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What is Neuroplasticity and Why Should You Care?
According to Taber's Cyclopedic Medical Dictionary (2005), neuroplasticity is “the ability of the nervous system to adapt to trauma or disease; the ability of nerve cells to grow and form new connections to other neurons.” Basically, it is the ability of the brain and nervous system to change in response to experience or stimuli.
Until recently, the mainstream scientific view was that the adult human brain couldn’t change structurally and that functions were hardwired in specific areas. So if you had a stroke or lesion or something that destroyed the functioning of part of your brain, you might improve a little bit, but on the whole you were just out of luck.
More recent research has shown that this isn’t true. For example, people who practice the violin a lot develop a larger area of their brain devoted to mapping the fingers that are used for fingering. For those of us with MS, this is tremendously exciting because it means there may be ways to compensate for the damage that MS has done to our brains and hopefully there will be more research on effective ways to do this.
In fact, we have probably been benefiting from neuroplasticity and just didn’t know it. In The Handbook of Multiple Sclerosis, Kraft and Shah point out that “clinicians often note a disconnection between the marked brain atrophy present in an individual patient (implying significant loss of pre-formed neural pathways) and the ability of such a patient to function. To function as well as they do, extensive plasticity—confirmed by imaging studies—has occurred in these patients” (284). Your brain has probably been compensating for damage before it become apparent to you or anyone else. Cifelli and Matthews suggest that “the observation that patterns of functional activation are altered with movements of even clinically uninvolved limbs, emphasizes that functionally significant injury may be occurring even before clinical manifestations, adding to the argument for early implementation of disease-modifying therapy” (198).
There’s a fascinating and accessible book on neuroplasticity called The Brain that Changes Itself by Norman Doidge. The book starts out with a story of a woman who completely lost the functioning of the vestibular apparatus in her brain and how she used this special helmet which detects movement in two planes and sends signals to a strip of electrodes on her tongue to teach her brain how to perceive balance again. You can read a little bit about this in the excerpt at http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2008/07/26/sm_brain126.xml
When I went to physical therapy for walking problems, the physical therapist determined that much of my balance problem was coming from the fact that my vestibular apparatus was not communicating with my brain and thus not contributing to my attempts to stay upright. She gave me exercises that involved standing on a pillow (to reduce somatosensory input from the feet) with my eyes closed (to eliminate visual input) in a safe place. I am then supposed to move my head in different ways and this is supposed to force my brain to strengthen and rewire its connections to the vestibular system. And, in fact, my balance has improved significantly.
Doidge also talks about different types of therapies, such as constraint-induced movement therapy (CI or CIMT) where stroke victims go through an intense period of training where they are prevented from using their good limbs and are forced to use their paralyzed limbs for various tasks. This can work even with people who have been previously unable to use the affected limbs for years or decades. Recently, this type of therapy has also been tried by Mark et al. in people with progressive MS who “showed overall improvements on all clinical measures including fatigue” (http://www.acceleratedcure.org:8080/node/3296).
There is also research into the plasticity of cognitive functioning and ways to improve our ability to learn, process information, and remember. Doidge looks at the work of Michael Merzenich, a pioneer in brain plasticity research. Merzenich has created a computer program that has helped many learning-disabled children improve their auditory processing of sounds through exercises that increase the speed at which their auditory cortex neurons fire. This helped the children be able to read and understand better.
Merzenich has also been researching how to help older people improve their mental functioning and has a company called Posit Science (http://www.positscience.com) that sells software to combat the decline of memory, thinking, and processing speed that commonly comes with aging, but might also help those of us affected by MS. They sell programs with both auditory and visual processing exercises.
Posit Science’s products are fairly expensive ($395), but there are a number of alternatives, including a membership in HAPPYneuron (http://www.happy-neuron.com), which provides access to online games that stimulate your “attention, language, memory, visual-spatial, and executive function skills.” Other options include CogniFit (http://www.cognifit.com), Fit Brains (http://www.fitbrains.com, in beta, but you can play games online for free), and games for video game consoles, such as Nintendo Brain Age and Big Brain Academy for the Wii.
Presumably the ongoing damage to the central nervous system in MS can eventually reach the limits of neuroplasticity, but finding ways to make our brains work smarter and more effectively with what we have is potentially a very fruitful approach.
Cifelli, A. and Matthews, P.M. “Cerebral Plasticity in Multiple Sclerosis.” Multiple Sclerosis 8.3 (2002):193-99.
Doidge, Norman. The Brain That Changes Itself: Stories of Personal Triumph
from the Frontiers of Brain Science. New York: Viking, 2007. (Amazon: http://www.amazon.com/Brain-That-Changes-Itself-Frontiers/dp/067003830X; Find in a library: http://www.worldcat.org/oclc/71189897).
Kraft, George H., and Anjali N. Shah. “Rehabilitation: Its Role in Multiple Sclerosis.” Handbook of Multiple Sclerosis. 4th ed. Ed. Stuart D. Cook. New York: Taylor and Francis Group, 2006. 281-300.
Mark, V. et al. “Constraint-Induced Movement Therapy Can Improve Hemiparetic Progressive Multiple Sclerosis. Preliminary Findings.” Multiple Sclerosis 14.7 (2008): 992-4.
“Neuroplasticity.” Taber's Cyclopedic Medical Dictionary. Philadelphia: F.A. Davis Company, 2005.
Begley, Sharon. Train Your Mind, Change Your Brain: How a New Science Reveals Our Extraordinary Potential to Transform Ourselves. New York: Ballantine Books, 2007. (Amazon: http://www.amazon.com/Train-Your-Mind-Change-Brain/dp/0345479890; Find in a library: http://www.worldcat.org/oclc/69028460). Talks about current research in neuroplasticity and about research on the effects of long-term meditation on the brains of Buddhist monks.
The Brain Fitness Program, a 2007 PBS program on neuroplasticity (Amazon: http://www.amazon.com/Brain-Fitness-Program-Peter-Coyote/dp/B0012M1KW2; Find in a library: http://www.worldcat.org/oclc/212414132)
Schwartz, Jeffrey, and Sharon Begley. The Mind and the Brain: Neuroplasticity and the Power of Mental Force. New York: Regan Books, 2002. (Amazon: http://www.amazon.com/Mind-Brain-Neuroplasticity-Power-Mental/dp/0060988479; Find in a library: http://www.worldcat.org/oclc/49681471). Discusses neuroplasticity in the context of Schwartz’s work with people with obsessive-compulsive disorder (OCD).
If you'd rather listen than read, the Brain Science Podcast (http://docartemis.com/brainsciencepodcast) includes several episodes that talk about neuroplasticity:
#10 Neuroplasticity: http://tinyurl.com/98zho4
#26 Norman Doidge on Neuroplasticity: http://tinyurl.com/8dcfvy
#28 Edward Taub on stroke rehab: http://tinyurl.com/9mtped
(Monster Brain Cupcake from http://flickr.com/photos/ginamig/1762633852 -- Totally gratuitous image just to see if I could get it to work)