Error processing in major depressive disorder: a systematic review and meta-analysis of event-related potential studies

Kai-Jie Liang¹, Chun-Che Hung², Chia-Wen Ko³, Pin-Chi Lin³, Pei-Ying S Chan⁴, Chia-Hsiung Cheng⁵

Affiliations

¹ Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan; Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
² Department of Psychology, University of Florida, Gainesville, FL, USA.
³ Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan.
⁴ Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan. Electronic address: chanp@cgu.edu.tw.
⁵ Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Electronic address: ch.cheng@mail.cgu.edu.tw.

PMID: 41564625
DOI: 10.1016/j.clinph.2026.2111503

Error processing in major depressive disorder: a systematic review and meta-analysis of event-related potential studies

Kai-Jie Liang et al. Clin Neurophysiol. 2026.

. 2026 Jan 9:184:2111503.

doi: 10.1016/j.clinph.2026.2111503. Online ahead of print.

Authors

Kai-Jie Liang¹, Chun-Che Hung², Chia-Wen Ko³, Pin-Chi Lin³, Pei-Ying S Chan⁴, Chia-Hsiung Cheng⁵

Affiliations

¹ Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan; Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
² Department of Psychology, University of Florida, Gainesville, FL, USA.
³ Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan.
⁴ Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan. Electronic address: chanp@cgu.edu.tw.
⁵ Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Electronic address: ch.cheng@mail.cgu.edu.tw.

PMID: 41564625
DOI: 10.1016/j.clinph.2026.2111503

Abstract

Objective: Alterations in error-related negativity (ERN) and error positivity (Pe)-electrophysiological markers of error processing-have been frequently reported in major depressive disorder (MDD); findings, however, remain inconsistent.

Methods: Literature search was performed using Web of Science, MEDLINE/PubMed, and Scopus electronic databases. The effect sizes (Hedges' g) in the comparisons of ERN (22 studies) and Pe (10 studies) amplitudes between MDD and healthy controls (HC) were employed by a random-effect, inverse-variance weighted model.

Results: ERN and Pe amplitudes in MDD patients were generally comparable to those of HC. Nevertheless, moderator analyses revealed specific conditions under which Pe amplitudes were reduced in MDD. Specifically, MDD patients with comorbid conditions showed diminished Pe amplitudes relative to HC (p = 0.001). Moreover, task type moderated Pe responses: studies using the Flanker task reported significantly reduced Pe amplitudes in MDD patients (p = 0.012), a pattern not observed with other paradigms. No significant moderators were identified for ERN amplitudes.

Conclusions: Comorbidity and task design, particularly the use of the Flanker task, appear to influence Pe amplitudes in patients with MDD and should be carefully considered in future research.

Significance: Our data highlight the importance of methodological factors in interpreting error processing deficits in MDD.

Keywords: Error positivity (Pe); Error processing; Error-related negativity (ERN); Flanker task; Major depressive disorder; Meta-analysis.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Error processing in major depressive disorder: a systematic review and meta-analysis of event-related potential studies

Affiliations

Error processing in major depressive disorder: a systematic review and meta-analysis of event-related potential studies

Authors

Affiliations

Abstract

Conflict of interest statement

LinkOut - more resources

Full Text Sources