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Published on: December 19, 2025
Network localization of hemichorea-hemiballismus
Simon Laganiere1, Aaron D Boes1, Michael D Fox2
1From the Berenson-Allen Center for Noninvasive Brain Stimulation (S.L., A.D.B., M.D.F.), Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston; Departments of Pediatric Neurology (A.D.B.) and Neurology (M.D.F.), Massachusetts General Hospital, Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (M.D.F.), Massachusetts General Hospital, Charlestown.
Strokes causing hemichorea-hemiballismus, though anatomically diverse, consistently affect a common functional network. Lesion network mapping reveals these strokes connect to the posterolateral putamen, aiding understanding of movement disorders.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Hemichorea-hemiballismus is a hyperkinetic movement disorder often caused by strokes.
- The anatomical locations of lesions causing this disorder are known to be heterogeneous.
- Identifying a common functional network underlying these diverse lesions is crucial for understanding the pathophysiology.
Purpose of the Study:
- To determine if anatomically diverse strokes causing hemichorea-hemiballismus localize to a common functional network.
- To investigate the utility of lesion network mapping in identifying neuroanatomical substrates of movement disorders.
Main Methods:
- A literature search identified 29 cases of lesion-induced hemichorea-hemiballismus.
- Lesion network mapping was employed, analyzing functional connectivity of lesions using a healthy participant connectome dataset.
- Specificity and reproducibility were assessed using control cohorts and an independent case series.
Main Results:
- Despite heterogeneous lesion locations, over 90% showed network overlap in the posterolateral putamen.
- This finding was specific to hemichorea-hemiballismus and reproducible in an independent cohort.
- The posterolateral putamen network predicted lesion distribution, linking it to a broader motor network.
Conclusions:
- Strokes causing hemichorea-hemiballismus, while anatomically varied, converge on a common functional network linked to the posterolateral putamen.
- Lesion network mapping is a valuable tool for elucidating the neuroanatomical basis of disorders with heterogeneous lesion presentations.
- This approach enhances understanding of hyperkinetic movement disorders.
