Getting Closer or Keeping Distance? 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The Role of Prefrontal Cortex and Temporoparietal Junction in Interpersonal Comfort and Emotional Approach Vahid Nejati, Aylin Mardanpour, Abbas Zabihzadeh, Reza Estaji, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2920840/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 07 Dec, 2023 Read the published version in Scientific Reports → Version 1 posted 11 You are reading this latest preprint version Abstract Our perception of physical distance to individuals and stimuli is influenced by our mental distance and relatedness. The present study aimed to investigate the role of the dorsolateral prefrontal cortex (dlPFC), ventromedial prefrontal cortex (vmPFC), and right temporoparietal junction (rTPJ) in interpersonal comfortable distance and approach behaviors towards emotional stimuli. Twenty healthy volunteers received brain stimulation in four separate sessions with a one-week interval, including anodal left dlPFC, anodal right vmPFC, anodal rTPJ, and sham condition, with an extracranial return electrode. Our results revealed an increase in interpersonal distance during anodal rTPJ stimulation and a decrease in distance to positive pictures during anodal vmPFC stimulation. These findings suggest that the rTPJ plays a role in the perceptual component of self-other distancing, while the vmPFC is involved in approaching positive emotions. Biological sciences/Neuroscience Biological sciences/Psychology dorsolateral prefrontal cortex (dlPFC) ventromedial prefrontal cortex (vmPFC) right temporoparietal junction (rTPJ) interpersonal comfortable distance transcranial direct current stimulation (tDCS) Figures Figure 1 Introduction Social cognition is the ability to understand and navigate social interactions based on representations of the self and others (Adolphs, 2001 ). These two components, self and other, are essential for social cognition (Nejati et al., 2012 ). Most of our social processing involves these components and their interaction, including self-referential processing, theory of mind, in-group/out-group categorization, interpersonal relationships, and empathy. Although the interaction and interdependence of self and other are crucial for normal social processing, it is equally important to distinguish between these two components as an integral part of this interaction. Self-other discrimination (SOD) refers to the ability to determine the boundary of self against other at both physical and conceptual/mental levels. This distinction has been described as a prerequisite of higher social cognitive functions such as empathy (Bird & Viding, 2014 ; Decety & Lamm, 2007 ) and theory of mind (Steinbeis, 2016 ). The SOD concept pertains to the demarcation and differentiation of self and others. Studies have shown that romantic relationships often involve blurred self and other boundaries and decreased interpersonal distance. (Quintard et al., 2020 , 2021 ), described in the metaphorical expression of “we are one”. Beyond this extreme integration, interpersonal distance serves as a social signal for approach/avoidance in our social interaction (Lloyd, 2009 ). Different comfortable interpersonal distance has been described as a hallmark of different personalities (Abdevali et al., 2021 ; Humphrey et al., 2021 ), attachment styles (Kaitz et al., 2004 ; Yukawa et al., 2007 ), and psychopathologies (Duke & Mullens, 1973 ; Haim-Nachum et al., 2021 ; Lüönd et al., 2022 ). Interpersonal distance has the potential to reveal our emotional and mental attitudes towards others. Apart from our own emotional states, the emotions that we perceive in others are also crucial in determining our approach and avoidance behaviors. Typically, psychologically sound individuals tend to favor positive self-referential processing. (Auerbach et al., 2016 ; Burrows et al., 2016 ), a preference that may protect against internalizing disorders such as depression (Goldstein et al., 2015 ). At the neural level, several cortical areas have been described as the neural structures of self-other discrimination. Neuroimaging studies found the role of the right superior marginal gyrus (SMG), as a part of the right temporo-parietal junction (TPJ), in self-other distinction (Bukowski et al., 2020 ; Uddin et al., 2006 ). The posterior portion of the right TPJ involves in non-affective self-other distinction (Blanke et al., 2005 ; Farrer et al., 2003 ). Furthermore, the ventromedial prefrontal cortex (vmPFC) is involved in both self and other perception (Heatherton, 2011 ). While the vmPFC is involved in both self and other perception and shows some overlap in the brain structure, the area responsible for self-perception tends to be located more ventrally, whereas the other-related area is typically more dorsal (Heatherton, 2011 ; Mitchell et al., 2005 ). Sui and Humphreys ( 2013 ) in an fMRI study described the activation of the vmPFC in the processing of self-related stimuli, while the dlPFC activated in the processing of the stranger-related stimuli. Humphreys and Sui ( 2016 ) propose a self-attention network in which the vmPFC is a self-representation core, which is controlled by the dlPFC through a top-down control. Beyond correlational neuroimaging studies, non-invasive brain stimulation (NIBS) studies found causal association between these cortical areas and self-other distinction. Transcranial magnetic stimulation (TMS) found the role of the right SMG (Bukowski et al., 2020 ; Silani et al., 2013 ) and the vmPFC (Wittmann et al., 2021 ) in self-other distinction. Transcranial direct current stimulation (tDCS) also described the role of the right TPJ and the vmPFC in self-other discrimination. For instance, anodal right TPJ stimulation improved self-other representations (Payne & Tsakiris, 2017 ; Santiesteban et al., 2012 ). Anodal vmPFC stimulation improves social framing (Chen et al., 2021 ), self-referential processing (Mohammad Ali Salehinejad et al., 2020 ), and altruistic behaviors (Zheng et al., 2016 ). Several tDCS studies found that the vmPFC as a part of off-task/default mode network (DMN) work in concert with the dorsolateral prefrontal cortex (dlPFC) as the hub of on-task/central executive network (CEN) in several social/emotional processing, including emotional processing (Vahid Nejati et al., 2021 ), self-referential processing (Mohammad Ali Salehinejad et al., 2020 ), and emotion regulation (M.A. Salehinejad et al., 2017 ). However, a HD-tDCS study found a null effect of the dlPFC and the vmPFC in prioritization effects for self, friend, and stranger (Martínez-Pérez et al., 2020 ). In the present study, we hypothesized the role of right TPJ, the vmPFC, and the dlPFC in self-other discrimination. We aimed to investigate the role of these cortical areas in comfortable interpersonal space and approach/avoidance to emotional faces as two indicators of self-other discrimination. Materials and Methods Participants . The study recruited twenty healthy adults (11 females) aged between 27–45 years, with an average age of 37.30 ± 5.47 years. All participants were right-handed and had normal or corrected-to-normal vision, with no history of head trauma, drug addiction, or psychiatric or neurological disorders. The research was conducted in compliance with the ethical standards outlined in the Helsinki Declaration of 1975, as revised in 2013, and was approved by the national ethical committee (Ethics Code: IR.SBU.REC.1401.106). Comfortable interpersonal distance task (CIDT). This task was used to measure the preferred interpersonal distance (Duke & Mullens, 1973 ). This task measures the optimal physical distance between oneself and others, and involves participants imagining themselves in a room with a circle drawn on paper. An imaginary person enters the room from one of the eight doors on the circle's periphery, and participants indicate the point on the paper where they would allow the person to approach. The test has been found to be valid and reliable in various cultures and correlates with optimal interpersonal distances in real-life interactions (Abdevali et al., 2021 ). In this study, in a computerized version of the task, we used three types of avatars representing self, mother, and president. Approach avoidance task (AAT). This task was used to discover the proper distance with emotional material (Gable & Harmon-Jones, 2008 ). This task involves presenting an emotional stimulus on a screen that moves towards or away from the viewer, allowing the viewer to control its distance by pressing the space bar to stop its movement at a comfortable distance. In this study, we used 100 emotional faces, happy, sad, angry, disgust and neutral faces, equally. The faces were selected from the Nimstim set of facial expressions (Tottenham et al., 2009 ). Stimuli of all tasks were presented on a laptop with a 15.2” screen at a viewing distance of approximately 50 cm. The task took around 5 minutes to perform. tDCS protocol. ActivaDose stimulator (ActivaTek Inc., USA) was used to deliver the stimulation. The stimulator produced an electrical direct current of 2 mA, which was applied for 20 minutes through a pair of saline-soaked sponge electrodes measuring 25 cm2 (5x5). The current was ramped up over a period of 30 seconds and down over a period of 30 seconds. The tDCS protocol involved four sessions, spaced one week apart, with the electrodes positioned according to the 10–20 EEG international system. The four conditions were: (1) anodal dlPFC (F3), (2) anodal vmPFC (FPZ), (3) anodal rTPJ (TP6), and (4) sham stimulation. For the sham condition, the placement of the electrodes was randomly selected from one of the real conditions. The return electrode was placed on the contralateral shoulder in all conditions. Procedure . Once the inclusion criteria were verified, and informed consent was obtained, the tasks and procedures were explained to the participants by AM. Then, in a single-blinded design, the stimulation was applied randomly and in a counterbalanced order. After five minutes of stimulation, the participants performed the AAT and ICD tasks in a random order, which took approximately 15 minutes. Following each session, the participants completed a side effect checklist (Brunoni et al., 2011 ) and were asked to guess whether they received real or sham stimulation. Data analysis. We used the statistical package SPSS for Windows to analyze the data. The normality and sphericity assumptions were confirmed based on the results of the Shapiro-Wilk and Mauchly's tests. We conducted a 2×4 repeated measures analysis of variance (ANOVA) with emotional state in AAT (happy, neutral, sad, angry, and disgusted) or avatar (self, mother, and president) and tDCS conditions (four conditions) as the within-subject factors, and the pixel of comfortable distance as the dependent variable. We conducted Mauchly's test to check the sphericity of the data, and we used the Greenhouse-Geisser method to correct the degrees of freedom if necessary. Post hoc analyses were conducted using Fisher's Least Significant Difference (LSD) test. Additionally, we integrated session order and task order as covariates in an ANCOVA. We applied a significance level of p < .05 for all statistical comparisons. Results The participants exhibited good tolerance to the stimulation with minimal side effects. Table 2 displays the means and standard deviations of the different side effects across the stimulation conditions. The results of one-way ANOVAs indicated that there were no significant differences between the conditions for most of the side effects, except for burning (F1.93= 6.15, p= .05, ηp2= .24) and tingling (F2.11= 3.65, p= .03, ηp2= .16), Table 1. Post hoc LSD analysis revealed that during tDCS over dlPFC, vmPFC, and rTPJ, participants experienced higher levels of burning compared to sham stimulation (MD= .75, p <.001; MD= .55, p= .02; MD= .90, p <.001 respectively). Furthermore, the participants reported higher levels of tingling during stimulation of dlPFC (MD= .70, p= .03) and rTPJ (MD= .80, p <.001) relative to the sham condition. Guesses of real stimulation for vmPFC, dlPFC, rTPJ, and sham stimulation were 75%, 60%, 50%, and 40%, respectively (χ2(1) = 2.86, p= .09) Table 1. Side effects of tDCS (means and sd) in the different stimulation conditions and the results of the respective ANOVAs. Measures Conditions, M(SD) Statistics dl vm rTPJ Sham df F P ηp2 Pain Vertigo Burning .05 (.22) .00 (.00) .75 (.71) .05 (.22) .05 (.22) .55 (.99) .00 (.00) .00 (.00) .90 (.85) .25 (.44) .00 (.00) .00 (.00) 1.74 3 1.93 3.12 1.00 6.15 .06 .40 .05 .14 .05 .24 Tingling .80 (1.32) .45 (.75) .90 (.78) .10 (.30) 2.11 3.65 .03 .16 Confusion .05 (.22) .20 (.52) .10 (.30) .15 (.36) 3 .54 .65 .02 Drowsiness .25 (.71) .55 (.82) .80 (1.43) .70 (1.26) 3 1.01 .39 .05 Abbreviations: M: mean, SD: standard deviation, dl: dorsolateral prefrontal cortex, vm: ventromedial prefrontal cortex, rTPJ: right tempro-parietal junction. df: degrees of freedom, F; F-value, P: P-value, ηp2: partial eta squared Table 2. Mean and standard deviation of measurements in different stimulation conditions Measures dl/vm vm/dl rTPJ Sham CIDT Self 34.69 (34.94) 3.99 (28.28) 4.74 (35.84) 34.34 (25.77) Mother 73.14 (53.05) 62.40 (46.06) 92.66 (57.58) 67.28 (6.90) President 154.02 (81.38) 171.65 (71.72) 199.06 (74.27) 178.34 (85.79) Total 87.28 (43.22) 88.35 (34.83) 11.82 (37.15) 93.32 (43.77) AAT Happy 5.24 (11.28) 61.02 (15.89) 5.05 (13.89) 37.66 (8.98) Neutral 43.35 (11.23) 52.89 (16.76) 44.19 (11.91) 45.34 (12.14) Sad 32.04 (8.75) 4.96 (13.10) 31.02 (1.85) 5.85 (14.11) Angry 27.22 (8.69) 36.82 (15.20) 26.06 (1.14) 3.45 (1.09) Disgusted 25.15 (6.93) 32.36 (9.68) 25.53 (8.09) 27.53 (8.89) Total 35.60 (6.32) 44.81 (12.15) 35.37 (9.08) 93.32 (43.77) Abbreviations: CIDT: comfortable interpersonal distance task, AAT: approach avoidance task, M: mean, SD: standard deviation, dl: dorsolateral prefrontal cortex, vm: ventromedial prefrontal cortex, rTPJ: right tempro-parietal junction. Table 3. The result of two factorial ANOVA on the study measures Stimulation Effect Avatar/Emotion Effect Stimulation * Avatar/Emotion df F P ηp2 df F P ηp2 df F P ηp2 CIDT 3 6.94 <.001 .26 2 48.45 <.001 .71 3.26 2.71 .04 .12 AAT 3 7.21 <.001 .27 1.94 5.92 <.001 .72 5.19 .99 .42 .05 Abbreviations: CIDT: comfortable interpersonal distance task, AAT: approach avoidance task, dl: dorsolateral prefrontal cortex, vm: ventromedial prefrontal cortex, rTPJ: right tempro-parietal junction. df: degrees of freedom, F; F-value, P: P-value, ηp2: partial eta squared. For the CID task, the ANOVA revealed a significant main effect of tDCS conditions (F 3 = 6.94, p <.001, ηp2 = .26). Additionally, significant main effects were found for avatar identity (F 2 = 48.45, p <.001, ηp2 = .71) and the interaction between stimulation and avatar (F 3.26 = 2.71, p = .04, ηp2 = .12). The LSD post hoc analysis showed that during rTPJ stimulation, participants kept avatar images at a greater distance compared to dlPFC (MD (mean difference) = 23.53, p = .001), vmPFC (MD= 22.47, p = .001), and sham (MD= 17.49, p = .004) stimulation. For avatar stimuli, participants tended to keep the "president" stimuli at a further distance than the "self" (MD= 14.57, p <.001) and "mother" (MD= 101.89, p <.001) conditions. Furthermore, the "mother" stimuli were kept at a longer distance than the "self" stimuli (MD = 38.68, p = .002). The post hoc analysis of the interaction showed that during "mother" trials, distance scores were higher during rTPJ stimulation compared to dlPFC (MD = 19.51, p = .01), vmPFC (MD = 3.25, p = .001), and sham (MD= 25.37, p = .003) conditions. For "president" stimuli, larger distances were recorded under rTPJ stimulation compared to dlPFC (MD = 45.04, p = .004), vmPFC (MD = 27.41, p = .003), and sham (MD = 2.72, p = .01) stimulation, Table 2 and 3. For the AAT, the ANOVA results revealed a significant main effect of stimulation conditions (F 3 = 7.21, p < .001, ηp2 = .27) and a significant main effect of emotion (F 1.94 = 5.92, p < .001, ηp2 = .72). However, there was a non-significant interaction of stimulation and emotion (F5.19 = .99, p = .42, ηp2 = .50). Post-hoc analyses were performed using LSD to examine pairwise comparisons between tDCS conditions. The results showed that anodal vmPFC led participants to magnify emotional images more and keep them in a smaller distance than dlPFC (MD = 9.21, p = .003), rTPJ (MD = 9.44, p = .004), and sham (MD = 7.15, p = .005) stimulation. Furthermore, the LSD results indicated that participants tended to make emotional faces bigger in a descending order during happy, neutral, sad, angry, and disgusted trials. Specifically, there were significant differences between happy and sad (MD = 18.49, p < .001), happy and angry (MD = 22.90, p < .001), happy and disgusted (MD = 25.39, p < .001), happy and neutral (MD = 6.59, p = .01), neutral and sad (MD = 11.90, p < .001), neutral and angry (MD = 16.31, p < .001), neutral and disgusted (MD = 18.80, p < .001), sad and angry (MD = 4.40, p < .001), sad and disgusted (MD = 6.89, p < .001), and angry and disgusted (MD= 2.49, p= .01), Table 2 and 3. Discussion In this study, our objective was to evaluate the effects of stimulating three brain regions - the dlPFC, the vmPFC, and the rTPJ - on self-other discrimination and approach/avoidance behavior in response to emotional states. Our findings indicate that anodal stimulation of the rTPJ has a significant impact on self-other distance, while anodal stimulation of the vmPFC increases approach behavior towards positive emotional stimuli. Additionally, we found that the identity of the moving avatar had a significant impact on the effectiveness of anodal rTPJ stimulation, regardless of whether the avatar represented a significant or non-significant other, a mother, or a president. The interaction between emotional states and stimulation montages, however, was not significant, suggesting that the vmPFC plays a valence-insensitive role in emotional processing. In the following section, we will discuss the results in the context of previous brain stimulation studies. Increased interpersonal comfortable distance. The results suggest a longer interpersonal comfortable distance to mother and president, and not the self, during anodal rTPJ stimulation compared to all other conditions. Earlier tDCS studies found improved self-other discrimination during anodal right rTPJ stimulation using video-morphing task (Payne & Tsakiris, 2017), perspective taking task (Santiesteban et al., 2012). Uddin et al. (2006) observed that applying rTMS to the right inferior parietal lobule (IPL), which is part of the temporoparietal area, resulted in a disturbance in the capacity to differentiate one's own face from that of another. Neuroimaging studies have revealed that the rTPJ plays a key role in various complex social cognitive functions such as theory of mind (Frith & Frith, 2006), empathy (Schaefer et al., 2021), and perspective taking (Perner et al., 2006; Santiesteban et al., 2017). Interestingly, these complex social-cognitive functions also involve basic self-other processing. The areas of the brain responsible for self-other processing overlap with those associated with complex social-cognitive functions and include the rTPJ (Decety & Lamm, 2007). In the present study, the distance of self and other was greater during anodal rTPJ, indicating an egocentric role of the rTPJ. A tDCS study found anodal rTPJ increase self-effacing attributions, refers to downplay the self-role in positive outcomes instead of external factors (Takano & Nomura, 2019). Similarly, several tDCS studies found anodal rTPJ stimulation did not improve ToM functioning in healthy adults (Martin et al., 2017; Santiesteban et al., 2015) However, one study did observe a decrease in ToM accuracy following cathodal stimulation of the rTPJ (Mai et al., 2016). It seems the rTPJ plays a perceptual/physical role in social cognition, including theory of mind, refers to the ability to mentally rotate into an allocentric viewpoint, known as perspective taking, is considered a prerequisite for ToM (Pearson et al., 2013). This role of the rTPJ in lower-order, but not higher order, social processing has been described earlier (Martin et al., 2019). The interaction between stimulation and avatar identity revealed the role of the vmPFC for increase the interpersonal comfortable distance for the president and mother avatars, but not the self-avatar. This result could be interpreted as reflecting the different demands of the task for the self-avatar versus the other avatars. Given the self-fixed avatar in the center of the room, when the other avatar enters the room, both the self-fixed avatar and the moving-other avatar should be imagined as two physically separate avatars. However, when the entering avatar is the self-avatar, the self-fixed avatar in the center and the moving self-avatar have an identical physical identity, which should be imagined as two separate mental identities. This mentalization makes the task more demanding and diminishes the role of the rTPJ. Increased approach to emotional stimuli . Independent of the emotional expressions, anodal vmPFC increased approach to emotional stimuli. Earlier tDCS studies found application of anodal tDCS over the vmPFC with an extracranial reference electrode increased attention bias to happy faces or scenes, while cathodal tDCS decreased this bias (Winker et al., 2019). Another tDCS study described an attenuation of anger and aggression during anodal vmPFC stimulation using anger-infused ultimatum game in healthy participants (Gilam et al., 2018). Moreover, anodal vmPFC stimulation with extracranial reference electrode enhanced pleasant scene processing in healthy participants (Junghofer et al., 2017). These results are in further accordance with evidence from neuroimaging studies showing that the vmPFC downregulates emotionally negative responses of the amygdala (Blair, 2008; Motzkin et al., 2015). Regardless of the montage used, individuals tend to respond more to positive facial expressions than negative ones. In the present study, we did not observe any significant interaction between expressions and stimulation. This result can be explained by the role of the ventromedial prefrontal cortex (vmPFC) in emotional processing. An earlier tDCS study in healthy participants showed that the vmPFC plays a role in arousal, but not valence, of emotional stimuli (Vahid Nejati et al., 2021). However, Iarrobino et al. (2021) conducted a crossover study using anodal stimulation on the right and left vmPFC, with an extracranial return electrode, and found that discrimination of angry faces increased with left-sided stimulation, while discrimination of sad faces decreased with right-sided stimulation in healthy individuals. This study used an explicit emotion recognition task, which is relatively different from the approach-avoidance test used as an implicit task in the current study. Limitation and future direction. There are certain limitations to this study that need to be considered. Firstly, the study had a single-session design to explore the role stimulation of some target areas in self-other discrimination and approach, which may limit the ability to draw a conclusion about the clinical relevance of the intervention. Furthermore, we target the dlPFC, vmPFC and rTPJ as involved area in self-other discrimination. However, the involves brain areas in self-other perception and discrimination are not limited to these areas. Secondly, the sample size of this pilot study was moderate and the design was single-blind. For future studies, a larger sample size and a double-blind design should be implemented to improve the rigor of the design. Furthermore, future studies should include physiological markers to understand the underlying mechanisms of the observed cognitive effects and titrate the intervention dosage according to intensity and duration for personalized intervention approaches. Conclusion This study revealed that the rTPJ plays a critical role in self-other discrimination, particularly in situations where the moving avatar represented mother or president, and not for the hypothetical self. These results suggest that the rTPJ has a spatial/physical, rather than conceptual/mental, role in social cognition. On the other hand, the study revealed that anodal stimulation of the vmPFC increases approach behavior towards positive emotional stimuli, indicating its involvement in emotional component of approaching. In summary, the vmPFC can be considered the emotional component of self-referential processing, while the rTPJ plays a perceptual role in self-other distinction. Declarations Authors’ contributions: V.N.: Conceptualization, writing, and supervision, A.M.: Data gathering, AZ and RE: Data analysis and visualization, S.S.: Methodology Data Availability: The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. References Abdevali, M., Mazaheri, M. A., Besharat, M. A., Zabihzadeh, A., & Green, J. D. (2021). Borderline personality disorder and larger comfortable interpersonal distance in close relationships. Personality and Individual Differences , 182 , 111067. Adolphs, R. (2001). The neurobiology of social cognition. Current Opinion in Neurobiology , 11 (2), 231–239. Auerbach, R. P., Bondy, E., Stanton, C. H., Webb, C. A., Shankman, S. A., & Pizzagalli, D. A. (2016). Self‐referential processing in adolescents: Stability of behavioral and ERP markers. Psychophysiology , 53 (9), 1398–1406. Bird, G., & Viding, E. (2014). 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Examining the dorsolateral and ventromedial prefrontal cortex involvement in the self-attention network: A randomized, sham-controlled, parallel group, double-blind, and multichannel HD-tDCS study. Frontiers in Neuroscience , 14 , 683. Mitchell, J. P., Banaji, M. R., & Macrae, C. N. (2005). The link between social cognition and self-referential thought in the medial prefrontal cortex. Journal of Cognitive Neuroscience , 17 (8), 1306–1315. Motzkin, J. C., Philippi, C. L., Wolf, R. C., Baskaya, M. K., & Koenigs, M. (2015). Ventromedial prefrontal cortex is critical for the regulation of amygdala activity in humans. Biological Psychiatry , 77 (3), 276–284. Nejati, Vahid, Majdi, R., Salehinejad, M. A., & Nitsche, M. A. (2021). The role of dorsolateral and ventromedial prefrontal cortex in the processing of emotional dimensions. Scientific Reports , 11 (1), 1–12. Nejati, Vhid, Zabihzadeh, A., Nikfarjam, M. R., Pournaghdali, A., Naderi, Z., & Riyahi, M. T. (2012). Self as a social cue: Evidence for reading mind from eyes test. Procedia-Social and Behavioral Sciences , 32 , 82–88. Payne, S., & Tsakiris, M. (2017). Anodal transcranial direct current stimulation of right temporoparietal area inhibits self-recognition. Cognitive, Affective, & Behavioral Neuroscience , 17 (1), 1–8. Pearson, A., Ropar, D., & de C. Hamilton, A. F. (2013). A review of visual perspective taking in autism spectrum disorder. Frontiers in Human Neuroscience , 7 , 652. Perner, J., Aichhorn, M., Kronbichler, M., Staffen, W., & Ladurner, G. (2006). Thinking of mental and other representations: The roles of left and right temporo-parietal junction. Social Neuroscience , 1 (3–4), 245–258. Quintard, V., Jouffe, S., Hommel, B., & Bouquet, C. A. (2021). Embodied self-other overlap in romantic love: a review and integrative perspective. Psychological Research , 85 (3), 899–914. Quintard, V., Jouffre, S., Croizet, J.-C., & Bouquet, C. A. (2020). The influence of passionate love on self–other discrimination during joint action. Psychological Research , 84 (1), 51–61. Salehinejad, M.A., Nejati, V., & Derakhshan, M. (2017). Neural correlates of trait resiliency: Evidence from electrical stimulation of the dorsolateral prefrontal cortex (dLPFC) and orbitofrontal cortex (OFC). Personality and Individual Differences , 106 . https://doi.org/10.1016/j.paid.2016.11.005 Salehinejad, Mohammad Ali, Nejati, V., & Nitsche, M. A. (2020). Neurocognitive correlates of self-esteem: From self-related attentional bias to involvement of the ventromedial prefrontal cortex. Neuroscience Research , 161 , 33–43. Santiesteban, I., Banissy, M. J., Catmur, C., & Bird, G. (2012). Enhancing social ability by stimulating right temporoparietal junction. Current Biology , 22 (23), 2274–2277. Santiesteban, I., Banissy, M. J., Catmur, C., & Bird, G. (2015). Functional lateralization of temporoparietal junction–imitation inhibition, visual perspective‐taking and theory of mind. European Journal of Neuroscience , 42 (8), 2527–2533. Santiesteban, I., Kaur, S., Bird, G., & Catmur, C. (2017). Attentional processes, not implicit mentalizing, mediate performance in a perspective-taking task: Evidence from stimulation of the temporoparietal junction. NeuroImage , 155 , 305–311. Schaefer, M., Kühnel, A., Rumpel, F., & Gärtner, M. (2021). Do Empathic Individuals Behave More Prosocially? Neural Correlates for Altruistic Behavior in the Dictator Game and the Dark Side of Empathy. Brain Sciences , 11 (7), 863. Silani, G., Lamm, C., Ruff, C. C., & Singer, T. (2013). Right supramarginal gyrus is crucial to overcome emotional egocentricity bias in social judgments. Journal of Neuroscience , 33 (39), 15466–15476. Steinbeis, N. (2016). The role of self–other distinction in understanding others’ mental and emotional states: neurocognitive mechanisms in children and adults. Philosophical Transactions of the Royal Society B: Biological Sciences , 371 (1686), 20150074. Sui, J., & Humphreys, G. W. (2013). Self-referential processing is distinct from semantic elaboration: Evidence from long-term memory effects in a patient with amnesia and semantic impairments. Neuropsychologia , 51 (13), 2663–2673. Takano, R., & Nomura, M. (2019). Anodal transcranial direct current stimulation of the right temporoparietal junction enhances the self-effacing bias in Japanese individuals. Culture and Brain , 7 , 80–91. Tottenham, N., Tanaka, J. W., Leon, A. C., McCarry, T., Nurse, M., Hare, T. A., Marcus, D. J., Westerlund, A., Casey, B. J., & Nelson, C. (2009). The NimStim set of facial expressions: judgments from untrained research participants. Psychiatry Research , 168 (3), 242–249. Uddin, L. Q., Molnar-Szakacs, I., Zaidel, E., & Iacoboni, M. (2006). rTMS to the right inferior parietal lobule disrupts self–other discrimination. Social Cognitive and Affective Neuroscience , 1 (1), 65–71. Winker, C., Rehbein, M. A., Sabatinelli, D., Dohn, M., Maitzen, J., Roesmann, K., Wolters, C. H., Arolt, V., & Junghoefer, M. (2019). Noninvasive stimulation of the ventromedial prefrontal cortex indicates valence ambiguity in sad compared to happy and fearful face processing. Frontiers in Behavioral Neuroscience , 13 , 83. Wittmann, M. K., Trudel, N., Trier, H. A., Klein-Flügge, M. C., Sel, A., Verhagen, L., & Rushworth, M. F. S. (2021). Causal manipulation of self-other mergence in the dorsomedial prefrontal cortex. Neuron , 109 (14), 2353–2361. Yukawa, S., Tokuda, H., & Sato, J. (2007). Attachment style, self-concealment, and interpersonal distance among Japanese undergraduates. Perceptual and Motor Skills , 104 (3_suppl), 1255–1261. Zheng, H., Huang, D., Chen, S., Wang, S., Guo, W., Luo, J., Ye, H., & Chen, Y. (2016). Modulating the activity of ventromedial prefrontal cortex by anodal tDCS enhances the trustee’s repayment through altruism. Frontiers in Psychology , 7 , 1437. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2920840","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":201720112,"identity":"04b98cbd-60e2-4bb1-9866-70c6905b21b0","order_by":0,"name":"Vahid Nejati","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAv0lEQVRIiWNgGAWjYHCCBAYGAxsGAwhHgkgtBwzSSNPCwHCA4TBMCxHAnL3h4ecPBeftzSUSGD/8YLDIJ6jFsudAssQBg9uJO2ckMEv2MEhYNhDSYnAjIQGkJQHIYJAG+oWwAw3uP0j+ccDgnD1QC/Nv4rTcYEgD2nKAccONBDYibTmTkGZxxiA5cWfPwzbLHgNitBw/k3yj4o+dvTl78uEbPyrqiAlsngQog7GBgcjYYT9AlLJRMApGwSgYwQAAey86fu04yKYAAAAASUVORK5CYII=","orcid":"","institution":"Shahid Beheshti University","correspondingAuthor":true,"prefix":"","firstName":"Vahid","middleName":"","lastName":"Nejati","suffix":""},{"id":201720113,"identity":"7cfa0c77-66ba-427f-a4c9-7a1d7a66501b","order_by":1,"name":"Aylin Mardanpour","email":"","orcid":"","institution":"Shahid Beheshti University","correspondingAuthor":false,"prefix":"","firstName":"Aylin","middleName":"","lastName":"Mardanpour","suffix":""},{"id":201720114,"identity":"fe91d2a6-ade1-4f04-842f-16763beac2e8","order_by":2,"name":"Abbas Zabihzadeh","email":"","orcid":"","institution":"Shahid Beheshti University","correspondingAuthor":false,"prefix":"","firstName":"Abbas","middleName":"","lastName":"Zabihzadeh","suffix":""},{"id":201720115,"identity":"d880f873-d614-42d3-9171-8960ab89e6e1","order_by":3,"name":"Reza Estaji","email":"","orcid":"","institution":"Shahid Beheshti University","correspondingAuthor":false,"prefix":"","firstName":"Reza","middleName":"","lastName":"Estaji","suffix":""},{"id":201720116,"identity":"a142fd27-5ea0-423c-9221-ed83575963a6","order_by":4,"name":"Shahriar Shahidi","email":"","orcid":"","institution":"Shahid Beheshti University","correspondingAuthor":false,"prefix":"","firstName":"Shahriar","middleName":"","lastName":"Shahidi","suffix":""}],"badges":[],"createdAt":"2023-05-11 15:29:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2920840/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2920840/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-023-48099-0","type":"published","date":"2023-12-07T15:01:39+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":37330874,"identity":"b436d82e-88bd-4d97-a6c4-0516af3ac930","added_by":"auto","created_at":"2023-05-22 15:06:53","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":188973,"visible":true,"origin":"","legend":"\u003cp\u003eUnnumbered image in the Result section.\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-2920840/v1/27887487482d8180f9a01ba7.jpeg"},{"id":47989874,"identity":"17ed0175-27a1-4187-801e-15129b1ec87b","added_by":"auto","created_at":"2023-12-11 15:10:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":319560,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2920840/v1/4f8e7329-de58-44bb-bd0e-f0ad3b16201b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Getting Closer or Keeping Distance? The Role of Prefrontal Cortex and Temporoparietal Junction in Interpersonal Comfort and Emotional Approach","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSocial cognition is the ability to understand and navigate social interactions based on representations of the self and others (Adolphs, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2001\u003c/span\u003e). These two components, self and other, are essential for social cognition (Nejati et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Most of our social processing involves these components and their interaction, including self-referential processing, theory of mind, in-group/out-group categorization, interpersonal relationships, and empathy. Although the interaction and interdependence of self and other are crucial for normal social processing, it is equally important to distinguish between these two components as an integral part of this interaction. Self-other discrimination (SOD) refers to the ability to determine the boundary of self against other at both physical and conceptual/mental levels. This distinction has been described as a prerequisite of higher social cognitive functions such as empathy (Bird \u0026amp; Viding, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Decety \u0026amp; Lamm, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) and theory of mind (Steinbeis, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe SOD concept pertains to the demarcation and differentiation of self and others. Studies have shown that romantic relationships often involve blurred self and other boundaries and decreased interpersonal distance. (Quintard et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2020\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), described in the metaphorical expression of \u0026ldquo;we are one\u0026rdquo;. Beyond this extreme integration, interpersonal distance serves as a social signal for approach/avoidance in our social interaction (Lloyd, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). Different comfortable interpersonal distance has been described as a hallmark of different personalities (Abdevali et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Humphrey et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), attachment styles (Kaitz et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Yukawa et al., \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2007\u003c/span\u003e), and psychopathologies (Duke \u0026amp; Mullens, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e1973\u003c/span\u003e; Haim-Nachum et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; L\u0026uuml;\u0026ouml;nd et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Interpersonal distance has the potential to reveal our emotional and mental attitudes towards others. Apart from our own emotional states, the emotions that we perceive in others are also crucial in determining our approach and avoidance behaviors. Typically, psychologically sound individuals tend to favor positive self-referential processing. (Auerbach et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Burrows et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), a preference that may protect against internalizing disorders such as depression (Goldstein et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAt the neural level, several cortical areas have been described as the neural structures of self-other discrimination. Neuroimaging studies found the role of the right superior marginal gyrus (SMG), as a part of the right temporo-parietal junction (TPJ), in self-other distinction (Bukowski et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Uddin et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). The posterior portion of the right TPJ involves in non-affective self-other distinction (Blanke et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Farrer et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). Furthermore, the ventromedial prefrontal cortex (vmPFC) is involved in both self and other perception (Heatherton, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). While the vmPFC is involved in both self and other perception and shows some overlap in the brain structure, the area responsible for self-perception tends to be located more ventrally, whereas the other-related area is typically more dorsal (Heatherton, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Mitchell et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2005\u003c/span\u003e). Sui and Humphreys (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) in an fMRI study described the activation of the vmPFC in the processing of self-related stimuli, while the dlPFC activated in the processing of the stranger-related stimuli. Humphreys and Sui (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) propose a self-attention network in which the vmPFC is a self-representation core, which is controlled by the dlPFC through a top-down control.\u003c/p\u003e \u003cp\u003eBeyond correlational neuroimaging studies, non-invasive brain stimulation (NIBS) studies found causal association between these cortical areas and self-other distinction. Transcranial magnetic stimulation (TMS) found the role of the right SMG (Bukowski et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Silani et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) and the vmPFC (Wittmann et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) in self-other distinction. Transcranial direct current stimulation (tDCS) also described the role of the right TPJ and the vmPFC in self-other discrimination. For instance, anodal right TPJ stimulation improved self-other representations (Payne \u0026amp; Tsakiris, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Santiesteban et al., \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Anodal vmPFC stimulation improves social framing (Chen et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), self-referential processing (Mohammad Ali Salehinejad et al., \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), and altruistic behaviors (Zheng et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Several tDCS studies found that the vmPFC as a part of off-task/default mode network (DMN) work in concert with the dorsolateral prefrontal cortex (dlPFC) as the hub of on-task/central executive network (CEN) in several social/emotional processing, including emotional processing (Vahid Nejati et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), self-referential processing (Mohammad Ali Salehinejad et al., \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), and emotion regulation (M.A. Salehinejad et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). However, a HD-tDCS study found a null effect of the dlPFC and the vmPFC in prioritization effects for self, friend, and stranger (Mart\u0026iacute;nez-P\u0026eacute;rez et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the present study, we hypothesized the role of right TPJ, the vmPFC, and the dlPFC in self-other discrimination. We aimed to investigate the role of these cortical areas in comfortable interpersonal space and approach/avoidance to emotional faces as two indicators of self-other discrimination.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cb\u003eParticipants\u003c/b\u003e. The study recruited twenty healthy adults (11 females) aged between 27\u0026ndash;45 years, with an average age of 37.30\u0026thinsp;\u0026plusmn;\u0026thinsp;5.47 years. All participants were right-handed and had normal or corrected-to-normal vision, with no history of head trauma, drug addiction, or psychiatric or neurological disorders. The research was conducted in compliance with the ethical standards outlined in the Helsinki Declaration of 1975, as revised in 2013, and was approved by the national ethical committee (Ethics Code: IR.SBU.REC.1401.106).\u003c/p\u003e \u003cp\u003e \u003cb\u003eComfortable interpersonal distance task (CIDT).\u003c/b\u003e This task was used to measure the preferred interpersonal distance (Duke \u0026amp; Mullens, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e1973\u003c/span\u003e). This task measures the optimal physical distance between oneself and others, and involves participants imagining themselves in a room with a circle drawn on paper. An imaginary person enters the room from one of the eight doors on the circle's periphery, and participants indicate the point on the paper where they would allow the person to approach. The test has been found to be valid and reliable in various cultures and correlates with optimal interpersonal distances in real-life interactions (Abdevali et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). In this study, in a computerized version of the task, we used three types of avatars representing self, mother, and president.\u003c/p\u003e \u003cp\u003e \u003cb\u003eApproach avoidance task (AAT).\u003c/b\u003e This task was used to discover the proper distance with emotional material (Gable \u0026amp; Harmon-Jones, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). This task involves presenting an emotional stimulus on a screen that moves towards or away from the viewer, allowing the viewer to control its distance by pressing the space bar to stop its movement at a comfortable distance. In this study, we used 100 emotional faces, happy, sad, angry, disgust and neutral faces, equally. The faces were selected from the Nimstim set of facial expressions (Tottenham et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). Stimuli of all tasks were presented on a laptop with a 15.2\u0026rdquo; screen at a viewing distance of approximately 50 cm. The task took around 5 minutes to perform.\u003c/p\u003e \u003cp\u003e \u003cb\u003etDCS protocol.\u003c/b\u003e ActivaDose stimulator (ActivaTek Inc., USA) was used to deliver the stimulation. The stimulator produced an electrical direct current of 2 mA, which was applied for 20 minutes through a pair of saline-soaked sponge electrodes measuring 25 cm2 (5x5). The current was ramped up over a period of 30 seconds and down over a period of 30 seconds. The tDCS protocol involved four sessions, spaced one week apart, with the electrodes positioned according to the 10\u0026ndash;20 EEG international system. The four conditions were: (1) anodal dlPFC (F3), (2) anodal vmPFC (FPZ), (3) anodal rTPJ (TP6), and (4) sham stimulation. For the sham condition, the placement of the electrodes was randomly selected from one of the real conditions. The return electrode was placed on the contralateral shoulder in all conditions.\u003c/p\u003e \u003cp\u003e\u003cb\u003eProcedure\u003c/b\u003e. Once the inclusion criteria were verified, and informed consent was obtained, the tasks and procedures were explained to the participants by AM. Then, in a single-blinded design, the stimulation was applied randomly and in a counterbalanced order. After five minutes of stimulation, the participants performed the AAT and ICD tasks in a random order, which took approximately 15 minutes. Following each session, the participants completed a side effect checklist (Brunoni et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) and were asked to guess whether they received real or sham stimulation.\u003c/p\u003e \u003cp\u003e \u003cb\u003eData analysis.\u003c/b\u003e We used the statistical package SPSS for Windows to analyze the data. The normality and sphericity assumptions were confirmed based on the results of the Shapiro-Wilk and Mauchly's tests. We conducted a 2\u0026times;4 repeated measures analysis of variance (ANOVA) with emotional state in AAT (happy, neutral, sad, angry, and disgusted) or avatar (self, mother, and president) and tDCS conditions (four conditions) as the within-subject factors, and the pixel of comfortable distance as the dependent variable. We conducted Mauchly's test to check the sphericity of the data, and we used the Greenhouse-Geisser method to correct the degrees of freedom if necessary. Post hoc analyses were conducted using Fisher's Least Significant Difference (LSD) test. Additionally, we integrated session order and task order as covariates in an ANCOVA. We applied a significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;.05 for all statistical comparisons.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe participants exhibited good tolerance to the stimulation with minimal side effects. Table 2 displays the means and standard deviations of the different side effects across the stimulation conditions. The results of one-way ANOVAs indicated that there were no significant differences between the conditions for most of the side effects, except for burning (F1.93= 6.15, p= .05, \u0026eta;p2= .24) and tingling (F2.11= 3.65, p= .03, \u0026eta;p2= .16), Table 1. Post hoc LSD analysis revealed that during tDCS over dlPFC, vmPFC, and rTPJ, participants experienced higher levels of burning compared to sham stimulation (MD= .75, p \u0026lt;.001; MD= .55, p= .02; MD= .90, p \u0026lt;.001 respectively). Furthermore, the participants reported higher levels of tingling during stimulation of dlPFC (MD= .70, p= .03) and rTPJ (MD= .80, p \u0026lt;.001) relative to the sham condition. Guesses of real stimulation for vmPFC, dlPFC, rTPJ, and sham stimulation were 75%, 60%, 50%, and 40%, respectively (\u0026chi;2(1) = 2.86, p= .09)\u003c/p\u003e\n\u003cp\u003eTable 1. Side effects of tDCS (means and sd) in the different stimulation conditions and the results of the respective ANOVAs.\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMeasures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eConditions, M(SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cu\u003e\u0026nbsp;\u003c/u\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cu\u003e\u0026nbsp;\u003c/u\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eStatistics\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003edl\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003evm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003erTPJ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSham\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003edf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026eta;p2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePain\u003c/p\u003e\n \u003cp\u003eVertigo\u003c/p\u003e\n \u003cp\u003eBurning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.05 (.22)\u003c/p\u003e\n \u003cp\u003e.00 (.00)\u003c/p\u003e\n \u003cp\u003e.75 (.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.05 (.22)\u003c/p\u003e\n \u003cp\u003e.05 (.22)\u003c/p\u003e\n \u003cp\u003e.55 (.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.00 (.00)\u003c/p\u003e\n \u003cp\u003e.00 (.00)\u003c/p\u003e\n \u003cp\u003e.90 (.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.25 (.44)\u003c/p\u003e\n \u003cp\u003e.00 (.00)\u003c/p\u003e\n \u003cp\u003e.00 (.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.74\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e1.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.12\u003c/p\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003cp\u003e6.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.06\u003c/p\u003e\n \u003cp\u003e.40\u003c/p\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.14\u003c/p\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003cp\u003e.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTingling\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.80 (1.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.45 (.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.90 (.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.10 (.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eConfusion\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.05 (.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.20 (.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.10 (.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.15 (.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDrowsiness\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.25 (.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.55 (.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.80 (1.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.70 (1.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviations: M: mean, SD: standard deviation, dl: dorsolateral prefrontal cortex, vm: ventromedial prefrontal cortex, rTPJ: right tempro-parietal junction. df: degrees of freedom, F; F-value, P: P-value, \u0026eta;p2: partial eta squared\u003c/p\u003e\n\u003cp\u003eTable 2. Mean and standard deviation of measurements in different stimulation conditions\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMeasures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003edl/vm\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003evm/dl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003erTPJ\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSham\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCIDT\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSelf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34.69 (34.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.99 (28.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.74 (35.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34.34 (25.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e73.14 (53.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e62.40 (46.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92.66 (57.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e67.28 (6.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePresident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e154.02 (81.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e171.65 (71.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e199.06 (74.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e178.34 (85.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e87.28 (43.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88.35 (34.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.82 (37.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e93.32 (43.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAAT\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHappy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.24 (11.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e61.02 (15.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.05 (13.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37.66 (8.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNeutral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e43.35 (11.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e52.89 (16.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44.19 (11.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45.34 (12.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSad\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32.04 (8.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.96 (13.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31.02 (1.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.85 (14.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAngry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27.22 (8.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36.82 (15.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26.06 (1.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.45 (1.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDisgusted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.15 (6.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32.36 (9.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.53 (8.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27.53 (8.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35.60 (6.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44.81 (12.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35.37 (9.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e93.32 (43.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviations: CIDT: comfortable interpersonal distance task, AAT: approach avoidance task, M: mean, SD: standard deviation, dl: dorsolateral prefrontal cortex, vm: ventromedial prefrontal cortex, rTPJ: right tempro-parietal junction.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3. The result of two factorial ANOVA on the study measures\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"bottom\"\u003e\n \u003cp\u003eStimulation Effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eAvatar/Emotion Effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eStimulation * Avatar/Emotion\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003edf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026eta;p2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003edf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026eta;p2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003edf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026eta;p2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCIDT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e6.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e48.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAAT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e7.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e5.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviations: CIDT: comfortable interpersonal distance task, AAT: approach avoidance task, dl: dorsolateral prefrontal cortex, vm: ventromedial prefrontal cortex, rTPJ: right tempro-parietal junction. df: degrees of freedom, F; F-value, P: P-value, \u0026eta;p2: partial eta squared.\u003c/p\u003e\n\u003cp\u003eFor the CID task, the ANOVA revealed a significant main effect of tDCS conditions (F\u003csub\u003e3\u003c/sub\u003e= 6.94, p \u0026lt;.001, \u0026eta;p2 = .26). Additionally, significant main effects were found for avatar identity (F\u003csub\u003e2\u003c/sub\u003e = 48.45, p \u0026lt;.001, \u0026eta;p2 = .71) and the interaction between stimulation and avatar (F\u003csub\u003e3.26\u003c/sub\u003e = 2.71, p = .04, \u0026eta;p2 = .12). The LSD post hoc analysis showed that during rTPJ stimulation, participants kept avatar images at a greater distance compared to dlPFC (MD (mean difference) = 23.53, p = .001), vmPFC (MD= 22.47, p = .001), and sham (MD= 17.49, p = .004) stimulation. For avatar stimuli, participants tended to keep the \u0026quot;president\u0026quot; stimuli at a further distance than the \u0026quot;self\u0026quot; (MD= 14.57, p \u0026lt;.001) and \u0026quot;mother\u0026quot; (MD= 101.89, p \u0026lt;.001) conditions. Furthermore, the \u0026quot;mother\u0026quot; stimuli were kept at a longer distance than the \u0026quot;self\u0026quot; stimuli (MD = 38.68, p = .002). The post hoc analysis of the interaction showed that during \u0026quot;mother\u0026quot; trials, distance scores were higher during rTPJ stimulation compared to dlPFC (MD = 19.51, p = .01), vmPFC (MD = 3.25, p = .001), and sham (MD= 25.37, p = .003) conditions. For \u0026quot;president\u0026quot; stimuli, larger distances were recorded under rTPJ stimulation compared to dlPFC (MD = 45.04, p = .004), vmPFC (MD = 27.41, p = .003), and sham (MD = 2.72, p = .01) stimulation, Table 2 and 3.\u003c/p\u003e\n\u003cp\u003eFor the AAT, the ANOVA results revealed a significant main effect of stimulation conditions (F\u003csub\u003e3\u003c/sub\u003e= 7.21, p \u0026lt; .001, \u0026eta;p2 = .27) and a significant main effect of emotion (F\u003csub\u003e1.94\u003c/sub\u003e= 5.92, p \u0026lt; .001, \u0026eta;p2 = .72). However, there was a non-significant interaction of stimulation and emotion (F5.19 = .99, p = .42, \u0026eta;p2 = .50). Post-hoc analyses were performed using LSD to examine pairwise comparisons between tDCS conditions. The results showed that anodal vmPFC led participants to magnify emotional images more and keep them in a smaller distance than dlPFC (MD = 9.21, p = .003), rTPJ (MD = 9.44, p = .004), and sham (MD = 7.15, p = .005) stimulation. Furthermore, the LSD results indicated that participants tended to make emotional faces bigger in a descending order during happy, neutral, sad, angry, and disgusted trials. Specifically, there were significant differences between happy and sad (MD = 18.49, p \u0026lt; .001), happy and angry (MD = 22.90, p \u0026lt; .001), happy and disgusted (MD = 25.39, p \u0026lt; .001), happy and neutral (MD = 6.59, p = .01), neutral and sad (MD = 11.90, p \u0026lt; .001), neutral and angry (MD = 16.31, p \u0026lt; .001), neutral and disgusted (MD = 18.80, p \u0026lt; .001), sad and angry (MD = 4.40, p \u0026lt; .001), sad and disgusted (MD = 6.89, p \u0026lt; .001), and angry and disgusted (MD= 2.49, p= .01), Table 2 and 3.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, our objective was to evaluate the effects of stimulating three brain regions - the dlPFC, the vmPFC, and the rTPJ - on self-other discrimination and approach/avoidance behavior in response to emotional states. Our findings indicate that anodal stimulation of the rTPJ has a significant impact on self-other distance, while anodal stimulation of the vmPFC increases approach behavior towards positive emotional stimuli. Additionally, we found that the identity of the moving avatar had a significant impact on the effectiveness of anodal rTPJ stimulation, regardless of whether the avatar represented a significant or non-significant other, a mother, or a president. The interaction between emotional states and stimulation montages, however, was not significant, suggesting that the vmPFC plays a valence-insensitive role in emotional processing. In the following section, we will discuss the results in the context of previous brain stimulation studies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIncreased interpersonal comfortable distance.\u003c/strong\u003e The results suggest a longer interpersonal comfortable distance to mother and president, and not the self, during anodal rTPJ stimulation compared to all other conditions. Earlier tDCS studies found improved self-other discrimination during anodal right rTPJ stimulation using video-morphing task\u0026nbsp;(Payne \u0026amp; Tsakiris, 2017), perspective taking task\u0026nbsp;(Santiesteban et al., 2012).\u0026nbsp;Uddin et al. (2006)\u0026nbsp;observed that applying rTMS to the right inferior parietal lobule (IPL), which is part of the temporoparietal area, resulted in a disturbance in the capacity to differentiate one\u0026apos;s own face from that of another. Neuroimaging studies have revealed that the rTPJ plays a key role in various complex social cognitive functions such as theory of mind\u0026nbsp;(Frith \u0026amp; Frith, 2006), empathy\u0026nbsp;(Schaefer et al., 2021), and perspective taking\u0026nbsp;(Perner et al., 2006; Santiesteban et al., 2017). Interestingly, these complex social-cognitive functions also involve basic self-other processing. The areas of the brain responsible for self-other processing overlap with those associated with complex social-cognitive functions and include the rTPJ\u0026nbsp;(Decety \u0026amp; Lamm, 2007).\u003c/p\u003e\n\u003cp\u003eIn the present study, the distance of self and other was greater during anodal rTPJ, indicating an egocentric role of the rTPJ. A tDCS study found anodal rTPJ increase self-effacing attributions, refers to downplay the self-role in positive outcomes instead of external factors\u0026nbsp;(Takano \u0026amp; Nomura, 2019).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSimilarly, several tDCS studies found anodal rTPJ stimulation did not improve ToM functioning in healthy adults\u0026nbsp;(Martin et al., 2017; Santiesteban et al., 2015)\u0026nbsp;However, one study did observe a decrease in ToM accuracy following cathodal stimulation of the rTPJ\u0026nbsp;(Mai et al., 2016). It seems the rTPJ plays a perceptual/physical role in social cognition, including theory of mind, refers to the ability to mentally rotate into an allocentric viewpoint, known as perspective taking, is considered a prerequisite for ToM\u0026nbsp;(Pearson et al., 2013). This role of the rTPJ in lower-order, but not higher order, social processing has been described earlier\u0026nbsp;(Martin et al., 2019).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe interaction between stimulation and avatar identity revealed the role of the vmPFC for increase the interpersonal comfortable distance for the president and mother avatars, but not the self-avatar. This result could be interpreted as reflecting the different demands of the task for the self-avatar versus the other avatars. Given the self-fixed avatar in the center of the room, when the other avatar enters the room, both the self-fixed avatar and the moving-other avatar should be imagined as two physically separate avatars. However, when the entering avatar is the self-avatar, the self-fixed avatar in the center and the moving self-avatar have an identical physical identity, which should be imagined as two separate mental identities. This mentalization makes the task more demanding and diminishes the role of the rTPJ.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIncreased approach to emotional stimuli\u003c/strong\u003e. Independent of the emotional expressions, anodal vmPFC increased approach to emotional stimuli. \u0026nbsp;Earlier tDCS studies found application of anodal tDCS over the vmPFC with an extracranial reference electrode increased attention bias to happy faces or scenes, while cathodal tDCS decreased this bias (Winker et al., 2019). Another tDCS study described an attenuation of anger and aggression during anodal vmPFC stimulation using anger-infused ultimatum game in healthy participants (Gilam et al., 2018). Moreover, anodal vmPFC stimulation with extracranial reference electrode enhanced pleasant scene processing in healthy participants (Junghofer et al., 2017). These results are in further accordance with evidence from neuroimaging studies showing that the vmPFC downregulates emotionally negative responses of the amygdala (Blair, 2008; Motzkin et al., 2015). Regardless of the montage used, individuals tend to respond more to positive facial expressions than negative ones. In the present study, we did not observe any significant interaction between expressions and stimulation. This result can be explained by the role of the ventromedial prefrontal cortex (vmPFC) in emotional processing. An earlier tDCS study in healthy participants showed that the vmPFC plays a role in arousal, but not valence, of emotional stimuli (Vahid Nejati et al., 2021).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHowever,\u0026nbsp;Iarrobino et al. (2021)\u0026nbsp; conducted a crossover study using anodal stimulation on the right and left vmPFC, with an extracranial return electrode, and found that discrimination of angry faces increased with left-sided stimulation, while discrimination of sad faces decreased with right-sided stimulation in healthy individuals. This study used an explicit emotion recognition task, which is relatively different from the approach-avoidance test used as an implicit task in the current study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitation and future direction.\u003c/strong\u003e There are certain limitations to this study that need to be considered. Firstly, the study had a single-session design to explore the role stimulation of some target areas in self-other discrimination and approach, which may limit the ability to draw a conclusion about the clinical relevance of the intervention. Furthermore, we target the dlPFC, vmPFC and rTPJ as involved area in self-other discrimination. However, the involves brain areas in self-other perception and discrimination are not limited to these areas. Secondly, the sample size of this pilot study was moderate and the design was single-blind. For future studies, a larger sample size and a double-blind design should be implemented to improve the rigor of the design. Furthermore, future studies should include physiological markers to understand the underlying mechanisms of the observed cognitive effects and titrate the intervention dosage according to intensity and duration for personalized intervention approaches.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study revealed that the rTPJ plays a critical role in self-other discrimination, particularly in situations where the moving avatar represented mother or president, and not for the hypothetical self. These results suggest that the rTPJ has a spatial/physical, rather than conceptual/mental, role in social cognition. On the other hand, the study revealed that anodal stimulation of the vmPFC increases approach behavior towards positive emotional stimuli, indicating its involvement in emotional component of approaching. In summary, the vmPFC can be considered the emotional component of self-referential processing, while the rTPJ plays a perceptual role in self-other distinction.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eV.N.: Conceptualization, writing, and supervision, A.M.: Data gathering, AZ and RE: Data analysis and visualization, S.S.: Methodology\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAbdevali, M., Mazaheri, M. A., Besharat, M. A., Zabihzadeh, A., \u0026amp; Green, J. D. (2021). 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Modulating the activity of ventromedial prefrontal cortex by anodal tDCS enhances the trustee\u0026rsquo;s repayment through altruism. \u003cem\u003eFrontiers in Psychology\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e, 1437.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"
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