Asymmetrical Brain Plasticity: Physiology and Pathology.

The brain is inherently asymmetrical. How that attribute, manifest both structurally (volumetric, cytological, molecular) as well as functionally, relates to cognitive function, is not fully understood. Since the early descriptions of Paul Broca and Marc Dax it has been known that the processing of language in the brain is fundamentally asymmetrical. Contemporary imaging studies have corroborated early observations, and have also revealed significant functional links to multiple other systems, such as those sub serving memory or emotion. Recent studies have demonstrated that laterality is both plastic and adaptive. Learning and training have shown to affect regional changes in asymmetry, such as that observed in the volume of the planum temporale associated with musical practice. Increasing task complexity has been demonstrated to induce recruitment of contralateral regions, suggesting that laterality is a manifestation of functional reserve. Indeed, in terms of cognitive function, successful aging is often associated with a reduction of asymmetrical activity. The goal of this review is to survey and critically appraise the current literature addressing brain laterality, both morphological and functional, with particular emphasis on the asymmetrical plasticity associated with environmental factors and training. The plastic recruitment of contralateral areas associated with aging and unilateral lesions will be discussed in the context of the loss of asymmetry as a compensatory mechanism, and specific instances of maladaptive plasticity will be explored.