Direct cortical stimulation-evoked symptoms in the human temporal pole: A systematic review

The temporal pole represents a key node within temporolimbic networks and may contribute to seizure generation in temporal lobe epilepsy. Direct cortical stimulation (DCS), performed during intracranial presurgical evaluation, is a valuable method for delineating the seizure onset zone by reproducing electro-clinical features of a patient's habitual seizures. However, data specifically addressing temporopolar stimulation remain limited and dispersed. We conducted a systematic review in accordance with PRISMA criteria to summarize published evidence on the semiology of DCS-induced signs and symptoms arising from stimulation of the temporal pole. Thirteen eligible studies were identified, demonstrating substantial heterogeneity in stimulation protocols, symptom classification, and reporting standards. Across studies, temporopolar stimulation consistently elicited multimodal symptoms spanning sensory, visceral, emotional, cognitive, and behavioral domains, largely overlapping with those reported following stimulation of adjacent temporal lobe regions. Overall, the available clinical evidence supports the role of the temporal pole as an integrative hub within temporolimbic networks rather than as a region characterized by a distinct stimulation-induced semiology.