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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 \u2018lesion network mapping\u2019 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.<\/jats:p>\n                  <jats:p>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.<\/jats:p>\n                  <jats:p>Taken together, our results reveal a common brain network involved in tic generation, which shows potential as a therapeutic target for neuromodulation.<\/jats:p>","DOI":"10.1093\/brain\/awac009","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T15:13:48Z","timestamp":1641914028000},"page":"4385-4397","source":"Crossref","is-referenced-by-count":87,"title":["A neural network for tics: insights from causal brain lesions and deep brain stimulation"],"prefix":"10.1093","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0695-6025","authenticated-orcid":false,"given":"Christos","family":"Ganos","sequence":"first","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology with Experimental Neurology , 10117 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0067-6177","authenticated-orcid":false,"given":"Bassam","family":"Al-Fatly","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology with Experimental Neurology , 10117 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Frederik","family":"Fischer","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology with Experimental Neurology , 10117 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan-Carlos","family":"Baldermann","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne , 50931 Cologne , Germany"},{"name":"Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne , 50931 Cologne , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Hennen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne , 50931 Cologne , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veerle","family":"Visser-Vandewalle","sequence":"additional","affiliation":[{"name":"Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne , 50931 Cologne , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3153-1045","authenticated-orcid":false,"given":"Clemens","family":"Neudorfer","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology with Experimental Neurology , 10117 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Martino","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Calgary , Calgary 3330, AB , Canada"},{"name":"Hotchkiss Brain Institute , Calgary 3330, AB , 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Medical Centre , 6229 HX Maastricht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2070-1299","authenticated-orcid":false,"given":"Nadya","family":"Pyatigorskaya","sequence":"additional","affiliation":[{"name":"Sorbonne University, Paris Brain Institute - ICM, Inserm, CNRS, Department of Radiology, H\u00f4pital de la Piti\u00e9 Salp\u00eatri\u00e8re (DMU 6), AP-HP , 75013, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5903-9370","authenticated-orcid":false,"given":"Yulia","family":"Worbe","sequence":"additional","affiliation":[{"name":"Sorbonne University, ICM, Inserm, CNRS, Department of Neurophysiology, H\u00f4pital Saint Antoine (DMU 6) , AP-HP, 75013 Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"Fox","sequence":"additional","affiliation":[{"name":"Center for Brain Circuit Therapeutics, Department of Neurology, Psychiatry, and Radiology, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, MA 02115 , USA"},{"name":"Athinoula A. Martinos Centre for Biomedical Imaging, Department of Neurology and Radiology, Massachusetts General Hospital , Charlestown, MA 02129 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea A","family":"K\u00fchn","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology with Experimental Neurology , 10117 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0675-9064","authenticated-orcid":false,"given":"Andreas","family":"Horn","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology with Experimental 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