Scalp EEG predicts intracranial brain activity in humans

Inferring deep brain activity from noninvasive scalp recordings remains a fundamental challenge in neuroscience. Here, we analyzed concurrent scalp and intracranial recordings from 1918 electrode contacts across 20 patients affected by drug-resistant epilepsy undergoing intracranial depth electrode monitoring for pre-surgical evaluation to establish predictive relationships between surface and deep brain signals. Using regularized and cross-validated linear regression within subjects, we demonstrate that scalp recordings can predict spontaneous intracranial activity, with accuracy varying by region, depth, and frequency. Low-frequency signals (<12 Hz) were most predictable, with our models explaining approximately 10% of intracranial signal variance across contacts. Prediction accuracy decreased with contact depth, particularly for high-frequency signals. Using Bayesian modeling with leave-one-patient-out cross-validation, we observed generalizable prediction of activity in mesial temporal, prefrontal, and orbitofrontal cortices, explaining 10-12% of low-frequency signal variance. This scalp-to-intracranial mapping derived from spontaneous activity was further validated by its correlation with scalp responses evoked by direct electrical stimulation. These findings support the development of improved inverse models of brain activity and potentially more accurate scalp-based markers of disease and treatment response.