Intracerebral stimulation inducing emotions in SEEG: a systematic review.

BACKGROUND

Direct intracerebral electrical stimulation during SEEG offers a unique opportunity to explore the neural correlates of human emotional experience, yet data on stimulation-induced emotions remain scattered and no systematic review has specifically addressed this topic.

OBJECTIVE

To systematically review subjective emotional responses induced by SEEG stimulation and characterize their anatomical distribution, valence, hemispheric lateralization, and relationship with stimulation parameters.

METHODS

A systematic search of PubMed, Embase, Web of Science, and ScienceDirect was conducted for studies published up to June 30, 2025. Data were extracted on stimulated regions, emotional valence, laterality, and stimulation parameters.

RESULTS

Thirty-four publications (21 cohort studies, 13 clinical cases) were included, encompassing 2434 patients and 14,492 total stimulations, with only 3.0% inducing subjective emotional responses. Emotional effects were predominantly negative (78.1%). Temporo-mesial and temporo-basal regions were mainly associated with negative emotions, whereas cingulo-frontal and subcortical regions showed a significant overrepresentation of positive responses relative to the overall corpus distribution; the insula exhibited no preferential valence. Hemispheric asymmetries were largely non-significant. An exploratory analysis revealed a directional trend toward higher intensities for negative responses, which did not survive intra-study normalization; total delivered charge yielded heterogeneous results.

CONCLUSION

SEEG-induced emotional responses are rare but display region-dependent valence profiles. The relationship between stimulation parameters and emotional valence proved complex underscoring the need for prospective intra-patient titration studies. These findings contribute to a network-based understanding of stimulation-induced emotions with implications for affective neuromodulation.