Open Journal of Depression, 2020, 9, 43-57 https://www.scirp.org/journal/ojd ISSN Online: 2169-9674 ISSN Print: 2169-9658 DOI: 10.4236/ojd.2020.93005 Aug. 3, 2020 43 Open Journal of Depression The Neurophysiological Substrate of the Decision-Making Process in Depressed Patients Silvia Gomes Laurentino 1* , Sandra Lopes de Souza 2 , Everton Botelho Sougey 2 1 Post Graduate Program of Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Brazil 2 Department of Neuropsychiatry, Federal University of Pernambuco, Recife, Brazil Abstract Background: The neural circuits involved in the decision-making process and social emotion participate in the same circuits seen in major depressive disorder. This study aimed to investigate in depressed patients, the decision making process in risk/reward situations using neurophysiological methods for a better assessment of functional aspects related to decision making deficit that are seen in major depression. Methods: Forty patients were studied, 20 with depression and 20 without. After applied the Structured Clinical Inter- view for DSM-IV Axis I Disorders (SCID-I) and Hamilton Depression scale (HAM-D), the Iowa Gambling Task (IGT) was applied to analyze the risk/ reward decision-making behavior. The Skin Conductance Response (SCR) was recorded to analyze the emotional anticipatory learning effect during the IGT. Besides, an EEG was recorded to measure the Frontal Alpha Asymmetry Index (FAAI). Results: Depressed patients presented a lower Net score and a deficit in anticipatory learning effect in the IGT. Furthermore, the FAAI re- vealed more frontal right activation as have described in previous studies. Conclusion: Patients with major depression have a dysfunction in the cir- cuits that modulate cognitive, emotional and social behavior, and also, im- pairment in cognitive fluidity for evaluating strategies for risk-reward. The EEG helps to confirm that asymmetry in frontal areas and oscillation of al- pha frequencies participate in the regulation of emotion in depressed pa- tients. Keywords Major Depression, Decision Making, Iowa Gambling Task, Somatic Marker, Skin Conductance Response, EEG How to cite this paper: Laurentino, S. G., de Souza, S. L., & Sougey, E. B. (2020). The Neurophysiological Substrate of the Deci- sion-Making Process in Depressed Patients. Open Journal of Depression, 9, 43-57. https://doi.org/10.4236/ojd.2020.93005 Received: May 31, 2020 Accepted: July 31, 2020 Published: August 3, 2020 Copyright © 2020 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access