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Pre-frontal stimulation does not reliably increase reward responsiveness

Hadden, L.M.; Penny, H.; Jones, A.L.; Partridge, A.M.; Lancaster, T.M.; Allen, C.

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L.M. Hadden

H. Penny

A.L. Jones

A.M. Partridge

T.M. Lancaster

Dr Chris Allen
Post Doctoral Research Associate


Depression is the leading cause of disability worldwide and its effects can be fatal, with over 800,000 people dying by suicide each year. Neuromodulatory treatments such as transcranial magnetic stimulation (TMS) are being used to treat depression. Despite its endorsement by two regulatory bodies: NICE (2016) and the FDA (2008), there are major questions about the treatment efficacy and biological mechanisms of TMS. Ahn et al.’s (2013) justified the use of TMS in a clinical context in an important study indicating that excitatory TMS increases reward responsiveness. A pseudo-replication of this study by Duprat et al., (2016) also found a similar effect of active TMS, but only with the addition of an exploratory covariate to the analyses–trait reward responsiveness. Here we replicate Ahn et al.’s (2013) key study, and to test the reliability of the effects, and their dependency on trait reward responsiveness as described by Duprat et al., (2016). Using excitatory and sham TMS, we tested volunteers using the probabilistic learning task to measure their reward responsiveness both before and after stimulation. We also examined affect (positive, negative) following stimulation. Irrespective of TMS, the task was shown to be sensitive to reward responsiveness. However, we did not show TMS to be effective in increasing reward responsiveness and we did not replicate Ahn et al., (2013) or Duprat et al., (2016)'s key findings for TMS efficacy, where we provide evidence favouring the null. Moreover, exploratory analyses suggested following active stimulation, positive affect was reduced. Given our findings, we question the basic effects, which support the use of TMS for depression, particularly considering potential deleterious effects of reduced positive affect in patients with depression.


Hadden, L., Penny, H., Jones, A., Partridge, A., Lancaster, T., & Allen, C. (2023). Pre-frontal stimulation does not reliably increase reward responsiveness. Cortex, 159, 268-285.

Journal Article Type Article
Acceptance Date Nov 25, 2022
Online Publication Date Jan 18, 2023
Publication Date 2023-02
Deposit Date Mar 6, 2023
Publicly Available Date Apr 26, 2023
Journal Cortex
Print ISSN 0010-9452
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 159
Pages 268-285
Public URL


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