Throughout most of the 20th century, neuroscientists believed that brain structure was relatively immutable after a critical period during childhood. It is only recently that neuroplasticity, the capacity of the brain to change with experience, has been shown to persist throughout adulthood. Norman Doidge, MD, in his 2007 book The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science, provides numerous examples of how resilient and plastic the brain can be. As substantial work continues on utilizing neuroplasticity to supplement lost function in the injured brain, rehabilitation programs increasingly leverage the ability of the brain to develop new pathways based upon stimulation and feedback loops.
Neuroplasticity results from repetitive stimulation of new neuronal pathways. As we process information, our brains utilize the fastest and most regularly used nerve pathways. If those pathways are damaged, and we wish to retain that function, we need the remainder of our brain to find a way to process the information and achieve the same outcome. That involves creating new pathways to achieve a similar functional outcome.
The ability to leverage the neuroplasticity of our brains can positively influence both how we manage the problems of a damaged brain, and how we improve cognitive function and prevent cognitive decline as a normal brain ages. This latter ability, to leverage neuroplasticity in a normally aging brain, was highlighted by Abhilash K. Desai, MD, in an article appearing in a recent issue of Medical Clinic of North America. Dr. Desai describes how older adults “maintain social connectedness, an ongoing sense of purpose, and the abilities to function independently, to permit functional recovery from illness or injury, and to cope with residual functional deficits.” His research is also applicable to rehabilitation and highlights the critical need to engage in activities that enhance brain health. Specifically, he found that “as the brain networks and neurons get activated repetitively, they become more efficient and can process faster,” and that they also “require less initial stimulus to fire up the action potential.” Dr. Desai identified some common factors that can influence neuroplasticity:
One of the tools used to treat both damaged and normal brains is technology known as the brain-computer interface (BCI). These devices receive input from receptors on the body that transmit signals to a device that then produces an action. The devices can provide different forms of output, which become sensory input to the person using the device. There are adaptive changes that occur in neurons and synapses throughout the central nervous system as a result of using these devices that support learning new information and acquiring new skills. These devices help a damaged nervous system find alternative pathways to deliver the same function, and they help healthy, aging brains improve cognitive function and slow cognitive decline. As the technology improves, it will be exciting to see the benefits to a wider range of individuals beyond the currently limited scope of neuro-rehab.