We talk a lot about neuroplasticity these days but what is it? And what kind of outcomes can we expect for a stroke victim with the kind of severe right hemisphere brain damage Mum has?
I admit I was hoping to put some more work into today’s post on neuroplasticity but I’ve unfortunately been very sick myself with some sort of viral respiratory infection. As such, I’m going to take the lazy route and link to some blog posts on the issue by Dr Steven Novella.
Novella, among other things, is a neurologist who writes a variety of blogs and is host of the amazing podcast The Skeptic’s Guide to the Universe. Mum and I used to often listen to this together; she particularly like the segment ‘Science or Fiction’ and enjoyed trying to work out which news stories were true or not.
Novella’s blog Neurologic deals with developments in neuroscience and has several relevant posts on the issue of neuroplasticity.
Plastic Brains: an overview of neuroplasticity and current areas of research into maximising it
Natural Stem Cells and Plasticity: a discussion into the use of stem cells for maximising plasticity
And, for a bit of human interest, here are two posts on children born with only one hemisphere (probably from a stroke in utero)
The important points of neuroplasticity to take away from this are:
1. Our brains are not hardwired: they can either rewire around damage; or other parts of our brain can step in and take on functions previously undertaken by a part of the brain that is now damaged
2. Our capacity for plasticity diminishes significantly as we age and is very much reduced in someone of Mum’s age
3. The capacity of the brain to take on tasks previously done by damaged sections of the brain is not infinite
The amazing thing about neuroplasticity is that the left hemisphere can be trained to take over functions previously performed by the right hemisphere. And in many ways Mum is lucky because the left hemisphere was her dominant one, meaning that vital functions such as language were already there. Mum can still speak and remember the main details of her life.
However, a stroke as significant as Mum’s means there is no rewiring of the brain around the damaged right hemisphere areas – you can’t rewire around an entire hemisphere. Our only hope is that intense physiotherapy and other rehab interventions such as speech therapy will encourage the left hemisphere to take on functions previously the domain of the right. But the significant damage Mum has experienced, combined with her age, means there is far less chance her left brain will acquire all the functions she has lost.
Mum’s left-side neglect and her inability to walk, for example, are two outcomes of the stroke that are unlikely to be mitigated significantly with therapy. Mum, in essence, will show a certain amount of improvement but she will never “get better” and she will never regain her former independence. Her brain damage is too severe for that.
To muddy the waters even further, I’ve included a further post by Novella who discusses whether rehabilitation after a stroke actually does create new neural pathways or only provides a functional (rather than neurological) recovery.
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