Offline rTMS inhibition of the bilateral dorsolateral prefrontal cortex impairs reappraisal efficacy

In the study we verified the causal role of the dorsolateral prefrontal cortex in performing reappraisal strategy of emotional control. Subjects underwent three sessions of inhibitory offline theta burst TMS stimulation that was targeted at either left dorsolateral, right dorsolateral or vertex area. During the experimental task they were asked to either passively watch or reappraise affective pictures. Efficacy of emotional control was quantified using the late positivity potential of the evoked brain responses. After both left and right dorsolateral stimulation, reappraisal was compromised compared to the vertex session. Worsening of affective control was reflected in earlier but not later time windows of the late positivity. It is suggested that inhibitory stimulation primarily affected top-down mechanism of attentional deployment necessary to focus on the content of experimental stimuli that enables elaboration of new, less negative interpretation of emotional content.