Dataset Information

Evidence for a general performance-monitoring system in the human brain.

ABSTRACT: Adaptive behavior relies on the ability of the brain to form predictions and monitor action outcomes. In the human brain, the same system is thought to monitor action outcomes regardless of whether the information originates from internal (e.g., proprioceptive) and external (e.g., visual) sensory channels. Neural signatures of processing motor errors and action outcomes communicated by external feedback have been studied extensively; however, the existence of such a general action-monitoring system has not been tested directly. Here, we use concurrent EEG-MEG measurements and a probabilistic learning task to demonstrate that event-related responses measured by electroencephalography and magnetoencephalography display spatiotemporal patterns that allow an effective transfer of a multivariate statistical model discriminating the outcomes across the following conditions: (a) erroneous versus correct motor output, (b) negative versus positive feedback, (c) high- versus low-surprise negative feedback, and (d) erroneous versus correct brain-computer-interface output. We further show that these patterns originate from highly-overlapping neural sources in the medial frontal and the medial parietal cortices. We conclude that information about action outcomes arriving from internal or external sensory channels converges to the same neural system in the human brain, that matches this information to the internal predictions.

SUBMITTER: Zubarev I

PROVIDER: S-EPMC6220993 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Evidence for a general performance-monitoring system in the human brain.

Zubarev Ivan I Parkkonen Lauri L

Human brain mapping 20180704 11

Adaptive behavior relies on the ability of the brain to form predictions and monitor action outcomes. In the human brain, the same system is thought to monitor action outcomes regardless of whether the information originates from internal (e.g., proprioceptive) and external (e.g., visual) sensory channels. Neural signatures of processing motor errors and action outcomes communicated by external feedback have been studied extensively; however, the existence of such a general action-monitoring sys ...[more]

PMID: 29974560

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Project description:When researchers evaluate brain-computer interface (BCI) systems, we want quantitative answers to questions such as: How good is the system's performance? How good does it need to be? and: Is it capable of reaching the desired level in future? In response to the current lack of objective, quantitative, study-independent approaches, we introduce methods that help to address such questions. We identified three challenges: (I) the need for efficient measurement techniques that adapt rapidly and reliably to capture a wide range of performance levels; (II) the need to express results in a way that allows comparison between similar but non-identical tasks; (III) the need to measure the extent to which certain components of a BCI system (e.g. the signal processing pipeline) not only support BCI performance, but also potentially restrict the maximum level it can reach.For challenge (I), we developed an automatic staircase method that adjusted task difficulty adaptively along a single abstract axis. For challenge (II), we used the rate of information gain between two Bernoulli distributions: one reflecting the observed success rate, the other reflecting chance performance estimated by a matched random-walk method. This measure includes Wolpaw's information transfer rate as a special case, but addresses the latter's limitations including its restriction to item-selection tasks. To validate our approach and address challenge (III), we compared four healthy subjects' performance using an EEG-based BCI, a 'Direct Controller' (a high-performance hardware input device), and a 'Pseudo-BCI Controller' (the same input device, but with control signals processed by the BCI signal processing pipeline).Our results confirm the repeatability and validity of our measures, and indicate that our BCI signal processing pipeline reduced attainable performance by about 33% (21 bits min(-1)).Our approach provides a flexible basis for evaluating BCI performance and its limitations, across a wide range of tasks and task difficulties.

Project description:BackgroundHealth systems' weakness remains one of the primary obstacles towards achieving universal access to quality healthcare in low-income settings. Performance-based financing (PBF) programs have been increasingly used to increase access to quality care in LMICs. However, evidence on the impacts of these programs remains fragmented and inconclusive. We analyze the health system impacts of the PBF program in the Democratic Republic of the Congo (DRC), one of the largest such programs introduced in LMICs to date.MethodsWe used a health systems perspective to analyze the benefits of PBF relative to unconditional financing of health facilities. Fifty-eight health zones in six provinces were randomly assigned to either a control group (28 zones) in which facilities received unconditional transfers or to a PBF program (30 zones) that started at the end of 2016. Follow-up data collection took place in 2021-2022 and included health facility assessments, health worker interviews, direct observations of consultations and deliveries, patient exit interviews, and household surveys. Using multivariate regression models, we estimated the impact of the program on 55 outcomes in seven health system domains: structural quality, technical process quality, non-technical process quality, service fees, facility management, providers' satisfaction, and service coverage. We used random-effects meta-analysis to generate pooled average estimates within each domain.ResultsThe PBF program improved the structural quality of health facilities by 4 percentage points (ppts) (95% CI 0.01-0.08), technical process quality by 5 ppts (0.03-0.07), and non-technical process by 2 ppts (0-0.04). PBF also increased coverage of priority health services by 3 ppts (0.02-0.04). Improvements were also observed for facility management (9 ppts, 0.04-0.15), service fee policies, and users' satisfaction with service affordability (14 ppts, 0.07-0.20). Service fees and health workers' satisfaction were not affected by the program.ConclusionsThe results suggest that well-designed PBF programs can lead to improvements in most health systems domains relative to comparable unconditional financing. However, the large persisting gaps suggest that additional changes, such as allocating more resources to the health system and reforming the human resources for health management, will be necessary in DRC to achieve the ambitious global universal health coverage and mortality goals.Trial registrationAmerican Economics Association Trial registry AEARCTR-0002880.

Dataset Information

Evidence for a general performance-monitoring system in the human brain.

Publications

Evidence for a general performance-monitoring system in the human brain.

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