What is neuroplasticity?
Let's break it down.
Neuro = related to the nervous system
Plasticity = the ability to change or adapt
Neuroplasticity refers to the brain's ability to create new connections or rewire itself. You may also hear brain plasticity or neural plasticity, all referring to the same thing.
Neuroplasticity allows the damaged brain to relearn through rehabilitation.
Kleim and Jones (2008) proposed 10 principles of neuroplasticity to help guide rehabilitation to optimize recovery and functional outcomes.
Neuroplasticity Principle #1: Use it or Lose it
"Neural circuits not actively engaged in task performance for an extended period of time will begin to degrade." (Kleim and Jones, 2008)
So, if we don't continually engage in that task (and activate those neural pathways), we may see a decrease in the ability to complete that task.
Progress and improvements that have been achieved require ongoing maintenance.
Rehabilitation professionals, including Speech-Language Pathologists may recommend a long term therapy plan which may include an independent home therapy program and periodic check-ins to ensure that progress will continue to be maintained.
Neuroplasticity Principle #2: Use it and Improve it
"Training that drives a specific brain function can lead to enhancement of that function."(Kleim and Jones, 2008)
By training a specific skill or task, we expect that you will get better at that task!
Maybe your goal in speech therapy is to improve word-finding. We can teach you strategies to help when you can't find the right word, but then we also need to practice using those strategies.
Neuroplasticity Principle #3: Specificity
"The nature of the training experience dictates the nature of plasticity." (Kleim and Jones, 2008)
Training of a new skill or strategy should be specific and resemble the goal you're trying to achieve.
If your goal is to improve your presentation skills, then we need to practice presenting, not just talk about how we want to present.
After the strategy or skill is first learned, then we can expand on it by broadening the goals and the context.
Neuroplasticity Principle #4: Repetition Matters
"Induction of plasticity requires sufficient repetition." (Kleim and Jones, 2008)
Repetition of a learned or relearned behavior is required to make improvements that can be maintained outside of therapy.
We need lots and lots of practice!
Your speech-language pathologist will give you lots of practice in your therapy session, and may recommend a home training program to practice that new skill outside of therapy.
Neuroplasticity Principle #5: Intensity Matters
"Induction of plasticity requires sufficient training intensity." (Kleim and Jones, 2008)
So, lots of repetition is important, but getting that repetition and practice in a short time frame is key.
Often, rehabilitation programs (whether it's for brain injury or stroke recovery) are intensive with daily or multiple sessions a week. This allows for massed practice (many trials that occur close together in time).
Neuroplasticity Principle #6: Time Matters
"Different forms of plasticity occur at different times during training." (Kleim and Jones, 2008)
As your brain relearns new skills, there will be periods of fast recovery and other periods that seem slower.
Generally, it is better to start rehabilitation earlier, rather than later. However, there is always the opportunity for meaningful change. So just because you may be in a slow period, doesn’t mean you should stop working towards your goals.
Your brain has the ability to change YEARS after your injury with the right support.
Neuroplasticity Principle #7: Salience Matters
"The training experience must be sufficiently salient to induce plasticity." (Kleim and Jones, 2008)
We are more likely to remember things that we find personally relevant, evoke our emotions, or are humorous. Therapy should be individualized and target tasks and behaviors that are relevant and meaningful to the you. Therefore, your therapy will look different than someone else's therapy.
We are more likely to pay attention and remember things that we actually care about!
Your speech therapist will always try to make your therapy sessions relevant and fun for you!
Neuroplasticity Principle #8: Age Matters
"Training-induced plasticity occurs more readily in younger brains." (Kleim and Jones, 2008)
Younger brains are more plastic and adaptable to change.
As we age, the plasticity of our brain becomes less profound and changes may occur at a slower rate. We see a reduction in experience-dependent synaptic potentiation, synaptogensis, and cortical map reorganization.
However, the older brain is still responsive to experience and therefore, all ages can benefit from rehabilitation.
While the effects of aging may vary depending on life experiences, they are generally better with greater mental and physical exercise.
Neuroplasticity Principle #9: Transference
"Plasticity in response to one training experience can enhance the acquisition of similar behaviors."
Improving a skill in one area can also improve skills in similar areas.
Being able to generalize or carryover this new skill into the real-world is our goal.
If your specific goal is trying to remember information during meetings at work, you will also improve memory or recall in other situations too.
Neuroplasticity Principle #10: Interference
"Plasticity in response to one experience can interfere with the acquisition of other behaviors."
During that early training period, addressing too many goals at once may inhibit progress.
In order to avoid interference, therapy should address fewer targets at a time, especially during that early learning period.
In summary, our brains are truly amazing!
Whether you are recovering from a concussion, a more severe brain injury, or stroke, there is always hope!
Find a practitioner in your area who specializes in rehabilitation of your particular injury. Ask them how they incorporate the principles of neuroplasticity into their practice!
If you or your loved one is in Ontario and interested in learning more about the recovery of concussion, brain injury or stroke, send us an email at firstname.lastname@example.org. or give us a call at 416-527-2066.
Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008 Feb;51(1):S225-39. doi: 10.1044/1092-4388(2008/018). PMID: 18230848.
Sohlberg, M. M., & Turkstra, L. S. (2011). Optimizing cognitive rehabilitation: Effective instructional methods. The Guilford Press.