How Neuroplasticity Aids In Stroke Recovery

November 23, 2022

An African American man in a wheelchair enjoying a walk at the park with his girlfriend.

Your brain is a remarkably complex organ, the master controller of every function in your body. Yet, for all of its complexity, there is a delicate balance between the billions of brain cells (neurons) and the functions for which they’re responsible. Neurons need not only the right amount of blood flow but also the right amount of oxygen to “talk” to each other through networks. This communication allows you to move your leg, blink your eye, discern colors, grasp a door handle, jump rope, speak, think, type on your keyboard, ski downhill and countless other tasks. Some of the brain’s ability is shaped by environment, some by repetitive tasks, and some by learning.

When a brain injury like a stroke deprives neurons of blood or oxygen, the cells die, and the functions they were responsible for are lost. But the brain is remarkably adaptable, and through neuroplasticity, which is the ability to heal and rewire itself, new cells and pathways can be trained to take over the lost functions.

What is neuroplasticity?

Neuroplasticity is the brain’s ability to reorganize its structure, function or connections after an injury in response to internal or external stimuli. [1]

Years ago, scientists believed brain function was fixed after a certain point in each person’s development. Now we know that’s not quite the case. Even though we train our brains to allow us to perform everyday tasks and unique talents, we now know that the brain can be trained to learn new tasks and re-learn old tasks after the brain is damaged. This flexibility is called “plasticity.”

How does neuroplasticity work?

Neuroplasticity is a lifelong process for your brain. As we learn new skills and think new thoughts, specific brain cells are trained to carry them out. The more often we perform a new skill, the connection between brain cells responsible for it grows stronger and more profound.

Think of it as building a brain communication roadmap: to throw a ball, brain region X communicates with other regions of the brain, which communicate with your arm, hand, fingers, shoulder, and back to coordinate movement. When this process is repeated over and over again, the pathway between brain cells (neural network) grows more pronounced and refined. As a result, after practicing it hundreds of times, you can easily throw a ball to another person.

But if a stroke damages any of the brain cells in the network, your brain will try to find a new pathway to throw a ball. It may be difficult and frustrating for an adult stroke survivor to re-learn something they easily did as a child, but with repetition, the skill should return. 

Are there limits to neuroplasticity?

There are limits to neuroplasticity, however. Most functions are distributed across multiple areas of the brain. This distribution is one of the keys to neuroplasticity because if one region is damaged, another can be taught to perform the same function.

But plasticity can also be limiting. For some functions, such as your eyesight, many regions of the rear lobes (occipital) of your brain are required. If one of the upstream regions is slightly damaged by a stroke, an adjoining region may take over its function, and your eyesight may be almost fully restored. But if that upstream region is substantially damaged, the downstream regions won’t receive the input necessary to perform their function. In that case, most or all of your eyesight may be lost, even though only one region is damaged.

Who performs neuroplasticity treatments?

A neuroplasticity treatment, also known as neuroplasticity therapy, is any therapy targeted at a particular region of the brain to restore or increase function.  Neuroplasticity therapies include:

  • Physical therapy
  • Aerobic exercise
  • Neurostimulation techniques
  • Cognitive training
  • Sensory and motor training
  • Speech therapy
  • Occupational therapy

For people recovering from stroke, here are the keys to benefiting from neuroplasticity:

  • Use it to improve it. Repetitive training enhances function. To regain the ability to walk, you must practice walking as much as possible.
  • Use it or lose it. Not using a function decreases your ability to use that function.
  • Sooner is better than later. The most beneficial time to start stroke rehabilitation is the day you’re hospitalized. That’s because the brain tries to reorganize itself immediately after an injury.
  • The quality of stroke therapy is critical. Therapy needs to be relevant and specific to the functions that are impacted.
  • Intensity matters. Hard work and repetition help the brain learn a new skill quickly. While it may seem unnecessary or overboard to the patient, repetition above and beyond helps to deepen neural connections and improve function.
  • Every stroke is personal. Brain injuries are complex. If two patients have identical damage to the same brain regions, they may not have the same impairment. They also may not have the same recovery or rate of recovery.

Learn more about Good Shepherd’s stroke rehabilitation program or call 1-888-44-REHAB.

[1] Puderbaugh M, Emmady PD. Neuroplasticity. [Updated 2022 May 8].