Healthy and successful living involves carefully navigating rewarding and threatening situations by balancing approach and avoidance behaviors. Excessive avoidance to evade potential threats often leads to forfeiting potential rewards. However, little is known about how reward and threat information is integrated neurally to inform approach or avoidance. In this preregistered study, participants (N_behavior = 31, 17F; N_MRI = 28, 15F) made approach–avoidance decisions under varying reward (monetary gains) and threat (electrical stimulations) prospects during functional MRI scanning. In contrast to theorized parallel subcortical processing of reward and threat information before cortical integration, Bayesian multivariate multilevel analyses revealed subcortical reward and threat integration prior to indicating approach–avoidance decisions. This integration occurred in the ventral striatum, thalamus, and bed nucleus of the stria terminalis (BNST). When reward was low, risk-diminishing avoidance decisions dominated, which was linked to more positive tracking of threat magnitude prior to indicating avoidance than approach decisions. In contrast, the amygdala exhibited dual sensitivity to reward and threat. While anticipating outcomes of risky approach decisions, we observed positive tracking of threat magnitude within the salience network (dorsal anterior cingulate cortex, thalamus, periaqueductal gray, BNST). Conversely, after risk-diminishing avoidance, characterized by reduced reward prospects, we observed more negative tracking of reward magnitude in the ventromedial prefrontal cortex and ventral striatum. These findings shed light on the temporal dynamics of approach–avoidance decision-making. Importantly, they demonstrate the role of subcortical integration of reward and threat information in balancing approach and avoidance, challenging theories positing predominantly separate subcortical processing prior to cortical integration.

健康和成功的生活包括通过平衡接近和回避行为来小心地驾驭奖励和威胁的情况。过度回避以逃避潜在威胁通常会导致失去潜在的回报。然而，关于奖励和威胁信息如何在神经上整合以告知接近或避免，人们知之甚少。在这项预先注册的研究中，参与者（N_行为 = 31、17F;N_MRI = 28， 15F） 在功能性 MRI 扫描期间，根据不同的奖励（金钱收益）和威胁（电刺激）前景做出接近回避决策。与皮层整合前奖励和威胁信息的理论平行皮层下处理相反，贝叶斯多变量多层次分析揭示了皮层下奖励和威胁整合，然后再指示接近-回避决策。这种整合发生在终纹 （BNST） 的腹侧纹状体、丘脑和床核中。当回报较低时，降低风险的回避决策占主导地位，这与在表明回避之前对威胁程度的更积极跟踪有关，而不是接近决策。相比之下，杏仁核对奖励和威胁表现出双重敏感性。在预测风险方法决策的结果时，我们观察到显著性网络 （背侧前扣带皮层、丘脑、导水管周围灰质、BNST） 内威胁程度的正向跟踪。相反，在以降低回报前景为特征的风险递减避免之后，我们观察到腹内侧前额叶皮层和腹侧纹状体对奖励幅度的负跟踪更多。这些发现揭示了接近-回避决策的时间动态。 重要的是，它们展示了奖励和威胁信息的皮层下整合在平衡接近和避免中的作用，挑战了在皮层整合之前主要分离皮层下加工的理论。