{
  "abstract": "BackgroundThe mechanisms driving cervical dystonia remain unclear, limiting effective, non-invasive treatment development. Lesion network mapping previously localized a brain network derived from lesions causing cervical dystonia, with a network hub in the somatosensory cortex, a viable target for non-invasive brain stimulation.\n\nObjectivesWe conducted a randomized, sham-controlled, crossover trial administering continuous theta-burst stimulation (cTBS) to the S1 lesion network hub, testing whether modulating this network reduces CD symptoms.\n\nMethodsThirteen idiopathic cervical dystonia patients (57.85 {+/-} 10.85 years) received two 10-session blocks of bilateral somatosensory cortex cTBS (active or sham; counterbalanced). The primary outcome was change in cervical dystonia symptoms, measured by the Toronto Western Spasmodic Torticollis Scale (TWSTRS). A wearable motion sensor objectively measured change in head and neck movement patterns. Motor evoked potentials and resting-state fMRI assessed cTBS-induced changes in corticospinal excitability and functional connectivity, respectively.\n\nResultsActive cTBS did not significantly reduce cervical dystonia symptoms compared to sham (condition x timepoint interaction: p = .149). Range of motion significantly increased with active, versus sham, cTBS (p = .015). Corticospinal excitability decreased following sham (p = .042), but not active, cTBS. No significant connectivity changes were seen from the somatosensory cortex stimulation site after active cTBS; however, significant changes emerged from the globus pallidus interna.\n\nConclusionThis study prospectively tested the effects of neuromodulation on a lesion network mapping-derived target. Active cTBS did not significantly improve TWSTRS scores relative to sham. The intervention was well tolerated by all patients, and future studies could consider higher-dose or alternative protocols to this target.",
  "abstract_shown": true,
  "affiliations": [
    "Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, Australia"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "J. Morrison-Ham"
    },
    {
      "name": "E. F. P. Younger"
    },
    {
      "name": "E. G. Ellis"
    },
    {
      "name": "N. Parsons"
    },
    {
      "name": "T. Hart"
    },
    {
      "name": "B. Speranza"
    },
    {
      "name": "L. Dipnall"
    },
    {
      "name": "M. Do"
    },
    {
      "name": "R. Perellon-Alfonso"
    },
    {
      "name": "P. M. Pecoraro"
    },
    {
      "name": "L. di Biase"
    },
    {
      "name": "K. L. Bertram"
    },
    {
      "name": "P. A. Aguis"
    },
    {
      "name": "F. Morgante"
    },
    {
      "name": "J. Joutsa"
    },
    {
      "name": "A. T. Hill"
    },
    {
      "name": "P. G. Enticott"
    },
    {
      "name": "D. T. Corp"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bzsxkzvgm88h1.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.10.26362783",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.10.26362783v1.full",
  "id": "bzsxkzvgm88h1",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.10.26362783v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "neurology"
    ],
    [
      "openalex",
      "2728|Neurological disorders and treatments"
    ]
  ],
  "openalex": "W7202122984",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.10.26362783v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-10",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/bzsxkzvgm88h1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:27Z",
      "native_id": "10.64898/2026.09.10.26362783",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.10.26362783v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:neurology",
      "subfield": "neurology"
    }
  ],
  "title": "Continuous theta-burst stimulation to a lesion network in cervical dystonia: a randomized, double-blind, sham-controlled, pilot trial",
  "title_text": "Continuous theta-burst stimulation to a lesion network in cervical dystonia: a randomized, double-blind, sham-controlled, pilot trial",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:27Z",
  "url": "https://research.draconitic.com/paper/bzsxkzvgm88h1",
  "venue": "medRxiv",
  "versions": []
}