Disrupting selective persistent activity with electrical stimulation impairs human working memory

Working memory (WM) enables the temporary maintenance and manipulation of information, supporting flexible, goal-directed behavior. While converging evidence suggests that persistent activity in the hippocampus and other areas of the brain contributes to WM storage, this link has not been examined by manipulating neural activity experimentally. Here, we combined simultaneous intracranial single-neuron recordings with focal electrical stimulation in the human hippocampus to test the role of memoranda-selective persistent neural activity for WM. Thirty patients with implanted hybrid depth electrodes performed a WM task with images as memoranda. Electrical stimulation (2 s, 50 Hz, 1 mA) was delivered to the hippocampus during the maintenance period on a subset of trials. Behaviorally, stimulation impaired WM performance, increasing response times especially in low-load conditions. Neuronally, stimulation reduced memoranda-selective activity in hippocampus and ventral temporal cortex (VTC), thereby disrupting content-specific neural representations of WM content. The extent of stimulation-induced change in firing rate mediated trial-by-trial impaired WM-related behavior, linking disrupted neural selectivity to impaired WM. At the population level, stimulation shifted neural trajectories farther from attractor states, consistent with degraded mnemonic fidelity. Together, these data provide evidence that selective persistent activity of individual neurons in hippocampus and VTC supports WM maintenance in humans. Our results demonstrate that hippocampal stimulation disrupts both single-neuron coding and population-level attractor stability, linking cellular mechanisms to behavior and highlighting the contributions of persistent activity to WM maintenance.