Sex differences in the human reward system: Convergent behavioral, autonomic, and neural evidence.

Several studies have suggested that females and males differ in reward behaviors and their underlying neural circuitry. Whether human sex differences extend across neural and behavioral levels for both rewards and punishments remains unclear. We studied a community sample of 221 young women and men who performed a monetary incentive task known to engage the mesoaccumbal pathway and salience network. Both stimulus salience (behavioral relevance) and valence (win versus loss) varied during the task. In response to high- versus low-salience stimuli presented during the monetary incentive task, men showed greater subjective arousal ratings, behavioral accuracy, and skin conductance responses (p < 0.006, Hedges' effect size g = 0.38 to 0.46). In a sub-sample studied with functional MRI (n = 44), men exhibited greater responsiveness to stimulus salience in the nucleus accumbens, midbrain, anterior insula, and dorsal anterior cingulate cortex (p < 0.02, g = 0.86 to 1.7). Behavioral, autonomic, and neural sensitivity to the valence of stimuli did not differ by sex, indicating that responses to rewards versus punishments were similar in women and men. These results reveal novel and robust sex differences in reward- and punishment-related traits, behavior, autonomic activity, and neural responses. These convergent results suggest a neurobehavioral basis for sexual dimorphism observed in the reward system, including reward-related disorders.