Original Investigation

Neural Markers of Reward Valuation and Impulsive Decision-Making in Mania Risk

JAMA Psychiatry 10.1001/jamapsychiatry.2026.2510

August 19, 2026 at 11:00 AM EDT

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The findings in this cross-sectional study suggest that RE-associated L-vlPFC and pre-SMA activation may represent dissociable neural pathways to mania or hypomania risk. Elevated L-vlPFC activation was associated with sensitivity to reward value, whereas elevated pre-SMA activation was associated with impulsive decision-making, and this latter association was moderated by depression severity.

Corresponding Author: Robert Raeder, MSc, MA, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, 121 Meyran Ave, Pittsburgh, PA 15213 (raederr@upmc.edu).

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