Abnormal resting-state functional connectivity in anhedonia: A systematic review and meta-analysis

Anhedonia is a treatment-resistant symptom of major depressive disorder and has prompted neuroimaging studies aimed at clarifying its neural basis. However, findings from seed-based resting-state functional connectivity (rsFC) studies remain inconsistent. We conducted a whole-brain meta-analysis to synthesize rsFC alterations associated with anhedonia. PubMed, Web of Science, and Scopus were searched up to June 14, 2026. Two researchers independently screened eligible studies and analyzed anhedonia-related rsFC. Subgroup analyses, jackknife sensitivity analyses, meta-regression, and publication-bias assessments were performed to evaluate the robustness of the findings. Greater anhedonia severity was associated with stronger NAcc connectivity with the right anterior cingulate cortex, left insula, left middle occipital gyrus, corpus callosum, and left anterior thalamic projections and with weaker NAcc connectivity with the right medial superior frontal gyrus, left caudate nucleus, left orbitofrontal cortex, and left middle frontal gyrus. Greater anhedonia severity was also associated with stronger VC connectivity with the right angular gyrus and weaker VC connectivity with the right cuneus and left calcarine fissure. Subgroup analyses yielded patterns broadly consistent with the main analysis. Meta-regression analyses showed no significant moderating effects of age or sex, and sensitivity analyses supported the stability of the findings. Anhedonia was associated with convergent NAcc- and VC-centered rsFC alterations across reward, salience, and sensory regions. These findings support a distributed circuit-level model of anhedonia and may inform future research on symptom-targeted neuromodulation.