Choosing how much effort to expend is critical for everyday decisions. While several neuroimaging studies have examined effort-based decision-making, results have been highly heterogeneous, leaving unclear which brain regions process effort-related costs and integrate them with rewards. We conducted two meta-analyses of functional magnetic resonance imaging data to examine consistent neural correlates of effort demands (23 studies, 15 maps, 549 participants) and net value (15 studies, 11 maps, 428 participants). The pre-supplementary motor area (pre-SMA) scaled positively with pure effort demand, whereas the ventromedial prefrontal cortex (vmPFC) showed the opposite effect. Moreover, regions that have been previously implicated in value integration in other cost domains, such as the vmPFC and ventral striatum, were consistently involved in signaling net value. The opposite response patterns of the pre-SMA and vmPFC imply that they are differentially involved in the representation of effort costs and value integration. These findings provide conclusive evidence that the vmPFC is a central node for net value computation and reveal potential brain targets to treat motivation-related disorders.

Aims: To estimate the aggregated effect sizes of reward‐related decision‐making deficits in internet gaming disorder (IGD) and to explore potential moderators on the variability of effect sizes across studies.Design: Review of peer‐reviewed studies comparing reward‐related decision‐making performance between IGD and control participants identified via PubMed, Web of Science and ProQuest databases. Random‐effects modeling was conducted using Hedge‘s g as the effect size (ES). The effects of decision‐making situation, valence, sample type, testing environment, IGD severity and self‐reported impulsivity on decision‐making differences were examined by moderator analyses.Setting: No restrictions on location.Participants: Twenty‐four studies (20 independent samples) were included in the meta‐analysis, resulting in 604 IGD and 641 control participants and 35 ESs.Measures: Reward‐related decision‐making differences between IGD and control groups.Findings: The overall ES for decision‐making deficits in IGD was small (g = −0.45, P < 0.01). The effects were comparable across risky, ambiguous and inter‐temporal decision‐making. Larger aggregate ESs were identified for pure‐gain and mixed compared with pure‐loss decision‐making. Studies based on clinical and community samples showed similar effects. No significant difference between behavioral studies and those with extra measurements was observed. Decision‐making alterations were not closely associated with IGD severity or self‐reported impulsivity differences at the study level.Conclusions: Internet gaming disorder appears to be consistently associated with reward‐related decision‐making deficits.

Decisions that require taking effort costs into account are ubiquitous in real life. The neural common currency theory hypothesizes that a particular neural network integrates different costs (e.g., risk) and rewards into a common scale to facilitate value comparison. Although there has been a surge of interest in the computational and neural basis of effort-related value integration, it is still under debate if effort-based decision-making relies on a domain-general valuation network as implicated in the neural common currency theory. Therefore, we comprehensively compared effort-based and risky decision-making using a combination of computational modeling, univariate and multivariate fMRI analyses, and data from two independent studies. We found that effort-based decision-making can be best described by a power discounting model that accounts for both the discounting rate and effort sensitivity. At the neural level, multivariate decoding analyses indicated that the neural patterns of the dorsomedial prefrontal cortex (dmPFC) represented subjective value across different decision-making tasks including either effort or risk costs, although univariate signals were more diverse. These findings suggest that multivariate dmPFC patterns play a critical role in computing subjective value in a task-independent manner and thus extend the scope of the neural common currency theory.