What is neuroplasticity and why should I care?

When thinking about this article I happened to be playing with a new AI (artificial intelligence), natural language, tool. There is a lot of buzz around AI (at the moment and it’s application to many sectors including healthcare. So I thought I would ask it a question - “What is neuroplasticity?”. The following is the answer I got - which I think is pretty impressive.

Neuroplasticity is the ability of the brain to change and adapt throughout life. It refers to the brain's ability to reorganize itself by forming new connections between neurons (nerve cells) and by changing the strength of existing connections. This plasticity, or flexibility, allows the brain to adapt to new experiences, learn new information, and recover from injuries.

Neuroplasticity is a fundamental property of the brain that allows it to continually adapt and improve throughout life. It is a process that occurs naturally, but it can also be influenced by various factors such as learning, experience, and environment.

There are many different forms of neuroplasticity, including changes that occur in response to learning new skills or forming new memories, as well as changes that result from brain injuries or diseases. Neuroplasticity is an important aspect of brain function, and it plays a key role in many aspects of cognitive and behavioral development.

I didn’t ask the AI tool - “why should I care?” otherwise my contribution to this article would be minimal. So - why should you care?

Understanding neuroplasticity would help us to develop more effective treatments for brain injuries and neurological disorders, such as spinal cord injuries, stroke, traumatic brain injury, and dementia. By understanding how the brain can change and adapt, we can develop better strategies for promoting brain health and improving brain function.

The discovery of neuroplasticity has been of great benefit to those looking to recover from neurological conditions. At the very least it has inspired hope but lets face it, hope won’t be sustained unless we can back this up with results.

At the moment, strategies based on practice and training provide the best opportunities. When there is a neuropathology, the body adapts (learns) to this situation because there is a maladaptive plasticity. The challenge is how to promote an adapticve plasticity that is supportive of function.

There are several factors commonly involved in motor learning and hence neuroplasticity. To some extent, they overlap:

• Carrying out a skill practice that is challenging, but not too difficult.

• Practice should be specific.

• Skill practice must be intense.

• Practice should be progressive.

• Timing matters.

• Engage motivation to enhance the learning.

Research evidence shows that the difficulty of the task matters to the process of learning (Magness, 2022). The challenge is how to create a situation where practice is difficult and cognitively engaging, but not impossible.

Specificity effects have been recognised in learning research for more than 100 years, the general finding being that transfer of skills from practice to real-world application will be small unless the skills required are nearly identical. What this means is that general exercise and activities like strength training are most effective when combined with task-specific training programmes. Research is now looking at how practice in one task can transfer to another task in a meaningful way.

What do we mean by ‘intense’? Intensity implies that some combination of the dose, frequency and duration of training practice is important to getting results. Although this suggestion is supported by research results, there is a lack of detail when we try to pin down what exactly is a necessary and sufficient level of intensity for an individual case.

Some researchers point out that being able to tap into someone’s motivation to practise may be more effective than simply cranking up the intensity of the practice. The idea here is that focusing on practice simply to reduce impairment is less motivating than looking at seeking benefits that directly impact on the person’s quality of life.

There is no doubt that repeated attempts to solve a motor-control task benefit neuroplasticity and motor learning, but tasks must not be too simple or repetitive. Simple tasks well within the capability of the performer will not induce neural plasticity. What’s needed could be described as ‘repetition without repetition’.

Imagine learning a golf swing that involves lots of repetition. Let’s say you have been taught well and don’t see learning the golf swing as just rapidly hitting 1,000 golf balls down the driving range. For each stroke, you learn to follow the same thoughtful process with careful setup and attention to detail. However carefully you try to replicate each golf swing, there are going to be lots of small deviations in muscle and limb joint activity, and so on. What seems like exact repetition is not exactly so, but over time, you may consciously learn from your results and refine your swing.

When it comes to robotic systems that allow repetitive practice, perhaps the same observations hold. For example, the Icone robot for upper-limb rehabilitation allows the user to practise arm movement guided within an adjustable ‘haptic tunnel’. This allows the task to take place repetitively without constraining the movement to be the same with each repetition. Over time, the haptic tunnel’s size can be adjusted as the user’s performance improves.

Different forms of plasticity occur at different times during training. This implies that the timing of an intense therapy programme is important. Some researchers are advocating early interventions, for example in the first month after a stroke. This seems to make sense, but a lot of stroke research has only been carried out in the chronic phase of recovery.

Many therapeutic interventions rely on extrinsic motivation to be effective. It seems to me that the best results come when motivation is intrinsic and the person’s mindset is adjusted to provide a consistent drive to work at improvement.

At present, we have a growing but incomplete picture of how to take advantage of neuorplasticity to promote functional recovery. The points listed above are a little vague but a good starting point. The precise keys to recovery will almost certainly vary a little from cae to case but at least there is a reason to make an effort and strive for improvement.

Reading

Magness, S (2022) “Do hard things: Why we get resilience wrong and the surprising science of real toughness”. Harper Collins