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Journal Articles Brain - A Journal of Neurology Year : 2022

A neural network for tics: insights from causal brain lesions and deep brain stimulation

Christos Ganos
Bassam Al-Fatly
Jan-Frederik Fischer
  • Function : Author
Juan-Carlos Baldermann
  • Function : Author
Christina Hennen
  • Function : Author
Veerle Visser-Vandewalle
  • Function : Author
Clemens Neudorfer
Davide Martino
  • Function : Author
Jing Li
  • Function : Author
Tim Bouwens
  • Function : Author
Linda Ackermanns
  • Function : Author
Albert Leentjens
  • Function : Author
Yulia Worbe
Michael Fox
  • Function : Author
Andrea Kühn
  • Function : Author
Andreas Horn

Abstract

Brain lesions are a rare cause of tic disorders. However, they can provide uniquely causal insights into tic pathophysiology and can also inform on possible neuromodulatory therapeutic targets. Based on a systematic literature review, we identified 22 cases of tics causally attributed to brain lesions and employed 'lesion network mapping' to interrogate whether tic-inducing lesions would be associated with a common network in the average human brain. We probed this using a normative functional connectome acquired in 1000 healthy participants. We then examined the specificity of the identified network by contrasting tic-lesion connectivity maps to those seeding from 717 lesions associated with a wide array of neurological and/or psychiatric symptoms within the Harvard Lesion Repository. Finally, we determined the predictive utility of the tic-inducing lesion network as a therapeutic target for neuromodulation. Specifically, we collected retrospective data of 30 individuals with Tourette disorder, who underwent either thalamic (n = 15; centromedian/ventrooralis internus) or pallidal (n = 15; anterior segment of globus pallidus internus) deep brain stimulation and calculated whether connectivity between deep brain stimulation sites and the lesion network map could predict clinical improvements. Despite spatial heterogeneity, tic-inducing lesions mapped to a common network map, which comprised the insular cortices, cingulate gyrus, striatum, globus pallidus internus, thalami and cerebellum. Connectivity to a region within the anterior striatum (putamen) was specific to tic-inducing lesions when compared with control lesions. Connectivity between deep brain stimulation electrodes and the lesion network map was predictive of tic improvement, regardless of the deep brain stimulation target. Taken together, our results reveal a common brain network involved in tic generation, which shows potential as a therapeutic target for neuromodulation.

Dates and versions

hal-04587711 , version 1 (24-05-2024)

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Christos Ganos, Bassam Al-Fatly, Jan-Frederik Fischer, Juan-Carlos Baldermann, Christina Hennen, et al.. A neural network for tics: insights from causal brain lesions and deep brain stimulation. Brain - A Journal of Neurology , 2022, 145 (12), pp.4385-4397. ⟨10.1093/brain/awac009⟩. ⟨hal-04587711⟩
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