neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.63769/1683-3295-2025-27-2-142-153neurosurgery-1692Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWФеномен нейропластичности коры головного мозга человекаPhenomenon of cortical neuroplasticity in humansГоряйновС. А.GoryaynovS. A.

Сергей Алексеевич Горяйнов

249031 Обнинск, ул. Маршала Жукова, 10

2140190 Смоленск, ул. Крупской, 28

 

Sergey Alekseevich Goryajnov 

10 Marshala Zhukova St., Obninsk 249031

28 Krupskoy St., Smolensk 214019

sgoraynov@gmail.comhttps://orcid.org/0000-0002-9451-3565БуклинаС. Б.BuklinaS. B.

125047 Москва, ул. 4-я Тверская-Ямская, 16

117997 Москва, ул. Островитянова, 1

16 4-ya Tverskaya-Yamskaya St., Moscow 125047

1 Ostrovityanova St., Moscow 117513

https://orcid.org/0000-0003-0183-5643МасловаН. Н.MaslovaN. N.

2140190 Смоленск, ул. Крупской, 28

28 Krupskoy St., Smolensk 214019

https://orcid.org/0000-0001-9419-3533ЮрьеваН. В.Yur’evaN. V.

2140190 Смоленск, ул. Крупской, 28

28 Krupskoy St., Smolensk 214019

https://orcid.org/0000-0002-8924-7346БаталовА. И.BatalovA. I.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4-ya Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-2523-3009ЖуковВ. Ю.ZhukovV. Yu.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4-ya Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0001-5327-314XАлександроваЕ. В.AleksandrovaE. V.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4-ya Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-0931-1636ГусевД. В.GusevD. V.

117997 Москва, ул. Островитянова, 1

1 Ostrovityanova St., Moscow 117513

https://orcid.org/0000-0002-0516-3613ЗахароваН. Е.ZakharovaN. E.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4-ya Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-4480-0275ПронинИ. Н.ProninI. N.

125047 Москва, ул. 4-я Тверская-Ямская, 16

16 4-ya Tverskaya-Yamskaya St., Moscow 125047

Медицинский радиологический научный центр им. А. Ф. Цыба – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России; ФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава РоссииРоссияA.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Health of Russia; Smolensk State Medical University, Ministry of Health of RussiaRussian FederationФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. акад. Н. Н. Бурденко» Минздрава России; ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава РоссииРоссияN.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaRussian FederationФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава РоссииРоссияSmolensk State Medical University, Ministry of Health of RussiaRussian FederationФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. акад. Н. Н. Бурденко» Минздрава РоссииРоссияN.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава РоссииРоссияN.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaRussian Federation202518082025272142153Copyright © Горяйнов С.А., Буклина С.Б., Маслова Н.Н., Юрьева Н.В., Баталов А.И., Жуков В.Ю., Александрова Е.В., Гусев Д.В., Захарова Н.Е., Пронин И.Н., 20252025Горяйнов С.А., Буклина С.Б., Маслова Н.Н., Юрьева Н.В., Баталов А.И., Жуков В.Ю., Александрова Е.В., Гусев Д.В., Захарова Н.Е., Пронин И.Н.Goryaynov S.A., Buklina S.B., Maslova N.N., Yur’eva N.V., Batalov A.I., Zhukov V.Y., Aleksandrova E.V., Gusev D.V., Zakharova N.E., Pronin I.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1692Введение

Введение. Нейропластичность коры головного мозга является уникальным феноменом, имеющим не только фундаментальное, но и клиническое значение в неврологии и нейрохирургии.

Цель исследования – анализ данных литературы о феномене нейропластичности мозга человека при различных заболеваниях и факторах, влияющих на него.

Материалы и методы

Материалы и методы. Анализ литературы в системе PubMed выполнен по поиску слов “neuroplasticity”, “cortical plasticity” и “glioma surgery”. В работе в качестве иллюстраций использованы несколько клинических примеров из практики авторов.

Результаты

Результаты. На основании данных литературы в статье приводятся основные виды нейропластичности в зависимости от типа патологического процесса; локализации кортикальных зон, участвующих в формировании нейропластичности; полноты возмещения утраченной мозговой функции; времени возникновения феномена; скорости развития патологического процесса. Показана особая роль сохранности трактов белого вещества в обеспечении нейропластичности. Показано клиническое значение данного феномена для нейрохирургии на примере внутримозговых опухолей, локализованных в функционально значимых зонах головного мозга.

Заключение

Заключение. Нейропластичность коры головного мозга наиболее характерна для «медленных» патологических процессов, таких как глиомы низкой степени злокачественности, в отличие от «быстрых» процессов, таких как злокачественные опухоли, травмы, инсульты. Речевые зоны коры головного мозга более подвержены пластичности, чем двигательные (за исключением дополнительной моторной области). В механизмы компенсации могут включаться зоны коры, расположенные как вблизи очага поражения, так и на отдалении, в том числе контралатеральное полушарие. Феномен нейропластичности помогает компенсировать функции пораженных участков коры головного мозга как при развитии заболевания, так и при выполнении многоэтапных нейрохирургических вмешательств. Возможной перспективой является технология транскраниальной магнитной стимуляции для управления нейропластичностью как при опухолевых, так и при неопухолевых поражениях головного мозга.

Background

Background. Neuroplasticity of the brain cortex is a unique phenomenon. It has both scientific and clinical significance for neurology and neurosurgery.

Aim

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

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

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.

нейропластичностькора головного мозгатракты белого веществаглиомаneuroplasticitycerebral cortexwhite matter tractsgliomaРабота выполнена при поддержке гранта Министерства образования и науки РФ № 075-15-2021-1343 «Развитие биоресурсной коллекции опухолей нервной системы человека с молекулярно-генетической паспортизацией для персонифицированного лечения пациентов с нейроонкологическими заболеваниями».The study was performed with support from the grant of the Ministry of Education and Science of the Russian Federation No. 075-15-2021- 1343 “Development of bioresource collection of tumors of the human nervous system with molecular and genetic passporting for personalized treatment of patients with neuro-oncological diseases”.ReferencesCargnelutti E., Ius T., Skrap M., Tomasino B. What do we know about pre- and postoperative plasticity in patients with glioma? A review of neuroimaging and intraoperative mapping studies. Neuroimage Clin 2020;28:102435. 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The authors declare that there are no conflicts of interest present.