Transcranial magnetic stimulation over the dorsolateral prefrontal cortex affects emotional processing: accounting for individual differences in antisocial behavior
2020 — cTBS of DLPFC and emotion recognition
Population and APD classification
N = 93 healthy young adults. The ASRI-4 was used to measure APD symptoms before stimulation. The authors explicitly state that the scale did not establish clinical diagnosis.
A sample-relative median split produced:
- High APD: N = 38, M = 3.06, SD = 1.35
- Low APD: N = 55, M = 0.34, SD = 0.48
APD symptoms therefore function as a subgroup/moderator variable, not a treatment endpoint.
Intervention
Participants received one 40-second session of real or sham cTBS over the left or right DLPFC.
Outcome
After stimulation participants completed a dynamic face-recognition task involving happy, fearful, painful, and sad expressions.
Direct finding
Real DLPFC stimulation improved recognition of selected emotions relative to sham. The significant emotion-recognition differences were concentrated in the high-APD-symptom group. Left stimulation was associated with better recognition of happy, painful, and sad expressions in this group; right stimulation showed a happy-expression effect.
Why it matters
The program crosses an inference gate from observational neural/cognitive associations to experimental manipulation of a neural target and a proximal emotional-processing outcome.
Critical limitations
- no baseline emotion-recognition measurement;
- APD groups were created from a median split, not a diagnostic threshold;
- participants did not have diagnosed APD;
- APD symptoms were not remeasured after stimulation;
- no aggression/antisocial-behavior outcome;
- single-session acute experiment;
- no follow-up;
- no demonstrated mediation from emotion recognition to later antisocial symptom change.
Inference boundary
This study supports:
cTBS can acutely alter emotion-recognition performance, especially among participants elevated on self-reported APD symptoms.
It does not support:
cTBS reduced APD/ASPD symptoms.
