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> お前は寂しくないのかよ

It sounds kind of rough, so I suppose it is a masculine alternative of
something else. Also, it does not really sound as a question intonation-wise
compared to this following sentence.

> お前は寂しくない?

How does this question differ in nuance?
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question
sentence-final-particles
How is “のかよ” used in this question?
It's a question marker か followed by a sentence-final particle よ. This
combination does sound masculine, like an informal conversation between two
young male friends, but it's used also by young female speakers in slangy
speech.

明鏡国語辞典 defines this as follows:

> ### よ
>
> ❸《疑問の語や質問の文に付いて》質問・反問に **詰問・反駁** の意を添える。
> 「こんなことしたの誰だよ」「一体何考えてるのよ」「おまえなんかにできるかよ」「そんなこと言えた義理かよ」
>
> 【使い方】
> 常体に使うのが普通で、「誰が行きますかよぅ」などと敬体に使うと、皮肉な調子が出る。「誰だよ」「できるかよ」など、「だよ」「かよ」の形は女性にはあまり使われない。

So basically this type of よ adds a nuance of rebuttal, accusation or
irritation. The closest equivalent in English I can think of would be "come
on" as in "Come on, are you serious?"

かよ can form both a genuine question and a rhetorical question, and お前は寂しくないのかよ
is not a rhetorical question. As compared to お前は寂しくないの(か), it sounds like the
speaker is dubious and serious. Note that this is not necessarily rude as long
as it's used appropriately between friends. Also note that よ outside questions
are totally different.
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answer