The online Dana magazine Cerebrum has a great article on neurorehabilitation – the art and science of helping someone to recover from brain injury both by harnessing the brain’s natural ability to adapt, and by teaching the injured person new skills and abilities.
The article discuss both rehabilitation medicine, the practice of training patients to adapt and improve, and the neuroscience techniques which are being developed to try and tackle the problem at the cellular level.
One of the key processes which science is trying to understand and optimise is ‘neuroplasticity‘, the process by which the brain makes new connections, reorganises and routes around damage.
The article sets out six key questions for neuroscience that, when answered, should revolutionise who we can treat brain injury:
1. Since so much of what we think we know about regeneration is derived from experiments on immature nerve cells, are the mechanisms of regeneration in the injured mature nervous system the same as those that apply to the developing embryonic nervous system?
2. Since the vast majority of experiments in regeneration of nerve pathways have been done in rats and mice, how predictive are these experiments for results in human patients? Apart from molecular differences, rodents are much smaller than we are. Nerve fibers may have to regenerate much farther in humans in order to achieve the same level of reconnection that underlies functional improvement in smaller animals.
3. Even if sufficient nerve regeneration can be achieved, will the connections made be specific enough to underlie real function?
4. How helpful are stem cells? Can they survive after transplantation into the human spinal cord or will they be rejected? Can they replace damaged neurons or will they serve only as sources of chemical substances that support survival and growth of the brain‚Äôs own nerve cells?
5. Will we be able to identify a single approach that is so fundamental that it can yield dramatic improvements in recovery from brain injury, or will we need to develop a cocktail approach, using multiple treatments simultaneously?
6. Will approaches that enhance regeneration in one circumstance, for example spinal cord injury, also work in other situations, such as stroke or traumatic brain injury?
On a related note, Sharp Brains has picked up on the fact that American TV channel PBS will shortly be broadcasting a special on brain fitness and neuroplasticity.
It’ll probably focus on normal ageing and brain fitness rather than brain injury, but hopefully should tackle some of the neuroscience behind brain changes in general.
There’s a trailer available online.