Emotion regulation of social pain: double dissociation of lateral prefrontal cortices supporting reappraisal and distraction

Neuroenhancement by repetitive transcranial magnetic stimulation (rTMS) on DLPFC in healthy adults

The term "neuroenhancement" describes the enhancement of cognitive function associated with deficiencies resulting from a specific condition. Nevertheless, there is currently no agreed-upon definition for the term "neuroenhancement", and its meaning can change based on the specific research being discussed. As humans, our continual pursuit of expanding our capabilities, encompassing both cognitive and motor skills, has led us to explore various tools. Among these, repetitive Transcranial Magnetic Stimulation (rTMS) stands out, yet its potential remains underestimated. Historically, rTMS was predominantly employed in studies focused on rehabilitation objectives. A small amount of research has examined its use on healthy subjects with the goal of improving cognitive abilities like risk-seeking, working memory, attention, cognitive control, learning, computing speed, and decision-making. It appears that the insights gained in this domain largely stem from indirect outcomes of rehabilitation research. This review aims to scrutinize these studies, assessing the effectiveness of rTMS in enhancing cognitive skills in healthy subjects. Given that the dorsolateral prefrontal cortex (DLPFC) has become a popular focus for rTMS in treating psychiatric disorders, corresponding anatomically to Brodmann areas 9 and 46, and considering the documented success of rTMS stimulation on the DLPFC for cognitive improvement, our focus in this review article centers on the DLPFC as the focal point and region of interest. Additionally, recognizing the significance of theta burst magnetic stimulation protocols (TBS) in mimicking the natural firing patterns of the brain to modulate excitability in specific cortical areas with precision, we have incorporated Theta Burst Stimulation (TBS) wave patterns. This inclusion, mirroring brain patterns, is intended to enhance the efficacy of the rTMS method. To ascertain if brain magnetic stimulation consistently improves cognition, a thorough meta-analysis of the existing literature has been conducted. The findings indicate that, after excluding outlier studies, rTMS may improve cognition when compared to appropriate control circumstances. However, there is also a considerable degree of variation among the researches. The navigation strategy used to reach the stimulation site and the stimulation location are important factors that contribute to the variation between studies. The results of this study can provide professional athletes, firefighters, bodyguards, and therapists-among others in high-risk professions-with insightful information that can help them perform better on the job.

fNIRS neurofeedback facilitates emotion regulation: Exploring individual differences over the ventrolateral prefrontal cortex

The ventrolateral prefrontal cortex (VLPFC) plays a pivotal role in emotion regulation, yet the effectiveness of neurofeedback (NF) training targeting the VLPFC remains uncertain, suggesting significant individual differences in outcomes. In this study, we aimed to clarify these differences by enrolling 90 participants, randomly assigned to either an experimental group or a sham group (n = 48/42). Participants in the experimental group underwent VLPFCNF training over eight sessions across two consecutive days, while those in the sham group received random signals from functional near-infrared spectroscopy (fNIRS). To investigate individual variability, participants in the experimental group were further categorized as high or low-efficacy groups based on their training efficiency, determined by the regression slope of VLPFC activity over the sessions. Our results revealed a significant reduction in negative emotions and increased VLPFC activity during emotion regulation in the high-efficacy group, compared to both the low-efficacy group and sham group. Importantly, the benefit in emotion regulation, as reflected by decreased negativity ratings, was predicted by NF training efficiency. Furthermore, the enhancement of VLPFC activity during emotion regulation fully mediated the relationship between NF training efficiency and emotion regulation benefits. Participants with higher VLPFCNF training efficiency exhibited greater engagement of the VLPFC during emotion regulation, leading to superior emotional outcomes. Additionally, VLPFCNF training efficiency was linked to the habitual use of reappraisal strategies in daily life. This study provides novel causal evidence that VLPFCNF training can effectively enhance emotion regulation, highlighting the importance of individual differences in training outcomes. Our findings suggest that NF training targeting the VLPFC offers a promising and personalized intervention strategy for improving emotion regulation, with potential applications for treating emotional disorders. This research underscores the potential of personalized NF approaches, offering new avenues for tailored therapeutic interventions in the future.

Interpersonal brain synchronization in social pain contexts: an fNIRS-based exploration of empathy

Social pain is a common occurrence in interpersonal interactions, yet limited research has explored the neural mechanisms underlying both social pain and social pain empathy. Existing studies often focus on the neural processes of individuals experiencing pain, referred to as "subjects," or those empathizing with them, known as "observers." This study examines the neural mechanisms involved in the process of social pain empathy from the perspective of interpersonal brain synchronization (IBS). To do so, we employed functional near-infrared spectroscopy to simultaneously scan the brains of both subjects and observers in social pain scenarios created using the Cyberball paradigm. The study's findings indicate that in social pain contexts, the IBS among dyads composed of subjects and observers was significantly enhanced in the dorsolateral prefrontal cortex compared to nonsocial pain contexts. This brain region is associated with emotion regulation. Furthermore, we found that this enhancement depended on the observers' levels of rejection sensitivity. This study provides the inaugural exploration into the neural mechanisms underlying social pain empathy through the lens of IBS.

Scarcity mindset facilitates empathy for social pain and prosocial intention: behavioral and neural evidences

Empathy for social pain encompasses both affective and cognitive responses to others' emotional reactions following negative social encounters, facilitating an understanding of their suffering and promoting prosocial behaviors. This study examined how a scarcity mindset affects empathy for social pain and prosocial intentions at behavioral and neural levels. Sixty participants were randomly assigned to either the scarcity or abundance mindset group. They viewed images of social exclusion or neutral scenarios and subsequently rated the perceived unpleasantness of the target person and their willingness to provide comfort during a stage-game paradigm. The results showed that participants in the scarcity mindset group demonstrated greater differentiation in their ratings of unpleasantness and willingness to comfort when exposed to social exclusion images compared to neutral ones, relative to the abundance mindset group. Electrophysiological data revealed that social exclusion images elicited larger late positive potential (LPP) amplitudes in the scarcity mindset group, but not in the abundance mindset group. Additionally, within the scarcity mindset group, affective empathy trait scores moderated the relationship between LPP amplitudes and willingness to comfort ratings. These findings highlight the amplifying effects of a scarcity mindset on empathy for social pain and prosocial intentions, and emphasize the role of affective empathy traits in this dynamic process.

Multiple faces of anxiety: a frontal lobe perspective

Marked dysregulation of the human prefrontal cortex (PFC) and anterior cingulate cortex (ACC) characterises a variety of anxiety disorders, and its amelioration is a key feature of treatment success. Overall treatment response, however, is highly variable, and about a third of patients are resistant to treatment. In this review we hypothesise that a major contributor to this variation in treatment response are the multiple faces of anxiety induced by distinct forms of frontal cortex dysregulation. Comparison of findings from humans and non-human primates reveals marked similarity in the functional organisation of threat regulation across the frontal lobes. This organisation is discussed in relation to the 'predatory imminence continuum' model of threat and the differential engagement of executive functions at the core of both emotion generation and regulation strategies.

Survival, Attachment, and Healing: An Evolutionary Lens on Interventions for Trauma-Related Dissociation

Purpose

Dissociation is a necessary part of our threat response system, common to all animal species, normally temporarily activated under conditions of extreme or inescapable threat. Pathological dissociation, however, continues to occur after the initial threat has passed, in response to reminders or inaccessibility of safety and security. Present across the spectrum of psychiatric diagnoses, recurrent dissociative symptoms are linked to severe trauma exposure, insecure attachment, treatment non-response, and maladaptive coping behaviors such as substance use, suicidality, and self-harm. However, empirical studies testing treatments specific to dissociative processes remain scarce. This narrative review summarizes existing studies and provides theoretical, neurobiological, and evolutionary perspectives on dissociative processes and treatments for pathological dissociation.

Methods

A systematic search of five databases (MEDLINE, EMBASE, APA PsycINFO, CINAHL plus, Scopus) was conducted on April 13, 2023. Peer-reviewed clinical studies with adult participants, assessing intervention effects on dissociative symptoms, were included. Results were thematically analyzed and summarized.

Results

Sixty-nine studies were identified, mainly focused on posttraumatic stress disorder, trauma-exposed populations, and borderline personality disorder. Psychotherapy was studied in 72.5% of studies; other interventions included medications and neurostimulation. The majority reported positive outcomes, despite the heterogeneous spectrum of interventions. However, treatment of dissociative symptoms was the primary objective in only a minority.

Conclusion

Pathological dissociation is a complex phenomenon involving brain and body systems designed for perceiving and responding to severe threats, requiring an individualized approach. A literature is emerging regarding potentially evidence-based treatments to help those impacted by recurrent dissociative symptoms. When contextualized within a neurobiological and evolutionary perspective, these treatments can be understood as facilitating an internal and/or relational sense of safety, resulting in symptom reduction. Further studies are needed to explore effective treatments for dissociative symptoms.

Enhancing ventrolateral prefrontal cortex activation mitigates social pain and modifies subsequent social attitudes: Insights from TMS and fMRI

Social pain, a multifaceted emotional response triggered by interpersonal rejection or criticism, profoundly impacts mental well-being and social interactions. While prior research has implicated the right ventrolateral prefrontal cortex (rVLPFC) in mitigating social pain, the precise neural mechanisms and downstream effects on subsequent social attitudes remain elusive. This study employed transcranial magnetic stimulation (TMS) integrated with fMRI recordings during a social pain task to elucidate these aspects. Eighty participants underwent either active TMS targeting the rVLPFC (n = 41) or control stimulation at the vertex (n = 39). Our results revealed that TMS-induced rVLPFC facilitation significantly reduced self-reported social pain, confirming the causal role of the rVLPFC in social pain relief. Functional connectivity analyses demonstrated enhanced interactions between the rVLPFC and the dorsolateral prefrontal cortex, emphasizing the collaborative engagement of prefrontal regions in emotion regulation. Significantly, we observed that negative social feedback led to negative social attitudes, whereas rVLPFC activation countered this detrimental effect, showcasing the potential of the rVLPFC as a protective buffer against adverse social interactions. Moreover, our study uncovered the impact role of the hippocampus in subsequent social attitudes, a relationship particularly pronounced during excitatory TMS over the rVLPFC. These findings offer promising avenues for improving mental health within the intricate dynamics of social interactions. By advancing our comprehension of the neural mechanisms underlying social pain relief, this research introduces novel intervention strategies for individuals grappling with social distress. Empowering individuals to modulate rVLPFC activation may facilitate reshaping social attitudes and successful reintegration into communal life.