Cerebellar non-invasive stimulation of social and emotional mentalizing: A meta-analysis

The present meta-analysis investigated the impact of non-invasive stimulation, using transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) targeting the posterior cerebellum, on social and emotional mentalizing about others. Prior research has convincingly shown that the posterior cerebellum supports social and emotional cognition. We identified 14 studies targeting the cerebellum with appropriate control conditions (i.e., sham, control site), which exclude general learning effects of the task or placebo effects. The studies included 29 task conditions where stimulation before or during a social or emotional task was applied on healthy samples. The results showed significant evidence that sustained anodal tDCS and TMS generally improved social and emotional performance after stimulation, in comparison with sham or control conditions, with a small effect size. In contrast, cathodal stimulation showed mixed facilitatory and inhibitory results. In addition, short TMS pulses, administered with the aim of interfering with ongoing social or emotional processes, induced a small but consistent inhibitory effect. Control tasks without social or emotional components also showed significant improvement after sustained anodal tDCS and TMS, suggesting that transcranial stimulation of the cerebellum may also improve other functions. This was not the case for short TMS pulses, which did not modulate non-social and non-emotional control tasks. Taken together, this meta-analysis shows that cerebellar neurostimulation confirms a causal role of the cerebellum in socio-emotional cognition, has a small but significant effect on improving socio-emotional skills, and may, therefore, have important clinical applications in pathologies where social and emotional cognition is impaired.