Think of your brain like a city. Different parts of the city are in charge of different jobs. The ventral occipitotemporal cortex (VOTC) is like the district that handles visual tasks. It helps you recognize faces, objects, words, and places. In most people, this area is set up in a predictable way, with certain clusters of brain cells always responding to the same kinds of things. Scientists believe this setup comes partly from the brain’s natural structure and partly from what we learn and experience.
But what happens if part of this “city” is removed? This study looked at five children who had surgery to remove part of the VOTC to treat drug-resistant epilepsy. Researchers compared them to 25 kids without brain surgery. The results were surprising and showed just how flexible and adaptable the developing brain can be.
One major finding was that the brain can reorganize itself when needed. For example, the parts of the brain that normally handle reading and language are usually in the left hemisphere. But in three children who had the left VOTC removed, those entire reading and language networks moved over to the right side of the brain. This wasn’t just a small adjustment; it was a big relocation of an entire system. Kids who had surgery on the right side, or further forward on the left, did not show this same dramatic shift.
Even when these functions moved, the brain kept some of its “rules.” The overall layout stayed orderly, just in a new location. Over time, the brain also showed it could create new specialized areas to handle important skills like reading.
The study also supported the idea that reading works best when the word area (called the Visual Word Form Area, or VWFA) is located near language areas. In kids who lost the left VOTC, the whole network—VWFA plus language regions—shifted together to the right hemisphere, keeping that close connection. This shows how important it is for these systems to stay linked.
Not all outcomes were the same, though. In one child who had surgery later in childhood, the relocated reading and language areas weren’t as sharp as in the other two. This suggests that the age of surgery or how long seizures had been present may affect how well the brain can reorganize.
The study also looked at competition within the brain. Some areas had to “choose sides.” For example, regions that used to focus on faces sometimes switched to focusing on words instead. Interestingly, this competition mainly happened between faces and words, since both need high-detail vision. Other categories, like objects and houses, stayed stable.
Despite these big changes, most children in the study did very well. Their test results were close to those of kids without surgery, showing that the brain can adapt and still function strongly even after losing a major part.
That said, it’s important to note that this was a small study with only five patients who had very specific surgeries. These results don’t apply to every child with brain injury or surgery. But the findings do give us a powerful example of how resilient and flexible the developing brain can be.
Source: Liu, T.T., Granovetter, M.C., S. Maallo, A.M. et al. Cross-sectional and longitudinal changes in category selectivity in visual cortex following pediatric cortical resection. Commun Biol 8, 1200 (2025). https://doi.org/10.1038/s42003-025-08554-2
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