Damage to specific brain circuits can cause specific neuropsychiatric symptoms. Therapeutic stimulation to these same circuits may modulate these symptoms. To determine whether these circuits converge, we studied depression severity after brain lesions (n = 461, five datasets), transcranial magnetic stimulation (n = 151, four datasets) and deep brain stimulation (n = 101, five datasets). Lesions and stimulation sites most associated with depression severity were connected to a similar brain circuit across all 14 datasets (P < 0.001). Circuits derived from lesions, deep brain stimulation and transcranial magnetic stimulation were similar (P < 0.0005), as were circuits derived from patients with major depression versus other diagnoses (P < 0.001). Connectivity to this circuit predicted out-of-sample antidepressant efficacy of transcranial magnetic stimulation and deep brain stimulation sites (P < 0.0001). In an independent analysis, 29 lesions and 95 stimulation sites converged on a distinct circuit for motor symptoms of Parkinson’s disease (P < 0.05). We conclude that lesions, transcranial magnetic stimulation and DBS converge on common brain circuitry that may represent improved neurostimulation targets for depression and other disorders.

特定脑回路的损伤会导致特定的神经精神症状。对这些相同回路的治疗性刺激可能会调节这些症状。为了确定这些回路是否收敛，我们研究了脑损伤（n  = 461，五个数据集）、经颅磁刺激（n  = 151，四个数据集）和深部脑刺激（n  = 101，五个数据集）后抑郁的严重程度。在所有 14 个数据集中，与抑郁严重程度最相关的病变和刺激部位都与相似的大脑回路相连（P  < 0.001）。来自病变、深部脑刺激和经颅磁刺激的电路相似（P < 0.0005），来自重度抑郁症患者的回路与其他诊断的比较（P  < 0.001）。与该电路的连接预测了经颅磁刺激和深部脑刺激部位的样本外抗抑郁功效（P  < 0.0001）。在一项独立分析中，29 个病变和 95 个刺激部位汇聚在帕金森病运动症状的不同回路上（P  < 0.05）。我们得出的结论是，病变、经颅磁刺激和 DBS 汇聚在共同的大脑回路上，这可能代表了抑郁症和其他疾病的神经刺激目标的改善。