Functional recovery and neuroplasticity post-hemispherectomy in humans

Area of Science:

• Neuroscience
• Neurosurgery
• Rehabilitation Medicine

Background:

• Hemispherectomy, initially for gliomas and epilepsy, faced high mortality.
• Surgical advancements have reduced perioperative mortality to 0-1%, enabling its resurgence.

Purpose of the Study:

• To synthesize evidence on functional recovery after hemispherectomy.
• To explore neuroplasticity and brain reorganization using hemispherectomy as a model.

Main Methods:

• Systematic review of current evidence on post-hemispherectomy functional outcomes.
• Analysis of recovery across sensorimotor, linguistic, visual, cognitive, and social domains.

Main Results:

• Motor recovery involves alternative pathways and cortical recruitment.
• Language function shows adaptability, especially in early-life surgery.
• Visual field deficits persist, but compensatory behaviors can mitigate loss.
• Degeneracy is identified as a key principle in brain reorganization.

Conclusions:

• Hemispherectomy provides a unique model for studying neuroplasticity and brain functional redistribution.
• Findings offer insights into individualized neurorehabilitation strategies.