The stimulated social brain: effects of transcranial direct current stimulation on social cognition

Metaplastic neuromodulation via transcranial direct current stimulation has no effect on corticospinal excitability and neuromuscular fatigue

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation tool with potential for managing neuromuscular fatigue, possibly due to alterations in corticospinal excitability. However, inconsistencies in intra- and inter- individual variability responsiveness to tDCS limit its clinical use. Emerging evidence suggests harnessing homeostatic metaplasticity induced via tDCS may reduce variability and boost its outcomes, yet little is known regarding its influence on neuromuscular fatigue in healthy adults. We explored whether cathodal tDCS (ctDCS) prior to exercise combined with anodal tDCS (atDCS) could augment corticospinal excitability and attenuate neuromuscular fatigue. 15 young healthy adults (6 males, 22 ± 4 years) participated in four pseudo-randomised neuromodulation sessions: sham stimulation prior and during exercise, sham stimulation prior and atDCS during exercise, ctDCS prior and atDCS during exercise, ctDCS prior and sham stimulation during exercise. The exercise constituted an intermittent maximal voluntary contraction (MVC) of the right first dorsal interosseous (FDI) for 10 min. Neuromuscular fatigue was quantified as an attenuation in MVC force, while motor evoked potential (MEP) amplitude provided an assessment of corticospinal excitability. MEP amplitude increased during the fatiguing exercise, whilst across time, force decreased. There were no differences in MEP amplitudes or force between neuromodulation sessions. These outcomes highlight the ambiguity of harnessing metaplasticity to ameliorate neuromuscular fatigue in young healthy individuals.

Transcranial direct current stimulation suggests a causal role of the medial prefrontal cortex in learning social hierarchy

Social hierarchies can be inferred through observational learning of social relationships between individuals. Yet, little is known about the causal role of specific brain regions in learning hierarchies. Here, using transcranial direct current stimulation, we show a causal role of the medial prefrontal cortex (mPFC) in learning social versus non-social hierarchies. In a Training phase, participants acquired knowledge about social and non-social hierarchies by trial and error. During a Test phase, they were presented with two items from hierarchies that were never encountered together, requiring them to make transitive inferences. Anodal stimulation over mPFC impaired social compared with non-social hierarchy learning, and this modulation was influenced by the relative social rank of the members (higher or lower status). Anodal stimulation also impaired transitive inference making, but only during early blocks before learning was established. Together, these findings demonstrate a causal role of the mPFC in learning social ranks by observation.

High definition transcranial direct current stimulation of the Cz improves social dysfunction in children with autism spectrum disorder: A randomized, sham, controlled study

The purpose of this study was to determine the effect of the Cz of high-definition 5-channel tDCS (HD-tDCS) on social function in 4-12 years-old children with autism spectrum disorder (ASD). This study was a randomized, double-blind, pseudo-controlled trial in which 45 ASD children were recruited and divided into three groups with sex, age, and rehabilitation treatment as control variables. Each group of 15 children with ASD was randomly administered active HD-tDCS with the Cz as the central anode, active HD-tDCS with the left dorsolateral prefrontal cortex (F3) as the central anode, and sham HD-tDCS with the Cz as the central anode with 14 daily sessions in 3 weeks. The Social Responsiveness Scale Chinese Version (SRS-Chinese Version) was compared 1 week after stimulation with values recorded 1 week prior to stimulation. At the end of treatment, both the anodal Cz and anodal left DLFPC tDCS decreased the measures of SRS-Chinese Version. The total score of SRS-Chinese Version decreased by 13.08%, social cognition decreased by 18.33%, and social communication decreased by 10.79%, which were significantly improved over the Cz central anode active stimulation group, especially in children with young age, and middle and low function. There was no significant change in the total score and subscale score of SRS-Chinese Version over the Cz central anode sham stimulation group. In the F3 central anode active stimulation group, the total score of SRS-Chinese Version decreased by 13%, autistic behavior decreased by 19.39%, and social communication decreased by 14.39%, which were all significantly improved. However, there was no significant difference in effect between the Cz and left DLPFC stimulation conditions. HD-tDCS of the Cz central anode may be an effective treatment for social dysfunction in children with ASD.

Does rDLPFC activity alter trust? Evidence from a tDCS study

Trust plays an important role in the human economy and people's social lives. Trust is affected by various factors and is related to many brain regions, such as the dorsolateral prefrontal cortex (DLPFC). However, few studies have focused on the impact of the DLPFC on trust through transcranial direct current stimulation (tDCS), although abundant psychology and neuroscience studies have theoretically discussed the possible link between DLPFC activity and trust. In the present study, we aimed to provide evidence of a causal relationship between the rDLPFC and trust behavior by conducting multiple rounds of the classical trust game and applying tDCS over the rDLPFC. We found that overall, anodal stimulation increased trust compared with cathodal stimulation and sham stimulation, while the results in different stages were not completely the same. Our work indicates a causal relationship between rDLPFC excitability and trust behavior and provides a new direction for future research.

Brain-to-brain mechanisms underlying pain empathy and social modulation of pain in the patient-clinician interaction

Social interactions such as the patient-clinician encounter can influence pain, but the underlying dynamic interbrain processes are unclear. Here, we investigated the dynamic brain processes supporting social modulation of pain by assessing simultaneous brain activity (fMRI hyperscanning) from chronic pain patients and clinicians during video-based live interaction. Patients received painful and nonpainful pressure stimuli either with a supportive clinician present (Dyadic) or in isolation (Solo). In half of the dyads, clinicians performed a clinical consultation and intake with the patient prior to hyperscanning (Clinical Interaction), which increased self-reported therapeutic alliance. For the other half, patient-clinician hyperscanning was completed without prior clinical interaction (No Interaction). Patients reported lower pain intensity in the Dyadic, relative to the Solo, condition. In Clinical Interaction dyads relative to No Interaction, patients evaluated their clinicians as better able to understand their pain, and clinicians were more accurate when estimating patients' pain levels. In Clinical Interaction dyads, compared to No Interaction, patients showed stronger activation of the dorsolateral and ventrolateral prefrontal cortex (dlPFC and vlPFC) and primary (S1) and secondary (S2) somatosensory areas (Dyadic-Solo contrast), and clinicians showed increased dynamic dlPFC concordance with patients' S2 activity during pain. Furthermore, the strength of S2-dlPFC concordance was positively correlated with self-reported therapeutic alliance. These findings support that empathy and supportive care can reduce pain intensity and shed light on the brain processes underpinning social modulation of pain in patient-clinician interactions. Our findings further suggest that clinicians' dlPFC concordance with patients' somatosensory processing during pain can be boosted by increasing therapeutic alliance.

Non-Invasive Brain Stimulation for the Modulation of Aggressive Behavior-A Systematic Review of Randomized Sham-Controlled Studies

INTRO

Aggressive behavior represents a significant public health issue, with relevant social, political, and security implications. Non-invasive brain stimulation (NIBS) techniques may modulate aggressive behavior through stimulation of the prefrontal cortex.

AIMS

To review research on the effectiveness of NIBS to alter aggression, discuss the main findings and potential limitations, consider the specifics of the techniques and protocols employed, and discuss clinical implications.

METHODS

A systematic review of the literature available in the PubMed database was carried out, and 17 randomized sham-controlled studies investigating the effectiveness of NIBS techniques on aggression were included. Exclusion criteria included reviews, meta-analyses, and articles not referring to the subject of interest or not addressing cognitive and emotional modulation aims.

CONCLUSIONS

The reviewed data provide promising evidence for the beneficial effects of tDCS, conventional rTMS, and cTBS on aggression in healthy adults, forensic, and clinical samples. The specific stimulation target is a key factor for the success of stimulation on aggression modulation. rTMS and cTBS showed opposite effects on aggression compared with tDCS. However, due to the heterogeneity of stimulation protocols, experimental designs, and samples, we cannot exclude other factors that may play a confounding role.

Social Brain Network of Children with Autism Spectrum Disorder: Characterization of Functional Connectivity and Potential Association with Stereotyped Behavior

Objective: To identify patterns of social dysfunction in adolescents with autism spectrum disorder (ASD), study the potential linkage between social brain networks and stereotyped behavior, and further explore potential targets of non-invasive nerve stimulation to improve social disorders. Methods: Voxel-wise and ROI-wise analysis methods were adopted to explore abnormalities in the functional activity of social-related regions of the brain. Then, we analyzed the relationships between clinical variables and the statistical indicators of social-related brain regions. Results: Compared with the typically developing group, the functional connectivity strength of social-related brain regions with the precentral gyrus, postcentral gyrus, supplementary motor area, paracentral lobule, median cingulum, and paracingulum gyri was significantly weakened in the ASD group (all p < 0. 01). The functional connectivity was negatively correlated with communication, social interaction, communication + social interaction, and the total score of the ADOS scale (r = -0.38, -0.39, -0.40, and -0.3, respectively; all p < 0.01), with social awareness, social cognition, social communication, social motivation, autistic mannerisms, and the total score of the SRS scale (r = -0.32, -0.32, -0.40, -0.30, -0.28, and -0.27, respectively; all p < 0.01), and with the total score of SCQ (r = -0.27, p < 0.01). In addition, significant intergroup differences in clustering coefficients and betweenness centrality were seen across multiple brain regions in the ASD group. Conclusions: The functional connectivity between social-related brain regions and many other brain regions was significantly weakened compared to the typically developing group, and it was negatively correlated with social disorders. Social network dysfunction seems to be related to stereotyped behavior. Therefore, these social-related brain regions may be taken as potential stimulation targets of non-invasive nerve stimulation to improve social dysfunction in children with ASD in the future.

Breakdown of intention-based outcome evaluation after transient right temporoparietal junction deactivation

People judge the nature of human behaviors based on underlying intentions and possible outcomes. Recent studies have demonstrated a causal role of the right temporoparietal junction (rTPJ) in modulating both intention and intention-based outcome evaluations during social judgments. However, these studies mainly used hypothetical scenarios with socially undesirable contexts (bad/neutral intentions and bad/neutral outcomes), leaving the role of rTPJ in judging good intentions and good outcomes unclear. In the current study, participants were instructed to make goodness judgments as a third party toward the monetary allocations from one proposer to another responder. Critically, in some cases, the initial allocation by the proposer could be reversed by the computer, yielding combinations of good/bad intentions (of the proposer) with good/bad outcomes (for the responder). Anodal (n = 20), cathodal (n = 21), and sham (n = 21) transcranial direct current stimulation (tDCS) over the rTPJ were randomly assigned to 62 subjects to further examine the effects of stimulation over the rTPJ in modulating intention-based outcome evaluation. Compared to the anodal and sham stimulations, cathodal tDCS over the rTPJ reduced the goodness ratings of good/bad outcomes when the intentions were good, whereas it showed no significant effect on outcome ratings under unknown and bad intentions. Our results provide the first evidence that deactivating the rTPJ modulates outcome evaluation in an intention-dependent fashion, mainly by reducing the goodness rating towards both good/bad outcomes when the intentions are good. Our findings argue for a causal role of the rTPJ in modulating intention-based social judgments and point to nuanced effects of rTPJ modulation.

The (un)learning of social functions and its significance for mental health

Social interactions are dynamic, context-dependent, and reciprocal events that influence prospective strategies and require constant practice and adaptation. This complexity of social interactions creates several research challenges. We propose a new framework encouraging future research to investigate not only individual differences in capacities relevant for social functioning and their underlying mechanisms, but also the flexibility to adapt or update one's social abilities. We suggest three key capacities relevant for social functioning: (1) social perception, (2) sharing emotions or empathizing, and (3) mentalizing. We elaborate on how adaptations in these capacities may be investigated on behavioral and neural levels. Research on these flexible adaptations of one's social behavior is needed to specify how humans actually "learn to be social". Learning to adapt implies plasticity of the relevant brain networks involved in the underlying social processes, indicating that social abilities are malleable for different contexts. To quantify such measures, researchers need to find ways to investigate learning through dynamic changes in adaptable social paradigms and examine several factors influencing social functioning within the three aformentioned social key capacities. This framework furthers insight concerning individual differences, provides a holistic approach to social functioning, and may improve interventions for ameliorating social abilities in patients.

The effects of prefrontal vs. parietal cortex transcranial direct current stimulation on craving, inhibition, and measures of self-esteem

While prefrontal cortex dysfunction has been implicated in high food cravings, other cortical regions, like the parietal cortex, are potentially also involved in regulating craving. This study explored the effects of stimulating the inferior parietal lobule (IPL) and dorsolateral prefrontal cortex (DLPFC) on food craving state and trait. Transcranial direct current stimulation (tDCS) was administered at 1.5 mA for 5 consecutive days. Participants received 20 min of IPL, DLPFC, or sham stimulation (SHAM) each day which consisted of two rounds of 10-min stimulation, divided by a 10-min mindfulness task break. In addition, we studied inhibition and subjective psychological aspects like body image and self-esteem state and trait. To decompose immediate and cumulative effects, we measured the following on days 1 and 5: inhibition through the Go/No-go task; and food craving, self-esteem, and body appreciation through a battery of questionnaires. We found that false alarm errors decreased in the participants receiving active stimulation in the DLPFC (DLPFC-group). In contrast, false alarm errors increased in participants receiving active stimulation in the IPL (IPL-group). At the same time, no change was found in the participants receiving SHAM (SHAM-group). There was a trending reduction in craving trait in all groups. Momentary craving was decreased in the DLPFC-group and increased in IPL-group, yet a statistical difference was not reached. According to time and baseline, self-esteem and body perception improved in the IPL-group. Furthermore, self-esteem trait significantly improved over time in the DLPFC-group and IPL-group. These preliminary results indicate that tDCS modulates inhibition in frontoparietal areas with opposite effects, enhancing it in DLPFC and impairing it in IPL. Moreover, craving is moderately linked to inhibition, self-esteem, and body appreciation which seem not to be affected by neuromodulation but may rely instead on broader regions as more complex constructs. Finally, the fractionated protocol can effectively influence inhibition with milder effects on other constructs.

A systematic review of randomized controlled trials on efficacy and safety of transcranial direct current stimulation in major neurodevelopmental disorders: ADHD, autism, and dyslexia

OBJECTIVE

Among the target groups in child and adolescent psychiatry, transcranial direct current stimulation (tDCS) has been more applied in neurodevelopmental disorders specifically, attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and dyslexia. This systematic review aims to provide the latest update on published randomized-controlled trials applying tDCS in these disorders for evaluating its efficacy and safety.

METHODS

Based on a pre-registered protocol (PROSPERO: CRD42022321430) and using the PRISMA approach, a literature search identified 35 randomized controlled trials investigating the effects of tDCS on children and adolescents with ADHD (n = 17), ASD (n = 11), and dyslexia (n = 7).

RESULTS

In ADHD, prefrontal anodal tDCS is reported more effective compared to stimulation of the right inferior frontal gyrus. Similarly in ASD, prefrontal anodal tDCS was found effective for improving behavioral problems. In dyslexia, stimulating temporoparietal regions was the most common and effective protocol. In ASD and dyslexia, all tDCS studies found an improvement in at least one of the outcome variables while 64.7% of studies (11 of 17) in ADHD found a similar effect. About 88% of all tDCS studies with a multi-session design in 3 disorders (16 of 18) reported a significant improvement in one or all outcome variables after the intervention. Randomized, double-blind, controlled trials consisted of around 70.5%, 36.3%, and 57.1% of tDCS studies in ADHD, ASD, and dyslexia, respectively. tDCS was found safe with no reported serious side effects in 6587 sessions conducted on 745 children and adolescents across 35 studies.

CONCLUSION

tDCS was found safe and partially effective. For evaluation of clinical utility, larger randomized controlled trials with a double-blind design and follow-up measurements are required. Titration studies that systematically evaluate different stimulation intensities, duration, and electrode placement are lacking.

Combinatorial approaches for treating neuropsychiatric social impairment

Social behaviour is an essential component of human life and deficits in social function are seen across multiple psychiatric conditions with high morbidity. However, there are currently no FDA-approved treatments for social dysfunction. Since social cognition and behaviour rely on multiple signalling processes acting in concert across various neural networks, treatments aimed at social function may inherently require a combinatorial approach. Here, we describe the social neurobiology of the oxytocin and endocannabinoid signalling systems as well as translational evidence for their use in treating symptoms in the social domain. We leverage this systems neurobiology to propose a network-based framework that involves pharmacology, psychotherapy, non-invasive brain stimulation and social skills training to combinatorially target trans-diagnostic social impairment. Lastly, we discuss the combined use of oxytocin and endocannabinoids within our proposed framework as an illustrative strategy to treat specific aspects of social function. Using this framework provides a roadmap for actionable treatment strategies for neuropsychiatric social impairment. This article is part of the theme issue 'Interplays between oxytocin and other neuromodulators in shaping complex social behaviours'.

Transcranial Direct Current Stimulation as an Approach to Mitigate Neurodevelopmental Disorders Affecting Excitation/Inhibition Balance: Focus on Autism Spectrum Disorder, Schizophrenia, and Attention Deficit/Hyperactivity Disorder

Transcranial direct current stimulation (tDCS) has been proposed as a promising therapy for rehabilitation of neurodevelopmental disorders. In this review, we discuss studies on the impact of tDCS as a therapy for autism, schizophrenia, and attention deficit/hyperactivity disorder, as well as the tDCS' mechanism of action, and propose future paths of research to optimize tDCS treatment protocols. The mechanism underlying tDCS effects is the modulation of excitatory and/or inhibitory activity, making it a valuable tool for restoring the excitation/inhibition (E/I) balance which is disrupted in many neurodevelopmental disorders. Clinical studies have shown that tDCS therapy is well-tolerated by patients and seems to ameliorate behavior and cognitive functions. Alterations in early development of neuronal circuits lead to disruptions in brain activity in neurodevelopmental disorders. An increasing amount of research into the effects of tDCS on neuronal activity has provided a foundation for its use as a therapy for behavior and cognitive characteristics of neurodevelopmental disorders. Clinical studies show that tDCS appears to ameliorate behavioral and cognitive outcomes of patients with autism, schizophrenia, and attention deficit/hyperactivity disorder. More research is needed to understand the mechanisms of action of tDCS and to optimize treatment protocols.

Somatic engagement alters subsequent neurobehavioral correlates of affective mentalizing

Socio‐emotional encounters involve a resonance of others' affective states, known as affect sharing (AS); and attribution of mental states to others, known as theory‐of‐mind (ToM). Empathy necessitates the integration of both processes, yet their interaction during emotional episodes and subsequent generation of inferences on others' affective states has rarely been tested. To address this, we developed a novel experimental design, wherein we manipulated AS by presenting nonverbal emotionally negative movies twice—each time accompanied by one of two soundtracks that accentuated either somatic cues or externally generated sounds. Movies were followed by questions addressing affective‐ToM (emotional inferences), cognitive‐ToM (inferences on beliefs and knowledge), and non‐ToM aspects. Results revealed a neural differentiation between AS, affective‐ToM, and cognitive‐ToM. AS movies activated regions that have been implicated in emotional (e.g., amygdala) and somatosensory processing, and synchronized brain activity between participants in the latter. Affective‐ToM activated the middle insula, limbic regions, and both ventral and dorsal portions of the medial prefrontal cortex (ventral medial prefrontal cortex [VMPFC] and dorsal medial prefrontal cortex [DMPFC], respectively), whereas cognitive‐ToM activated posteromedial and lateral–prefrontal and temporal cortices. Critically, AS movies specifically altered neural activation in AS and ToM‐related regions during subsequent affective‐ToM inferences, most notably in the DMPFC. Moreover, DMPFC–VMPFC connectivity correlated with affective‐ToM accuracy, when such questions followed AS movies. Our results associate empathic processes with designated neural activations and shed light on how neuro‐behavioral indices of affective ToM are shaped by preceding somatic engagement.

Mentalizing with the future: Electrical stimulation of the right TPJ increases sustainable decision-making

While many people acknowledge the urgency to drastically change our consumption patterns to mitigate climate change, most people fail to live sustainably. We hypothesized that a lack of sustainability stems from insufficient intergenerational mentalizing (i.e., taking the perspective of people in the future). To causally test our hypothesis, we applied high-definition transcranial direct current stimulation (HD-tDCS) to the temporo-parietal junction (TPJ). We tested participants twice (receiving stimulation at the TPJ or the vertex as control), while they engaged in a behavioral economic paradigm measuring sustainable decision-making, even if sustainability was costly. Indeed, excitatory anodal HD-tDCS increased sustainable decision-making, while inhibitory cathodal HD-tDCS had no effect. These finding cannot be explained by changes in participants' fairness norms or their estimation of how other people would behave. Shedding light on the neural basis of sustainability, our results could inspire targeted interventions tackling the TPJ and give neuroscientific support to theories on how to construct public campaigns addressing sustainability issues.

Enhancing Cognition in Older Persons with Depression or Anxiety with a Combination of Mindfulness-Based Stress Reduction (MBSR) and Transcranial Direct Current Stimulation (tDCS): Results of a Pilot Randomized Clinical Trial

Objectives

Individuals with subjective memory complaints and symptoms of depression and/or anxiety are at high risk for further cognitive decline, and possible progression to dementia. Low-burden interventions to help slow or prevent cognitive decline in this high-risk group are needed. The objective of this study is to assess the feasibility of combining Mindfulness-Based Stress Reduction (MBSR) with transcranial direct current stimulation (tDCS) to increase putative benefits of MBSR for cognitive function and everyday mindfulness in depressed or anxious older adults with subjective cognitive decline.

Methods

We conducted a two-site pilot double-blind randomized sham-controlled trial, combining active MBSR with either active or sham tDCS. The intervention included weekly in-class group sessions at the local university hospital and daily at-home practice. Anodal tDCS was applied for 30 min during MBSR meditative practice, both in-class and at-home.

Results

Twenty-six individuals with subjective cognitive complaints and symptoms of depression and/or anxiety were randomized to active (n = 12) or sham tDCS (n = 14). The combination of MBSR and tDCS was safe and well tolerated, though at-home adherence and in-class attendance were variable. While they were not statistically significant, the largest effect sizes for active vs. sham tDCS were for everyday mindfulness (d = 0.6) and social functioning (d = 0.9) (F_(1,21) = 3.68, p = 0.07 and F_(1,21) = 3.9, p = 0.06, respectively).

Conclusions

Our findings suggest that it is feasible and safe to combine tDCS with MBSR in older depressed and anxious adults, including during remote, at-home use. Furthermore, tDCS may enhance MBSR via transferring its meditative learning and practice into increases in everyday mindfulness. Future studies need to improve adherence to MBSR with tDCS.

Trial Registration

ClinicalTrials.gov (NCT03653351 and NCT03680664).

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-021-01764-9.

Stimulation of the Social Brain Improves Perspective Selection in Older Adults: A HD-tDCS Study

There is evidence for dissociable, causal roles for two key social brain regions in young adults. Specifically, the right temporoparietal junction (rTPJ) is associated with embodied perspective taking, whereas the dorsomedial prefrontal cortex (dmPFC) is associated with the integration of social information. However, it is unknown whether these causal brain-behaviour associations are evident in older adults. Fifty-two healthy older adults were stratified to receive either rTPJ or dmPFC anodal high-definition transcranial direct current stimulation in a sham-controlled, double-blinded, repeated-measures design. Self-other processing was assessed across implicit and explicit level one (line-of-sight) and level two (embodied rotation) visual perspective taking (VPT) tasks, and self-other encoding effects on episodic memory. Both rTPJ and dmPFC stimulation reduced the influence of the alternate perspective during level one VPT, indexed by a reduced congruency effect (difference between congruent and incongruent perspectives). There were no stimulation effects on level two perspective taking nor self-other encoding effects on episodic memory. Stimulation to the rTPJ and dmPFC improved perspective selection during level one perspective taking. However, dissociable effects on self-other processing, previously observed in young adults, were not identified in older adults. The results provide causal evidence for age-related changes in social brain function that requires further scrutinization.

The tDCS effect on Prosocial Behavior: A Meta-Analytic Review

Previous studies have shown that transcranial direct current stimulation (tDCS) could potentially promote prosocial behaviors. However, results from randomized controlled trials are inconsistent. The current meta-analysis aimed to assess the effects of anodal and cathodal tDCS using single-session protocols on prosocial behaviors in healthy young adults and explore potential moderators of these effects. The results showed that compared with sham stimulation, anodal (excitatory) stimulation significantly increased (g = 0.27, 95% CI [0.11, 0.43], Z = 3.30, P = 0.001) and cathodal (inhibitory) stimulation significantly decreased prosocial behaviors (g = −0.19, 95% CI [−0.39, −0.01], Z = −1.95, P = 0.051) using a multilevel meta-analytic model. These effects were not significantly modulated by stimulation parameters (e.g. duration, intensity and site) and types of prosocial behavior. The risk of publication bias for the included effects was minimal, and no selective reporting (e.g. P-hacking) was found in the P-curve analysis. This meta-analysis showed that both anodal and cathodal tDCS have small but significant effects on prosocial behaviors. The current study provides evidence that prosocial behaviors are linked to the activity of the ‘social brain’. Future studies are encouraged to further explore whether tDCS could effectively treat social dysfunctions in psychiatry disorders.

Contribution of the right temporoparietal junction and ventromedial prefrontal cortex to theory of mind in autism: A randomized, sham-controlled tDCS study

Theory of mind (ToM) is the ability to attribute subjective mental states to oneself and others and is significantly impaired in autism spectrum disorder (ASD). A frontal-posterior network of regions including the ventromedial prefrontal cortex (vmPFC) and temporoparietal junction (TPJ) is involved in ToM. Previous studies show an underactivation of these regions in ASD. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation method for causally investigating brain-behavior relationships via induction of cortical excitability alterations. tDCS, mostly over the dorsolateral prefrontal cortex, has been increasingly applied for improving behavioral problems in ASD leaving other potentially interesting regions untouched. Here we investigated contribution of the vmPFC and right TPJ in ToM abilities of ASD children via tDCS in a pilot study. Sixteen children with ASD (mean age = 10.7 ± 1.9) underwent three tDCS sessions (1 mA, 20 min) in a randomized, sham-controlled design. Stimulation protocols included: (a) anodal vmPFC tDCS, (b) anodal r-TPJ tDCS, and (c) sham tDCS. ToM abilities were explored during tDCS using the theory of mind test (TOMT). Our results show that activation of the vmPFC with anodal tDCS significantly improved ToM in children with ASD compared with both, r-TPJ tDCS, and sham stimulation. Specifically, precursors of ToM (e.g., emotion recognition, perception, and imitation) and elementary ToM skills (e.g., first-order mental state reasoning) were significantly improved by anodal vmPFC tDCS. Based on these results, the vmPFC could be a potential target region for the reduction of ASD symptoms via noninvasive brain stimulation, which should be examined in larger detail in future studies. LAY SUMMARY: Theory of mind (ToM) is the ability to infer mental states of oneself and others, which is impaired in autism. Brain imaging studies have shown involvement of two brain regions in ToM (ventromedial prefrontal cortex, temporoparietal junction) which are underactivated in autism. We increased activation of these regions via noninvasive brain stimulation in this experiment to see how it would affect ToM abilities in autism. We found that increased activation of the ventromedial prefrontal cortex improved ToM abilities in children with autism.

The limited effect of neural stimulation on visual attention and social cognition in individuals with schizophrenia

BACKGROUND

Research demonstrates a relationship between faulty visual attention and poorer social cognition in schizophrenia. One potential explanatory model suggests abnormal neuromodulation in specific neural networks may result in reduced attention to socially important cues, leading to poorer understanding of another's emotional state or intentions.

OBJECTIVE

The current study experimentally manipulated neural networks using tDCS to examine this potential causal mechanism. The primary aim was to determine whether stimulation to the right temporoparietal junction (rTPJ) improves visual attention, and secondary aims were to determine whether 1) stimulation improves social cognitive performance and 2) visual attention moderates this improved performance.

METHOD

Using a double-blind crossover design, 69 individuals with schizophrenia underwent both active and sham stimulation to either the rTPJ of the ventral attention network (n = 36) or the dorsomedial prefrontal cortex of the social brain network (dmPFC; n = 33). Following stimulation, participants completed tasks assessing emotion recognition and mentalizing. Concurrent eye tracking assessed visual attention, measuring proportion of time spent attending to areas of interest.

RESULTS

For emotion recognition, stimulation failed to impact either visual attention or social cognitive task accuracy. Similarly, neurostimulation failed to affect visual attention on the mentalizing task. However, exploratory analyses demonstrated that mentalizing accuracy significantly improved after stimulation to the active comparator, dmPFC, with no improvement after stimulation to rTPJ.

CONCLUSION

Results demonstrate limited effect of a single stimulation session on visual attention and emotion recognition accuracy but provide initial support for an alternate neural mechanism for mentalizing, highlighting the importance of executive functions over visual attention.

Effect of Modulating Activity in the Right DLPFC on Revenge Behavior: Evidence From a Noninvasive Brain Stimulation Investigation

Revenge is common in our daily lives, and people feel good when engaging in revenge behavior. However, revenge behavior is a complex process and remains somewhat of a puzzle of human behavior. Neuroimaging studies have revealed that revenge behaviors are associated with activation of a neural network containing the anterior cingulate cortex, ventral striatum, inferior frontal gyrus, and dorsolateral prefrontal cortex (DLPFC). Recent brain stimulation research using transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation has shown a causal relationship between brain regions and revenge behaviors, but the findings have been mixed. In the present study, we aimed to study whether stimulation in the DLPFC can change participants' revenge behavior in conditions where participants' wealth was taken away in different ways. We adapted the moonlighting game and designed a new paradigm. Our study revealed that revenge behavior increased following activation in the right DLPFC, suggesting that the right DLPFC plays an important role in overriding self-interest and retaliation. In addition, our results revealed that the right DLPFC is crucial in revenge behavior related to the motivation of invasion.

Transcranial direct current stimulation and emotion processing deficits in psychosis and depression

Emotional processing deficits (EPDs) are commonly observed among individuals diagnosed with (1) psychotic disorders (2) and depression. Given that EPDs can impact overall functioning and quality of life, the need to identify effective interventions is critical. To date, our current understanding of treatments for these impairments is limited. However, there is increasing interest in investigating the efficacy of transcranial direct current stimulation (tDCS). This neuromodulation technique releases a weak electrical current through the brain. Given research suggesting promise for using tDCS to improve symptoms and cognition across psychopathology, this approach may be useful for improving EPDs and related symptoms in psychosis and depression. In the current review, we provide an overview of the literature determining the effects of tDCS for EPDs and related symptoms in these groups. Furthermore, we highlight methodological advances and pinpoint potential future directions.

Effects of Transcranial Direct Current Stimulation on Information Processing Speed, Working Memory, Attention, and Social Cognition in Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system. Cognitive impairment occurs in 40-65% of patients and could drastically affect their quality of life. Deficits could involve general cognition (e.g., attention and working memory) as well as social cognition. Transcranial direct current stimulation (tDCS), is a novel brain stimulation technique that has been assessed in the context of several neuropsychiatric symptoms, including those described in the context of MS. However, very rare trials have assessed tDCS effects on general cognition in MS, and none has tackled social cognition. The aim of this work was to assess tDCS effects on general and social cognition in MS. Eleven right-handed patients with MS received two blocks (bifrontal tDCS and sham, 2 mA, 20 min, anode/cathode over left/right prefrontal cortex) of 5 daily stimulations separated by a 3-week washout interval. Working memory and attention were, respectively, measured using N-Back Test (0-Back, 1-Back, and 2-Back) and Symbol Digit Modalities Test (SDMT) at the first and fifth day of each block and 1 week later. Social cognition was evaluated using Faux Pas Test and Eyes Test at baseline and 1 week after each block. Interestingly, accuracy of 1-Back test improved following sham but not active bifrontal tDCS. Therefore, active bifrontal tDCS could have impaired working memory via cathodal stimulation of the right prefrontal cortex. No significant tDCS effects were observed on social cognitive measures and SDMT. Admitting the small sample size and the learning (practice) effect that might arise from the repetitive administration of each task, the current results should be considered as preliminary and further investigations in larger patient samples are needed to gain a closer understanding of tDCS effects on cognition in MS.

Causal Role of the Right Dorsolateral Prefrontal Cortex in Organizational Fairness Perception: Evidence From a Transcranial Direct Current Stimulation Study

The right dorsolateral prefrontal cortex (rDLPFC) plays an essential role in social decision-making. Although several neural imaging studies have provided evidence that the rDLPFC is correlated with fairness perception, little research has investigated the causal effect of this encephalic region on individuals’ consciousness, particularly perceptions of organizational fairness. The present study explores the causal relationship between the rDLPFC and organizational fairness perception by using brain modulation techniques. Healthy participants received transcranial direct current stimulation (tDCS) and fulfilled the modified ultimatum game (UG) in the sham-controlled experiment. Our results showed that only cathodal stimulation of the rDLPFC resulted in increasing rejection offers compared with the sham stimulation in conditions of disadvantageous inequity. No differences were found between the anodal and sham stimulation in any inequity condition. This study strengthens the main functional effects of the rDLPFC in negative emotional control in relation to organizational fairness perceptions.

Modulating the Activity of vmPFC Regulates Informational Social Conformity: A tDCS Study

Social conformity has been evaluated in many different contexts, ranging from an emotional contagion in psychology, to speculative episodes in economics, to mass protests concerning politics. Previous neuroscience studies suggest that the ventromedial prefrontal cortex (vmPFC) participates in social conformity, especially when it comes to the value integration process, but the specific mechanism of vmPFC is still unclear. In this study, we aimed to identify a direct link between the vmPFC and conformity tendencies by means of transcranial direct current stimulation (tDCS). Conformity tendencies are measured by the probability that participants change their decisions when they observe the majority responses. In our experiment, subjects could make two decisions in each trial, once without social information and once with social information, which allowed us to directly observe the conformity tendency of subjects in different conditions. We found that cathodal stimulation of the vmPFC significantly increased conformity tendency and decreased response time when the initial decision of participants differs from the majority opinion. Based on the experimental results, our study suggests that the vmPFC mainly inhibits and regulates the informational conformity behavior. These findings complement investigations of the neural mechanism of conformity and the role of the vmPFC in the neural circuit behind conformity behavior.

Examining the Dorsolateral and Ventromedial Prefrontal Cortex Involvement in the Self-Attention Network: A Randomized, Sham-Controlled, Parallel Group, Double-Blind, and Multichannel HD-tDCS Study

Background

Attention and perception are strongly biased toward information about oneself compared to information about others. The self-attention network, an integrative theoretical framework for understanding the self-prioritization effects (SPE), proposes that the ventromedial prefrontal cortex (VMPFC), and the posterior superior temporal sulcus (pSTS) are the two nodes responsible for the preferential processing of self-related stimuli, which interact with the attentional control network (associated with the dorsolateral prefrontal cortex, DLPFC), responsible for processing other-related stimuli. So far, neuroimaging studies have provided considerable correlational evidence supporting the self-attention network.

Objective

Here we went beyond correlational evidence by manipulating cortical activity using high-definition transcranial direct current stimulation (HD-tDCS), a non-invasive brain stimulation method. We assessed whether anodal and cathodal stimulation of the VMPFC or the DLPFC modulates the processing of self- and other-related stimuli.

Methods

We used an associative unbiased learning procedure, the so-called shape-label matching task, to assess the SPE in a sample of N = 90. We accomplished to overcome different methodological weaknesses of previous studies using different multichannel montages for excitatory and inhibitory effects over both the VMPFC and the DLPFC.

Results

We found no effect of shape association for non-matching pairs, whereas there was an effect of shape association in the matching condition. Performance (reaction times and accuracy) was better for the self association than for the other two associations, and performance for the friend association was better than for the stranger association. Thus, we replicated the SPE with behavioral data. At the neural level, none of the stimulation succeeded to modulate the magnitude of the SPE effect.

Conclusion

We discuss the implications of these findings, in particular why cognitive modeling theories about SPEs should favor an epiphenomenal rather than a causal link between VMPFC/DLPFC and the impact of personal significance stimuli on perception.

Transcranial electric stimulation as a neural interface to gain insight on human brain functions: current knowledge and future perspective

The use of brain-stimulation approaches in social and affective science has greatly increased over the last two decades. The interest in social factors has grown along with technological advances in brain research. Transcranial electric stimulation (tES) is a research tool that allows scientists to establish contributory causality between brain functioning and social behaviour, therefore deepening our understanding of the social mind. Preliminary evidence is also starting to demonstrate that tES, either alone or in combination with pharmacological or behavioural interventions, can alleviate the symptomatology of individuals with affective or social cognition disorders. This review offers an overview of the application of tES in the field of social and affective neuroscience. We discuss issues and challenges related to this application and suggest avenue for future basic and translational research.

Non-invasive stimulation in the social brain: the methodological challenges

Use of non-invasive brain stimulation methods (NIBS) has become a common approach to study social processing in addition to behavioural, imaging and lesion studies. However, research using NIBS to investigate social processing faces challenges. Overcoming these is important to allow valid and reliable interpretation of findings in neurotypical cohorts, but also to allow us to tailor NIBS protocols to atypical groups with social difficulties. In this review, we consider the utility of brain stimulation as a technique to study and modulate social processing. We also discuss challenges that face researchers using NIBS to study social processing in neurotypical adults with a view to highlighting potential solutions. Finally, we discuss additional challenges that face researchers using NIBS to study and modulate social processing in atypical groups. These are important to consider given that NIBS protocols are rarely tailored to atypical groups before use. Instead, many rely on protocols designed for neurotypical adults despite differences in brain function that are likely to impact response to NIBS.

Transforming treatments for schizophrenia: Virtual reality, brain stimulation and social cognition

Schizophrenia is characterised by delusions, hallucinations, anhedonia and apathy; while impairments in social cognition are often less recognised. Poor social cognition can lead to difficulties in obtaining and maintaining employment, academic progression, interpersonal relationships, and community functioning. Current interventions are highly intensive, require significant resources and have only modest effects on functional outcomes. Virtual reality (VR) and non-invasive brain stimulation (NIBS) may have a role in addressing these limitations. VR allows treatments that are potentially more accessible, less delivery intensive, and have higher ecological validity. While NIBS is able to directly modulate activity in social brain areas in order to promote neuroplasticity, strengthen neural connections and enhance brain function related to social cognitive behaviours. Therefore, the combination of VR and NIBS may allow for more efficient and transferrable interventions than those currently available. This review will explore the potential role of these technologies in the treatment of social cognitive impairment.

Theory of Mind Performance Predicts tDCS-Mediated Effects on the Medial Prefrontal Cortex: A Pilot Study to Investigate the Role of Sex and Age

Transcranial Direct Current Stimulation (tDCS) has become an increasingly promising tool for understanding the relationship between brain and behavior. The purpose of this study was to investigate whether the magnitude of sex- and age-related tDCS effects previously found in the medial prefrontal cortex (mPFC) during a Theory of Mind (ToM) task correlates with social cognition performance; in particular, we explored whether different patterns of activity would be detected in high- and low-performing participants. For this, young and elderly, male and female participants were categorized as a low- or high-performer according to their score on the Reading the Mind in the Eyes task. Furthermore, we explored whether sex- and age-related effects associated with active tDCS on the mPFC were related to cognitive functioning. We observed the following results: (i) elderly participants experience a significant decline in ToM performance compared to young participants; (ii) low-performing elderly females report slowing of reaction time when anodal tDCS is applied over the mPFC during a ToM task; and (iii) low-performing elderly females are characterized by lower scores in executive control functions, verbal fluency and verbal short-term memory. The relationship between tDCS results and cognitive functioning is discussed in light of the neuroscientific literature on sex- and age-related differences.

The Right Temporoparietal Junction Is Causally Associated with Embodied Perspective-taking

A prominent theory claims that the right temporoparietal junction (rTPJ) is especially associated with embodied processes relevant to perspective-taking. In the present study, we use high-definition transcranial direct current stimulation to provide evidence that the rTPJ is causally associated with the embodied processes underpinning perspective-taking. Eighty-eight young human adults were stratified to receive either rTPJ or dorsomedial PFC anodal high-definition transcranial direct current stimulation in a sham-controlled, double-blind, repeated-measures design. Perspective-tracking (line-of-sight) and perspective-taking (embodied rotation) were assessed using a visuo-spatial perspective-taking task that required understanding what another person could see or how they see it, respectively. Embodied processing was manipulated by positioning the participant in a manner congruent or incongruent with the orientation of an avatar on the screen. As perspective-taking, but not perspective-tracking, is influenced by bodily position, this allows the investigation of the specific causal role for the rTPJ in embodied processing. Crucially, anodal stimulation to the rTPJ increased the effect of bodily position during perspective-taking, whereas no such effects were identified during perspective-tracking, thereby providing evidence for a causal role for the rTPJ in the embodied component of perspective-taking. Stimulation to the dorsomedial PFC had no effect on perspective-tracking or taking. Therefore, the present study provides support for theories postulating that the rTPJ is causally involved in embodied cognitive processing relevant to social functioning.SIGNIFICANCE STATEMENT The ability to understand another's perspective is a fundamental component of social functioning. Adopting another perspective is thought to involve both embodied and nonembodied processes. The present study used high-definition transcranial direct current stimulation (HD-tDCS) and provided causal evidence that the right temporoparietal junction is involved specifically in the embodied component of perspective-taking. Specifically, HD-tDCS to the right temporoparietal junction, but not another hub of the social brain (dorsomedial PFC), increased the effect of body position during perspective-taking, but not tracking. This is the first causal evidence that HD-tDCS can modulate social embodied processing in a site-specific and task-specific manner.

Transcranial direct current stimulation (tDCS) as an intervention to improve empathic abilities and reduce violent behavior in forensic offenders: study protocol for a randomized controlled trial

BACKGROUND

Recent studies show that changes in one of the brain areas related to empathic abilities (i.e. the ventromedial prefrontal cortex (vmPFC)) plays an important role in violent behavior in abusers of alcohol and cocaine. According to the models of James Blair, empathy is a potential inhibitor of violent behavior. Individuals with less empathic abilities may be less susceptible and motivated to inhibit violent behavior, which causes a higher risk of violence. Recent neuroscientific research shows that modulating (stimulation or inhibition) certain brain areas could be a promising new intervention for substance abuse and to reduce violent behavior, such as the neurostimulation technique transcranial direct current stimulation (tDCS). This study aims to investigate tDCS as an intervention to increase empathic abilities and reduce violent behavior in forensic substance use offenders.

METHODS/DESIGN

A total sample of 50 male forensic substance abuse patients (25 active and 25 sham stimulation) will be tested in a double-blind placebo-controlled study, from which half of the patients will receive an active stimulation plus treatment as usual (TAU) and the other half will receive sham stimulation (placebo) plus TAU. The patients in the active condition will receive multichannel tDCS targeting the bilateral vmPFC two times a day for 20 min for five consecutive days. Before and after the stimulation period, the patients will complete self-report measurements, perform the Point Subtraction Aggression Paradigm (PSAP) and a passive viewing empathy task. Resting state electroencephalography (rsEEG) will be performed before and after the treatment period. A follow up will be conducted after 6 months. The primary outcome is to investigate multichannel tDCS as a new intervention to increase empathic abilities and reduce violent behavior in offenders with substance abuse problems. In addition, we will determine whether electrophysiological responses in the brain are affected by the tDCS intervention. Finally, the effects of tDCS on reducing craving will be investigated.

DISCUSSION

This study is one of the first studies using multichannel tDCS targeting the vmPFC in a forensic sample. This study will explore the opportunities to introduce a new intervention to improve empathic abilities and reduce violence in forensic substance use offenders. Specifically, this study may give insight into how to implement the tDCS intervention in the setting of daily clinical practice in this complex, multiple-problem target group and with that contribute to reduction of recidivism.

TRIAL REGISTRATION

Dutch Trial Register, NTR7701. Registered on 12 January 2019. Prospectively registered before the recruitment phase. https://www.trialregister.nl/trial/7459. Recruitment started on the 1st of February 2019 and will be finished approximately in the winter of 2019. Protocol version 1. 22 May 2019.

Statistical Analysis to Find out the Optimal Locations for Non Invasive Brain Stimulation

Non-invasive brain electrical stimulation (NIBES) techniques are progressively used for modulation of neuronal membrane potentials, which alters cortical excitability. The neuronal activity depends on position of channel locations for electrodes and the amount and direction of injected weak current through the target neurons area. In the present paper hybrid near infrared spectroscopy and electroencephalogram (NIRS-EEG) open access dataset for brain computer interface (BCI) has been used to find the best locations for NIBES. The percentage oxygen saturation has been calculated with the help of provided NIRS experimental dataset of changes in concentration of oxy-hemoglobin (HbO₂) and deoxy-hemoglobin (Hb) in thirty-six scalp site locations of twenty-eight healthy subjects. The variation in standard deviation have been calculated for given pre-processed EEG signals of thirty locations for same twenty-eight healthy subjects. The statistical one-way ANOVA method has been used to find out the best channels and locations which are having less variation in all motion artifacts. In this method, F value is calculated for these locations and those locations are selected which are significant at 99% confidence interval (P < 0.01). In this study, out of sixty-six locations sixteen best locations have been selected for non-invasive brain electrical stimulation. This pilot study has been used to find out the appropriate locations on the scalp sites to place the electrodes to provide weak direct current stimulation which are less affected by motion artifacts.

Modulation of income redistribution decisions by anodal tDCS over the medial prefrontal cortex

One cause of the persistence of income inequality may be rooted in people's resistance to change the existing income distribution. Prior studies have shown that the medial prefrontal cortex (mPFC) may be associated with the decision making that influences income distribution. However, it is unclear whether the mPFC is involved in income redistribution tasks when third-party decision makers are unaffected by the outcome of the decision. In this study, we elucidate the neural mechanism underlying the tolerance of income inequality and the decision making that is related to income redistribution. By applying the transcranial direct current stimulation (tDCS) over the mPFC, we investigate whether the change in the activation of the mPFC can influence a subject's inclination to expropriate a rich person's endowment and transfer it to a poor person. The main finding is that the anodal stimulation significantly reduced the subject's inclination to redistribute wealth from the rich to the poor, and lowered the rate of accepting options for redistribution. However, the willingness of income redistribution did not change following the cathodal stimulation compared with the sham condition. The effect of the anodal stimulation was constant across three types of initial inequality. The stimulation effect is likely caused by the subject's enhanced loss aversion or desire to reinforce social hierarchies.

Neural correlates of social well-being: gray matter density in the orbitofrontal cortex predicts social well-being in emerging adulthood

Social well-being reflects the perception of one’s social functioning, which plays an important role in physical and psychological health. However, the exact neuroanatomical substrate for social well-being remains unclear. To address the issue, we employed the voxel-based morphometry method to probe the neuroanatomical basis of individual variation in social well-being in young healthy adults (n = 136). The results revealed a significant negative association between social well-being and regional gray matter density (rGMD) in an anatomical cluster that mainly includes the left orbitofrontal cortex (OFC) that has been involved in emotion regulation and social cognition. Furthermore, a balanced 4-fold cross-validation using the machine learning approach revealed that rGMD in the left OFC could be reliably related to social well-being. More importantly, the multiple mediation analysis revealed that neuroticism and dispositional forgiveness independently mediated the association between rGMD in the left OFC and social well-being. In addition, all these results remained stable when subjective socioeconomic status was controlled. Together, our results provide the initial evidence that the OFC is a neuroanatomical substrate for social well-being and demonstrate that the OFC is a crucial neural site linking neuroticism and dispositional forgiveness to social well-being.

Functions of the right DLPFC and right TPJ in proposers and responders in the ultimatum game

Recent studies explored a network of brain regions involved in economic decision making. The present study focuses on two of those regions, each relevant for specific and distinct functions in economic decision making: the right temporoparietal junction (rTPJ) and the right dorsolateral prefrontal cortex (rDLPFC). In two experiments using transcranial direct current stimulation, we explored two proposed functions of these areas in bargaining situations using the ultimatum game (UG): understanding the others perspective and integration of fairness norms. Participants first took the role of the proposer and then the role of the responder. We showed that stimulation of the rTPJ only affected the proposer condition. Interestingly, inhibition of the rTPJ led to fairer offers, which strengthens the view that the role of the rTPJ in bargaining situations is to differentiate one’s own from the other’s perspective. Furthermore, we argue that the rDLPFC is most likely involved in suppressing self-interest when a person is confronted with a direct reward but does not play a role in long-term reward anticipation or integrating social fairness norms. We conclude that self-interest inhibition is shown only in responders, and that perspective taking seems to be a necessary specifically for proposers in the UG.

Aging, sex and cognitive Theory of Mind: a transcranial direct current stimulation study

Aging is accompanied by changes in cognitive abilities and a great interest is spreading among researchers about aging impact on social cognition skills, such as the Theory of Mind (ToM). Transcranial direct current stimulation (tDCS) has been used in social cognition studies founding evidence of sex-related different effects on cognitive ToM task in a young people sample. In this randomized, double-blind, sham-controlled study, we applied one active and one sham tDCS session on the medial prefrontal cortex (mPFC) during a cognitive ToM task, including both social (i.e., communicative) and nonsocial (i.e., private) intention attribution conditions, in sixty healthy aging individuals (30 males and 30 females). In half of the participants the anode was positioned over the mPFC, whereas in the other half the cathode was positioned over the mPFC. The results showed that: (i) anodal tDCS over the mPFC led to significant slower reaction times (vs. sham) for social intention attribution task only in female participants; (ii) No effects were found in both females and males during cathodal stimulation. We show for the first time sex-related differences in cognitive ToM abilities in healthy aging, extending previous findings concerning young participants.

Gender Difference in Gender Bias: Transcranial Direct Current Stimulation Reduces Male's Gender Stereotypes

Stereotypes exist in the interactions between different social groups, and gender stereotypes are particularly prevalent. Previous studies have suggested that the medial prefrontal cortex (mPFC) is involved in the social cognition that plays an important role in gender stereotypes, but the specific causal effect of the mPFC remains controversial. In this study, we aimed to use transcranial direct current stimulation (tDCS) to identify a direct link between the mPFC and gender bias. Implicit stereotypes were measured by the gender implicit association test (IAT), and explicit prejudice was measured by the Ambivalent Sexism Inventory (ASI). We found that male and female participants had different behavioral and neural correlates of gender stereotypes. Anodal tDCS significantly reduced male participants’ gender D-IAT scores compared with cathodal and sham stimulation, while the stimulation had an insignificant effect in female participants. The reduction in male participants’ gender bias mainly resulted from a decrease in the difference in reaction time (RT) between congruent and incongruent blocks. Regarding the explicit bias measurement, male and female participants had distinct attitudes, but tDCS had no effect on ASI. Our results revealed that the mPFC played a causal role in controlling implicit gender stereotypes, which is consistent with previous observations and complements past lesion, neuroimaging, and transcranial magnetic stimulation (TMS) studies and suggests that males and females have different neural bases for gender stereotypes.

Modulating Activity in the Dorsolateral Prefrontal Cortex Changes Punishment in the 3-Player Prisoner's Dilemma: A Transcranial Direct Current Stimulation Study

Altruistic punishment of social norm violations plays a crucial role in maintaining widespread cooperation in human societies, and punitive behavior has been suggested to be related to the activity level of the dorsolateral prefrontal cortex (DLPFC). This study used unilateral and bilateral transcranial direct current stimulation (tDCS) to investigate how modulating the activity of the DLPFC affects cooperation and punishment in a 3-player prisoner's dilemma. We found that none of the unilateral stimulations changed the participants' cooperation behaviors, while left anodal/right cathodal stimulation increased the participants' cooperation. For punitive behavior, we found that all unilateral stimulations (i.e., right anodal, right cathodal, left anodal, left cathodal) and bilateral stimulations (i.e., right anodal/left cathodal, left anodal/right cathodal) significantly decreased the punishment imposed by the cooperators toward the defectors. In addition, right anodal stimulation significantly decreased the participant's third-party punishment (TPP) imposed by the cooperators toward the defectors. The other three unilateral stimulations also significantly decreased the participant's TPP imposed by the cooperators toward the defectors, but only when the punishment was revealed to the punished person. Our findings indicate that the mechanisms of selfishness and negative emotions suggested by previous studies probably interact with different stimulations: for anodal stimulations, the mechanism of negative emotions may overwhelm the mechanism of selfishness, while for cathodal stimulations, the mechanism of selfishness may be more dominant than the mechanism of negative emotions.

Effects of High-Definition Transcranial Direct Current Stimulation and Theta Burst Stimulation for Modulating the Posterior Parietal Cortex

OBJECTIVES

Noninvasive brain stimulation methods, including high-definition transcranial direct current stimulation (HD-tDCS) and theta burst stimulation (TBS) have emerged as novel tools to modulate and explore brain function. However, the relative efficacy of these newer stimulation approaches for modulating cognitive functioning remains unclear. This study investigated the cognitive effects of HD-tDCS, intermittent TBS (iTBS) and prolonged continuous TBS (ProcTBS) and explored the potential of these approaches for modulating hypothesized functions of the left posterior parietal cortex (PPC).

METHODS

Twenty-two healthy volunteers attended four experimental sessions in a cross-over experimental design. In each session, participants either received HD-tDCS, iTBS, ProcTBS or sham, and completed cognitive tasks, including a divided attention task, a working memory maintenance task and an attention task (emotional Stroop test).

RESULTS

The results showed that compared to sham, HD-tDCS, iTBS and ProcTBS caused significantly faster response times on the emotional Stroop task. The effect size (Cohen's d) was d = .32 for iTBS (p < .001), .21 for ProcTBS (p = .01) and .15 for HD-tDCS (p = .044). However, for the performance on the divided attention and working memory maintenance tasks, no significant effect of stimulation was found.

CONCLUSIONS

The results suggest that repetitive transcranial magnetic stimulation techniques, including TBS, may have greater efficacy for modulating cognition compared with HD-tDCS, and extend existing knowledge about specific functions of the left PPC.

High-definition tDCS to the right temporoparietal junction modulates slow-wave resting state power and coherence in healthy adults

The right temporoparietal junction (rTPJ) is a multisensory integration hub that is increasingly utilized as a target of stimulation studies exploring its rich functional network roles and potential clinical applications. While transcranial direct current stimulation (tDCS) is frequently employed in such studies, there is still relatively little known regarding its local and network neurophysiological effects, particularly at important nonmotor sites such as the rTPJ. The current study applied either anodal, cathodal, or sham high-definition tDCS to the rTPJ of 53 healthy participants and used offline EEG to assess the impacts of stimulation on resting state (eyes open and eyes closed) band power and coherence. Temporoparietal and central region delta power was increased after anodal stimulation (the latter trend only), whereas cathodal stimulation increased frontal region delta and theta power. Increased coherence between right and left temporoparietal regions was also observed after anodal stimulation. All significant effects occurred in the eyes open condition. These findings are discussed with reference to domain general and mechanistic theories of rTPJ function. Low-frequency oscillatory activity may exert long-range inhibitory network influences that enable switching between and integration of endogenous/exogenous processing streams.

NEW & NOTEWORTHY Through the novel use of high-definition transcranial direct current stimulation (tDCS) and EEG, we provide evidence that both anodal and cathodal stimulation of the right temporoparietal junction selectively modulate slow-wave power and coherence in distributed network regions of known relevance to proposed temporoparietal junction functionality. These results also provide direct evidence of the ability of tDCS to modulate oscillatory activity at a long-range network level, which may have explanatory power in terms of both neurophysiological and behavioral effects.

Anodal tDCS Over the Right Temporoparietal Junction Lowers Overbidding in Contests

Overbidding, which means bidding over the Nash equilibrium, is commonly observed in competitive social interactions, such as a contest or auction. Recent neuroscience studies show that the right temporoparietal junction (rTPJ) is related to overbidding and associated with inferring the intentions of others during competitive interactions. The present study investigates the neural underpinnings of overbidding and how the rTPJ impacts bidding behavior by using tDCS to modulate the activation of the rTPJ. Participants completed a two-person proportional prize contest, in which overbidding was frequently observed and each participant's share of the prize was equal to the individual's expenditure divided by the aggregated expenditure. We observed a significant tDCS effect, i.e., participants' average expenditure and overbidding rate were significantly reduced in the anodal stimulation compared with the cathodal and sham stimulation. Possible explanations include that enhanced activity in the rTPJ via the anodal stimulation increased the accuracy of a participant's inference of the strategies of others, or a participant's concern for others, and thus helped the participant bid optimally. Our findings provide evidence supporting that the activation of the rTPJ in contests affects overbidding and bidding strategy, and further confirm that the rTPJ is involved in the inference of mental states in a competition context.

A double-blind HD-tDCS/EEG study examining right temporoparietal junction involvement in facial emotion processing

Prior studies have demonstrated that aspects of social cognition can be modulated via temporoparietal junction (TPJ) transcranial direct current stimulation (tDCS). However, this technique lacks focality and electrophysiological effects or correlates are rarely examined. The present study investigated whether anodal and/or cathodal high-definition tDCS (HD-tDCS) would influence facial emotion processing performance relative to sham stimulation, and whether task performance changes were related to neurophysiological changes. Participants completed a facial emotion attribution tasks before and after rTPJ HD-tDCS, with event-related potentials (ERP) recorded during task performance. Anodal rTPJ HD-tDCS improved facial emotion processing performance for static depictions of fear (but not surprise). Stimulation condition influenced P300 latency, and also influenced the relationship between behavioural and electrophysiological (ERP) outcomes in several circumstances, findings which both support and challenge anodal-excitation/cathodal-inhibition accounts of tDCS effects. Results suggest that rTPJ anodal HD-tDCS can influence facial emotion recognition (i.e., affective mentalizing), and elucidate the nature and distribution of underlying neurophysiological processes. Stimulation effects, however, might depend on the intensity and salience/valence (negativity/threat) of the emotion, and these behavioural effects may not relate directly or simply to the ERPs assessed here.

Transcranial direct current stimulation enhances theory of mind in Parkinson's disease patients with mild cognitive impairment: a randomized, double-blind, sham-controlled study

Background

Parkinson’s Disease (PD) with mild cognitive impairment (MCI) (PD-MCI) represents one of the most dreaded complications for patients with PD and is associated with a higher risk of developing dementia. Although transcranial direct current stimulation (tDCS) has been demonstrated to improve motor and non-motor symptoms in PD, to date, no study has investigated the effects of tDCS on Theory of Mind (ToM), i.e., the ability to understand and predict other people’s behaviours, in PD-MCI.

Methods

In this randomized, double-blind, sham-controlled study, we applied active tDCS over the medial frontal cortex (MFC) to modulate ToM performance in twenty patients with PD-MCI. Twenty matched healthy controls (HC) were also enrolled and were asked to perform the ToM task without receiving tDCS.

Results

In the patients with PD-MCI, i) ToM performance was worse than that in the HC, ii) ToM abilities were poorer in those with fronto-executive difficulties, and iii) tDCS over the MFC led to significant shortening of latency for ToM tasks.

Conclusions

We show for the first time that active tDCS over the MFC enhances ToM in patients with PD-MCI, and suggest that non-invasive brain stimulation could be used to ameliorate ToM deficits observed in these patients.