Lesions causing self-injurious behavior engage putative networks modulated by deep brain stimulation

Self-injurious behaviors (SIB) are persistent, non-accidental actions that result in physical damage inflicted on one’s self. Rare cases of adult-onset SIB may result from an acquired dysfunction in neural circuitry. In this study, we aimed to first understand the networks disrupted by brain lesions causing acquired SIB and second, to investigate how networks engaged by therapeutic targets for SIB overlap or interact with these networks. We utilize lesion network mapping (LNM) [1], based on the hypothesis that heterogenous lesions within the brain that result in a shared clinical phenotype are linked by common brain network(s). This technique has been validated for 2D representations of 3D lesions [2], such as those found in case reports, and ideal for studying rare lesion-induced neurologic symptoms, such as SIB. The current work presents a novel view based on extensive analysis of rare acquired lesions to inform the assessment and treatment of SIB.