Plasticity in neurological disorders and challenges for noninvasive brain stimulation (NBS)

Journal of NeuroEngineering and Rehabilitation, 2009 · DOI: 10.1186/1743-0003-6-4 · Published: February 17, 2009

Simple Explanation

Noninvasive brain stimulation (NBS) techniques are being explored for neurological conditions, based on the idea that they modulate neuroplasticity. Plasticity is believed to contribute to functional recovery after brain injury and to the pathophysiology of neurological disorders. Brain plasticity refers to the brain's adaptability and reorganization capabilities. While there's no age limit to this adaptability, the degree and form of plastic changes vary. To be maximally effective, NBS techniques must consider the diversity of neurological symptoms, the differences between acute, longstanding, and chronic progressive diseases, and the roles of functional and dysfunctional plasticity in brain and spinal cord diseases.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Neuroplasticity, involving both neuronal and non-neuronal mechanisms, plays a significant role in brain function, with synaptic transmission being a key site for plasticity.
2
Plasticity can be either functional, aiding in recovery and adaptation, or dysfunctional, contributing to conditions like spasticity.
3
The effectiveness of NBS in treating neurological disorders depends on factors such as the specific disorder, its heterogeneity, and its time course, requiring tailored interventions.

Research Summary

Noninvasive brain stimulation (NBS) is being investigated for neurological conditions, with the understanding that it can modulate neuroplasticity. Plasticity is considered crucial for functional recovery after brain injury and in the pathophysiology of neurological disorders. While evidence supports neuroplasticity and its mechanisms, the relationship between neuroplasticity and functional outcome remains unclear, necessitating a re-appraisal to guide clinical application of NBS. To be effective, NBS interventions must consider the diversity of neurological symptoms, the differences between acute, longstanding, and chronic progressive diseases, and the roles of functional and dysfunctional plasticity in brain and spinal cord diseases.

Practical Implications

Personalized NBS Protocols

Develop NBS protocols tailored to the specific neurological disorder, its stage, and the individual's symptoms to maximize therapeutic benefits.

Combination Therapies

Explore combining NBS with other therapies, such as physical therapy or medication, to achieve more lasting functional improvements.

Targeting Metaplasticity

Investigate interventions that target metaplasticity to change the set-point for inducing plasticity, potentially offering a more promising approach for conditions like dystonia.

Study Limitations

1
The relationship between neuroplasticity and functional outcome remains unclear.
2
NBS is difficult to administer chronically and may not have the flexibility to manage constantly changing baselines in progressive diseases.
3
There is still much that is not known about the basis of many neurological conditions.

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