An intracranial dissection of human escape circuits.

Predators attack across diverse spatiotemporal scales, prompting prey to respond through simple motor reactions (e.g., fleeing) or more complex cognitive processes (e.g., strategic planning). Recent studies suggest that escape relies on two distinct circuits: the reactive and cognitive fear circuits. However, their specific roles in different stages of escaping remain unclear. In this study, we recorded SEEG from epilepsy patients while they performed a modified flight initiation distance task. We identified cognitive fear regions, including the vmPFC and hippocampus, that encoded threat levels during the information processing stage. In the actual escaping stage, especially under rapid attack, the reactive fear circuit, including the midcingulate cortex and amygdala, was prominently activated. Notably, under rapid attack, we observed significant theta-band information flow from the amygdala to the vmPFC, suggesting dynamic communication between the reactive and cognitive fear circuits. These findings illuminate the distinct and complementary roles of the reactive and cognitive fear circuits in facilitating successful human escape.