Decreased sensitivity to risk levels in ventral stratum in major depressive disorder during risky decision-making

Abstract Background Reduced decision-making ability in depressive people has been observed both in daily life and experimental behavioral studies. However, the neurobiology of dysfunction in decision-making among depressive people is still unclear. Methods The study included 63 patients with major depressive disorder (MDD) and 49 healthy controls (HCs). The balloon analog risk task (BART), a risky decision-making paradigm, was used in a functional magnetic resonance imaging experiment to evaluate how brain activation was modulated by different levels of risk. Results No significant difference in behavioral performance was found. In prespecified brain regions, the activation of the left ventral stratum (VS) in MDD patients showed reduced modulation by risk levels compared with HCs. No significant group difference was found in prespecified dorsal anterior cingulate cortex (dACC) and right dorsal lateral prefrontal cortex (DLPFC). Limitations BART did not isolate stages of making a choice and experiencing the outcome of the choice. Conclusion The left VS was less sensitive to risk levels in MDD patients compared with HCs, indicating inefficient reward processing in risky decision-making in MDD.