take it easy I try,d to soon wish I knew then what I know now




Neuroplasticity and Traumatic Brain Injury (TBI)

Evidence suggests the brain is more dynamic and ever-changing than once thought. Psychologists once believed that the brain’s ability to change - plasticity - was limited to children and young adults. In a recent legal update, Dr. Sam Goldstein first defines neuroplasticity, and then relates it to TBI recovery.

“Neuroplasticity is defined as the capacity of brain cells to fight the chemical and structural changes that occur following trauma that can eventually kill them if not controlled. Neuroplasticity also refers to the ability of brain cells to modify their activity in response to change in the environment, to store information from the environment and to permit the organism to move about and survive. Thus, all functioning brains to some extent operate under the principle of neuroplasticity throughout life.”

Dr. Goldstein notes that “the once held belief that recovery from brain injury is limited to the first one to two years following injury has now been met with considerable challenge. Further, the idea that remediation of function can only be accomplished in the first eighteen months post accident is increasingly being challenged. The idea that the development of compensatory strategies many years post accident leading to improved daily functioning may have no direct impact on the structure and biochemistry of the brain is also increasingly in question. A significant number of studies have now demonstrated that many people can make significant physical, cognitive and behavioral recovery as long as five years or more post brain injury. As Stein noted in 1995, ‘There is no rule of neuroscience that the processes of functional recovery must occur rapidly or that treatment should be terminated after a fixed period of time because the early results are unsatisfactory.’”

Advances in “Neuro-rehabilitative therapy, in particular cognitive rehabilitation, may well facilitate the brain's plasticity. This theory has been demonstrated not only from the patient's perspective and observations of others, but even through SPECT and PET scanning. It also appears that neuro re-organization can be enhanced through specific training. Though compensatory strategies can be helpful post brain injury, plasticity research suggests that the appropriate timing of teaching these strategies is a critical and complex issue. If strategies are implemented too early, those potentially available, compensatory parts of the brain may not be capable of effectively taking over function.((((((((((( This may explain the significant problems many mild to low moderate brain injured patients experience when they return, often within a few days post injury, to every day activities, particularly work. Thus, too much activity too early post injury may lead to increased adverse outcome.)))))))))))))))))”