Interpersonal neural synchrony and mental disorders: unlocking potential pathways for clinical interventions

Frontiers in Neuroscience, vol. 18, pp. 1286130

Abstract

Introduction: Interpersonal synchronization involves the alignment of behavioral, affective, physiological, and brain states during social interactions. It facilitates empathy, emotion regulation, and prosocial commitment. Mental disorders characterized by social interaction dysfunction, such as Autism Spectrum Disorder (ASD), Reactive Attachment Disorder (RAD), and Social Anxiety Disorder (SAD), often exhibit atypical synchronization with others across multiple levels. With the introduction of the "second-person" neuroscience perspective, our understanding of interpersonal neural synchronization (INS) has improved, however, so far, it has hardly impacted the development of novel therapeutic interventions. Methods: To evaluate the potential of INS-based treatments for mental disorders, we performed two systematic literature searches identifying studies that directly target INS through neurofeedback (12 publications; 9 independent studies) or brain stimulation techniques (7 studies), following PRISMA guidelines. In addition, we narratively review indirect INS manipulations through behavioral, biofeedback, or hormonal interventions. We discuss the potential of such treatments for ASD, RAD, and SAD and using a systematic database search assess the acceptability of neurofeedback (4 studies) and neurostimulation (4 studies) in patients with social dysfunction. Results: Although behavioral approaches, such as engaging in eye contact or cooperative actions, have been shown to be associated with increased INS, little is known about potential long-term consequences of such interventions. Few proof-of-concept studies have utilized brain stimulation techniques, like transcranial direct current stimulation or INS-based neurofeedback, showing feasibility and preliminary evidence that such interventions can boost behavioral synchrony and social connectedness. Yet, optimal brain stimulation protocols and neurofeedback parameters are still undefined. For ASD, RAD, or SAD, so far no randomized controlled trial has proven the efficacy of direct INS-based intervention techniques, although in general brain stimulation and neurofeedback methods seem to be well accepted in these patient groups. Discussion: Significant work remains to translate INS-based manipulations into effective treatments for social interaction disorders. Future research should focus on mechanistic insights into INS, technological advancements, and rigorous design standards. Furthermore, it will be key to compare interventions directly targeting INS to those targeting other modalities of synchrony as well as to define optimal target dyads and target synchrony states in clinical interventions.

Authors 11

1. Kerstin Konrad corresponding Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

   Forschungszentrum Jülich · Universitätsklinikum Aachen · Jülich Aachen Research Alliance · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany

   JARA Brain Institute II, Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany

2. Christian Gerloff Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

   Forschungszentrum Jülich · University of Cambridge · Universitätsklinikum Aachen · Jülich Aachen Research Alliance · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany

   Department of Applied Mathematics and Theoretical Physics, Cambridge Centre for Data-Driven Discovery, University of Cambridge, Cambridge, United Kingdom

   JARA Brain Institute II, Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany

3. Simon H. Kohl Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

   Forschungszentrum Jülich · Universitätsklinikum Aachen · Jülich Aachen Research Alliance · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany

   JARA Brain Institute II, Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany

4. David M. A. Mehler Aachen Department of Psychiatry, Psychotherapy and Psychosomatics Medical School

   University of Münster · Cardiff University · RWTH Aachen University

   Affiliation as printed

   Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany

   Institute for Translational Psychiatry, University of Münster, Münster, Germany

   School of Psychology, Cardiff University Brain Research Imaging Center (CUBRIC), Cardiff University, Cardiff, United Kingdom

5. Lena Mehlem Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany

6. Emily L. Volbert Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany

7. Maike Komorek Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany

8. Alina T. Henn Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany

9. Maren Boecker Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry Institute of Medical Psychology and Medical Sociology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany

   Institute of Medical Psychology and Medical Sociology, University Hospital RWTH, Aachen, Germany

10. Eileen Oberwelland Weiß Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry Institute of Medical Psychology and Medical Sociology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany

    Institute of Medical Psychology and Medical Sociology, University Hospital RWTH, Aachen, Germany

11. Vanessa Reindl Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

    Nanyang Technological University · Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany

    Department of Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore