Lesion network localization of functional and somatic symptoms

This is the authors' abstract. We don't add key points for this paper.

Functional and somatic symptoms with no detectable structural abnormalities are a common cause of disability. These symptoms are widely believed to have neuropsychiatric origins, and thus may respond to network-targeted brain stimulation. To derive a network-based target, we studied functional and somatic disability after focal brain lesions. Using a normative human connectome database (n=1000), we mapped the circuitry functionally connected to lesions that selectively influence such symptoms in two datasets. First, in ischemic stroke (n=101), we mapped a network causally associated with self-reported functional disability, independent of individual measures of disability. In an independent sample with penetrating head trauma (n=181), lesions connected to our network were associated with greater somatic concern (p=0.001). Across both datasets, functional and somatic symptoms were most associated with lesions connected to the orbitofrontal cortex (pFWE<0.01) and dorsal anterior cingulate, which we propose as potential brain stimulation targets.