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Review
. 2025 Jun 28;25(1):44.
doi: 10.1007/s11910-025-01431-9.

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

Kaitlyn E Davis  1   2 , Rajesh K Kana  3 , Jerzy P Szaflarski  4
Affiliations
Review

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

Kaitlyn E Davis et al. Curr Neurol Neurosci Rep. .

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.

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Conflict of interest statement

Declarations. Human and Animal Rights: This article does not contain any studies with human or animal subjects performed by any of the authors. Competing Interests: K.D. and R.K. have no competing interest. J.S. discloses the following: Funding: NIH, NSF, DoD, Shor Foundation for Epilepsy Research, UCB Biosciences, NeuroPace Inc., SAGE Therapeutics Inc., Serina Therapeutics Inc., LivaNova Inc., Greenwich Biosciences Inc., Biogen Inc., Eisai Inc., State of AL Consulting/Advisory Boards: PureTech Health, Biopharmaceutical Research Company, LivaNova Inc., UCB Pharma, AdCel Pharma, iFovea Inc. Editor-in-Chief, Epilepsy & Behavior Reports (paid) Editorial board member for Epilepsy & Behavior, Journal of Epileptology (associate editor), Journal of Medical Science, and Folia Medica Copernicana. Dr. Szaflarski has served on the Alabama Medical Cannabis Commission (2021–2024; nominated by Dr. Scott Harris, State Health Officer).

Figures

Fig. 1
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
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"
See this image and copyright information in PMC

References

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