title: Inhibitory repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex modulates early affective processing.
abstract: The dorsolateral prefrontal cortex (dlPFC) has often been suggested as a key modulator of emotional stimulus appraisal and regulation. Therefore, in clinical trials, it is one of the most frequently targeted regions for non-invasive brain stimulation such as repetitive transcranial magnetic stimulation (rTMS). In spite of various encouraging reports that demonstrate beneficial effects of rTMS in anxiety disorders, psychophysiological studies exploring the underlying neural mechanisms are sparse. Here we investigated how inhibitory rTMS influences early affective processing when applied over the right dlPFC. Before and after rTMS or sham stimulation, subjects viewed faces with fearful or neutral expressions while whole-head magnetoencephalography (MEG) was recorded. Due to the disrupted functioning of the right dlPFC, visual processing in bilateral parietal, temporal, and occipital areas was amplified starting at around 90 ms after stimulus onset. Moreover, increased fear-specific activation was found in the right TPJ area in a time-interval between 110 and 170 ms. These neurophysiological effects were reflected in slowed reaction times for fearful, but not for neutral faces in a facial expression identification task while there was no such effect on a gender discrimination control task. Our study confirms the specific and important role of the dlPFC in regulation of early emotional attention and encourages future clinical research to use minimal invasive methods such as transcranial magnetic (TMS) or direct current stimulation (tDCS).
authors.affiliation: Department of Psychiatry, Mood and Anxiety Disorders Research Unit, University Hospital Muenster, D-48149 Muenster, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Zwanzger
authors.affiliation: Institute for Biomagnetism and Biosignalanalysis, University Hospital Muenster, D-48149 Muenster, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Steinberg
authors.affiliation: Institute for Biomagnetism and Biosignalanalysis, University Hospital Muenster, D-48149 Muenster, Germany.
authors.forename: Maimu Alissa
authors.initials: MA
authors.lastname: Rehbein
authors.affiliation: Institute for Biomagnetism and Biosignalanalysis, University Hospital Muenster, D-48149 Muenster, Germany.
authors.forename: Ann-Kathrin
authors.initials: AK
authors.lastname: Bröckelmann
authors.affiliation: Institute for Biomagnetism and Biosignalanalysis, University Hospital Muenster, D-48149 Muenster, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Dobel
authors.affiliation: Department of Psychiatry, Mood and Anxiety Disorders Research Unit, University Hospital Muenster, D-48149 Muenster, Germany.
authors.forename: Maxim
authors.initials: M
authors.lastname: Zavorotnyy
authors.affiliation: Department of Psychiatry, Mood and Anxiety Disorders Research Unit, University Hospital Muenster, D-48149 Muenster, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Domschke
authors.affiliation: Institute for Biomagnetism and Biosignalanalysis, University Hospital Muenster, D-48149 Muenster, Germany. Electronic address: Markus.Junghoefer@wwu.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Junghöfer
mesh_terms: D000328:Adult; D005149:Facial Expression; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D015225:Magnetoencephalography / Q000379:methods*; D008297:Male; D010364:Pattern Recognition, Visual / Q000502:physiology*; D017397:Prefrontal Cortex / Q000502:physiology*; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D055815:Young Adult
keywords: Amygdala; Anxiety; Cortico-limbic control; MEG; TMS