The neural mechanisms mediating sensory-guided decision-making have received considerable attention, but animals often pursue behaviors for which there is currently no sensory evidence. Such behaviors are guided by internal representations of choice values that have to be maintained even when these choices are unavailable. We investigated how four macaque monkeys maintained representations of the value of counterfactual choices—choices that could not be taken at the current moment but which could be taken in the future. Using functional magnetic resonance imaging, we found two different patterns of activity co-varying with values of counterfactual choices in a circuit spanning the hippocampus, the anterior lateral prefrontal cortex and the anterior cingulate cortex. Anterior cingulate cortex activity also reflected whether the internal value representations would be translated into actual behavioral change. To establish the causal importance of the anterior cingulate cortex for this translation process, we used a novel technique, transcranial focused ultrasound stimulation, to reversibly disrupt anterior cingulate cortex activity.

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The data that support the findings of this study are available from the corresponding author upon reasonable request

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Funding for this work was provided by the Wellcome Trust (grant nos. 203139/Z/16/Z, WT100973AIA, 103184/Z/13/Z and 105238/Z/14/Z), the Medical Research Council (grant nos. MR/P024955/1 and G0902373), the Bettencourt Schueller Foundation and the Agence Nationale de la Recherche (grant no. ANR-10-EQPX-15) and Christ Church, University of Oxford. We are very grateful for the care afforded to the animals by the veterinary and technical staff at the University of Oxford. We also thank J. Scholl for helpful comments on the manuscript.

Author information

Author notes

  1. These authors contributed equally: Elsa F. Fouragnan, Bolton K. H. Chau, Davide Folloni.

  2. These authors jointly supervised this work: Jerome Sallet, Matthew F. S. Rushworth.


  1. School of Psychology, University of Plymouth, Plymouth, UK

    • Elsa F. Fouragnan
  2. Wellcome Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, Oxford, UK

    • Elsa F. Fouragnan
    • , Bolton K. H. Chau
    • , Davide Folloni
    • , Nils Kolling
    • , Lennart Verhagen
    • , Miriam Klein-Flügge
    • , Lev Tankelevitch
    • , Georgios K. Papageorgiou
    • , Jerome Sallet
    •  & Matthew F. S. Rushworth
  3. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China

    • Bolton K. H. Chau
  4. McGovern Institute for Brain Research and Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA

    • Georgios K. Papageorgiou
  5. Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Paris, France

    • Jean-Francois Aubry
  6. Wellcome Integrative Neuroimaging, Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK

    • Matthew F. S. Rushworth


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E.F.F., B.K.H.C. and M.F.S.R. designed the experiments. B.K.H.C., G.K.P., D.F. and J.S. collected the data. E.F.F. analyzed the behavioral, fMRI and TUS data. L.V. contributed to the rs-fMRI analysis. B.K.H.C., N.K. and M.K.F. contributed to fMRI analysis tools. L.T. contributed preprocessing analysis tools. J.S. and J.F.A. contributed to the ultrasound. E.F.F. and M.F.S.R. wrote the manuscript. All authors discussed the results and implications and commented on the manuscript at all stages.

Competing interests

The authors declare no competing interests.

Corresponding author

Correspondence to Elsa F. Fouragnan.

Integrated supplementary information

  1. Supplementary Figure 1 Behavioral simulation and comparison of several RL models.

    a, Bayesian model comparison using BIC scores revealed that the Maintain model explained the data better than a Decay model in which a free parameter captured how much the animals would ‘forget’ the unavailable option as well as two risk-sensitive models where the probabilities could be distorted by the animals. BICs are summed across 20 sessions. b, Distortion parameter for the simple distortion model across animals/sessions as well as the mean. The blue line represents the mean distortion parameter across sessions (n = 20). c, To compare the Decay and Maintain model, we simulated choice data using the best fitted parameter of each model and compared choice rates pre and post reversals (~110th trials) (left panel) as well as switch behaviors after a win or a loss (right panel); n = 20 sessions. The real data are represented in black.

  2. Supplementary Figure 2 The hippocampus only reflects the unavailable option’s value.

    Whole-brain analysis shows no significant relationship between BOLD activity and the expected value associated with the currently chosen (red color) and unchosen options (blue color). All statistical images are uncorrected at a lenient threshold of P < 0.05, whole-brain fMRI analysis, n = 25 sessions.

  3. Supplementary Figure 3 Comparison of four potential models of ACC activity.

    a, We contrasted four different accounts of activity found in ACC. b, We found that activity in the ACC, unlike in the hippocampus (Fig. 3) was not significantly modulated by the value of the unavailable option (red trace in leftmost panel). By contrast, activity in the ACC was significantly related to the value of the best counterfactual option (black trace in panel second from the left). Activity in the ACC could not be explained by the hypothesis that only options available for choice (and which might therefore affect the difficulty of choice selection) determined activity levels. Instead even options unavailable for choice (which could not affect the difficulty of choice selection) affected activity. When options were coded as HV, LV and unavailable options, the LV option did not exert a consistent influence over the ACC (third panel from the left). Activity in the ACC could not be explained in a simple way as a function of the values assigned to particular object identities (rightmost panel). Shaded areas represent s.e.m. across 25 sessions. c, As a result, model comparison unambiguously supported the second hypothesis of ACC function. Note that ROI selection avoids double dipping in favor of the hypothesis we aimed to validate, since the ROIs were defined from Hypothesis 1 that we aimed to reject.

  4. Supplementary Figure 4 Neurostimulation site and ROIs for rs-fMRI analyses.

    a, Neurostimulation site where TUS was applied for each animal (S1 and S2) for the behavioral part. The TUS transducer was set at a resonance frequency of 250 kHz and concentrated ultrasound ina cigar-shaped focal spot in the ACC. b, ROIs used in the rs-fMRI connectivity analysis (see full details in Supplementary Table 1).

  5. Supplementary Figure 5 Supplementary analyses of the effects of ACC TUS.

    a, While entropy is negatively related to value difference, there was no difference between the ACC-TUS and SHAM conditions (n = 18 sessions). A linear model was used and a one-sample t-test was performed on the resulting coefficients. b, Similarly, the negative relationship between cumulative stay and value difference was not different between the ACC-TUS and SHAM conditions. c, Maintain model’s parameters (left panel). There was no difference in temperature parameter between the fMRI, SHAM TUS and ACC-TUS sessions (right panel). A similar picture emerged for the learning rates. While the mean learning rate in the ACC-TUS session was higher than in the fMRI and SHAM sessions, this result was not significant. A linear regression model was used to determine the difference between conditions. d, Decision accuracy (selecting the option with the highest subjective value) plotted as a function of difficulty (difference in subjective value between the best (HV) and worst (LV) presented options). Subjective values were estimated using the RL model (Methods). Each bin contains data binned according to percentile, with each point corresponding to the [0–5%], [5–10%], [10–15%], …, [90–95%], [95–100%] of the value difference amplitudes. Accuracy is the rate at which the participant picked the subjectively better option. Because subjective value estimates are obtained by fitting a model to the data and reflect the animals’ actual patterns of decisions, the overall difference in performance levels is no longer apparent between the TUS and sham conditions. If the animal is poor at learning or choosing the best option to take, then this pattern of behavior will mean that the RL model will estimate that the animal’s subjective valuations of the choices are closer together than they objectively are. The RL model therefore ‘explains away’ differences in performances as differences in subjective valuations. However, once again it is clear that there was no evidence of a TUS-induced impairment in performance that increased with difficulty (smaller HV – LV value differences on the left of the figure). Solid lines are linear fits to the data and the shaded area is the 95% confidence interval. Two-sample t-tests were performed between the ACC-TUS and control sessions (n = 18 sessions for each group, non-significant).

  6. Supplementary Figure 6 TUS of lateral orbitofrontal cortex (lOFC) did not impair translation of counterfactual choice values into actual behavioral change.

    a, Neurostimulation site where TUS was applied for each of the four animals. The TUS transducer was set at a resonance frequency of 250 kHz and concentrated ultrasound in a cigar-shaped focal spot in the lOFC. b, The significant difference between the influence of the better counterfactual option value on future switching behavior (in dark blue, as per Figs. 2f and 5c) was unaltered after lOFC TUS (in red, n = 20 sessions) compared to the control sham session (n = 20 sessions) collected on interleaved days (Cohen’s d = 0.21, t38 = 0.65, P = 0.51). Because of the position of the head post, it was only possible to apply TUS to ACC in two animals. If we focus just on the data collected from the same two individual animals during lOFC TUS and interleaved control sham days (n = 10 and 10 sessions), it is still the case that there is no evidence of a significant effect (Cohen’s d = 0.14, t18 = 0.59, P = 0.56). We can also compare the size of the effects produced by ACC TUS (for the better counterfactual) and the size of the effects produced by lOFC TUS (for the same predictor). This reveals that ACC TUS produced a significantly greater effect than lOFC TUS (Cohen’s d = 0.69, t36 = 2.08, P = 0.04). Moreover, there were no significant baseline differences in behavior in the SHAM testing days in the ACC-TUS and lOFC-TUS testing periods (Cohen’s d = 0.05, t36 = 0.14, P = 0.88; similarly if we only apply the test for the same two animals that had been examined in the ACC-TUS experiment: Cohen’s d = 0.08, t26 = 0.20, P = 0.84). There was also no difference in the effect of the worst counterfactual on switching behaviors (Cohen’s d = 0.27, t36 = 0.82, P = 0.42; similarly if we only test for the two animals that were tested with ACC TUS: Cohen’s d = 0.39, t26 = 1.00, P = 0.32). All analyses are mixed-effect models with sessions and animals as random effects. c, Entropy is strongly and negatively predictive of change in exploratory behavior (indexed by cumulative number of ‘stay’ choices—choices of the same option on one trial after another) in the control condition (blue) and this remains the case after lOFC TUS (Cohen’s d = −0.24, t28 = −0.64, P = 0.52; comparison between the lOFC effect against the ACC effect: Cohen’s d = −0.56, t64 = −2.23, P = 0.02).

  7. Supplementary Figure 7 Relationship between the unavailable option’s value and the efficiency of choice behavior.

    a, Average choice behavior when choosing between the left and right options plotted as a function of the value of the unavailable option (low value, blue; high value, red) value for each animal separately (data are averaged across sessions). Curves plot logistic functions fit to the choice data. b, A partial regression plot shows the uncontaminated effect of the unavailable option’s value on accuracy (y axis, accuracy residuals; x axis, residuals of the unavailable option’s value) for each animal during the fMRI sessions after partialling out the difference in value between the better and worse options in any given trial (which should rationally be the main determinant of decision-making). There was a linear relationship between the residual accuracy and the residual value of the unavailable option in three out of four animals (mixed-effect linear models, animal 1: t1160 = 2.28, P = 0.02; animal 2: t1358 = 3.85, P = 0.0001; animal 3: t1329 = 0.30, P = 0.76; animal 4, t950 = 5.85, P = 6.8 × 10–9). Each bin contains 25% of averaged data across sessions (±s.e.m.). c,d, Extra data from four animals (c) show the same effect as in the main fMRI experiment (d). e, The impact of the unavailable option on the current decision—an impact that seems to be mediated by vmPFC—was not significantly altered by the application of TUS to ACC; there was no difference between the ACC-TUS sessions (n = 18) and the baseline sessions.

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