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Supriya Ramesh • 06 Dec 2024
Rewiring the Brain for Recovery After Stroke and Brain Injury
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Neuroplasticity refers to the brain's ability to reorganise itself by forming new neural connections throughout life, particularly after injury or damage. This adaptive process allows the brain to compensate for lost functions or reorganise its activities, and it plays a critical role in recovery after events like stroke or brain injury.
Role of Neuroplasticity in Stroke and Brain Injury Recovery
Reorganisation of Brain Functions: After a stroke or brain injury, the brain areas affected may no longer function as they did before. “Neuroplasticity enables other brain parts to take over the functions of the damaged regions. For example, if the part of the brain responsible for speech is damaged, other regions in the brain may adapt to help with language processing,” Dr Rajesh Gupta, Director of Neurosciences and Neurology at the Max Super Speciality Hospital, Patparganj, explains.
Restoration of Motor Function: One of the most significant effects of neuroplasticity in stroke recovery is the restoration of motor function. When stroke damages motor areas of the brain, neuroplasticity facilitates the rewiring of neural pathways, allowing the brain to recruit other areas to regain some level of movement or dexterity, according to Dr Gupta.
“Rehabilitation therapies such as physical, occupational, and speech therapy stimulate neuroplasticity, promoting the brain’s ability to create new pathways for movement,” he adds.
Cognitive Recovery: Cognitive functions like memory, attention, and problem-solving can be impacted by stroke or brain injury. Dr Gupta says that neuroplasticity aids in the restructuring of neural networks that were affected by the injury. “With therapeutic interventions, patients can strengthen cognitive functions and improve mental agility by stimulating neuroplastic changes in the brain,” he says.
Critical Periods for Plasticity: While neuroplasticity can occur at any stage of life, Dr Gupta says, it tends to be more robust during certain windows of recovery, especially in the early stages following a stroke or brain injury. “The brain is more adaptable and responsive to rehabilitation efforts soon after the injury, which is why early intervention can significantly improve recovery outcomes,” he adds.
Intensive Rehabilitation and Neuroplasticity: The process of neuroplasticity is enhanced through intense and repetitive rehabilitation exercises. According to Dr Gupta, techniques like constraint-induced movement therapy, functional electrical stimulation, and mental practice encourage the brain to "retrain" itself. This intense activity, he says, can promote the reorganisation of neural circuits, helping patients recover physical, emotional, and cognitive functions.
Limitations and Variability: While neuroplasticity offers significant potential for recovery, it is not always sufficient to restore all functions, especially in severe brain injuries. “The degree of neuroplastic recovery can vary based on factors such as the location and extent of the brain damage, the patient’s age, pre-existing brain health, and the timing and intensity of rehabilitation. Additionally, the reorganisation might not fully replicate the original brain function,” Dr Gupta explains.
Brain Stimulation and Neuroplasticity: Recent studies have shown that certain forms of brain stimulation, such as transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS), can enhance neuroplasticity. “These non-invasive techniques stimulate the brain to promote neural recovery and functional reorganisation, providing additional support during the recovery process,” he says.
In a nutshell, through therapies and rehabilitation, the brain can adapt and form new neural pathways to compensate for damaged areas, offering hope for patients in their recovery journey. However, the extent of recovery varies, and the success of neuroplasticity often depends on early, targeted interventions.
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