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Investigating the methodological foundation of lesion network mapping

Martijn P. van den Heuvel, Ilan Libedinsky, Sebastian Quiroz Monnens, Jonathan Repple, Iris E. Sommer, Luca Cocchi

2026Nature Neuroscience18 citationsDOIOpen Access PDF

Abstract

Lesion network mapping (LNM) is a neuroimaging framework that uses normative functional connectivity (FC) data to link heterogeneous brain lesions and functional alterations to brain networks implicated in neurological and psychiatric conditions. However, many of the networks identified by LNM and related methods appear to be highly similar across diverse conditions such as addiction, depression, psychosis and epilepsy. To understand this similarity, we re-examined the data from multiple LNM studies and assessed the methodological roots of the method. Our findings reveal a foundational limitation: at its core, LNM involves a repetitive sampling of one and the same FC matrix. As a result, it systematically maps sets of local brain changes-whether they are patient lesions, magnetic resonance imaging-derived alterations, synthetic or random-onto the same nonspecific properties of the used FC data, producing highly similar networks across conditions. This central limitation cautions the use of LNM as a method for studying distinct biological networks underlying brain disorders. Our work may aid the development of a new generation of network-mapping methods from first principles.

Topics & Concepts

NeuroscienceNeuroimagingNormativeFunctional connectivityBrain mappingPsychosisComputer scienceFoundation (evidence)PsychologyArtificial intelligenceLesionFunctional neuroimagingFunctional magnetic resonance imagingCognitive scienceSchizophrenia (object-oriented programming)Magnetic resonance imagingMedicineIdentification (biology)Nerve netSampling (signal processing)Functional imagingNetwork analysisMachine learningBiological neural networkSIGNAL (programming language)Biological networkFunctional Brain Connectivity StudiesMental Health Research TopicsNeurotransmitter Receptor Influence on Behavior