The role of medial prefrontal cortex in theory of mind: a deep rTMS study

Neuroimaging studies suggest that the medial prefrontal cortex (mPFC) plays a central role in cognitive theory of mind (ToM). This can be assessed more definitively, however, using repetitive transcranial magnetic stimulation (rTMS). Sixteen healthy participants (10 females, 6 males) completed tasks assessing cognitive and affective ToM following low-frequency deep rTMS to bilateral mPFC in active-stimulation and placebo-stimulation sessions. There was no effect of deep rTMS on either cognitive or affective ToM performance. When examining self-reported empathy, however, there was evidence for a double dissociation: deep rTMS disrupted affective ToM performance for those with high self-reported empathy, but improved affective ToM performance for those with low self-reported empathy. mPFC appears to play a role in affective ToM processing, but the present study suggest that stimulation outcomes are dependent on baseline empathic abilities.