ArticlePsychoradiology2026
Neurocomputational mechanisms of reward-based online mood regulation in adolescents with bipolar disorder and major depressive disorder.
Article in Psychoradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The overlapping symptoms between bipolar disorder (BD) and major depressive disorder (MDD) pose a challenge in diagnosis and treatment. A prevailing hypothesis suggests that mood dysregulation may be linked to impairments in the reward system, but the neurocomputational differences between BD and MDD remain elusive. This study investigates whether atypical reward processing affects subjective mood in adolescents with BD and MDD. Our research aims to elucidate the behavioral and neural differences between the two groups, facilitating more accurate and timely diagnosis and intervention. Methods: Forty-five adolescents (aged ≤ 19 years) diagnosed with BD-II in depressed mood states ( Results: Adolescents with BD exhibited a lower best choice rate and a higher uncertain choice rate compared to those with MDD. Computational modeling and mediation analysis suggested a tripartite mediating relationship between RPE-mood association, decision rationality, and symptom severity. Using fMRI, we observed significant RPE-related activation in the ventral striatum, which showed a slight positive correlation with the RPE-mood association. We also noted subtle differences in several brain regions (i.e. medial orbitofrontal cortex) between the BD and MDD groups. These differences were further associated with manic symptoms. Conclusion: Decision rationality mediated the association between RPE-mood association and symptom severity. Relative to adolescents with MDD, those with BD showed decreased decision rationality, along with modest but distinct reward-related neural patterns on fMRI. These findings highlight the crucial role of reward processing in mood regulation and provide preliminary neurocomputational evidence that may inform future diagnostic biomarker development.
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