Functional resilience of the neural visual recognition system post-pediatric occipitotemporal resection

Summary: Neural representations for visual stimuli typically emerge with a bilateral distribution across occipitotemporal cortex (OTC). Pediatric patients undergoing unilateral OTC resection offer an opportunity to evaluate whether representations for visual stimulus individuation can sufficiently develop in a single OTC. Here, we assessed the non-resected hemisphere of patients with pediatric resection within (n = 9) and outside (n = 12) OTC, as well as healthy controls’ two hemispheres (n = 21). Using functional magnetic resonance imaging, we mapped category selectivity (CS), and representations for visual stimulus individuation (for faces, objects, and words) with repetition suppression (RS). There were no group differences in CS or RS. However, OTC resection patients’ accuracy on face and object (but not word) recognition was lower than controls’. The neuroimaging results highlight neural resilience following damage to the contralateral homologue. Critically, however, a single OTC does not suffice for typical behavior, and, thereby, implicates the necessary contributions of bilateral OTC for visual recognition.