Functional changes in the pediatric brain following neural injuries attest to remarkable feats of plasticity. Investigations of the neurobiological mechanisms that underlie this plasticity have largely focused on activation in the penumbra of the lesion or in contralesional, homotopic regions. Here, we adopt a whole-brain approach to evaluate the plasticity of the cortex in patients with large unilateral cortical resections due to drug-resistant childhood epilepsy. We compared the functional connectivity (FC) in patients’ preserved hemisphere with the corresponding hemisphere of matched controls as they viewed and listened to a movie excerpt in a functional magnetic resonance imaging (fMRI) scanner. The preserved hemisphere was segmented into 180 and 200 parcels using two different anatomical atlases. We calculated all pairwise multivariate statistical dependencies between parcels, or parcel edges, and between 22 and 7 larger-scale functional networks, or network edges, aggregated from the smaller parcel edges. Both the left and right hemisphere–preserved patient groups had widespread reductions in FC relative to matched controls, particularly for within-network edges. A case series analysis further uncovered subclusters of patients with distinctive edgewise changes relative to controls, illustrating individual postoperative connectivity profiles. The large-scale differences in networks of the preserved hemisphere potentially reflect plasticity in the service of maintained and/or retained cognitive function.

中文翻译：

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自然神经影像显示小儿癫痫患者皮层切除后的半球功能组织


神经损伤后儿童大脑的功能变化证明了可塑性的显着特征。对这种可塑性背后的神经生物学机制的研究主要集中在病变半影或对侧同伦区域的激活。在这里，我们采用全脑方法来评估因耐药儿童癫痫而进行大面积单侧皮质切除的患者的皮质可塑性。当患者在功能磁共振成像（fMRI）扫描仪中观看和收听电影摘录时，我们将患者保留的半球与匹配对照的相应半球的功能连接（FC）进行了比较。使用两个不同的解剖图谱将保存下来的半球分割成 180 和 200 个地块。我们计算了宗地或宗地边缘之间以及从较小宗地边缘聚合的 22 到 7 个较大规模功能网络或网络边缘之间的所有成对多元统计依赖性。与匹配对照相比，保留左半球和右半球的患者组的 FC 普遍降低，尤其是网络内边缘。病例系列分析进一步揭示了相对于对照组具有独特边缘变化的患者亚群，说明了个体术后连接情况。保留半球网络的大规模差异可能反映了为维持和/或保留认知功能服务的可塑性。