Phenomenon of cortical neuroplasticity in humans

Background. Neuroplasticity of the brain cortex is a unique phenomenon. It has both scientific and clinical significance for neurology and neurosurgery. Aim. The aim of this study is to analyze literature data on human brain neuroplasticity in various diseases and describe factors affecting it. Materials and methods. Analysis of literature presented in the PubMed database was performed using searches for words “neuroplasticity”, “cortical plasticity” and “glioma surgery”. Several clinical cases from the authors’ practice are used as illustrations. Results. Based on literature data, the article presents the main types of neuroplasticity depending on: type of pathological process; location of cortical zones participating in neuroplasticity formation; level of compensation of lost brain function; time of phenomenon development; rate of pathological process development. The special role of preservation of white matter tracts in neuroplasticity is highlighted. Clinical significance of this phenomenon for neurosurgery is demonstrated using the example of intracerebral tumors located in functionally important parts of the brain. Conclusion. Neuroplasticity of the brain cortex is predominantly characteristic of “slow” pathological processes such as low-grade gliomas in contrast to “fast” processes (such as malignant tumors, injuries, strokes). Language areas of the cortex are more susceptible to plasticity than motor cortex (except the supplementary motor cortex). Areas neighboring the lesion, as well as distant areas including the contralateral hemisphere, can contribute to compensation mechanisms. Phenomenon of neuroplasticity helps to compensate functions of the affected cortex both during disease progression and multistage neurosurgical interventions. Transcranial magnetic stimulation is a promising technique for managing neuroplasticity in tumors and other types of brain diseases.