Throughout your day you make hundreds of decisions, ranging from what you eat for breakfast to when to go to bed, and every decision you make is based on your experiences—including the state of your mental health.

Our brains are constantly updating decision-making procedures to help us make our choices, which is directly impacted by neural activity and consequently our mental health.  This is known as adaptive decision making.

UT Austin biomedical engineering professor Samantha Santacruz and her research team conducted a study to determine how neural activity impacts adaptive decision-making and the effectiveness of electrical microstimulation for psychiatric care.

How time impacts our choices

The jury is out on how time directly impacts our decision-making process, as it varies from person to person. Some experts argue that our best estimate of values in the decisions we make come from more recent experiences while others estimate they are based on longer-term history.

Recent evidence shows that the brain represents value estimates on a range of timescales. Although this range of value estimates may be responsible for our ability to adapt our decision-making policies, we have little understanding of how the brain ultimately makes a final decision.

The focus of the study

The study used neuromodulation to investigate and modulate behaviors related to neuropsychiatric disorders. Neuromodulation refers to the use of targeted techniques to modify or regulate neural activity. There are several types of neuromodulation techniques, and each has its own purpose.

Electrical stimulation is one of the more common neuromodulation techniques.

Types of electrical stimulation

1. Transcutaneous Electrical Nerve Stimulation (TENS): Uses low-intensity electrical currents delivered through electrodes placed on the skin to relieve pain.

2. Spinal Cord Stimulation (SCS): Electrodes are placed near the spinal cord to manage chronic pain or neurological conditions.

3. Deep Brain Stimulation (DBS): Electrodes are implanted in specific brain regions to regulate abnormal neural activity and treat movement disorders such as Parkinson's disease or epilepsy.

Additionally, there are two approaches to using these methods: closed-loop neuromodulation and open-loop neuromodulation. Closed-loop neuromodulation provides therapeutic stimulation on an as-needed basis, compared to open-loop neuromodulation which is not sensitive to changes within the brain.

How the study was conducted

Santacruz and her team used closed-loop, deep brain electrical microstimulation. Research shows this method is known to induce neural plasticity and accelerates associative learning. The microstimulation targeted the caudate nucleus—a specific area deep within the brain that aids with the processing of visual information and movement control. The caudate nucleus is involved in working memory, cognitive function, and emotions.

Since this area plays a vital role in how the brain learns, particularly the storing and processing of memories, the caudate nucleus played an integral role the focal point of the research concerning adaptive decision making.

What the study found

The research indicates that microstimulation paired with a particular stimulus increases the selection of that stimulus. This effect is stimulus dependent and action independent. The results support potential future applications of microstimulation to correct maladaptive plasticity underlying dysfunctional decision-making related to neuropsychiatric conditions. The study results are evident in the use of transcranial magnetic stimulation (TMS) as a treatment option for depression, obsessive-compulsive disorder and other psychiatric conditions that impact adaptive decision making.

Why the study results matter

According to research cited by the National Center for Safe Learning Environments, college students are experiencing all-time high rates of depression, anxiety and suicidal ideation. The annual Health Minds survey received responses from 96,000 students across 133 campuses during the 2021–22 academic year. Of those, 44% reported symptoms of depression, 37% said they experienced anxiety, and 15% said they seriously considered suicide.

The results are the highest rates in the 15-year history of the survey. A separate survey conducted by the American College Health Association found nearly 75% of students reported moderate or severe psychological distress.

New approaches for a growing crisis

Mental health issues and psychiatric disorders are not new for college students, yet the prevalence and severity across campuses nationwide are at unforeseen levels.

Unfortunately, the sharp increase in a need for mental health services isn’t being met with an increase in funding. Nationwide, the average annual caseload for a college counselor is about 120 students, with some centers averaging more than 300 students per counselor, according to the 2021 Center for Collegiate Mental Health annual report.

Given the fact that depression and social anxiety are often associated with a feeling of isolation and a lack of belonging to a community—emotions exacerbated by the pandemic—educational institutions along with their faculty and staff must examine avenues to mitigate these negative feelings outside of the therapist’s office.

Santacruz is already engaged with this concept as part of a 2023 Whitehall Grant award. She combines art and a sense of inclusion together with field trips to the renowned Blanton Museum of Art on the UT Austin campus.

“I conjecture that to support the wellbeing of students, it is important to reinforce the sense of community in the classroom,” said Santacruz.

In collaboration with Siobhán McCusker, a Blanton Museum Educator, she developed curriculum for her biomedical engineering course on probability and statistics that integrated her course material into an art museum visit. Along with an atmosphere that provides positive effects on mental wellness, museums bring people together in a shared experience.

Lastly, museums provide opportunities for observation, critical thinking, and communication—all of which are crucial skills for educational success.

Santacruz found that based on quantitative and descriptive feedback from her students, the outcome of the experience positively influenced the students overall and provided them with a unique perspective on both art and statistics.

What the future holds

Santacruz hopes to have an established curriculum that integrates out-of-classroom experiences with course materials. The ultimate purpose is to simultaneously achieve academic goals while improving the mental wellbeing of students.

She is already noticing the potential as the reflections of her students indicate that they viewed the art museum visit as a positive occurrence.

As she continues to explore integrating her coursework with museum visits, Santacruz plans to focus on making a stronger connection between art observation and her academic material with direct interactions with her students during their experience.

RESOURCES: If you or someone you know is experiencing a mental health crisis, contact the Suicide Prevention Lifeline at 988, reach out to the UT Austin Counseling and Mental Health Center Crisis Line at 512-471-2255, or dial 911 in case of emergency.