Brain Plasticity in Neurosurgery

TLDR: Individual mapping studies in patients with well-defined brain lesions not only enhance the outcome of operations but may provide a practical route to understanding, visualizing, and even modulating brain plasticity.

Abstract: Neurons, neuronal networks, and signaling within critical brain networks follow the concept of leanness. Critical functional networks for perception, movement, and communication have developed to conserve time and energy in neuronal processing. In a healthy brain, networks are characterized by the organized mapping of basic functions close to each other and by precise wiring that builds large-scale maps in the individual brain. This concept is supplemented by overall redundancy in the human brain. We therefore have the neuronal capacity to overcome lesions and brain disorders by recruiting resources from anatomically connected reserve pathways, called neural plasticity. Applying the view of neural networks, the effect of disruptions on overall neural functions can be acknowledged. A massive amount of research has been devoted to the determinants and mechanisms that may compensate for brain lesions through plasticity—the adaptive ability of neurons and networks to modify their signaling properties. There is, however, a vast unbridged gap between current basic research and individual clinical applications. Individual mapping studies in patients with well-defined brain lesions not only enhance the outcome of operations but may provide a practical route to understanding, visualizing, and even modulating brain plasticity. This chapter therefore provides an overview on such mechanisms and ways to detect and evoke functional reorganization.