Cross-sectional and longitudinal changes in category selectivity in visual cortex following pediatric cortical resection

The topographic organization of category-selective responses in human ventral occipitotemporal cortex (VOTC) and its relationship to regions subserving language functions is remarkably uniform across individuals. This arrangement is thought to result from the clustering of neurons responding to similar inputs, constrained by intrinsic architecture and tuned by experience. We examine the malleability of this organization in individuals with unilateral resection of VOTC during childhood for the management of drug-resistant epilepsy. In cross-sectional and longitudinal functional imaging studies, we compare the topography and neural representations of 17 category-selective regions in individuals with a VOTC resection, a 'control patient' with a resection outside VOTC, and typically developing matched controls. We demonstrate both adherence to and deviation from the standard topography, particularly with respect to the hemispheric lateralization of category-selective regions, and uncover fine-grained competitive dynamics between word- and face-selectivity over time in the single, preserved VOTC. The findings elucidate the nature and extent of cortical plasticity and highlight the potential for remodeling of extrastriate architecture and function.