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Scientists once thought that the brain stopped developing after the first few years of life. They
thought that connections formed between the brains nerve cells during an early critical period
and then were fixed in place as we age. If connections between neurons developed only during
the first few years of life, then only young brains would be plastic and thus able to form new
ecause of this belief, scientists also thought that if a particular area of the adult brain was
damaged, the nerve cells could not form new connections or regenerate, and the functions
controlled by that area of the brain would be permanently lost. !owever, new research on animals
and humans has overturned this mista"en old view# today we recogni$e that the brain continues to
reorgani$e itself by forming new neural connections throughout life. This phenomenon, called
neuroplasticity, allows the neurons in the brain to compensate for in%ury and ad%ust their activity in
response to new situations or changes in their environment.
!ow does neuroplasticity wor"& ' large amount of research focuses on this (uestion. Scientists
are certain that the brain continually ad%usts and reorgani$es. In fact, while studying mon"eys, they
found that the neuronal connections in many brain regions appear to be organi$ed differently each
time they are examined) *xisting neural pathways that are inactive or used for other purposes
show the ability to ta"e over and carry out functions lost to degeneration, and there is evidence
that reorgani$ation in the adult brain can even involve the formation of new neural connections.
+nderstanding the brains ability to dynamically reorgani$e itself helps scientists understand how
patients sometimes recover brain functions damaged by in%ury or disease.
Brain Reorganization
,enes are certainly not the only factor determining how our brain develops and forms its inner
connections. -onditions in our environment, such as social interactions, challenging experiences
and even fresh air can play a crucial role in brain cell survival and the formation of connections.
.ust as the brain changes in response to environmental conditions, it can also change and
rearrange in response to in%ury or disease. -ommonly, these rearrangements involve changes in
the connection between lin"ed nerve cells, or neurons, in the brain. rain reorgani$ation ta"es
place by mechanisms such as axonal sprouting, where undamaged axons grow new nerve
endings to reconnect the neurons, whose lin"s were severed through damage. +ndamaged axons
can also sprout nerve endings and connect with other undamaged nerve cells, thus ma"ing new
lin"s and new neural pathways to accomplish what was a damaged function. /or example,
although each brain hemisphere has its own tas"s, if one brain hemisphere is damaged, the intact
hemisphere can sometimes ta"e over some of the functions of the damaged one. /lexible and
capable of such adaptation, the brain compensates for damage in effect by reorgani$ing and
forming new connections between intact neurons. The brain can also respond to a deficiency in
one type of sensory input by enhancing the processing of other sensory inputs. In blind
individuals, for instance, areas of the cortex normally assigned to visual processing can adapt to
process completely different sensory inputs, such as hearing or touch.
0ew connections can form at an ama$ing speed, but in order to reconnect, the neurons need to be
stimulated through activity. In one study, researchers damaged a small brain area in several
mon"eys, which resulted in the loss of particular hand movements. 1ue to the lac" of hand activity,
even the neurons surrounding the damaged brain area withered, resulting in further impairment of
hand movements. These observations confirm the notion that it is important to provide stimulation
to neurons in order for them to remain active and form new connections, promoting rehabilitation.
+nfortunately, this same brain reorgani$ation may sometimes contribute to the symptoms of
disease or impairment. /or example, people who are deaf sometimes suffer from a continual
ringing in their ears, which may be the result of the rewiring of brain cells starved for sound. It is
important to stimulate the neurons in %ust the right way for them to form beneficial new
connections. y better understanding how the brain reorgani$es itself, we can better learn how
this tas" can be accomplished.
Strategies for Promoting Brain Reorganization
' first "ey principle of neuroplasticity is this# brain activity promotes brain reorgani$ation. In other
words, brain wor"outs help the brain reorgani$e connections more (uic"ly and stimulate
reorgani$ation when the brain is not capable of reorgani$ing on its own. *ven simple brain
exercises such as presenting oneself with challenging intellectual environments, interacting in
social situations, or getting involved in physical activities will boost the general growth of
connections. !owever, generali$ed stimulation may not be very helpful for rebuilding a specific
damaged area of the brain.
'nother way to promote neuronal connections in the brain has been learned from efforts to help
stro"e patients. Studies show that drugs that increase the availability of the hormone
norepinephrine help in the rehabilitation of movement loss. These drugs stimulate or provo"e the
synapses of the nerve cells, ma"ing them more capable of forming new connections. ecause
they can be costly and have unintended side effects, drugs alone may not be the optimal approach
to rehabilitation. !owever, drugs may well be beneficial when used in con%unction with a third
approach# physical or rehabilitation therapy.
uilding on the principle that neuronal activity promotes new connections, rehabilitation therapy
attempts to stimulate particular neurons that have not been active for some time. !ere the goal is
to promote selective self2repair and reorgani$ation through specific motor activity. ecause brain
reorgani$ation generally becomes more difficult as we age 3for reasons not yet fully understood4, a
damaged adult brain needs a specific neuroplasticity %ump2start to rebuild. /or example,
practicing a particular movement over and over2referred to in the literature as constraint2induced
movement2based therapy2helps your brain form and strengthen the connections necessary for
that movement. Thus in ,ermany, seven patients who had lost the ability to wal" were placed on a
treadmill with a parachute and harness. They were given as much physical support as possible,
but the treadmill forced the movement of their legs. y the end of therapy, this forced movement
enabled some of the intact neurons in the damaged area of the brain to form new connections,
which in turn enabled three of the patients to wal" independently and another three to wal" with
'n important aspect of rehabilitation therapy is timing. If a person who has suffered from brain
damage does not practice a lost movement, the damaged neurons2as well as surrounding
neurons2are starved of stimulation and will be unable to reconnect. !owever, research on non2
human animals indicates that if an in%ured limb is used immediately after the brain area has been
damaged, damage to the brain actually increases. To be successful, rehabilitation must wait a
wee" or two. y the second wee", use of the in%ured limb stimulates damaged connections that
would otherwise atrophy without input. 5et, a particular movement can be practiced too much. If
practiced millions of times per month over years, for example, the pattern of connections can grow
so much that it inhibits or s(uee$es out other patterns of connection, resulting in the inability to
perform other movements. In short, rehabilitation therapy can indeed ta"e advantage of the brains
natural flexibility for forming new neural connections6 however, this is a delicate process that must
be done carefully and under professional guidance.
The Limits of Innate Brain Plasticity
0europlasticity enables the brain to compensate for damage, but sometimes an area of the brain
is so extensively damaged that its natural ability to reorgani$e is insufficient to regain the lost
function. In the case of !untingtons 1isease and other diseases that cause neuronal death, the
death of many cells may render the brain unable to reorgani$e corrective connections. In order to
have a chance of repair, a certain 3as yet un"nown4 number of neurons must remain intact. Thus,
if a highly speciali$ed brain circuit is completely destroyed, the associated mental function may
be lost. -urrently there is no way of determining with certainty whether a lost function can be
recovered. !owever, there is another source of hope. 7ecent research 3discussed in the next
section4 has shown that the brain can sometimes generate new neurons, not simply new
connections, and that these new neurons can sometimes migrate within the brain. This raises the
possibility that, under certain conditions, new neurons could migrate to damaged areas, form new
connections, and restore some or all lost functions. It is too early to tell for sure# we still have much
to learn about neuroplasticity)
3Source# !untingtons 8utreach 9ro%ect for *ducation at Stanford#;<=<:<>:neuroplasticity:4