Mapping neuroplastic potential in brain-damaged patients

The slow growth of diffuse low-grade gliomas (DLGG) allows progressive reshaping of brain function through plasticity. Herbet et al. use anatomical MRI and intraoperative electrostimulation mapping in 231 patients undergoing DLGG resection to generate a probabilistic atlas of neuroplasticity. Plasticity is high in cortex, but relatively low in connective tracts.The slow growth of diffuse low-grade gliomas (DLGG) allows progressive reshaping of brain function through plasticity. Herbet et al. use anatomical MRI and intraoperative electrostimulation mapping in 231 patients undergoing DLGG resection to generate a probabilistic atlas of neuroplasticity. Plasticity is high in cortex, but relatively low in connective tracts.It is increasingly acknowledged that the brain is highly plastic. However, the anatomic factors governing the potential for neuroplasticity have hardly been investigated. To bridge this knowledge gap, we generated a probabilistic atlas of functional plasticity derived from both anatomic magnetic resonance imaging results and intraoperative mapping data on 231 patients having undergone surgery for diffuse, low-grade glioma. The atlas includes detailed level of confidence information and is supplemented with a series of comprehensive, connectivity-based cluster analyses. Our results show that cortical plasticity is generally high in the cortex (except in primary unimodal areas and in a small set of neural hubs) and rather low in connective tracts (especially associative and projection tracts). The atlas sheds new light on the topological organization of critical neural systems and may also be useful in predicting the likelihood of recovery (as a function of lesion topology) in various neuropathological conditions-a crucial factor in improving the care of brain-damaged patients.