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<p>Transcranial electrical stimulation (tES) is one of the most widely used non-invasive brain stimulation (NIBS) methods employed to investigate the causal relationship between brain regions and cognitive functions. tES has been utilized in numerous studies to explore the role of brain regions involved in decision-making. The present study aims to review tES studies conducted to examine the causal relationship of neural regions involved in ambiguous and risky decision-making. A systematic review was conducted based on the PRISMA guidelines (PROSPERO record: CRD42024571443). A systematic search was performed in the PubMed database from 1985 to 2024. The search results were screened for eligibility based on inclusion and exclusion criteria. In addition to the qualitative synthesis, a random-effects meta-analysis was performed on eligible studies reporting sufficient statistical detail. This systematic review examined 19 studies involving 837 participants (351 men and 486 women) with an average age of 23.15 years, investigating the role of different brain regions in risky and ambiguous decision-making. Qualitative synthesis showed that the DLPFC has the strongest association with risky decision-making, particularly with significant changes observed after anodal stimulation in the right hemisphere and cathodal stimulation in the left hemisphere. Limited evidence also suggested roles for frontal asymmetry, the right orbitofrontal cortex (rOFC), and the dorsal anterior cingulate cortex (dACC) in risky decision-making. In the domain of ambiguous decision-making, only a few studies demonstrated the effect of anodal stimulation of the right DLPFC (RDLPFC). The only study using transcranial alternating current stimulation (tACS) also showed a connection between the beta frequency band and the DLPFC in risky decision-making. Complementing these results, the quantitative synthesis of 6 studies (14 effect sizes, <i>n</i> = 378) showed no significant overall effect of tES on decision-making, though subgroup analyses revealed polarity- and site-specific patterns, with cathodal stimulation of the dACC showing the most robust effect. The combined qualitative and quantitative evidence supports a causal role of prefrontal and cingulate regions in risky decision-making, with effects shaped by stimulation polarity and cortical target. Given the limited number of studies conducted, future research should focus on ambiguous decision-making. The use of neuroimaging techniques and simulations may enhance the results obtained.</p>

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Mapping the Causal Correlates of Risky and Ambiguous Decision-Making: Evidence from tES Research

  • 期刊论文

  • 发表日期：

    2025年12月1日

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  • Amin Tavakolipour,
  • Maedeh Haghvirdinezhad,
  • Reza Kazemi,
  • Mehrasa Elahian,
  • Amir-Homayun Hallajian

摘要

Transcranial electrical stimulation (tES) is one of the most widely used non-invasive brain stimulation (NIBS) methods employed to investigate the causal relationship between brain regions and cognitive functions. tES has been utilized in numerous studies to explore the role of brain regions involved in decision-making. The present study aims to review tES studies conducted to examine the causal relationship of neural regions involved in ambiguous and risky decision-making. A systematic review was conducted based on the PRISMA guidelines (PROSPERO record: CRD42024571443). A systematic search was performed in the PubMed database from 1985 to 2024. The search results were screened for eligibility based on inclusion and exclusion criteria. In addition to the qualitative synthesis, a random-effects meta-analysis was performed on eligible studies reporting sufficient statistical detail. This systematic review examined 19 studies involving 837 participants (351 men and 486 women) with an average age of 23.15 years, investigating the role of different brain regions in risky and ambiguous decision-making. Qualitative synthesis showed that the DLPFC has the strongest association with risky decision-making, particularly with significant changes observed after anodal stimulation in the right hemisphere and cathodal stimulation in the left hemisphere. Limited evidence also suggested roles for frontal asymmetry, the right orbitofrontal cortex (rOFC), and the dorsal anterior cingulate cortex (dACC) in risky decision-making. In the domain of ambiguous decision-making, only a few studies demonstrated the effect of anodal stimulation of the right DLPFC (RDLPFC). The only study using transcranial alternating current stimulation (tACS) also showed a connection between the beta frequency band and the DLPFC in risky decision-making. Complementing these results, the quantitative synthesis of 6 studies (14 effect sizes, n = 378) showed no significant overall effect of tES on decision-making, though subgroup analyses revealed polarity- and site-specific patterns, with cathodal stimulation of the dACC showing the most robust effect. The combined qualitative and quantitative evidence supports a causal role of prefrontal and cingulate regions in risky decision-making, with effects shaped by stimulation polarity and cortical target. Given the limited number of studies conducted, future research should focus on ambiguous decision-making. The use of neuroimaging techniques and simulations may enhance the results obtained.