Distinct and shared neural responses to reward and punishment in depression and anxiety: integrated neuroimaging and transcriptomic evidence

Depression and anxiety exhibit shared dysregulations in approach-avoidance processes, characterized by blunted reward approach and exaggerated punishment avoidance, alongside overlapping motivational symptoms such as anhedonia and withdrawal. However, whether these symptoms arise from common or disorder-specific neurobiological mechanisms remains unclear. Here we conducted a coordinate-based meta-analysis of whole-brain functional neuroimaging studies of reward- and punishment-related responses in depressive and anxiety disorders to identify shared and disorder-specific neurofunctional alterations, and further characterize network connectivity and molecular associations.