Intracranial Recordings in Epilepsy: an Approach to Understanding the Neural Mechanisms of Social Cognition

Abstract

Purpose of review: Social cognition, especially theory of mind (ToM), is often impaired in clinical populations including epilepsy, with serious consequences for quality of life. This review synthesizes evidence from clinical assessments, neuroimaging, and intracranial recording techniques to examine how social cognitive processes are represented in the human brain and how they may be disrupted in epilepsy. Emphasis is placed on the emerging contributions of intracranial electroencephalography (iEEG) and intracranial electrical stimulation (iES) to this field.

Recent findings: While the literature using iEEG/iES to investigate social cognition remains limited, recent studies have begun to map the spatiotemporal and causal underpinnings of ToM and related functions. This work complements behavioral and fMRI findings and suggests avenues for translational research. Intracranial techniques represent a promising tool for advancing social cognitive neuroscience. Integrating this approach with clinical data and established behavioral paradigms can enhance our understanding of social cognition and improve care for populations with focal epilepsy.

Keywords: Brain mapping; Direct electrical stimulation; Epilepsy; Intracranial EEG; Social cognition; Theory of mind.

Fig. 1

Schematic of social levels, Social brain networks enable social cognition & behavior, ultimately influencing social functioning. Figure based on Kennedy & Adolphs (2012) & created in BioRender.com

Fig. 2

Number of publications in PubMed using the terms: "iEEG", "intracranial electroencephalography", "sEEG", "stereoelectroencephalography", "ECoG", "electroencephalography", "iES", "intracranial electrical stimulation", "DES", or "direct electrical stimulation"