Gilles de la Tourette Syndrome (GTS) is a chronic tic disorder, characterized by unwanted motor actions and vocalizations. While brain stimulation techniques show promise in reducing tic severity, optimal target networks are not well-defined. Here, we leverage datasets from two independent deep brain stimulation (DBS) cohorts and a cohort of tic-inducing lesions to infer critical networks for treatment and occurrence of tics by mapping stimulation sites and lesions to a functional connectome derived from 1,000 healthy participants. We find that greater tic reduction is linked to higher connectivity of DBS sites (N = 37) with action-related functional resting-state networks, i.e., the cingulo-opercular (r = 0.62; p < 0.001) and somato-cognitive action networks (r = 0.47; p = 0.002). Regions of the cingulo-opercular network best match the optimal connectivity profiles of thalamic DBS. We replicate the significance of targeting cingulo-opercular and somato-cognitive action network connectivity in an independent DBS cohort (N = 10). Finally, we demonstrate that tic-inducing brain lesions (N = 22) exhibit similar connectivity to these networks. Collectively, these results suggest a critical role for these action-related networks in the pathophysiology and treatment of GTS.

Gilles de la Tourette 综合征 （GTS） 是一种慢性抽动性疾病，其特征是不需要的运动动作和发声。虽然脑刺激技术在降低抽动严重程度方面显示出希望，但最佳目标网络尚未明确定义。在这里，我们利用来自两个独立的深部脑刺激 （DBS） 队列和一组抽搐诱发病变的数据集，通过将刺激部位和病变映射到来自 1,000 名健康参与者的功能性连接组来推断治疗和抽搐发生的关键网络。我们发现，更大的抽动减少与 DBS 位点 （N = 37） 与动作相关的功能性静息态网络（即扣带鳃盖 （r = 0.62;p < 0.001）和体细胞认知动作网络 （r = 0.47;p = 0.002） 的更高连接有关。扣带鳃盖网络的区域与丘脑 DBS 的最佳连接曲线最匹配。我们在独立的 DBS 队列 （N = 10） 中复制了靶向扣带鳃盖和体细胞认知动作网络连接的重要性。最后，我们证明诱发抽搐的脑损伤 （N = 22） 表现出与这些网络的相似连接性。总的来说，这些结果表明这些动作相关网络在 GTS 的病理生理学和治疗中起着关键作用。