Advertisement

Neuroplasticity in Brain Injury: Maximizing Recovery

  • 76 Accesses

Abstract

Purpose of Review

The ability to promote greater neuroplasticity through external influencers is an emerging field of study with potentially significant consequences on the treatment of neurologic injury. Several of these methods are reviewed in this paper.

Recent Findings

Through advances in neuroscience, a clearer understanding of the complexity of the brain’s interconnectedness and its ability to adapt to the environment is leading to neurorehabilitation treatments that augment the brain’s capacity towards neuroplastic change.

Summary

An increased appreciation and recognition of neuroplasticity has led to novel approaches to promote neurorecovery that increase stimulation and the release of neutrophic factors. Some of these interventions include the use of pharmacologic agents, noninvasive stimulation, mirror therapy, aerobic and task-specific exercise, and the maximization of sleep. Future research will continue to build upon this foundation by continuing to pair therapeutic interventions with rehabilitation to enhance the brain’s natural healing power and improve functional outcomes.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 99

This is the net price. Taxes to be calculated in checkout.

References

    Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

    1. 1.

      Warraich Z, Kleim JA. Neural plasticity: the biological substrate for neurorehabilitation. PMR. 2010;2:S208–19. https://doi.org/10.1016/j.pmrj.2010.10.016.

    2. 2.

      Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008;51:S225–39. https://doi.org/10.1044/1092-4388(2008/018).

    3. 3.

      Stein DG, Hoffman SW. Concepts of CNS plasticity in the context of brain damage and repair. J Head Trauma Rehabil. 2003;18:317–41.

    4. 4.

      Nudo RJ, Milliken GW, Jenkins WM, Merzenich MM. Use-dependent alterations of movement representations in primary motor cortex of adult squirrel monkeys. J Neurosci. 1996;16:785–807.

    5. 5.

      Nudo RJ, Wise BM, SiFuentes F, Milliken GW. Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct. Science. 1996;272:1791–4.

    6. 6.

      Fuchs E, Flugge G. Adult neuroplasticity: more than 40 years of research. Neural Plast. 2014;2014:1–10.

    7. 7.

      Duffau H. The huge plastic potential of adult brain and the role of connectomics: new insights provided by serial mappings in glioma surgery. Cortex. 2014;58:325–37. https://doi.org/10.1016/j.cortex.2013.08.005.

    8. 8.

      Grefkes C, Fink GR. Reorganization of cerebral networks after stroke: new insights from neuroimaging with connectivity approaches. Brain. 2011;134:1264–76. https://doi.org/10.1093/brain/awr033.

    9. 9.

      • Clayton E, Kinley-Cooper SK, Weber RA, Adkins DL. Brain stimulation: neuromodulation as a potential treatment for motor recovery following traumatic brain injury. Brain Res. 2016;1640:130–8. https://doi.org/10.1016/j.brainres.2016.01.056. This review article presents the background literature on various brain stimulation devices. Specifically, transcranial magnetic stimulation and transcranial direct stimulation are discussed.

    10. 10.

      Thieme H, Mehrholz J, Pohl M, Behrens J, Dohle C. Mirror therapy for improving motor function after stroke. Cochrane Database of Systematic Reviews 2012, 7: Issue 3. Art. No.: CD008449. DOI: https://doi.org/10.1002/14651858.CD008449.pub2.

    11. 11.

      •• Carillo-Mora P, Alcantar-Shramm JM, Almaguer-Benavides KM, Macias-Gallardo JJ, Fuentes-Bello A, Rodriguez-Barragan MA. Pharmacological stimulation of neuronal plasticity in acquired brain injury. Clin Neuropharm. 2017;40:1–9. https://doi.org/10.1097/WNF.0000000000000217. This is article provides a comprehensive review of the medications thought to promote neuroplasticity in individuals with acquired brain injury.

    12. 12.

      Al-Dughmi M, Al-Sharman A, Stevens S, Siengsukon CF. Executive function is associated with off-line motor learning in people with chronic stroke. J Neurol Phys Ther. 2017;41(2):101–6. https://doi.org/10.1097/NPT.0000000000000170.

    13. 13.

      Doidge N. The brain that changes itself: stories of personal triumph from the frontiers of brain science. New York: Penguin Group; 2007.

    14. 14.

      Ventriglio A, Bhugra D. Descartes’ dogma and damage to western psychiatry. Epidemiol Psychiatr Sci. 2015;24:368–70. https://doi.org/10.1017/S2045796015000608.

    15. 15.

      Serrano-Castro PJ, Garcia-Torrecillas JM. Cajal’s first steps in scientific research. Neuroscience. 2012;217:1–5. https://doi.org/10.1016/j.neuroscience.2012.05.008.

    16. 16.

      Azmitia EC, et al. Prog Brain Res. 2002;136:87–100.

    17. 17.

      Sporns O, Honey CJ, Kotter R. Identification and classification of hubs in brain networks. PLoS One. 2007;2:e1049.

    18. 18.

      Nomura EM, Gratton C, Visser RM, Kayser A, Perez F, D’Esposito M. Double dissociation of two cognitive control networks in patients with focal brain lesions. Proc Natl Acad Sci U S A. 2010;107:12017–22. https://doi.org/10.1073/pnas.1002431107.

    19. 19.

      Merlo L, Cimino F, Angileri FF, La Torre D, Conti A, Cardali SM, et al. Alteration in synaptic function proteins following traumatic brain injury. J Neurotrauma. 2014;31:1375–85. https://doi.org/10.1089/neu.2014.3385.

    20. 20.

      • Wenderoth N. Motor learning triggers neuroplastic processes while awake and during sleep. Exerc Sport Sci Rev. 2018;46(3):152–9. https://doi.org/10.1249/JES.0000000000000154. This review provides a comprehensive overview that the role sleep has on motor learning.

    21. 21.

      Raven F, der Zee V, Meerlo P, Havekes R. The role of sleep in regulating structural plasticity and synaptic strength: implications for memory and cognitive function. Sleep Med Rev. 2018;39:3–11. https://doi.org/10.1016/j.smrv.2017.05.002.

    22. 22.

      • Bono J, Wilmes KA, Clopath C. Modelling plasticity in dendrites: from single cells to networks. Curr Opin Neurobiol. 2017;46:136–41. https://doi.org/10.1016/j.conb.2017.08.013. This article presents information on the complex role of dendrites in neuroplasticty.

    23. 23.

      Liebigt S, Schlegel N, Oberland J, Witte OW, Redecker C, Keiner S. Effects of rehabilitative training and anti-inflammatory treatment on functional recovery and cellular reorganization following stroke. Exp Neurol. 2012;233:116–82. https://doi.org/10.1016/j.expneurol.2011.11.037.

    24. 24.

      • Cassilhas RC, Tufik S, Tulio de Mello M. Physical exercise, neuroplasticity, spatial learning and memory. Cell Mol Life Sci. 2016;73:975–‘. https://doi.org/10.1007/s00018-015-2102-0. This article discusses the role of physical exercise in facilitating learning and memory through neuroplasticity.

    25. 25.

      Corrigan F, Arulsamy A, Teng J, Collins-Praino LE. Pumping the brakes: neurotrophic factors for the prevention of cognitive impairment and dementia after traumatic brain injury. J Neurotrauma. 2017;34:971–86. https://doi.org/10.1089/neu.2016.4589.

    26. 26.

      Ward J. Synesthia. Annu Rev Psychol. 2013;64:49–75. https://doi.org/10.1146/annurev-psych-113011-143840.

    27. 27.

      O’Neil-Pirozzi TM, Doruk D, Thomson JM, Fregni F. Immediate memory and electrophysiologic effects of prefrontal cortex transcranial direct current stimulation on neurotypical individuals and individuals with chronic traumatic brain injury: a pilot study. Int J Neurosci. 2017;127(7):592–600. https://doi.org/10.1080/00207454.2016.1216415.

    28. 28.

      Shin SS, Dixon E, Okonkwo DO, Richardson M. Neurostimulation for traumatic brain injury. J Neurosurg. 2014;121:1219–31. https://doi.org/10.3171/2014.7.JNS131826.

    29. 29.

      Neren D, Johnson MD, Legon W, Bachour SP, Ling G, Divani AA. Vagus nerve stimulation and other neuromodulation methods for treatment of traumatic brain injury. Neurocrit Care. 2016;24:308–19. https://doi.org/10.1007/s12028-015-0203-0.

    30. 30.

      Kim W, Lee K, Kim S, Cho S, Paik N. Transcranial direct current stimulation for the treatment of motor impairment following traumatic brain injury. J Neuroeng Rehabil. 2019;16:1–10. https://doi.org/10.1186/s12984-019-0489-9.

    31. 31.

      Deconinck FJA, Smorenburg ARP, Benham A, Ledebt A, Feltham MG, Savelsberg GJP. Reflections on mirror therapy: a systematic review of the effect of mirror visual feedback on the brain. Neurorehabil Neural Repair. 2015;29:349–61. https://doi.org/10.1177/1545968314546134.

    32. 32.

      • Zeng W, Guo Y, Wu G, Liu X, Fang Q. Mirror therapy for motor function of the upper extremity in patients with stroke: a meta-analysis. J Rehabil Med. 2018;50:8–15. https://doi.org/10.2340/16501977-2287. This review article presents data on the efficacy of mirror therapy on the upper extremity.

    33. 33.

      • Louie DR, Lim SB, Eng JJ. The efficacy of lower extremity mirror therapy for improving balance, gait, and motor function poststroke: a systematic review and meta-analysis. Journal of Stroke and Cerebrovascular Diseases. 2019;28(1):107–20. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.09.017. This review paper presents data on the efficacy of mirror therapy on balance, walking (specifically walking speed) and lower limb function.

    34. 34.

      •• Alawieh A, Zhao J, Feng W. Factors affecting post-stroke motor recovery: implications on neurotherapy after brain injury. Behavioural Brain Research. 2018;340:94–101. https://doi.org/10.1016/j.bbr.2016.08.029. This review articles discusses three categories of factors (sociodemographic, clinical and genetic) and how they may impact motor recovery following a stroke.

    35. 35.

      Mang CS, Campbell KL, Ross CJD, Boyd LA. Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor. Phys Ther. 2013;93(12):1707–16. https://doi.org/10.2522/ptj.20130053.

    36. 36.

      Gomez Beldarrain M, Gonzalez Astorgano A, Bilbao Gonzalez A, Garcia-Monco JC. Sleep improves sequential motor learning and performance in patients with prefrontal lobe lesions. Clin Neurol Neurosurg. 2008;110:245–52.

    37. 37.

      Al-Sharman A, Siengsukon CF. Performance on a functional motor task is enhanced by sleep in middle-aged and older adults. JNPT. 2014;38:161–9. https://doi.org/10.1097/NPT.0000000000000048.

    38. 38.

      Bachhaus W, Kempe S, Hummel FC. The effect of sleep on motor learning in the aging and stroke population- a systematic review. Restor Neurol Neurosci. 2015;34(1):153–64. https://doi.org/10.3233/RNN-150521.

    39. 39.

      Siengsukon C, Al-Dughmi M, Al-Sharman A, Stevens S. Sleep parameters, functional status, and time post-stroke are associated with offline motor skill learning in people with chronic stroke. Front Neurol. 2015;6:225. https://doi.org/10.3389/fneur.2015.00225.

    40. 40.

      Nielsen JB, Willerslev-Olsen M, Christianen L, Lundbye-Jensen J, Lorentzen. Science-based neurorehabilitation: recommendation for neurorehabilitation from basic science. J Mot Behav. 2015;47(1):7–17. https://doi.org/10.1080/00222895.2014.931273.

    41. 41.

      Siengsukon CF, Boyd LA. Sleep to learn after stroke: implicit and explicit off-line motor learning. Neurosci Lett. 2009;451(1):1–5. https://doi.org/10.1016/j.neulet.2008.12.040.

    42. 42.

      Siengsukon C, Boyd L. Sleep enhances off-line spatial and temporal motor learning after stroke. Neurorehabil Neural Repair. 2009;23(4):327–35. https://doi.org/10.1177/1545968308326631.

    43. 43.

      Mathias JL, Alvaro PK. Prevalence of sleep disturbances, disorders, and problems following traumatic brain injury: a meta-analysis. Sleep Med. 2012;13:898–905. https://doi.org/10.1016/j.sleep.2012.04.006.

    Download references

    Author information

    Correspondence to Neil Jasey.

    Ethics declarations

    Conflict of Interest

    Neil Jasey and Irene Ward declare that they have no conflicts of interest.

    Human and Animal Rights and Informed Consent

    This article does not contain any studies with human or animal subjects performed by any of the authors.

    Additional information

    Publisher’s Note

    Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

    This article is part of the Topical Collection on Brain Injury Medicine and Rehabilitation

    Rights and permissions

    Reprints and Permissions

    About this article

    Verify currency and authenticity via CrossMark

    Cite this article

    Jasey, N., Ward, I. Neuroplasticity in Brain Injury: Maximizing Recovery. Curr Phys Med Rehabil Rep 7, 333–340 (2019). https://doi.org/10.1007/s40141-019-00242-7

    Download citation

    Keywords

    • Neuroplasticity
    • Neural plasticity
    • Neurorecovery
    • Rehabilitation
    • Brain injury