Lesion network localization of functional and somatic symptoms

Area of Science:

• Neuroscience
• Neurology
• Psychiatry

Background:

• Functional and somatic symptoms without clear structural abnormalities are a significant cause of disability.
• These symptoms are often attributed to neuropsychiatric origins, suggesting potential benefits from brain stimulation therapies.
• Understanding the neural circuitry underlying these symptoms is crucial for developing effective treatments.

Purpose of the Study:

• To identify network-based targets in the brain for stimulation therapies aimed at alleviating functional and somatic symptoms.
• To investigate the relationship between focal brain lesions and the manifestation of functional and somatic disability.
• To propose specific brain regions as potential targets for network-targeted brain stimulation.

Main Methods:

• Utilized a normative human connectome database (n=1000) to map brain circuitry.
• Analyzed two independent datasets: ischemic stroke (n=101) and penetrating head trauma (n=181).
• Mapped functional connectivity between lesions and brain networks associated with disability and somatic concern.

Main Results:

• Identified a network causally associated with self-reported functional disability in stroke patients.
• Found that lesions connected to this network in head trauma patients correlated with increased somatic concern (p=0.001).
• Orbitofrontal cortex and dorsal anterior cingulate emerged as key regions connected to lesions influencing these symptoms (pFWE<0.01).

Conclusions:

• The orbitofrontal cortex and dorsal anterior cingulate are proposed as potential targets for brain stimulation to treat functional and somatic symptoms.
• Network-based mapping of brain lesions provides a method for identifying therapeutic targets for neuropsychiatric conditions.
• Findings support the role of network dysfunction in functional and somatic symptoms and suggest novel treatment avenues.