A PRISMA-compliant Systematic Review and Meta-Analysis of the Late Positive Potential in Depression.

Across 51 studies, depression was associated with a small reduction in the brain's late positive response to positive material. This group-level pattern is not a diagnostic test or an individual treatment guide.

Santopetro NJ, Thompson B, El Jamal C, Brush CJ, Schmidt B, Hajcak G.
Biological psychology · Publication date: 2026-09-18
Added to site: 2026-09-19
DOI: 10.1016/j.biopsycho.2026.109386

Online-ahead-of-print publication date verified in PubMed.

Modalities

EEG, ERP

Clinical focus

Depression, Late positive potential, Emotional processing

Population

Published and unpublished depression-related LPP studies from 1981 through 2024

Sample

51 studies with 4,517 participants

Intervention / method

Meta-analysis of LPP responses to positive, negative and neutral stimuli, with moderators for experimental methods, clinical characteristics and demographics

Comparator

LPP effect sizes across depression status or severity, stimulus valence and study-level moderators

Clinician summary

Robust-variance meta-regression found a small significant negative association between depression and positive-stimulus LPP, stronger in early windows and adults. Comorbid internalizing samples also showed a small negative association for negative-stimulus LPP.

How to interpret the findings

The accessible abstract does not provide risk-of-bias results, heterogeneity estimates, publication-bias analyses or diagnostic performance. Small group-level ERP effects, varied paradigms and moderator findings do not establish specificity, causality or individual prediction.

Equipment and disclosures

The meta-analysis covered studies of the EEG late positive potential; equipment and acquisition methods varied across the included literature and were not detailed in the accessible abstract.

The authors declared no known competing financial interests or personal relationships. Funding was not reported in the checked indexed record.

Related evidence

Compare findings from the same clinical area, including mixed results.

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• TMS-EEG Correlate of Suicidal Ideation in Individuals with Depression: A Multi-Site Synthesis. · Positive with limitations
• Motor Cortex rTMS Alleviates Pain and Comorbid Depression After Spinal Cord Injury with a Correlate in M1 Intracortical Inhibition. · Positive with limitations
• Feasibility, tolerability, and preliminary effectiveness of an accelerated bilateral intermittent theta-burst stimulation protocol in adults with posttraumatic stress disorder and comorbid depressive disorder following mild traumatic brain injury. · Positive with limitations
• Accelerated TMS is associated with changes of subgenual cingulate-default mode network coupling in depression: an observational 7 Tesla fMRI study. · Mixed
• Identifying poor responders to repetitive transcranial magnetic stimulation using structural brain networks. · Positive with limitations
• Theta burst stimulation with 80 and 120% resting motor threshold do not differ in their antidepressant efficacy: a retrospective analysis. · Positive with limitations
• TMS-Evoked Cortical Reactivity Signatures as a Multidimensional Biomarker of Depression: A TMS-EEG Meta-Analysis from Diagnosis to Prognosis. · Positive with limitations
• The effects of cognitive-behavioural therapy (CBT) on heart rate variability (HRV) in people with depression and/or anxiety disorders: A systematic review and meta-analysis · Positive with limitations