ArticleFrontiers in human neuroscience2025
Structural and functional alterations in the contralateral hemisphere following pediatric intracranial surgery: a pilot longitudinal neuroimaging study.
Article in Frontiers in human neuroscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Intracranial space-occupying lesions (ISOLs) are common pediatric conditions. Recent therapeutic advances have significantly improved survival rates, necessitating increased attention to post-operative cognitive outcomes, which are crucial determinants of patients' quality of life. Objective: While previous studies have predominantly focused on short-term post-operative changes, this study aimed to investigate longitudinal changes in cognition, brain structure, and function of the contralateral hemisphere following pediatric neurosurgery. Methods: Nineteen pediatric patients with ISOLs were enrolled in a paired design study. Cognitive assessments, structural imaging, and functional imaging data were collected at three time points: pre-operation, first post-operative follow-up (mean 75 days pre-operation), and second post-operative follow-up (mean 316 days pre-operation). Relevant metrics were computed and compared across time points. Results: The majority of cognitive domains exhibited a gradual longitudinal improvement trajectory, with three domains showing significant enhancement at the second follow-up compared to preoperative baseline: cognitive flexibility ( Conclusion: Our findings suggest that post-craniotomy structural and functional brain changes in children follow a subcortical-to-cortical trajectory, with structural alterations (decreased gray matter density) preceding functional activation. This process demonstrates progressive and cumulative characteristics. These modifications appear to correlate with cognitive function recovery and may represent potential mechanisms underlying spontaneous cognitive rehabilitation in pediatric patients post-surgery. Cautiously interpreted, the deeper neuroplastic mechanisms underlying these changes might involve synaptic pruning-like processes induced by external perturbation.
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