Predicting Future Errors During Skill Performance

Recruiting

• Conditions: Healthy

• Registration Number: NCT06707207
• Lead Sponsor: National Institute of Neurological Disorders and Stroke (NINDS)

Brief Summary

Background:

Many tasks people do every day require a series of individual movements. Control over these movements is called motor skills. But even highly skilled people can make mistakes. Researchers have found that they can predict when a person will make a mistake 0.1 second before it happens. Now, they want to find out if they can increase that time up to 1 second-long enough to warn the person and prevent the mistake.

Objective:

To see if motor skill errors can be detected up to 1 second before they occur.

Eligibility:

Right-handed healthy adults aged 18 to 35.

Design:

Participants will have 2 to 5 study visits. Each visit will be 1 to 2 hours.

They will have a physical and neurological exam.

They will have 1 or 2 magnetic resonance imaging (MRI) scans. They will lie on a table that slides into a large cylinder. The MRI uses strong magnets to capture images of the inside of the body, including the brain.

They will have another scan, called magnetoencephalography (MEG). Small metal disks attached to wires will be taped to their head. Participants will sit in a padded chair with their head inside of a helmet. The helmet will not cover their eyes or face. Participants will perform a series of typing tasks on a keyboard. They will have short breaks between each round. Their head movements will be tracked, and their eye and finger movements will be videotaped.

Detailed Description

Study Description:

Human motor skills are composed of sequences of individual actions performed with utmost precision. However, even highly skilled human behavior is susceptible to errors. When these errors occur, they may have serious consequences, for example, when pilots are manually landing a plane or when surgeons control robotic devices during surgery. In such cases, the ability to predict and prevent these upcoming errors from occurring would clearly be advantageous. We recently utilized a withinindividual machine learning strategy to characterize brain activity predictive of future motor skill performance errors, in a manner consistent with accepted practices in the field. Implementation of this novel approach combining brain oscillatory activity (particularly in the low frequency delta range) and behavior (keypress transition times, KTT) in our previous work showed that we can predict up to 70% of single future erroneous keypress actions within 0.1s before they occur. One limitation of this work is that 0.1s preceding errors does not give enough time for subjects to stop an upcoming erroneous action. This protocol aims to characterize using this within-individual machine learning approach, already demonstrated to be effective in our own lab, to predict future erroneous actions up to approximately 1s before they occur. We intend to eventually develop a warning signal that allows subjects to stop upcoming skill errors. This development would allow communication to rapidly inform subjects to stop potential future errors. To this effect, we will record neural magnetoencephalography (MEG) activity while human participants perform sequences of motor actions.

Objectives:

The primary objective is to detect future skill errors up to approximately 1s before they occur. To predict these future errors, we will evaluate how brain activity and behavioral features preceding an error differ from those preceding correct sequence keypresses. We will also explore the feasibility of providing a feedback signal to participants when brain activity encodes future errors in real-time. Secondarily, we will evaluate spatial and temporal features of neural representations and replay and their relationship with erroneous and correct sequences.

Endpoints:

The primary endpoint measure will be predictive classification accuracy of upcoming erroneous keypresses from combined brain oscillatory and behavioral features. The exploratory endpoint measures are the characterization of neural representations and replay associated with correct and erroneous keypresses.

Study Timeline

• Study First Submitted: 2024-11-23
• Study First Submitted QC: 2024-11-26
• Study First Posted: 2024-11-27
• Status Verified: 2025-05-08
• Last Update Submitted: 2025-05-20
• Last Update Posted: 2025-05-21
• Study Start: 2025-05-26
• Primary Completion: 2029-04-01
• Study Completion: 2029-10-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To detect future skill errors up to approximately 1 s before they occur	60 months	We measure prediction performance by contrasting predicted probability of future errors against their behavioral performance. To predict future errors, we will evaluate how brain activity preceding an error differs from the preceding correct sequence keypresses. We will also explore the feasibility of providing feedback signal to the participant when brain activity encodes future errors in real-time.

Secondary Outcome Measures

Name	Time	Method
We will evaluate preparatory neural activity features for upcoming skill actions, correct and erroneous keypresses, during skill learning as well as neural replay associated with both correct and erroneous keypresses and skill performance.	60 months

Trial Locations

Locations (1)

National Institutes of Health Clinical Center; 🇺🇸 Bethesda, Maryland, United States