#Neuroplasticity: clinical interventions, treatment, recovery. #Experience_dependent interventions, mechanism of neuroplasticity, require multimodal approach.
By: Dr. Lukianoff
Although quantifiable (scientific) results on this topic are still in its infancy, research findings suggest a positive outcome in working clinically with the principles of neuroplasticity for interventions and treatment outcome.
Experience-dependent clinical interventions based on the principles of neuroplasticity require a multimodal treatment approach. Implementing the Hebbian principles, a neuroscience theory explaining the process of neurogenesis during learning, with cognitive behavioral techniques, achieving tasks and goals, socializing and exercising, can produce a measurable outcome. “A key principle in neuroplasticity is the value of coupling a plasticity-promoting intervention with behavioral reinforcement…” (Cramer, Sur, Dobkin, O'Brien, Sanger, Trojanowski, & Vinogradov, p. 1598, 2011).
Neuroplasticity occurs when the nervous system responds to experiences, thus experience-dependent. Experiences create a stimulus that ignites neural firing patterns in the brain to imprint or re-transcribe an experience, or to reorganize the infrastructure of previous experiences via new neural pathways.
Researchers Cramer, Sur, Dobkin, O'Brien, Sanger, Trojanowski, & Vinogradov (2011) examine the function of neuroplasticity in the context of clinical psychology via interventions and treatments, including CNS trauma recovery.
“To advance the translation of Neuroplasticity research towards clinical applications, the National Institutes of Health Blueprint for Neuroscience Research sponsored a workshop in 2009. Basic and clinical researchers in disciplines from central nervous system injury/stroke, mental/addictive disorders, pediatric/developmental disorders and neurodegenerative/ aging identified cardinal examples of Neuroplasticity, underlying mechanisms, therapeutic implications and common denominators”, (p. 1592, 2011).
Implicit in the clinical application of working with the principles of neuroplasticity is a multidisciplinary and multimodal approach to treatment/interventions. Within the clinical context, the emphasis is on adaptive plasticity, associated with a positive gain in treatment or functionality. Participating in regular physical exercise and learning something new illuminate the experience-dependent neural growth aspect of neuroplasticity and neurogenesis. “Aerobic exercise is associated with increased neurogenesis and angiogenesis…”, “…aerobic exercise programs lasting even just a few months significantly benefit cognitive functioning…have been shown to increase brain volume in a variety of regions (Colcombe et al., 2006; Pajonk et al., 2010)…and to enhance brain network functioning…” (p. 1600, 2011). Exercise enhances cognitive functioning which increases our learning capacity.
Interventions and treatments designed with the intention of working with the principles of neuroplasticity are used for various CNS injuries, like traumatic brain injury. These treatment interventions are measurable in terms of outcome. “Interestingly, after spinal cord injury, treatment-induced brain plasticity can be measured in the absence of behavioral change”, (p. 1594). The mechanisms of neuroplasticity apply to a range of CNS injuries and treatments.
“Studies of motor recovery after stroke illustrate the principle that many forms of neuroplasticity can be ongoing in parallel. Injury to a region of the motor network can result in spontaneous intra-hemispheric changes, such as in representational maps, e.g. the hand area can shift dorsally to invade the shoulder region (Nudo et al., 1996; Muellbacher et al., 2002) or face region (Weiller et al., 1993; Cramer and Crafton, 2006)”, , (Sur, Dobkin, O'Brien, Sanger, Trojanowski, & Vinogradov, p. 1592-3, 2011).
A clinical psychology perspective includes, among many interdisciplinary approaches, a combination of psychopharmacological interventions with cognitive behavioral treatments, and an understanding of the mechanisms involved in the formation of new neural networks, patterns, and pathways. Already established clinical psychological practices closely related to neuroplasticity include developmental psychology and critical periods of (neural) growth.
A rehabilitative perspective includes patients who’ve suffered CNS injury, stroke, and spinal cord injury. In particular, patients recovering from stroke are dependent upon new neural growth, neurogenesis, and new neural patterns and pathways, neuroplasticity. The brain of a recovering stroke victim begins reorganizing itself.
Cramer, S. C., Sur, M., Dobkin, B. H., O'Brien, C., Sanger, T. D., Trojanowski, J. Q. & Vinogradov, S. (2011). Harnessing neuroplasticity for clinical applications. Brain, a Journal of Neurology. Volume 134(6); p.p.: 1591-1609. DOI: http://dx.doi.org/10.1093/brain/awr039 .
This blog is intended to explore ideas, educate, entertain and expand our thinking. Some posts speak to current trends in the brain sciences, neural benefits of exercise & sports, emotional intelligence and personal growth.