Investigating how the anterior insula processes surprise signals

Investigating Surprise Signals in the Anterior Insula in Epilepsy Patients With Stereoelectroencephalography Recording

Observational University Hospital, Geneva · NCT05997758

This study is testing how the brain area called the anterior insula helps people with drug-resistant epilepsy react to surprises while they perform tasks that involve learning and decision-making.

Quick facts

Study typeObservational
Enrollment50 (estimated)
Ages18 Years and up
SexAll
SponsorUniversity Hospital, Geneva Academic / other
Locations1 site (Geneva)
Trial IDNCT05997758 on ClinicalTrials.gov

What this trial studies

This observational study aims to explore the role of the anterior insula in processing surprise signals through a behavioral experiment involving patients with drug-resistant epilepsy. Participants will undergo stereoelectroencephalogram (SEEG) recording while performing tasks that require them to anticipate movements in different learning environments. The study will differentiate between two adaptation strategies: optimizing, where individuals continue to learn for better performance, and satisficing, where they stop adapting once a satisfactory level is reached. The findings could enhance our understanding of brain functions related to surprise and decision-making.

Who should consider this trial

Good fit: Ideal candidates include adults aged 18 and older with drug-resistant focal epilepsy who have SEEG electrodes implanted in the anterior insula.

Not a fit: Patients with severe psychiatric conditions, those with implanted stimulation devices, or individuals unable to perform the required tasks may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide insights into brain mechanisms that influence learning and adaptation, potentially leading to improved treatments for epilepsy.

How similar studies have performed: While the specific approach of this study is novel, similar studies investigating brain regions and their roles in cognitive processes have shown promising results.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* 18 years or older
* Fluent in French or English
* Patient who suffers from potentially surgically remediable drug-resistant focal epilepsy
* Patient who requires evaluation with intracranial stereo-EEG electrodes and has them implanted in the anterior insula
* Patient who is able and willing to provide informed consent

Exclusion Criteria:

* Severe concomitant psychiatric disease or major psychological distress
* Patients who have an implanted stimulation device (e.g. pacemaker, defibrillator, neurostimulator)
* Intellectual/neurological/psychiatric deficiencies\* or inability to understand or follow the procedure
* Visual/motor deficiencies which could affect task performance
* The presence of seizures during routine clinical stimulation of insular electrodes
* Failure to complete the pre-experiment task training

  * As determined by their clinical evaluation.

Where this trial is running

Geneva

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Drug Resistant EpilepsyHealthy
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.