NEUROPLASTICITY
Nancy Benson: For thousands and thousands of years, the brain was considered sort
of a "black box" by the age's learned men. How the brain works was a mystery, and so
they came to a lot of wrong conclusions. For example, doctors had always believed that
when part of the brain was damaged, it would never heal, and the function associated
with that part of the brain would be completely lost.
Norman Doige: For the longest time, scientists thought of the brain as though it were a
machine with parts, and each part performs a single mental function in a single location
in the brain. They started to think of the brain as an electrical machine with hardwired
circuits. So, like your computer, the circuitry in the computer is not changing once you
get it. They thought the brain was like hardware, if you will. And the only change that
hardware undergoes is degeneration with use over time. But the brain is not inanimate
like a machine. It’s animate, and just as when you use your muscles, or, you know, your
other tissues, they change. So to does the brain within certain design parameters alter
in a very dynamic way.
Nancy Benson: That’s Dr. Norman Doige, Professor of Psychiatry at the University of
Toronto and the Columbia University Center for Psychoanalytic Training and Research.
He’s also the author of the new book The Brain’s Way Of Healing, Remarkable
Discoveries And Recoveries From The Frontiers Of Neuroplasticity.
Norman Doige: Neuroplasticity is that property of the brain that allows it to change its
structure and function in response to mental activity or experience. So, that means
change at many levels, but particularly at the level of the connections between the
neurons of the nerve cells in the brain. They’re not, as was thought, hardwired. They’re
constantly forming, unforming and rechanging in response to what we do. The kinds of
change I’m describing are most akin to the slow incremental changes that occur when
you learn a language or a musical instrument or something like that. You have to stick to
it and do it every single day, or very frequently, and you slowly find that you can just
grow by leaps and bounds. But only slowly and over time.
Nancy Benson: Neuroplasticity is a concept that shows promise for the treatment of
many brain diseases. If we can get the brain to change, there's the potential to treat
Parkinson’s disease, multiple sclerosis, attention deficit disorders, and even stroke, from
which patients are often given virtually no hope of recovery.
Edward Taub: They are typically told that one year after stroke, they are not going to
improve, no matter what therapy is administered, whatever they have at one year, that’s
it for the rest of their life. That is completely false. We’ve worked with people who are as
much as 50 years post stroke.
Nancy Benson: That’s behavioral neuroscientist Dr. Edward Taub, Professor of
Psychiatry at the University of Alabama, Birmingham, and Director of the Taub Training
Clinic.
Edward Taub: One gentleman I recall had a stroke when he was five years old, and we
treated him when he was fifty-five, and he had just as good a response to the treatment
as a sixteen year old. We routinely work with people in their eighties. We’ve worked with
some people in their nineties. There is a persisting plasticity in the nervous system that
continues throughout the lifespan, so that we have as good a result with a eighty-five
year old individual as we do with a two year old.
Nancy Benson: Taub is the developer of a technique for stroke victims called
Constraint-Induced Movement therapy, or CI Therapy, which takes advantage of
neuroplastic principles. For example, if a stroke has affected a person's arm, the patient
could learn to use it again by being restricted in the use of his good arm.
Edward Taub: We restrain the good arm with a padded mitt so the person can’t use the
hand of the good arm. And this forces the person to use the impaired arm. The average
patient started at about nine percent of the use of their more affected arm in the life
situation compared to before stroke, and at the end of two weeks of treatment, they were
at fifty two percent of the amount of use of the more affected arm in the life situation
compared to before stroke. And that’s a five times improvement.
Nancy Benson: CI Therapy is grueling work, about three hours a day, but taub says an
experienced clinician can tell what a patient is capable of doing.
Edward Taub: We have the patients push it but only a little bit. Push it up to the point
that the nervous system is capable of supporting it, and no more.
Nancy Benson: The real test, however, is when the patient returns home. Taub
supplies all his patients with what he calls a transfer package, a series of exercises to be
done at home.
Edward Taub: If the person isn’t using the arm, say, to brush their teeth, and the
therapist knows that the patient can do it, and the patient has agreed to try to do it the
therapist will, what we call, problem solve with the patient, to enable them to do it.
Nancy Benson: The key to CI Therapy is consistent daily practice, not just in the clinic,
but especially at home.
Edward Taub: The patient becomes the critical factor in enabling his own improvement.
Typically the people are very highly motivated because the thing in the world that they
want almost more than anything usually is to regain the function that they once had.
Nancy Benson: Unfortunately, if a person is told right off the bat that they'll never regain
the ability to talk or move their arm again, it can become a self-fulfilling prophesy.
Edward Taub: But if the person is told that they can improve and given hope where
there was no hope before and then they are made to engage in this whole therapeutic
process, which does lead to rapid improvement, so that day by day, or at least every
second or third day, they can see substantial improvement having occurred, that is very
rewarding and adds to their motivation to keep at this regimen.
Nancy Benson: The field of neuroplasticity is fairly new, so researchers don’t know the
limits of rehabilitation. Many scientists around the world are excited about the
remarkable discoveries and potential recoveries now that we know the brain can heal
itself, too. You can learn more about today’s guests and find a link to the book The
Brain’s Way Of Healing, which describes Taub’s and other researchers’ work, by visiting
our website, radiohealthjournal dot net. You can always find our shows on iTunes and
Stitcher. Our writer/producer this week is Polly Hansen.
Our production directors are Sean Waldron. I’m Nancy Benson.