Lesion network mapping

Lesion network mapping is a neuroimaging technique that analyzes the connectivity pattern of brain lesions to identify neuroanatomic correlates of symptoms.[1][2][3] The scientific validity of these methods has been widely disputed.[4][5] The technique was developed by Aaron Boes to understand the network anatomy of lesion induced neurologic and psychiatric symptoms that can not be explained by focal anatomic localization.[6][7] Lesion network mapping applies a network-based approach to identify connected brain networks, rather than focal brain regions, that correlate with a specific symptom.

In focal neuroanatomic localization, developed by Paul Broca and others, specific symptoms that occur due to brain lesions can be understood by identifying a specific brain region that is injured by lesions to establish brain-symptom relationships.[2] However, a number of neurologic symptoms, such as peduncular hallucinosis, are not amenable to this approach since the lesions associated with the symptom do not map to one focal brain location.[1] Lesion network mapping helps to explain these lesion-induced syndromes by showing that lesion locations associated with a given symptom all map to a shared brain network even if they do not all map to a focal brain region.[2] The technique maps the location of lesions associated with a specific symptom and analyzes the connectivity pattern of the lesions compared to large, standardized human brain atlases. While initially developed using resting-state fMRIs such as the Human Connectome Project,[1] the technique has been expanded to include large structural network atlases [8] and multimodal-connectome datasets.[9] Software tools for that facilitate lesion network mapping exist within the Lead-DBS framework,[10] which is also used for a related technique, DBS network mapping.

Lesion network mapping has helped map the network anatomy of numerous rare neurologic syndromes (peduncular hallucinosis,[1] delusional misidentification,[11] reduplicative paramensia,[12] akinetic mutism,[13] blindsight,[14] visual anosognosia[15]), common neurologic syndromes (seizures,[16] aphasia,[17] amnesia,[18] parkinsonism,[19] topographical disorientation[20]), psychiatric syndromes[21] (depression,[22][23] mania[24]), as well as complex human behaviors (spirituality,[25] religious fundamentalism,[26] consciousness,[27][28] free will,[13] criminality,[29] addiction[30]). The technique has been successfully applied to a broad range of diseases and lesion types including lesions due to stroke,[1] traumatic brain injury,[25] tuberous sclerosis[31][32] and multiple sclerosis.[33][34] The technique has been broadened to map the connectivity of locations from transcranial magnetic stimulation[23] and deep brain stimulation[35] sites to understand treatment responsiveness.

Research findings based on lesion network mapping have been reported in the New York Times,[36] Scientific American[37] and USA Today[38] and the term has been included in the New England Journal of Medicine's general medical glossary.[3]

References

  1. ^ a b c d e Boes, Aaron D.; Prasad, Sashank; Liu, Hesheng; Liu, Qi; Pascual-Leone, Alvaro; Caviness, Verne S.; Fox, Michael D. (October 2015). "Network localization of neurological symptoms from focal brain lesions". Brain: A Journal of Neurology. 138 (Pt 10): 3061–3075. doi:10.1093/brain/awv228. ISSN 1460-2156. PMC 4671478. PMID 26264514.
  2. ^ a b c Fox, Michael D. (2018-12-06). "Mapping Symptoms to Brain Networks with the Human Connectome". New England Journal of Medicine. 379 (23): 2237–2245. doi:10.1056/NEJMra1706158. ISSN 0028-4793. PMID 30575457. S2CID 58666837.
  3. ^ a b NEJM. "Illustrated Glossary - NEJM". New England Journal of Medicine. Retrieved 2023-08-18.
  4. ^ van den Heuvel, Martijn P.; Libedinsky, Ilan; Quiroz Monnens, Sebastian; Repple, Jonathan; Sommer, Iris; Cocchi, Luca (2026-01-15). "Investigating the methodological foundation of lesion network mapping". Nature Neuroscience. doi:10.1038/s41593-025-02196-7. ISSN 1097-6256.
  5. ^ Salvalaggio, Alessandro; De Filippo De Grazia, Michele; Zorzi, Marco; Thiebaut de Schotten, Michel; Corbetta, Maurizio (2020-07-01). "Post-stroke deficit prediction from lesion and indirect structural and functional disconnection". Brain. 143 (7): 2173–2188. doi:10.1093/brain/awaa156. ISSN 0006-8950. PMC 7363494. PMID 32572442.
  6. ^ Joutsa, Juho; Corp, Daniel T.; Fox, Michael D. (2022-08-01). "Lesion network mapping for symptom localization: recent developments and future directions". Current Opinion in Neurology. 35 (4): 453–459. doi:10.1097/WCO.0000000000001085. ISSN 1473-6551. PMC 9724189. PMID 35788098.
  7. ^ Nabizadeh, Fardin; Aarabi, Mohammad Hadi (2023-06-30). "Functional and structural lesion network mapping in neurological and psychiatric disorders: a systematic review". Frontiers in Neurology. 14 1100067. doi:10.3389/fneur.2023.1100067. ISSN 1664-2295. PMC 10349201. PMID 37456650.
  8. ^ Bowren, Mark; Bruss, Joel; Manzel, Kenneth; Edwards, Dylan; Liu, Charles; Corbetta, Maurizio; Tranel, Daniel; Boes, Aaron D. (2022-05-24). "Post-stroke outcomes predicted from multivariate lesion-behaviour and lesion network mapping". Brain: A Journal of Neurology. 145 (4): 1338–1353. doi:10.1093/brain/awac010. ISSN 1460-2156. PMC 9630711. PMID 35025994.
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  13. ^ a b Darby, R. Ryan; Joutsa, Juho; Burke, Matthew J.; Fox, Michael D. (2018-10-16). "Lesion network localization of free will". Proceedings of the National Academy of Sciences of the United States of America. 115 (42): 10792–10797. Bibcode:2018PNAS..11510792D. doi:10.1073/pnas.1814117115. ISSN 1091-6490. PMC 6196503. PMID 30275309.
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