Motivational deficits represent a core transdiagnostic challenge across a broad spectrum of neurological and psychiatric conditions, including major depressive disorder, Parkinson’s disease, and schizophrenia. These deficits, manifesting as anhedonia, apathy, and amotivation, severely impair a patient’s capacity to engage in goal-directed behavior, ultimately leading to a profoundly diminished quality of life. Despite their clinical prevalence, the development of targeted therapeutic interventions is hindered by a fragmented understanding of the underlying neural circuit mechanisms.

A primary obstacle in contemporary research is the reliance on traditional effort-based decision-making (EBDM) paradigms. These models often utilize low-stakes laboratory tasks, such as repetitive button-pressing, which fail to capture the complex physiological demands and metabolic costs inherent in daily activities. To address this limitation, we develop novel experimental frameworks that integrate multimodal brain-body measurements with behavioral assays requiring naturalistic effort expenditure. By synchronizing high-resolution brain recordings with physiological indices of exertion, our approach integrates cognitive decision-making and physiological costs of real-world activities.

Our preliminary results from healthy volunteers identify neural signatures within the anterior cingulate cortex (ACC) that track effort perception and substrate utilization. Furthermore, data obtained from clinical subjects undergoing invasive neurophysiological monitoring reveal that neural signatures of decision-making are distinct when tasks involve high physiological demand compared to typical stationary conditions. These findings suggest that the physiological demands play a critical role on the neural processes governing motivation. By characterizing these integrated brain-body interactions, our research aims to provide an ecologically valid foundation for identifying new biomarkers and developing next-generation treatments for motivational dysfunction.