Exploring Neurosurgery Techniques for Enhancing Brain Thing Functions in General Populations and Other Area Matters: A Narrative Review

Abstract

Background: The field of neurosurgery is evolving from a discipline focused on structural correction to one capable of directly modulating brain function. This progression prompts a fundamental question: are the functional outcomes of these interventions a result of specific neuromodulation or a consequence of the physical surgical act itself? Objective: This narrative review aims to critically examine the existing literature to determine whether contemporary neurosurgical techniques enhance brain function through a primarily "neuro" mechanism, a "surgical" mechanism, or a synergistic interplay of both. Main Discussion Points: The review synthesizes evidence across key themes, including the circuit-level modulation achieved by deep brain stimulation for neuropsychiatric disorders, the cognitive consequences of surgical disconnection in ablative procedures, and the emergent network reorganization following resective surgery for epilepsy. The analysis highlights that while advanced techniques demonstrate targeted neurophysiological effects, the evidence is often constrained by methodological limitations such as small sample sizes and a lack of controlled trials. The discussion also explores the implications of these findings for potential cognitive enhancement beyond severe pathology. Conclusion: The evidence suggests that the most significant functional outcomes arise from a synergistic model where the surgical procedure enables precise, targeted neuromodulation, rendering the "neuro" and "surgical" components inseparable. Future progress hinges on larger, mechanistic studies employing standardized outcome measures to fully elucidate these interactions and guide the ethical application of these powerful interventions.