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Direct cortical stimulation-evoked symptoms in the human temporal pole: a cohort study
Yulia Novitskaya1, Andreas Schulze-Bonhage1
1Epilepsy Center, Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, Freiburg 79106, Germany.
Clinical Neurophysiology Practice
|June 8, 2026
Summary
Direct cortical stimulation (DCS) of the temporal pole in epilepsy patients causes varied symptoms. Cognitive, emotional, and visceral responses were more likely to match seizure types, limiting DCS
Area of Science:
- Neuroscience
- Epileptology
- Neurosurgery
Background:
- The temporal pole is implicated in temporolimbic networks and epilepsy.
- Direct cortical stimulation (DCS) offers insights into functional organization during epilepsy surgery.
Purpose of the Study:
- To analyze temporopolar DCS data in epilepsy patients.
- To characterize stimulation-induced symptoms and their relation to seizure semiology.
Main Methods:
- Retrospective analysis of DCS data from 50 epilepsy patients (2012-2025).
- Categorization of stimulation-induced symptoms by modality and frequency.
- Statistical analysis (GLMM) to assess symptom likelihood and seizure semiology resemblance.
Main Results:
- 66% of patients reported symptoms during temporopolar DCS.
- Sensory and motor symptoms were most common (75%).
- Cognitive, emotional, and visceral symptoms (24%) were more likely to mimic habitual seizure semiology (OR=13.0, p=0.003).
Conclusions:
- Temporopolar DCS elicits diverse symptoms, indicating its role as an integrative network hub.
- The findings suggest limited localizing value for temporopolar DCS responses in epilepsy presurgical evaluation.
