Social exclusion refers to the experience of rejection by one or more people during a social event and can induce pain-related sensations. Cyberball, a computer program, is one of the most common tools for analyzing social exclusion. Regions of the brain that underlie social pain include networks linked to the dorsal lateral prefrontal cortex (DLPFC). Specifically, self-directed negative socially induced exclusion is associated with changes in DLPFC activity. Direct manipulation of this area may provide a better understanding of how the DLPFC can influence the perception of social exclusion and determine a causal role of the DLPFC. Transcranial magnetic stimulation (TMS) was applied to both the left and right DLPFC to gauge different reactions to the Cyberball experience. It was found that there were elevated exclusion indices following right DLPFC rTMS; participants consistently felt more excluded when the right DLPFC was excited. This may relate to greater feelings of social pain when the right DLPFC is manipulated. These data demonstrate that direct manipulation of the DLPFC results in changes in responses to social exclusion.

In the past decade, the functional role of the TPJ (Temporal Parietal Junction) has become more evident in terms of its contribution to social cognition. Studies have revealed the TPJ as a ‘distinguisher’ of self and other with research focused on non-clinical populations as well as in individuals with Autism and Type I Schizophrenia. Further research has focused on the integration of self-other distinctions with proprioception. Much of what we now know about the causal role of the right TPJ derives from TMS (Transcranial Magnetic Stimulation), rTMS repetitive Transcranial Magnetic Stimulation), and tDCS (transcranial Direct Cortical Stimulation). In this review, we focus on the role of the right TPJ as a moderator of self, which is integrated and distinct from ‘other’ and how brain stimulation has established the causal relationship between the underlying cortex and agency.

While the desire to uncover the neural correlates of consciousness has taken numerous directions, self-face recognition has been a constant in attempts to isolate aspects of self-awareness. The neuroimaging revolution of the 1990s brought about systematic attempts to isolate the underlying neural basis of self-face recognition. These studies, including some of the first fMRI (functional magnetic resonance imaging) examinations, revealed a right-hemisphere bias for self-face recognition in a diverse set of regions including the insula, the dorsal frontal lobe, the temporal parietal junction, and the medial temporal cortex. In this systematic review, we provide confirmation of these data (which are correlational) which were provided by TMS (transcranial magnetic stimulation) and patients in which direct inhibition or ablation of right-hemisphere regions leads to a disruption or absence of self-face recognition. These data are consistent with a number of theories including a right-hemisphere dominance for self-awareness and/or a right-hemisphere specialization for identifying significant social relationships, including to oneself.

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