence) and subjective (inferred from pupillometry) uncertainty dynamically followed social information. An attractor neural network model incorporating social information as top-down additive input captured the observed behavior and demonstrated the emergence of social alignment in virtual dyadic simulations. Electroencephalography showed that social exchange of confidence modulated the neural signature of perceptual evidence accumulation in the central parietal cortex. Our findings offer a neural population model for interpersonal alignment of shared beliefs.

Abstract perceptual choice signals during action-linked decisions in the human brain

Humans can make abstract choices independent of motor actions. However, in laboratory tasks, choices are typically reported with an associated action. Consequentially, knowledge about the neural representation of abstract choices is sparse, and choices are often thought to evolve as motor intentions. Here, we show that in the human brain, perceptual choices are represented in an abstract, motor-independent manner, even when they are directly linked to an action. We measured MEG signals while participants made choices with known or unknown motor response mapping. Using multivariate decoding, we quantified stimulus, perceptual choice, and motor response information with distinct cortical distributions. Choice representations were invariant to whether the response mapping was known during stimulus presentation, and they occupied a distinct representational space from motor signals. As expected from an internal decision variable, they were informed by the stimuli, and their strength predicted decision confidence and accuracy. Our results demonstrate abstract neural choice signals that generalize to action-linked decisions, suggesting a general role of an abstract choice stage in human decision-making.

Electrophysiological evidence of discontinuities in the propagation of lexical decision processes across the motor hierarchy

This research assessed the propagation of decisional effects across multiple electrophysiological indexes related to motor-response implementation within a lexical decision task, a paradigmatic case of a 2-alternative choice task on linguistic stimuli. By co-registering electroencephalographic and electromyographic data, we focused on the lexicality effect (i.e., the difference between responses to words and nonwords), and we tracked its influence across indexes of motor-response planning (indexed by effector-selective lateralization of beta-frequency desynchronizations), programming (indexed by the lateralized readiness potential) and execution (indexed by the chronometric durations of muscular responses). In addition, we explored corticomuscular coherence as the potential physiological underpinning of a continuous mapping of information between stimulus evaluation and response channels. The results revealed lexicality effects only on indexes of motor planning and execution, with no reliable involvement of the other measures. This pattern is discussed with reference to the hypothesis of multiple decisional components exerting different influences across the motor-hierarchy.

Confidence is predicted by pre- and post-choice decision signal dynamics

It is well established that one's confidence in a choice can be influenced by new evidence encountered after commitment has been reached, but the processes through which post-choice evidence is sampled remain unclear. To investigate this, we traced the pre- and post-choice dynamics of electrophysiological signatures of evidence accumulation (Centro-parietal Positivity, CPP) and motor preparation (mu/beta band) to determine their sensitivity to participants' confidence in their perceptual discriminations. Pre-choice CPP amplitudes scaled with confidence both when confidence was reported simultaneously with choice, and when reported 1 second after the initial direction decision with no intervening evidence. When additional evidence was presented during the post-choice delay period, the CPP exhibited sustained activation after the initial choice, with a more prolonged build-up on trials with lower certainty in the alternative that was finally endorsed, irrespective of whether this entailed a change-of-mind from the initial choice or not. Further investigation established that this pattern was accompanied by later lateralisation of motor preparation signals toward the ultimately chosen response and slower confidence reports when participants indicated low certainty in this response. These observations are consistent with certainty-dependent stopping theories according to which post-choice evidence accumulation ceases when a criterion level of certainty in a choice alternative has been reached, but continues otherwise. Our findings have implications for current models of choice confidence, and predictions they may make about EEG signatures.

Neural Mechanisms That Make Perceptual Decisions Flexible

Neural mechanisms of perceptual decision making have been extensively studied in experimental settings that mimic stable environments with repeating stimuli, fixed rules, and payoffs. In contrast, we live in an ever-changing environment and have varying goals and behavioral demands. To accommodate variability, our brain flexibly adjusts decision-making processes depending on context. Here, we review a growing body of research that explores the neural mechanisms underlying this flexibility. We highlight diverse forms of context dependency in decision making implemented through a variety of neural computations. Context-dependent neural activity is observed in a distributed network of brain structures, including posterior parietal, sensory, motor, and subcortical regions, as well as the prefrontal areas classically implicated in cognitive control. We propose that investigating the distributed network underlying flexible decisions is key to advancing our understanding and discuss a path forward for experimental and theoretical investigations.

Explaining Integration of Evidence Separated by Temporal Gaps with Frontoparietal Circuit Models

Perceptual decisions rely on accumulating sensory evidence over time. However, the accumulation process is complicated in real life when evidence resulted from separated cues over time. Previous studies demonstrate that participants are able to integrate information from two separated cues to improve their performance invariant to an interval between the cues. However, there is no neural model that can account for accuracy and confidence in decisions when there is a time interval in evidence. We used behavioral and EEG datasets from a visual choice task -Random dot motion- with separated evidence to investigate three candid distributed neural networks. We showed that decisions based on evidence accumulation by separated cues over time are best explained by the interplay of recurrent cortical dynamics of centro-parietal and frontal brain areas while an uncertainty-monitoring module included in the model.

Magnetoencephalography recordings reveal the neural mechanisms of auditory contributions to improved visual detection

Sounds enhance the detection of visual stimuli while concurrently biasing an observer's decisions. To investigate the neural mechanisms that underlie such multisensory interactions, we decoded time-resolved Signal Detection Theory sensitivity and criterion parameters from magneto-encephalographic recordings of participants that performed a visual detection task. We found that sounds improved visual detection sensitivity by enhancing the accumulation and maintenance of perceptual evidence over time. Meanwhile, criterion decoding analyses revealed that sounds induced brain activity patterns that resembled the patterns evoked by an actual visual stimulus. These two complementary mechanisms of audiovisual interplay differed in terms of their automaticity: Whereas the sound-induced enhancement in visual sensitivity depended on participants being actively engaged in a detection task, we found that sounds activated the visual cortex irrespective of task demands, potentially inducing visual illusory percepts. These results challenge the classical assumption that sound-induced increases in false alarms exclusively correspond to decision-level biases.

Motor cortical signals reflecting decision making and action preparation

Decision making often requires accumulating evidence in favour of a particular option. When choices are expressed with a motor response, these actions are preceded by reductions in the power of oscillations in the alpha and beta range in motor cortices. For unimanual movements, these reductions are greater over the hemisphere contralateral to the response side. Such lateralizations are hypothesized to be an online index of the neural state of decisions as they develop over time of processing. In contrast, the lateralized readiness potential (LRP) is considered to selectively activate a response and appears shortly before the motor output. We investigated to what extent these neural signals reflect integration of decision evidence or more motor-related action preparation. Using two different experiments, we found that lateralization of alpha and beta power (APL and BPL, respectively) rapidly emerged after stimulus presentation, even when making an overt response was not yet possible. In contrast, we show that even after prolonged stimulus presentation, no LRP was present. Instead, the LRP emerged only after an imperative cue, prompting participants to indicate their choice. Furthermore, we could show that variations in sensory evidence strength modulate APL and BPL onset times, suggesting that integration of evidence is represented in these motor cortical signals. We conclude that APL and BPL reflect higher cognitive processes rather than pure action preparation, whereas LRP is more closely tied to motor performance. APL and BPL potentially encode decision information in motor areas serving the later preparation of overt decision output.

A conflict between spatial selection and evidence accumulation in area LIP

The lateral intraparietal area (LIP) contains spatially selective neurons that help guide eye movements and, according to numerous studies, do so by accumulating sensory evidence in favor of one choice (e.g., look left) or another (look right). To examine this functional link, we trained two monkeys on an urgent motion discrimination task, a task with which the evolution of both the recorded neuronal activity and the subject's choice can be tracked millisecond by millisecond. We found that while choice accuracy increased steeply with increasing sensory evidence, at the same time, the LIP selection signal became progressively weaker, as if it hindered performance. This effect was consistent with the transient deployment of spatial attention to disparate locations away from the relevant sensory cue. The results demonstrate that spatial selection in LIP is dissociable from, and may even conflict with, evidence accumulation during informed saccadic choices.

Sequential sampling from memory underlies action selection during abstract decision-making

The study of perceptual decision-making in monkeys has provided insights into the process by which sensory evidence is integrated toward a decision. When monkeys make decisions with the knowledge of the motor actions the decisions bear upon, the process of evidence integration is instantiated by neurons involved in the selection of said actions. It is less clear how monkeys make decisions when unaware of the actions required to communicate their choice-what we refer to as "abstract" decisions. We investigated this by training monkeys to associate the direction of motion of a noisy random-dot display with the color of two targets. Crucially, the targets were displayed at unpredictable locations after the motion stimulus was extinguished. We found that the monkeys postponed decision formation until the targets were revealed. Neurons in the parietal association area LIP represented the integration of evidence leading to a choice, but as the stimulus was no longer visible, the samples of evidence must have been retrieved from short-term memory. Our results imply that when decisions are temporally unyoked from the motor actions they bear upon, decision formation is protracted until they can be framed in terms of motor actions.

Neurocomputational mechanisms underlying cross-modal associations and their influence on perceptual decisions

When exposed to complementary features of information across sensory modalities, our brains formulate cross-modal associations between features of stimuli presented separately to multiple modalities. For example, auditory pitch-visual size associations map high-pitch tones with small-size visual objects, and low-pitch tones with large-size visual objects. Preferential, or congruent, cross-modal associations have been shown to affect behavioural performance, i.e. choice accuracy and reaction time (RT) across multisensory decision-making paradigms. However, the neural mechanisms underpinning such influences in perceptual decision formation remain unclear. Here, we sought to identify when perceptual improvements from associative congruency emerge in the brain during decision formation. In particular, we asked whether such improvements represent ‘early’ sensory processing benefits, or ‘late’ post-sensory changes in decision dynamics. Using a modified version of the Implicit Association Test (IAT), coupled with electroencephalography (EEG), we measured the neural activity underlying the effect of auditory stimulus-driven pitch-size associations on perceptual decision formation. Behavioural results showed that participants responded significantly faster during trials when auditory pitch was congruent, rather than incongruent, with its associative visual size counterpart. We used multivariate Linear Discriminant Analysis (LDA) to characterise the spatiotemporal dynamics of EEG activity underpinning IAT performance. We found an ‘Early’ component (∼100–110 ms post-stimulus onset) coinciding with the time of maximal discrimination of the auditory stimuli, and a ‘Late’ component (∼330–340 ms post-stimulus onset) underlying IAT performance. To characterise the functional role of these components in decision formation, we incorporated a neurally-informed Hierarchical Drift Diffusion Model (HDDM), revealing that the Late component decreases response caution, requiring less sensory evidence to be accumulated, whereas the Early component increased the duration of sensory-encoding processes for incongruent trials. Overall, our results provide a mechanistic insight into the contribution of ‘early’ sensory processing, as well as ‘late’ post-sensory neural representations of associative congruency to perceptual decision formation.

Matching pictures and signs: An ERP study of the effects of iconic structural alignment in American sign language

Event-related potentials (ERPs) were used to explore the effects of iconicity and structural visual alignment between a picture-prime and a sign-target in a picture-sign matching task in American Sign Language (ASL). Half the targets were iconic signs and were presented after a) a matching visually-aligned picture (e.g., the shape and location of the hands in the sign COW align with the depiction of a cow with visible horns), b) a matching visually-nonaligned picture (e.g., the cow's horns were not clearly shown), and c) a non-matching picture (e.g., a picture of a swing instead of a cow). The other half of the targets were filler signs. Trials in the matching condition were responded to faster than those in the non-matching condition and were associated with smaller N400 amplitudes in deaf ASL signers. These effects were also observed for hearing non-signers performing the same task with spoken-English targets. Trials where the picture-prime was aligned with the sign target were responded to faster than non-aligned trials and were associated with a reduced P3 amplitude rather than a reduced N400, suggesting that picture-sign alignment facilitated the decision process, rather than lexical access. These ERP and behavioral effects of alignment were found only for the ASL signers. The results indicate that iconicity effects on sign comprehension may reflect a task-dependent strategic use of iconicity, rather than facilitation of lexical access.

Understanding neural signals of post-decisional performance monitoring: An integrative review

Performance monitoring is a key cognitive function, allowing to detect mistakes and adapt future behavior. Post-decisional neural signals have been identified that are sensitive to decision accuracy, decision confidence and subsequent adaptation. Here, we review recent work that supports an understanding of late error/confidence signals in terms of the computational process of post-decisional evidence accumulation. We argue that the error positivity, a positive-going centro-parietal potential measured through scalp electrophysiology, reflects the post-decisional evidence accumulation process itself, which follows a boundary crossing event corresponding to initial decision commitment. This proposal provides a powerful explanation for both the morphological characteristics of the signal and its relation to various expressions of performance monitoring. Moreover, it suggests that the error positivity -a signal with thus far unique properties in cognitive neuroscience - can be leveraged to furnish key new insights into the inputs to, adaptation, and consequences of the post-decisional accumulation process.

Neurophysiology of Human Perceptual Decision-Making

The discovery of neural signals that reflect the dynamics of perceptual decision formation has had a considerable impact. Not only do such signals enable detailed investigations of the neural implementation of the decision-making process but they also can expose key elements of the brain's decision algorithms. For a long time, such signals were only accessible through direct animal brain recordings, and progress in human neuroscience was hampered by the limitations of noninvasive recording techniques. However, recent methodological advances are increasingly enabling the study of human brain signals that finely trace the dynamics of the unfolding decision process. In this review, we highlight how human neurophysiological data are now being leveraged to furnish new insights into the multiple processing levels involved in forming decisions, to inform the construction and evaluation of mathematical models that can explain intra- and interindividual differences, and to examine how key ancillary processes interact with core decision circuits.

Distractors Selectively Modulate Electrophysiological Markers of Perceptual Decisions

Current models of perceptual decision-making assume that choices are made after evidence in favor of an alternative accumulates to a given threshold. This process has recently been revealed in human EEG recordings, but an unresolved issue is how these neural mechanisms are modulated by competing, yet task-irrelevant, stimuli. In this study, we tested 20 healthy participants on a motion direction discrimination task. Participants monitored two patches of random dot motion simultaneously presented on either side of fixation for periodic changes in an upward or downward motion, which could occur equiprobably in either patch. On a random 50% of trials, these periods of coherent vertical motion were accompanied by simultaneous task-irrelevant, horizontal motion in the contralateral patch. Our data showed that these distractors selectively increased the amplitude of early target selection responses over scalp sites contralateral to the distractor stimulus, without impacting on responses ipsilateral to the distractor. Importantly, this modulation mediated a decrement in the subsequent buildup rate of a neural signature of evidence accumulation and accounted for a slowing of RTs. These data offer new insights into the functional interactions between target selection and evidence accumulation signals, and their susceptibility to task-irrelevant distractors. More broadly, these data neurally inform future models of perceptual decision-making by highlighting the influence of early processing of competing stimuli on the accumulation of perceptual evidence.

Thalamocortical excitability modulation guides human perception under uncertainty

Knowledge about the relevance of environmental features can guide stimulus processing. However, it remains unclear how processing is adjusted when feature relevance is uncertain. We hypothesized that (a) heightened uncertainty would shift cortical networks from a rhythmic, selective processing-oriented state toward an asynchronous ("excited") state that boosts sensitivity to all stimulus features, and that (b) the thalamus provides a subcortical nexus for such uncertainty-related shifts. Here, we had young adults attend to varying numbers of task-relevant features during EEG and fMRI acquisition to test these hypotheses. Behavioral modeling and electrophysiological signatures revealed that greater uncertainty lowered the rate of evidence accumulation for individual stimulus features, shifted the cortex from a rhythmic to an asynchronous/excited regime, and heightened neuromodulatory arousal. Crucially, this unified constellation of within-person effects was dominantly reflected in the uncertainty-driven upregulation of thalamic activity. We argue that neuromodulatory processes involving the thalamus play a central role in how the brain modulates neural excitability in the face of momentary uncertainty.

Stimulus-response learning and expected reward value enhance stimulus cognitive processing: An ERP study

Reward affects our attention to stimuli, prioritizing those that lead to high-value outcomes. Recently, it has been suggested that such reward-related cognitive prioritization might be associated with the process of learning new stimulus-response (S-R) associations, because both are acquired through extended reward training, and once established, they are hard to overcome. We used event-related potentials (ERP) to analyze the contribution of S-R links to the formation of reward-related cognitive prioritization during reinforcement learning. Reward-related cognitive prioritization was measured by comparing the ERP signals for stimuli predicting high-value and low-value outcomes. In addition, we compared a strong S-R link (same stimulus, same response), with a weak S-R link condition (same stimulus, two different responses). The participants' performance was more accurate and faster when the procedure allowed for establishing strong S-R links and for high-value outcomes. Furthermore, those stimuli associated with strong S-R links showed a larger P3 amplitude at parietal sites. Value effects (larger ERP activity for those stimuli predicting a high-value outcome) were obtained at parietal and occipital sites in the P3 time window. However, value effects did not benefit from strong S-R links in either the P1 or the P3 components. These results suggest that strong S-R learning is not necessary to develop reward-related modulations of ERP activity.

Predictive activation of sensory representations as a source of evidence in perceptual decision-making

Our brains can represent expected future states of our sensory environment. Recent work has shown that, when we expect a specific stimulus to appear at a specific time, we can predictively generate neural representations of that stimulus even before it is physically presented. These observations raise two exciting questions: Are pre-activated sensory representations used for perceptual decision-making? And, do we transiently perceive an expected stimulus that does not actually appear? To address these questions, we propose that pre-activated neural representations provide sensory evidence that is used for perceptual decision-making. This can be understood within the framework of the Diffusion Decision Model as an early accumulation of decision evidence in favour of the expected percept. Our proposal makes novel predictions relating to expectation effects on neural markers of decision evidence accumulation, and also provides an explanation for why we sometimes perceive stimuli that are expected, but do not appear.

Neurocomputational mechanisms of prior-informed perceptual decision-making in humans

To interact successfully with diverse sensory environments, we must adapt our decision processes to account for time constraints and prior probabilities. The full set of decision-process parameters that undergo such flexible adaptation has proven to be difficult to establish using simplified models that are based on behaviour alone. Here, we utilize well-characterized human neurophysiological signatures of decision formation to construct and constrain a build-to-threshold decision model with multiple build-up (evidence accumulation and urgency) and delay components (pre- and post-decisional). The model indicates that all of these components were adapted in distinct ways and, in several instances, fundamentally differ from the conclusions of conventional diffusion modelling. The neurally informed model outcomes were corroborated by independent neural decision signal observations that were not used in the model's construction. These findings highlight the breadth of decision-process parameters that are amenable to strategic adjustment and the value in leveraging neurophysiological measurements to quantify these adjustments.

On the Boundaries between Decision and Action: Effector-selective Lateralization of Beta-frequency Power Is Modulated by the Lexical Frequency of Printed Words

Current computational and neuroscientific models of decision-making posit a discrete, serial processing distinction between upstream decisional stages and downstream processes of motor-response implementation. We investigated this framework in the context of two-alternative forced-choice tasks on linguistic stimuli, words and pseudowords. In two experiments, we assessed the impact of lexical frequency and action semantics on two effector-selective EEG indexes of motor-response activation: the lateralized readiness potential and the lateralization of beta-frequency power. This allowed us to track potentially continuous streams of processing progressively mapping the evaluation of linguistic stimuli onto corresponding response channels. Whereas action semantics showed no influence on EEG indexes of motor-response activation, lexical frequency affected the lateralization of response-locked beta-frequency power. We argue that these observations point toward a continuity between linguistic processing of word input stimuli and implementation of corresponding choice in terms of motor behavior. This interpretation challenges the commonly held assumption of a discrete processing distinction between decisional and motor-response processes in the context of decisions based on symbolic stimuli.

Evidence accumulation during perceptual decision-making is sensitive to the dynamics of attentional selection

The ability to select and combine multiple sensory inputs in support of accurate decisions is a hallmark of adaptive behaviour. Attentional selection is often needed to prioritize task-relevant stimuli relative to irrelevant, potentially distracting stimuli. As most studies of perceptual decision-making to date have made use of task-relevant stimuli only, relatively little is known about how attention modulates decision making. To address this issue, we developed a novel 'integrated' decision-making task, in which participants judged the average direction of successive target motion signals while ignoring concurrent and spatially overlapping distractor motion signals. In two experiments that varied the role of attentional selection, we used regression to quantify the influence of target and distractor stimuli on behaviour. Using electroencephalography, we characterised the neural correlates of decision making, attentional selection and feature-specific responses to target and distractor signals. While targets strongly influenced perceptual decisions and associated neural activity, we also found that concurrent and spatially coincident distractors exerted a measurable bias on both behaviour and brain activity. Our findings suggest that attention operates as a real-time but imperfect filter during perceptual decision-making by dynamically modulating the contributions of task-relevant and irrelevant sensory inputs.

Centroparietal activity mirrors the decision variable when tracking biased and time-varying sensory evidence

Decision-making is a fundamental human activity requiring explanation at the neurocognitive level. Current theoretical frameworks assume that, during sensory-based decision-making, the stimulus is sampled sequentially. The resulting evidence is accumulated over time as a decision variable until a threshold is reached and a response is initiated. Several neural signals, including the centroparietal positivity (CPP) measured from the human electroencephalogram (EEG), appear to display the accumulation-to-bound profile associated with the decision variable. Here, we evaluate the putative computational role of the CPP as a model-derived accumulation-to-bound signal, focussing on point-by-point correspondence between model predictions and data in order to go beyond simple summary measures like average slope. In two experiments, we explored the CPP under two manipulations (namely non-stationary evidence and probabilistic decision biases) that complement one another by targeting the shape and amplitude of accumulation respectively. We fit sequential sampling models to the behavioural data, and used the resulting parameters to simulate the decision variable, before directly comparing the simulated profile to the CPP waveform. In both experiments, model predictions deviated from our naïve expectations, yet showed similarities with the neurodynamic data, illustrating the importance of a formal modelling approach. The CPP appears to arise from brain processes that implement a decision variable (as formalised in sequential-sampling models) and may therefore inform our understanding of decision-making at both the representational and implementational levels of analysis, but at this point it is uncertain whether a single model can explain how the CPP varies across different kinds of task manipulation.

Human stereoEEG recordings reveal network dynamics of decision-making in a rule-switching task

The processing steps that lead up to a decision, i.e., the transformation of sensory evidence into motor output, are not fully understood. Here, we combine stereoEEG recordings from the human cortex, with single-lead and time-resolved decoding, using a wide range of temporal frequencies, to characterize decision processing during a rule-switching task. Our data reveal the contribution of rostral inferior parietal lobule (IPL) regions, in particular PFt, and the parietal opercular regions in decision processing and demonstrate that the network representing the decision is common to both task rules. We reconstruct the sequence in which regions engage in decision processing on single trials, thereby providing a detailed picture of the network dynamics involved in decision-making. The reconstructed timeline suggests that the supramarginal gyrus in IPL links decision regions in prefrontal cortex with premotor regions, where the motor plan for the response is elaborated.

The interplay between multisensory integration and perceptual decision making

Facing perceptual uncertainty, the brain combines information from different senses to make optimal perceptual decisions and to guide behavior. However, decision making has been investigated mostly in unimodal contexts. Thus, how the brain integrates multisensory information during decision making is still unclear. Two opposing, but not mutually exclusive, scenarios are plausible: either the brain thoroughly combines the signals from different modalities before starting to build a supramodal decision, or unimodal signals are integrated during decision formation. To answer this question, we devised a paradigm mimicking naturalistic situations where human participants were exposed to continuous cacophonous audiovisual inputs containing an unpredictable signal cue in one or two modalities and had to perform a signal detection task or a cue categorization task. First, model-based analyses of behavioral data indicated that multisensory integration takes place alongside perceptual decision making. Next, using supervised machine learning on concurrently recorded EEG, we identified neural signatures of two processing stages: sensory encoding and decision formation. Generalization analyses across experimental conditions and time revealed that multisensory cues were processed faster during both stages. We further established that acceleration of neural dynamics during sensory encoding and decision formation was directly linked to multisensory integration. Our results were consistent across both signal detection and categorization tasks. Taken together, the results revealed a continuous dynamic interplay between multisensory integration and decision making processes (mixed scenario), with integration of multimodal information taking place both during sensory encoding as well as decision formation.

Evidence accumulation during perceptual decisions in humans varies as a function of dorsal frontoparietal organization

Animal neurophysiological studies have identified neural signals within dorsal frontoparietal areas that trace a perceptual decision by accumulating sensory evidence over time and trigger action upon reaching a threshold. Although analogous accumulation-to-bound signals are identifiable on extracranial human electroencephalography, their cortical origins remain unknown. Here neural metrics of human evidence accumulation, predictive of the speed of perceptual reports, were isolated using electroencephalography and related to dorsal frontoparietal network (dFPN) connectivity using diffusion and resting-state functional magnetic resonance imaging. The build-up rate of evidence accumulation mediated the relationship between the white matter macrostructure of dFPN pathways and the efficiency of perceptual reports. This association between steeper build-up rates of evidence accumulation and the dFPN was recapitulated in the resting-state networks. Stronger connectivity between dFPN regions is thus associated with faster evidence accumulation and speeded perceptual decisions. Our findings identify an integrated network for perceptual decisions that may be targeted for neurorehabilitation in cognitive disorders.

Decoding Adaptive Visuomotor Behavior Mediated by Non-linear Phase Coupling in Macaque Area MT

The idea that a flexible behavior relies on synchronous neural activity within intra- and inter-associated cortical areas has been a matter of intense research in human and animal neuroscience. The neurophysiological mechanisms underlying this behavioral correlate of the synchronous activity are still unknown. It has been suggested that the strength of neural synchrony at the level of population is an important neural code to guide an efficient transformation of the sensory input into the behavioral action. In this study, we have examined the non-linear synchronization between neural ensembles in area MT of the macaque visual cortex by employing a non-linear cross-frequency coupling technique, namely bicoherence. We trained a macaque monkey to detect a brief change in the cued stimulus during a visuomotor detection task. The results show that the non-linear phase synchronization in the high-gamma frequency band (100-250 Hz) predicts the animal's reaction time. The strength of non-linear phase synchronization is selective to the target stimulus location. In addition, the non-linearity characteristics of neural synchronization are selectively modulated when the monkey covertly attends to the stimulus inside the neuron's receptive field. This additional evidence indicates that non-linear neuronal synchronization may be affected by a cognitive function like spatial attention. Our neural and behavioral observations reflect that two crucial processes may be involved in processing of visuomotor information in area MT: (I) a non-linear cortical process (measured by the bicoherence) and (II) a linear process (measured by the spectral power).

The role of premature evidence accumulation in making difficult perceptual decisions under temporal uncertainty

The computations and neural processes underpinning decision making have primarily been investigated using highly simplified tasks in which stimulus onsets cue observers to start accumulating choice-relevant information. Yet, in daily life we are rarely afforded the luxury of knowing precisely when choice-relevant information will appear. Here, we examined neural indices of decision formation while subjects discriminated subtle stimulus feature changes whose timing relative to stimulus onset ('foreperiod') was uncertain. Joint analysis of behavioural error patterns and neural decision signal dynamics indicated that subjects systematically began the accumulation process before any informative evidence was presented, and further, that accumulation onset timing varied systematically as a function of the foreperiod of the preceding trial. These results suggest that the brain can adjust to temporal uncertainty by strategically modulating accumulation onset timing according to statistical regularities in the temporal structure of the sensory environment with particular emphasis on recent experience.

Centro-parietal EEG potentials index subjective evidence and confidence during perceptual decision making

Recent studies suggest that a centro-parietal positivity (CPP) in the EEG signal tracks the absolute (unsigned) strength of accumulated evidence for choices that require the integration of noisy sensory input. Here, we investigated whether the CPP might also reflect the evidence for decisions based on a quantitative comparison between two sequentially presented stimuli (a signed quantity). We recorded EEG while participants decided whether the latter of two vibrotactile frequencies was higher or lower than the former in six variants of this task (n = 116). To account for biases in sequential comparisons, we applied a behavioral model based on Bayesian inference that estimated subjectively perceived frequency differences. Immediately after the second stimulus, parietal ERPs reflected the signed value of subjectively perceived differences and afterwards their absolute value. Strikingly, the modulation by signed difference was evident in trials without any objective evidence for either choice and correlated with choice-selective premotor beta band amplitudes. Modulations by the absolute strength of subjectively perceived evidence - a direct indicator of task difficulty - exhibited all features of statistical decision confidence. Together, our data suggest that parietal EEG signals first index subjective evidence, and later include a measure of confidence in the context of perceptual decision making.

Confidence Representation of Perceptual Decision by EEG and Eye Data in a Random Dot Motion Task

The Confidence of a decision could be considered as the internal estimate of decision accuracy. This variable has been studied extensively by different types of recording data such as behavioral, electroencephalography (EEG), eye and electrophysiology data. Although the value of the reported confidence is considered as one of the most important parameters in decision making, the confidence reporting phase might be considered as a restrictive element in investigating the decision process. Thus, decision confidence should be extracted by means of other provided types of information. Here, we proposed eight confidence related properties in EEG and eye data which are significantly descriptive of the defined confidence levels in a random dot motion (RDM) task. As a matter of fact, our proposed EEG and eye data properties are capable of recognizing more than nine distinct levels of confidence. Among our proposed features, the latency of the pupil maximum diameter through the stimulus presentation was established to be the most associated one to the confidence levels. Through the time-dependent analysis of these features, we recognized the time interval of 500-600 ms after the stimulus onset as an important time in correlating features to the confidence levels.

The EEG signature of sensory evidence accumulation during decision formation closely tracks subjective perceptual experience

How neural representations of low-level visual information are accessed by higher-order processes to inform decisions and give rise to conscious experience is a longstanding question. Research on perceptual decision making has revealed a late event-related EEG potential (the Centro-Parietal Positivity, CPP) to be a correlate of the accumulation of sensory evidence. We tested how this evidence accumulation signal relates to externally presented (physical) and internally experienced (subjective) sensory evidence. Our results show that the known relationship between the physical strength of the external evidence and the evidence accumulation signal (reflected in the CPP amplitude) is mediated by the level of subjective experience of stimulus strength. This shows that the CPP closely tracks the subjective perceptual evidence, over and above the physically presented evidence. We conclude that a remarkably close relationship exists between the evidence accumulation process (i.e. CPP) and subjective perceptual experience, suggesting that neural decision processes and components of conscious experience are tightly linked.

Reconciling age-related changes in behavioural and neural indices of human perceptual decision-making

Ageing impacts on decision-making behaviour across a range of cognitive tasks and scenarios. Computational modelling has proved valuable in providing mechanistic interpretations of these age-related differences; however, the extent to which model parameter differences accurately reflect changes to the underlying neural computations remains unclear. Here, we report that age-related effects on neural signatures of decision formation are inconsistent with behavioural fits derived from a prominent accumulation-to-bound model. Most notably, model-predicted bound differences were absent neurophysiologically. However, constraining the model to match the decision-predictive elements of the brain signals provided more parsimonious fits to behaviour and generated predictions regarding the neural data that were empirically validated. These included a task-dependent slowing of evidence accumulation among older adults and reduced between-trial accumulation rate variability, which was linked to enhanced attentional engagement. Our findings highlight how combining neurophysiological measurements with computational modelling can yield unique insights into group differences in neural decision mechanisms.

Bridging Neural and Computational Viewpoints on Perceptual Decision-Making

Sequential sampling models have provided a dominant theoretical framework guiding computational and neurophysiological investigations of perceptual decision-making. While these models share the basic principle that decisions are formed by accumulating sensory evidence to a bound, they come in many forms that can make similar predictions of choice behaviour despite invoking fundamentally different mechanisms. The identification of neural signals that reflect some of the core computations underpinning decision formation offers new avenues for empirically testing and refining key model assumptions. Here, we highlight recent efforts to explore these avenues and, in so doing, consider the conceptual and methodological challenges that arise when seeking to infer decision computations from complex neural data.

Decisions are expedited through multiple neural adjustments spanning the sensorimotor hierarchy

When decisions are made under speed pressure, "urgency" signals elevate neural activity toward action-triggering thresholds independent of the sensory evidence, thus incurring a cost to choice accuracy. While urgency signals have been observed in brain circuits involved in preparing actions, their influence at other levels of the sensorimotor pathway remains unknown. We used a novel contrast-comparison paradigm to simultaneously trace the dynamics of sensory evidence encoding, evidence accumulation, motor preparation, and muscle activation in humans. Results indicate speed pressure impacts multiple sensorimotor levels but in crucially distinct ways. Evidence-independent urgency was applied to cortical action-preparation signals and downstream muscle activation, but not directly to upstream levels. Instead, differential sensory evidence encoding was enhanced in a way that partially countered the negative impact of motor-level urgency on accuracy, and these opposing sensory-boost and motor-urgency effects had knock-on effects on the buildup and pre-response amplitude of a motor-independent representation of cumulative evidence.

Having More Choices Changes How Human Observers Weight Stable Sensory Evidence

Decision-making becomes slower when more choices are available. Existing models attribute this slowing to poor sensory processing, to attenuated rates of sensory evidence accumulation, or to increases in the amount of evidence required before committing to a decision (a higher decision threshold). However, studies have not isolated the effects of having more choices on sensory and decision-related processes from changes in task difficulty and divided attention. Here, we controlled task difficulty while independently manipulating the distribution of attention and the number of choices available to male and female human observers. We used EEG to measure steady-state visually evoked potentials (SSVEPs) and a frontal late positive deflection (LPD), EEG markers of sensory and postsensory decision-related processes, respectively. We found that dividing attention decreased SSVEP and LPD amplitudes, consistent with dampened sensory responses and slower rates of evidence accumulation, respectively. In contrast, having more choices did not alter SSVEP amplitude and led to a larger LPD. These results suggest that having more options largely spares early sensory processing and slows down decision-making via a selective increase in decision thresholds.SIGNIFICANCE STATEMENT When more choices are available, decision-making becomes slower. We tested whether this phenomenon is due to poor sensory processing, to reduced rates of evidence accumulation, or to increases in the amount of evidence required before committing to a decision (a higher decision threshold). We measured choice modulations of sensory and decision-related neural responses using EEG. We also minimized potential confounds from changes in the distribution of attention and task difficulty, which often covary with having more choices. Dividing attention reduced the activity levels of both sensory and decision-related responses. However, having more choices did not change sensory processing and led to larger decision-related responses. These results suggest that having more choices spares sensory processing and selectively increases decision thresholds.

Neurodynamic Evidence Supports a Forced-Excursion Model of Decision-Making under Speed/Accuracy Instructions

Evolutionary pressures suggest that choices should be optimized to maximize rewards, by appropriately trading speed for accuracy. This speed-accuracy tradeoff (SAT) is commonly explained by variation in just the baseline-to-boundary distance, i.e., the excursion, of accumulation-to-bound models of perceptual decision-making. However, neural evidence is not consistent with this explanation. A compelling account of speeded choice should explain both overt behavior and the full range of associated brain signatures. Here, we reconcile seemingly contradictory behavioral and neural findings. In two variants of the same experiment, we triangulated upon the neural underpinnings of the SAT in the human brain using both EEG and transcranial magnetic stimulation (TMS). We found that distinct neural signals, namely the event-related potential (ERP) centroparietal positivity (CPP) and a smoothed motor-evoked potential (MEP) signal, which have both previously been shown to relate to decision-related accumulation, revealed qualitatively similar average neurodynamic profiles with only subtle differences between SAT conditions. These signals were then modelled from behavior by either incorporating traditional boundary variation or utilizing a forced excursion. These model variants are mathematically equivalent, in terms of their behavioral predictions, hence providing identical fits to correct and erroneous reaction time distributions. However, the forced-excursion version instantiates SAT via a more global change in parameters and implied neural activity, a process conceptually akin to, but mathematically distinct from, urgency. This variant better captured both ERP and MEP neural profiles, suggesting that the SAT may be implemented via neural gain modulation, and reconciling standard modelling approaches with human neural data.

Dynamic Interplay of Value and Sensory Information in High-Speed Decision Making

In dynamic environments, split-second sensorimotor decisions must be prioritized according to potential payoffs to maximize overall rewards. The impact of relative value on deliberative perceptual judgments has been examined extensively [1-6], but relatively little is known about value-biasing mechanisms in the common situation where physical evidence is strong but the time to act is severely limited. In prominent decision models, a noisy but statistically stationary representation of sensory evidence is integrated over time to an action-triggering bound, and value-biases are affected by starting the integrator closer to the more valuable bound. Here, we show significant departures from this account for humans making rapid sensory-instructed action choices. Behavior was best explained by a simple model in which the evidence representation-and hence, rate of accumulation-is itself biased by value and is non-stationary, increasing over the short decision time frame. Because the value bias initially dominates, the model uniquely predicts a dynamic "turn-around" effect on low-value cues, where the accumulator first launches toward the incorrect action but is then re-routed to the correct one. This was clearly exhibited in electrophysiological signals reflecting motor preparation and evidence accumulation. Finally, we construct an extended model that implements this dynamic effect through plausible sensory neural response modulations and demonstrate the correspondence between decision signal dynamics simulated from a behavioral fit of that model and the empirical decision signals. Our findings suggest that value and sensory information can exert simultaneous and dynamically countervailing influences on the trajectory of the accumulation-to-bound process, driving rapid, sensory-guided actions.

Antagonistic Interactions Between Microsaccades and Evidence Accumulation Processes During Decision Formation

Despite their small size, microsaccades can impede stimulus detections if executed at inopportune times. Although it has been shown that microsaccades evoke both inhibitory and excitatory responses across different visual regions, their impact on the higher-level neural decision processes that bridge sensory responses to action selection has yet to be examined. Here, we show that when human observers monitor stimuli for subtle feature changes, the occurrence of microsaccades long after (up to 800 ms) change onset predicts slower reaction times and this is accounted for by momentary suppression of neural signals at each key stage of decision formation: visual evidence encoding, evidence accumulation, and motor preparation. Our data further reveal that, independent of the timing of the change events, the onset of neural decision formation coincides with a systematic inhibition of microsaccade production, persisting until the perceptual report is executed. Our combined behavioral and neural measures highlight antagonistic interactions between microsaccade occurrence and evidence accumulation during visual decision-making tasks.SIGNIFICANCE STATEMENT When fixating on a location in space, we frequently make tiny eye movements called microsaccades. In the present study, we show that these microsaccades impede our ability to make perceptual decisions about visual stimuli and this impediment specifically occurs via the disruption of several processing levels of the sensorimotor network: the encoding of visual evidence itself, the accumulation of visual evidence toward a response, and effector-selective motor preparation. Furthermore, we show that the production of microsaccades is inhibited during the perceptual decision, possibly as a counteractive measure to mitigate their negative effect on behavior in this context. The combined behavioral and neural measures used in this study provide strong and novel evidence for the interaction of fixational eye movements and the perceptual decision-making process.

The impact of natural aging on computational and neural indices of perceptual decision making: A review

It is well established that natural aging negatively impacts on a wide variety of cognitive functions and research has sought to identify core neural mechanisms that may account for these disparate changes. A central feature of any cognitive task is the requirement to translate sensory information into an appropriate action - a process commonly known as perceptual decision making. While computational, psychophysical, and neurophysiological research has made substantial progress in establishing the key computations and neural mechanisms underpinning decision making, it is only relatively recently that this knowledge has begun to be applied to research on aging. The purpose of this review is to provide an overview of this work which is beginning to offer new insights into the core psychological processes that mediate age-related cognitive decline in adults aged 65 years and over. Mathematical modelling studies have consistently reported that older adults display longer non-decisional processing times and implement more conservative decision policies than their younger counterparts. However, there are limits on what we can learn from behavioural modeling alone and neurophysiological analyses can play an essential role in empirically validating model predictions and in pinpointing the precise neural mechanisms that are impacted by aging. Although few studies to date have explicitly examined correspondences between computational models and neural data with respect to cognitive aging, neurophysiological studies have already highlighted age-related changes at multiple levels of the sensorimotor hierarchy that are likely to be consequential for decision making behaviour. Here, we provide an overview of this literature and suggest some future directions for the field.

On Why Targets Evoke P3 Components in Prediction Tasks: Drawing an Analogy between Prediction and Matching Tasks

P3 is the most conspicuous component in recordings of stimulus-evoked EEG potentials from the human scalp, occurring whenever some task has to be performed with the stimuli. The process underlying P3 has been assumed to be the updating of expectancies. More recently, P3 has been related to decision processing and to activation of established stimulus-response associations (S/R-link hypothesis). However, so far this latter approach has not provided a conception about how to explain the occurrence of P3 with predicted stimuli, although P3 was originally discovered in a prediction task. The present article proposes such a conception. We assume that the internal responses right or wrong both become associatively linked to each predicted target and that one of these two response alternatives gets activated as a function of match or mismatch of the target to the preceding prediction. This seems similar to comparison tasks where responses depend on the matching of the target stimulus with a preceding first stimulus (S1). Based on this idea, this study compared the effects of frequencies of first events (predictions or S1) on target-evoked P3s in prediction and comparison tasks. Indeed, frequencies not only of targets but also of first events had similar effects across tasks on target-evoked P3s. These results support the notion that P3 evoked by predicted stimuli reflects activation of appropriate internal “match” or “mismatch” responses, which is compatible with S/R-link hypothesis.

Beyond the Status Quo: A Role for Beta Oscillations in Endogenous Content (Re)Activation

Among the rhythms of the brain, oscillations in the beta frequency range (∼13-30 Hz) have been considered the most enigmatic. Traditionally associated with sensorimotor functions, beta oscillations have recently become more broadly implicated in top-down processing, long-range communication, and preservation of the current brain state. Here, we extend and refine these views based on accumulating new findings of content-specific beta-synchronization during endogenous information processing in working memory (WM) and decision making. We characterize such content-specific beta activity as short-lived, flexible network dynamics supporting the endogenous (re)activation of cortical representations. Specifically, we suggest that beta-mediated ensemble formation within and between cortical areas may awake, rather than merely preserve, an endogenous cognitive set in the service of current task demands. This proposal accommodates key aspects of content-specific beta modulations in monkeys and humans, integrates with timely computational models, and outlines a functional role for beta that fits its transient temporal characteristics.

Neural correlates of evidence accumulation during value-based decisions revealed via simultaneous EEG-fMRI

Current computational accounts posit that, in simple binary choices, humans accumulate evidence in favour of the different alternatives before committing to a decision. Neural correlates of this accumulating activity have been found during perceptual decisions in parietal and prefrontal cortex; however the source of such activity in value-based choices remains unknown. Here we use simultaneous EEG–fMRI and computational modelling to identify EEG signals reflecting an accumulation process and demonstrate that the within- and across-trial variability in these signals explains fMRI responses in posterior-medial frontal cortex. Consistent with its role in integrating the evidence prior to reaching a decision, this region also exhibits task-dependent coupling with the ventromedial prefrontal cortex and the striatum, brain areas known to encode the subjective value of the decision alternatives. These results further endorse the proposition of an evidence accumulation process during value-based decisions in humans and implicate the posterior-medial frontal cortex in this process.

Parietal and prefrontal cortices gather information to make perceptual decisions, but it is not known if the same is true for value-based choices. Here, authors use simultaneous EEG-fMRI and modelling to show that during value- and reward-based decisions this evidence is accumulated in the posterior medial frontal cortex.

Visuospatial Asymmetries Arise from Differences in the Onset Time of Perceptual Evidence Accumulation

Healthy subjects tend to exhibit a bias of visual attention whereby left hemifield stimuli are processed more quickly and accurately than stimuli appearing in the right hemifield. It has long been held that this phenomenon arises from the dominant role of the right cerebral hemisphere in regulating attention. However, methods that would enable more precise understanding of the mechanisms underpinning visuospatial bias have remained elusive. We sought to finely trace the temporal evolution of spatial biases by leveraging a novel bilateral dot motion detection paradigm. In combination with electroencephalography, this paradigm enables researchers to isolate discrete neural signals reflecting the key neural processes needed for making these detection decisions. These include signals for spatial attention, early target selection, evidence accumulation, and motor preparation. Using this method, we established that three key neural markers accounted for unique between-subject variation in visuospatial bias: hemispheric asymmetry in posterior α power measured before target onset, which is related to the distribution of preparatory attention across the visual field; asymmetry in the peak latency of the early N2c target-selection signal; and, finally, asymmetry in the onset time of the subsequent neural evidence-accumulation process with earlier onsets for left hemifield targets. Our development of a single paradigm to dissociate distinct processing components that track the temporal evolution of spatial biases not only advances our understanding of the neural mechanisms underpinning normal visuospatial attention bias, but may also in the future aid differential diagnoses in disorders of spatial attention.SIGNIFICANCE STATEMENT The significance of this research is twofold. First, it shows that individual differences in how humans direct their attention between left and right space reflects physiological differences in how early the brain starts to accumulate evidence for the existence of a visual target. Second, the novel methods developed here may have particular relevance to disorders of attention, such as unilateral spatial neglect. In the case of spatial neglect, pathological inattention to left space could have multiple underlying causes, including biased attention, impaired decision formation, or a motor deficit related to one side of space. Our development of a single paradigm to dissociate each of these components may aid in supporting more precise differential diagnosis in such heterogeneous disorders.