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• W2885325071 abstract "•A 3-year longitudinal investigation of visual plasticity post lobectomy in a child•Stable left homonymous hemianopia and no remapping of the early visual cortex•Competition between face and word selectivity within a single (left) hemisphere•Intact cognitive abilities and intermediate- and high-level visual function Investigations of functional (re)organization in children who have undergone large cortical resections offer a unique opportunity to elucidate the nature and extent of cortical plasticity. We report findings from a 3-year investigation of a child, U.D., who underwent surgical removal of the right occipital and posterior temporal lobes at age 6 years 9 months. Relative to controls, post-surgically, U.D. showed age-appropriate intellectual performance and visuoperceptual face and object recognition skills. Using fMRI at five different time points, we observed a persistent hemianopia and no visual field remapping. In category-selective visual cortices, however, object- and scene-selective regions in the intact left hemisphere were stable early on, but regions subserving face and word recognition emerged later and evinced competition for cortical representation. These findings reveal alterations in the selectivity and topography of category-selective regions when confined to a single hemisphere and provide insights into dynamic functional changes in extrastriate cortical architecture. Investigations of functional (re)organization in children who have undergone large cortical resections offer a unique opportunity to elucidate the nature and extent of cortical plasticity. We report findings from a 3-year investigation of a child, U.D., who underwent surgical removal of the right occipital and posterior temporal lobes at age 6 years 9 months. Relative to controls, post-surgically, U.D. showed age-appropriate intellectual performance and visuoperceptual face and object recognition skills. Using fMRI at five different time points, we observed a persistent hemianopia and no visual field remapping. In category-selective visual cortices, however, object- and scene-selective regions in the intact left hemisphere were stable early on, but regions subserving face and word recognition emerged later and evinced competition for cortical representation. These findings reveal alterations in the selectivity and topography of category-selective regions when confined to a single hemisphere and provide insights into dynamic functional changes in extrastriate cortical architecture. The human ventral visual “what” pathway, projecting through the occipital pole to the anterior temporal lobe, comprises a host of category-selective areas. This topography follows a well-defined medial to lateral arrangement in adults and is highly reproducible across individuals (Grill-Spector and Weiner, 2014Grill-Spector K. Weiner K.S. The functional architecture of the ventral temporal cortex and its role in categorization.Nat. Rev. Neurosci. 2014; 15: 536-548Crossref PubMed Scopus (389) Google Scholar). Whether this cortical visual organization is fixed or, alternatively, plastic, is unclear. Examining the impact of surgical resection (e.g., lobectomy) and possible restitution of function can therefore offer unique insights into the (re)organization of the cortical visual system and mechanisms of functional recovery after brain injury. To date, little attention has been paid to the recovery of function following the resection of regions of the cortical visual system. Theoretically, one may postulate a continuum of possible outcomes ranging from no plasticity to complete reorganization. The extreme case of no reorganization is predicted by the hypothesis that the functional topographic map in the ventral cortex is innately prespecified (McKone et al., 2012McKone E. Crookes K. Jeffery L. Dilks D.D. A critical review of the development of face recognition: experience is less important than previously believed.Cogn. Neuropsychol. 2012; 29: 174-212Crossref PubMed Scopus (159) Google Scholar) and that individual regions have a single assigned function (Kanwisher, 2010Kanwisher N. Functional specificity in the human brain: a window into the functional architecture of the mind.Proc. Natl. Acad. Sci. USA. 2010; 107: 11163-11170Crossref PubMed Scopus (498) Google Scholar), which may be immutable. At the opposite extreme is the view that all brain areas are equipotent (Lashley, 1929Lashley K. Brain Mechanisms and Intelligence: A Quantitative Study of Injuries to the Brain.. University of Chigago Press, 1929Crossref Google Scholar), which predicts that many, perhaps even all, regions may plausibly assume the function of another region, and recovery ought to be complete. Of course, there are many other patterns of structure-functions correspondences that fall between these endpoints. To assess the nature and extent of (re)organization of the residual visual cortex, we tracked the longitudinal changes in cortical organization in a pediatric case following surgical removal of the right ventral occipito-temporal cortex (VOTC) as a result of pharmacologically intractable epilepsy (Figures 1A and 1B ). Pre-surgically, U.D. showed typical activation in the retinotopic cortex of both hemispheres and language was left lateralized (Figure S1A). Post-surgically, U.D. had a persistent left homonymous hemianopia as confirmed by two visual perimetry tests conducted 3 years apart (Figure 1C). Starting at 13 months post-surgery (age 7 years 10 months) and during the subsequent 36 months (age 10 years 10 months), U.D. was scanned five times and changes in functional selectivity and/or topography of the higher-order and early visual cortices were explored (Figure 1D). Psychophysics experiments were conducted in parallel to characterize any changes in visual behavior. We mapped regions preferentially responsive to different stimulus categories (faces, scenes, objects, and words; see examples in Figure 2A) in U.D. (7 years 10 months–10 years 10 months) and in eight controls (7 years 5 months–11 years 5 months). Before the analyses, we carefully monitored and matched head motion and temporal signal-to-noise ratio (tSNR) in U.D. and controls (Figures 2D–2F) to ensure that any differences longitudinally or between U.D. and controls were not a result of differences in acquisition or data quality. Category-selective responses are visualized in Figure 2B as a group selectivity map of all controls, the younger controls, and the older controls (two children, 8 years 11 months old, fell on different sides after a median split). Consistent with developmental studies (Golarai et al., 2007Golarai G. Ghahremani D.G. Whitfield-Gabrieli S. Reiss A. Eberhardt J.L. Gabrieli J.D.E. Grill-Spector K. Differential development of high-level visual cortex correlates with category-specific recognition memory.Nat. Neurosci. 2007; 10: 512-522Crossref PubMed Scopus (364) Google Scholar, Scherf et al., 2007Scherf K.S. Behrmann M. Humphreys K. Luna B. Visual category-selectivity for faces, places and objects emerges along different developmental trajectories.Dev. Sci. 2007; 10: F15-F30Crossref PubMed Scopus (266) Google Scholar), the topography in the controls consisted of bilateral face-selective activation in the fusiform face area (FFA; Kanwisher et al., 1997Kanwisher N. McDermott J. Chun M.M. The fusiform face area: a module in human extrastriate cortex specialized for face perception.J. Neurosci. 1997; 17: 4302-4311Crossref PubMed Scopus (136) Google Scholar) and the posterior superior temporal sulcus (STS; Hoffman and Haxby, 2000Hoffman E.A. Haxby J.V. Distinct representations of eye gaze and identity in the distributed human neural system for face perception.Nat. Neurosci. 2000; 3: 80-84Crossref PubMed Scopus (991) Google Scholar), bilateral scene-selective activation in the parahippocampal place area (PPA; Epstein and Kanwisher, 1998Epstein R. Kanwisher N. A cortical representation of the local visual environment.Nature. 1998; 392: 598-601Crossref PubMed Scopus (2160) Google Scholar) and the transverse occipital sulcus (TOS; Nasr et al., 2011Nasr S. Liu N. Devaney K.J. Yue X. Rajimehr R. Ungerleider L.G. Tootell R.B.H. Scene-selective cortical regions in human and nonhuman primates.J. Neurosci. 2011; 31: 13771-13785Crossref PubMed Scopus (171) Google Scholar), bilateral object-selective activation in the lateral occipital complex (LOC; Malach et al., 1995Malach R. Reppas J.B. Benson R.R. Kwong K.K. Jiang H. Kennedy W.A. Ledden P.J. Brady T.J. Rosen B.R. Tootell R.B. Object-related activity revealed by functional magnetic resonance imaging in human occipital cortex.Proc. Natl. Acad. Sci. USA. 1995; 92: 8135-8139Crossref PubMed Scopus (1400) Google Scholar), and left-lateralized word-selective activation in the visual word form area (VWFA; Cohen et al., 2000Cohen L. Dehaene S. Naccache L. Lehéricy S. Dehaene-Lambertz G. Hénaff M.-A. Michel F. The visual word form area: spatial and temporal characterization of an initial stage of reading in normal subjects and posterior split-brain patients.Brain. 2000; 123: 291-307Crossref PubMed Scopus (1413) Google Scholar). That we were able to uncover robust topography of category selectivity both at the group and the individual levels in the controls attests to the sensitivity of the methods. U.D.’s selectivity maps from category localizer 1 (CL1) to CL4 (7 years 10 months–10 years 10 months) are displayed in Figure 2C. Because of the right VOTC resection, most of the category-selective responses in U.D. were confined to the left hemisphere (LH), including left FFA (lFFA) and left STS (lSTS), left PPA (lPPA) and left TOS (lTOS), left LOC (lLOC), and left VWFA. In addition, U.D.’s right STS (rSTS), the only region that showed robust category selectivity (t > 3) in the right hemisphere (RH), showed selectivity for faces. To quantify the stability of category-selective activations in U.D., we used Dice coefficients (Rombouts et al., 1997Rombouts S.A. Barkhof F. Hoogenraad F.G. Sprenger M. Valk J. Scheltens P. Test-retest analysis with functional MR of the activated area in the human visual cortex.AJNR Am. J. Neuroradiol. 1997; 18: 1317-1322PubMed Google Scholar) to assess the degree of overlap in each region across sessions in a pairwise fashion (see STAR Methods). The results revealed that the object-selective lLOC and the scene-selective lPPA and lTOS were identified at reproducible locations across all four sessions (Figure 2C). The moderate-to-high degrees of overlap in these regions (RlPPA = 0.73, threshold = 1440 voxels; RlTOS = 0.61, threshold = 760 voxels; RlLOC = 0.52, threshold = 1320 voxels) provides evidence of good test-retest reliability of longitudinal scans. In contrast, there was minimal overlap in the word-selective VWFA activation across sessions (RVWFA = 0.15, threshold = 300 voxels) and a lateral shift of the VWFA near the occipitotemporal sulcus from CL1 to CL3 (Figure 2C). The topography of face selectivity showed a mixed profile in which the activation remained stable in bilateral STS but was unstable in lFFA. Despite a lack of robust face selectivity in CL1, once face selectivity emerged in bilateral STS in CL2, its topography remained stable through CL4 (RlSTS = 0.69, threshold = 540 voxels; RrSTS = 0.58, threshold = 240 voxels). In contrast, a low Dice coefficient was found in the lFFA across three identifiable sessions (CL2–CL4; RlFFA = 0.29, threshold = 200 voxels). The source of the two low Dice coefficients were, however, different. Distinct from the VWFA, in which there was a shift in the location of activation, the low Dice coefficient in the lFFA was the result of a significant increase in the number of lFFA voxels as a function of age (Figure S2A; R2 = 0.99, p = 0.040). To evaluate whether U.D.’s category-selective topography and activation exhibited typical organization, we carried out three between-subject analyses comparing U.D. and controls. First, Crawford’s modified t test (Crawford and Howell, 1998Crawford J.R. Howell D.C. Comparing an Individual’s Test Score Against Norms Derived from Small Samples.Clin. Neuropsychol. 1998; 12: 482-486Crossref Scopus (942) Google Scholar) on the spatial distribution of category-selective voxels revealed significant deviations in U.D.’s location of word-selective voxels in the center-of-mass X coordinate in CL3 and CL4 (controls: −40.89 ± 2.80; U.D. in CL3: −48.92, t(6) = 2.683, p = 0.036; U.D. in CL4: −50.14, t(6) = 3.090, p = 0.021), but not in any other category-selective regions or sessions (all t < 1.352, all p > 0.225), nor in any of the controls (all t < 1.898, all p > 0.090). Second, there were significantly fewer voxels in the lFFA in U.D. in the second session (CL2) compared to the age-matched controls (t(6) = 2.498, p = 0.047), but not in other sessions or regions (all t < 2.087, all p > 0.05). Third, a linear regression analysis showed that the number of voxels as a function of age in each region of interest (ROI) in U.D. was not significantly different from that of the controls (95% CI; Weaver and Wuensch, 2013Weaver B. Wuensch K.L. SPSS and SAS programs for comparing Pearson correlations and OLS regression coefficients.Behav. Res. Methods. 2013; 45: 880-895Crossref PubMed Scopus (190) Google Scholar). We then examined the magnitude of the selectivity in each region within U.D. over time and then evaluated whether U.D.’s developmental trajectory of category selectivity deviated from that of the controls. To avoid selection bias, category-selective ROIs were identified, using one run in each participant (see STAR Methods), which included lFFA (in 7/8 controls and in U.D.), lSTS (in 5/8 controls and in U.D.), rSTS (in 6/8 controls and in U.D.), lLOC (in 8/8 controls and in U.D.), lPPA (in 8/8 controls and in U.D.), lTOS (in 6/8 controls and in U.D.), and VWFA (in 6/8 controls and U.D.). Within U.D., there was a significant increase in face selectivity with age in the lFFA (Figure 3A, R2 = 0.98, p = 0.008), but not in any other ROI (all R2 < 0.80, all p > 0.05). Consistent with longitudinal studies of newborn monkeys in which early face selectivity was present in future face patches (Livingstone et al., 2017Livingstone M.S. Vincent J.L. Arcaro M.J. Srihasam K. Schade P.F. Savage T. Development of the macaque face-patch system.Nat. Commun. 2017; 8: 14897Crossref PubMed Scopus (51) Google Scholar), the response of the future lFFA, lSTS, and rSTS (defined from run 1 in CL4) in CL1 showed early selectivity to faces (lFFA: t = 2.54, lSTS: t = 1.36, rSTS: t = 2.78), despite the absence of significant face-selective activations in CL1 (not robust at the t > 3 threshold; Figure 2C). Next, we conducted three between-subject analyses to evaluate the magnitude, run-to-run variability, and development of category selectivity in U.D. compared to the controls (Figure 3). First, the magnitude of category selectivity in each session in U.D. was not significantly different from the mean selectivity of the age-matched controls (all t < 1.549, all p > 0.172). Second, the run-to-run variability in selectivity (SD between runs, error bars in Figure 3) in each session in U.D. was also not significantly different from that of the controls in any ROI (all t < 0.597, all p > 0.569). Third, the regression slope (selectivity as a function of age) in each ROI in U.D. (gray dashed lines in Figure 3) was within the 95% CI of that of the controls (black dashed lines in Figure 3), suggesting no significant deviation in U.D.’s development of category selectivity from that of the controls. The normality also held for the significantly positive lFFA slope within U.D. (Figure 3A), which fell within the 95% CI of the controls’ lFFA slope. We have visualized and analyzed the topography and magnitude of category selectivity across sessions in U.D. and compared his profile to that of the matched controls. Particularly intriguing is the visually salient lateral shift of VWFA (Figure 2C), the increase in magnitude (Figure 3) and size (Figure S2) of the lFFA, and the corresponding low Dice coefficient in these two regions across sessions. In typically developing individuals, there is differential hemispheric specialization for word and face representations (greater LH than RH activation for words and the converse pattern for faces). Because both words and faces have many visually confusable and homogeneous exemplars, these two visual classes, but not other classes, are thought to rely on regions of visual cortex with higher-acuity resolution (Levy et al., 2001Levy I. Hasson U. Avidan G. Hendler T. Malach R. Center-periphery organization of human object areas.Nat. Neurosci. 2001; 4: 533-539Crossref PubMed Scopus (511) Google Scholar). However, because the image statistics of face and word exemplars are so dissimilar, it is thought that competition between word and face representations ensues during the course of literacy acquisition, with the result that word and face representations are localized to a greater degree in the LH and RH, respectively (Behrmann and Plaut, 2015Behrmann M. Plaut D.C. A vision of graded hemispheric specialization.Ann. N.Y. Acad. Sci. 2015; 1359: 30-46Crossref PubMed Scopus (79) Google Scholar, Dehaene et al., 2015Dehaene S. Cohen L. Morais J. Kolinsky R. Illiterate to literate: behavioural and cerebral changes induced by reading acquisition.Nat. Rev. Neurosci. 2015; 16: 234-244Crossref PubMed Scopus (374) Google Scholar). In U.D., in whom functional specialization was limited to one VOTC, we examined further the topographical relation between the VWFA and lFFA, with the prediction that the development in the lFFA (Figures 3A and S2A) and the change in topography of VWFA (Figure 2C) in U.D. may reflect experience-dependent plasticity under enhanced competition for neural resources. We tested this prediction using both univariate and multivariate analyses. Within the joint anatomical ROI (FG + OTS) of fusiform gyrus (FG) and the occipitotemporal sulcus (OTS) (Figures 4A and 4B ), a trend of encroachment of face-selective voxels and increase in face selectivity for previously non-selective voxels is evident across sessions (Figure 4C). The number of face-over-word selective voxels [t(face-word) > 0] increased from 45.94% (CL1) to 47.99% (CL2) to 51.68% (CL3) to 67.43% (CL4). The binary change of selectivity [0 if t(face-word) ≤ 0, 1 if t(face-word) > 0] at the voxel level was significant for each pair of sessions (McNemar’s test of change, all χ2 > 10.100, all asymptotic p < 0.005), suggesting that the developing lFFA and adjacent VWFA in the left VOTC exhibited patterns that are consistent with reorganization resulting from competition. Next, we computed the representational dissimilarity matrices (RDMs) to characterize the nature of the multivariate representations in the FG + OTS region (Figure 4D). The multidimensional scaling (MDS) plots (Figure 4E) reveal the similarity structure coded in the RDMs as distances between conditions in a 2D visualization. As apparent in the MDS plot, the different sessions of object and house conditions clustered together, whereas the distance between face and word conditions diverged over session. Using a bootstrap regression analysis (STAR Methods), a stable representation of houses and objects (Figure 4F [yellow dot]) was observed across sessions in the FG + OTS region (within 95% CI) and another control region (lateral occipital area 2 [LO2] [Wang et al., 2015Wang L. Mruczek R.E.B. Arcaro M.J. Kastner S. Probabilistic maps of visual topography in human cortex.Cereb. Cortex. 2015; 25: 3911-3931Crossref PubMed Scopus (291) Google Scholar]; Figure S3). In contrast, a dynamic relation between face and word representations (Figure 4F [red dot]) in the FG + OTS was evident across sessions (outside 95% CI) (see Figures S3C–S3E for a stable representation of faces and words in the control region). Although our focus has been primarily on the remapping of category-selective cortex, we also evaluated the integrity of early visual cortex in U.D. Meridian mapping in retinotopic mapping 1 (RM1) and RM2 (1 year 10 months apart; see STAR Methods) revealed typical retinotopic maps in U.D.’s intact LH, with greater responses to stimulation along the horizontal meridian (solid lines) shown in orange and yellow and greater responses to stimulation along the vertical meridians (dashed lines) shown in blue and green (Figure 5). Pre-surgically, stimulation in the LVF resulted in normal activation of the RH (Figure S1A). In neither post-surgical session was there a response to retinotopic stimulation in the RH under relevant contrasts (Figures 5D and 5E, S4D1, S4E1, S4D2, and S4E2), indicating no remapping of the left visual field to the ipsilateral hemisphere after resection of the right early visual cortex. More important, there was also no response to visual stimulation in the left visual field (LVF) in the intact LH in either session (Figures S4B2 and S4C2). This absence of activation from LVF input was consistent with the persistent left homonymous hemianopia (Figure 1C) and indicates that U.D.’s normal perception measured post-surgically (Figure S5; Table S1) was likely mediated solely by the residual left visual cortex. U.D.’s neuropsychological and scholastic records pre- and post-surgery (Table S2) revealed age-appropriate cognitive performance (IQ 116 and 118). To evaluate his visual behavior, on two separate behavioral testing (BT) sessions (1 year 10 months apart), relative to 14 age-matched controls, we compared his ability to perceive global forms (i.e., contour integration and Glass pattern), recognize faces, and discriminate objects (Figure S5). U.D.’s psychophysical thresholds for the contour integration task (Hadad et al., 2010Hadad B.S. Maurer D. Lewis T.L. The development of contour interpolation: evidence from subjective contours.J. Exp. Child Psychol. 2010; 106: 163-176Crossref PubMed Scopus (34) Google Scholar) fell within the normal range in both the aligned (BT1: t(13) = 0.277, p = 0.786; BT2: t(13) = 0.867, p = 0.402; Crawford’s modified t test) and 20° misaligned condition (BT1: t(13) = 0.416, p = 0.684; BT2: t(13) = 0.398, p = 0.697; Crawford’s modified t test) on both sessions (Table S1). His threshold for detecting the presence of Glass patterns (Lewis et al., 2002Lewis T.L. Ellemberg D. Maurer D. Wilkinson F. Wilson H.R. Dirks M. Brent H.P. Sensitivity to global form in glass patterns after early visual deprivation in humans.Vision Res. 2002; 42: 939-948Crossref PubMed Scopus (85) Google Scholar) was in the normal range at BT1 but was significantly better than the controls’ threshold at BT2 (BT1: t(13) = 1.727, p = 0.108; BT2: t(13) = 2.774, p = 0.016; Crawford’s modified t test) (Table S1). Given that the early visual cortex contributes to the perception of contours and Glass patterns (Field et al., 1993Field D.J. Hayes A. Hess R.F. Contour integration by the human visual system: evidence for a local “association field.”.Vision Res. 1993; 33: 173-193Crossref PubMed Scopus (1240) Google Scholar, Smith et al., 2002Smith M.A. Bair W. Movshon J.A. Signals in macaque striate cortical neurons that support the perception of glass patterns.J. Neurosci. 2002; 22: 8334-8345Crossref PubMed Google Scholar), these results implicate U.D.’s residual left visual cortex as the source of his normal performance. U.D.’s object discrimination performance, measured in a speeded same/different task (Gauthier et al., 1999Gauthier I. Behrmann M. Tarr M.J. Can face recognition really be dissociated from object recognition?.J. Cogn. Neurosci. 1999; 11: 349-370Crossref PubMed Scopus (256) Google Scholar), fell within the normal range in both sessions (controls: accuracy = 88.6% ± 5.9%, inverse efficiency = 1366.4 ± 321.0; BT1: accuracy = 89%, inverse efficiency = 1116.8; BT2: accuracy = 91%, inverse efficiency score = 1502.2; p > 0.05; Crawford’s modified t test) (Table S1). In both sessions, U.D.’s face recognition ability, measured using the Cambridge Face Memory Test for Children (CFMT-C; Croydon et al., 2014Croydon A. Pimperton H. Ewing L. Duchaine B.C. Pellicano E. The Cambridge Face Memory Test for Children (CFMT-C): a new tool for measuring face recognition skills in childhood.Neuropsychologia. 2014; 62: 60-67Crossref PubMed Scopus (30) Google Scholar), fell within the normal range of the control sample from Croydon et al., 2014Croydon A. Pimperton H. Ewing L. Duchaine B.C. Pellicano E. The Cambridge Face Memory Test for Children (CFMT-C): a new tool for measuring face recognition skills in childhood.Neuropsychologia. 2014; 62: 60-67Crossref PubMed Scopus (30) Google Scholar (BT1 compared to 9-year-olds: n = 33, t(32) = 0.540, p = 0.593; BT2 compared to 11-year-olds: n = 29, t(28) = 0.014, p = 0.989, Crawford’s modified t test). Pre-surgical neuropsychological evaluation at age 6 years 6 months (3 months before surgery) documented performance within the high average range in face memory (scaled score = 13 in A Developmental Neuropsychological Assessment-II [NEPSY-II] Memory for Faces subtest). U.D.’s reading comprehension, assessed using the Clinical Evaluation of Language Fundamentals-Fifth Edition (CELF-5), at BT2 revealed above-average performance in his age range (scaled score = 19, mean = 10, 3 SD above mean). His scholastic records and neuropsychological evaluations also documented above-average to proficient reading both before and after surgery (Table S2). In this study, we offer a 3-year longitudinal examination of the extent and nature of reorganization of the visual system in a child, U.D., who underwent a right occipital and posterior temporal lobectomy at age 6 years 9 months. Using both behavioral and neuroimaging approaches, we characterized the status and changes in early and extrastriate visual cortices, evaluated visuoperceptual performance, and assessed the extent to which the reorganized visual system obeyed the normal developmental profile. Several major findings emerged. First, there was no reorganization of the early visual cortex, and U.D. evinced persistent left hemianopia and no activation associated with stimulation in the hemianopic visual field (Figures 5 and S4), despite normal bilateral contralateral activation pre-surgically (Figure S1A). Second, two patterns were observed in category-selective regions: (1) in regions such as lPPA and lTOS, category selectivity was present from the first post-surgical scan, and the topography, extent, and selectivity of these regions fell within the normal distribution and did not change longitudinally (Figures 2, 3, and S2), and (2) the activation pattern of other regions such as the VWFA and the lFFA changed over time, with the location of the VWFA shifting and the extent of the lFFA expanding (Figures 2C and S2A). Moreover, univariate and multivariate analyses revealed that the proximal VWFA and lFFA regions became less similar over time (Figure 4), perhaps reflecting competition for representational space in the residual left VOTC. Notwithstanding the dynamic changes in VOTC, the developmental trajectory of these two regions was not differentiable from the trajectory of normal development, as measured by the slope of size and the slope of category selectivity as a function of age. Finally, consistent with the normal developmental trajectory, U.D.’s performance in tasks tapping intermediate- and high-level visual computations fell entirely within normal limits (Table S1). The dramatic findings of essentially normal perceptual behavior and normal (albeit rearranged) neural correlates, confirmed by converging analytic methods (univariate, multivariate) and multiple dependent measures (Dice coefficients, number of voxels, selectivity), attest to the power of plasticity of the higher-order visual system. We also confirmed that any observed changes in topography and selectivity were not artifacts of the test-retest scanning procedures. We matched the head motion and tSNR across sessions and participants (Figures 2D–2F), and our analytic approach relied primarily on weighted contrasts rather than on absolute response amplitudes. In addition, high Dice coefficients were derived from session to session from the activation profile for some regions (e.g., lPPA, lSTS), attesting to the stability of the data. These careful controls ensure that the observed alterations in topography and selectivity are the veridical product of remapping rather than the outcome of variability in data acquisition. Our data present a systematic longitudinal investigation of visual behavior and neural responses post-lobectomy in childhood and offer a window into the microgenesis of change in the visual system. There was no evidence of remapping in early visual areas, and U.D. evinced a persistent left hemianopia across all of the sessions. While both early and secondary visual areas in both hemispheres were activated in pre-surgery imaging (Figure S1A), no activation from stimulation of the LVF was observed in either hemisphere post-surgery (Figures S4B2–S4E2). The absence of visual field recovery is compatible with persistent contralateral hemianopia following hemispherectomy (Ptito and Leh, 2007Ptito A. Leh S.E. Neural substrates of blindsight after hemispherectomy.Neuroscientist. 2007; 13: 506-518Crossref PubMed Scopus (46) Google Scholar) or visual deprivation (Crair et al., 1998Crair M.C. Gillespie D.C. Stryker M.P. The role of visual experience in the development of columns in cat visual cortex.Science. 1998; 279: 566-570Crossref PubMed Scopus (448) Google Scholar), which indicate that the topography of the early visual cortex may be established and fixed at an early age. In regions whose category-selective emergence typically occurs earlier in development and whose cortical pattern is not typically lateralized to one hemisphere (e.g., lLOC, lPPA), U.D.’s spatial topography followed the normal d" @default.
• W2885325071 created "2018-08-22" @default.
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• W2885325071 date "2018-07-01" @default.
• W2885325071 modified "2023-10-18" @default.
• W2885325071 title "Successful Reorganization of Category-Selective Visual Cortex following Occipito-temporal Lobectomy in Childhood" @default.
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