Transcranial magnetic stimulation over the dorsolateral prefrontal cortex affects emotional processing: accounting for individual differences in antisocial behavior

Objectives: The study was designed to investigate the effects of transcranial magnetic stimulation (TMS) over the dorsolateral prefrontal cortex (DLPFC) on emotional recognition among individuals differentiated on antisocial personality disorder (APD) symptoms. Methods: Participants (N = 93) received continuous theta burst stimulation (cTBS) under four conditions: real or sham cTBS over the left and right DLPFC. After stimulation, participants performed a dynamic face recognition task depicting fearful, happy, sad, and painful expressions. Results: Left and right DLPFC stimulation were followed by improved accuracy of happy and painful emotions compared to sham conditions. Participants receiving left stimulation were also better able to recognize sad expressions compared to the left sham condition. A three-way interaction between type of stimulation, emotion recognition, and APD groups suggested that the identified TMS effects on emotion recognition were only significant for individuals at elevated risk for APD symptoms. Conclusions: Findings suggest that DLPFC stimulation can lead to benefits in emotion recognition among individuals high on APD symptoms.