• Andreas Nowacki, Kathleen Seidel, Philippe Schucht, Kaspar Schindler, Eugenio Abela, Dorothea Heinemann, Klemens Gutbrod, Roland Wiest, Andreas Raabe, and Claudio Pollo.
• Department of Neurosurgery, University Hospital Bern, 3010 Bern, Switzerland. Electronic address: neuro.nowacki@gmail.com.
• World Neurosurg. 2015 Aug 1;84(2):470-4.

PurposeA case is presented and a systematic review of the literature is provided to update our current knowledge of induction of fear by cortical stimulation.MethodsWe present a case of refractory epilepsy associated with a lesion where fear could be induced by intraoperative electrical stimulation of the posterior inner part of the superior temporal gyrus. We performed a systematic review of the literature using PubMed with the key words "epilepsy AND emotion", "cortical stimulation AND emotion," and "human brain stimulation AND behavior".ResultsIntraoperative cortical stimulation of the inner part of the posterior superior temporal gyrus reliably induced fear and progressive screaming behavior. Stimulation through subdural grid electrodes did not induce this phenomenon. A systematic review of the literature identified fear induction by stimulation of different widespread cortical areas including the temporal pole, the insula, and the anterior cingulate cortex. The posterior part of the superior temporal gyrus has so far not been associated with fear induction after electrical stimulation.ConclusionAlthough our observation suggests that this area of the brain could be part of a network involved in the elicitation of fear, dysfunction of this network induced by epilepsy could also explain the observed phenomenon. Electrophysiologic and imaging studies must be conducted to improve our understanding of the cortical networks forming the neuroanatomical substrate of higher brain functions and experiences such as fear.Copyright © 2015 Elsevier Inc. All rights reserved.

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