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The 10 Principles of Neuroplasticity

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The 10 Principles of Neuroplasticity- that’s a mouthful right?

I find that these principles come in handy whenever I need to defend my approaches or justify therapy for my patients with dementia.  Sometimes it is not enough to be a passionate advocate, or rely on anecdotal logic to speak for itself.  Of course folks with dementia benefit from therapy.  But when the decision for how to best spend therapy dollars is determined by nay-sayers and frugal insurance providers, we need some science legs to stand on.

Can a brain suffering from the effects of aging and/or neurodegeneration be improved? Thanks to neuroplasticity, the answer is yes.

Neuroplasticity:

  • The brain’s ability to reorganize itself by forming new neural connections throughout life.
  • Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.  (Definition of Neuroplasticity MedicineNet.com. April 7, 2012).

Whether you are a person who desires improved cognitive function, a caregiver, or a healthcare professional, applying the principles of neuroplasticity to life-skills training can result in positive brain changes. The most important thing to remember is that the development of new neural connections is experience-dependent: you must be an active participant in the activity, not a passive observer.

Here are the principles per Klien and Jones, 2008 with added commentary a la yours truly:

  • USE IT OR LOSE IT. Failure to drive specific brain functions can lead to functional degradation.
    • The key word here is function.  Brain functions and daily functions.  Keep doing functional things, and if you’re a caregiver, don’t over-help. Dependence can be learned if it is experienced.
  • USE IT AND IMPROVE IT. Training that drives brain functions can lead to enhancement of function.
    • Memory, problem solving, language… yes they can be improved.
  • SPECIFICITY. Nature of the training experience dictates the nature of the plasticity. 
    • Hone in on the specific functional task or specific brain function for optimal results.
  • REPETITION MATTERS. Plasticity requires sufficient repetition.
    • This one is HUGE.  In order to benefit from the advantages of procedural learning, you must perform a task over and over again.  This is an easy-to- administer, universal principle that pays high rewards.
  • INTENSITY MATTERS. Plasticity requires sufficient training intensity.
    • This is largely a matter of tolerance- so don’t give up if even mild levels of cognitive or functional training seem overwhelming and impossible.  Focused brain activity can be quite taxing, and building neural connections takes time. Be patient and start with a well tolerated level of activity.  Increase intensity as tolerance improves.
  • TIME MATTERS. Different forms of plasticity occur at different times during training and over the course of recovery.
    • The “timing” mentioned in this principle has to do with the timing of the injury or disease process and the timing of the task-oriented training.  There are different forms of plasticity that occur immediately after injury vs. training under chronic conditions.  The brain may try to repair a function or compensate for it, and to some degree this is time-dependent.
  • SALIENCE MATTERS. Training experience must be sufficiently salient to induce plasticity.
    • Self-evident, but the experience must be relevant, novel, and have meaning.
  • AGE MATTERS. Plasticity occurs more readily in younger brains; adult brains are capable of plastic adaptation and some degree of structural organization.
    • It’s really never too late.
  • TRANSFERENCE. Plasticity in response to one training experience can enhance acquisition of similar behaviors.
    • This can be a subtle and hard to notice benefit. But if you train someone to transfer from the wheelchair to the toilet, you haven’t necessarily taught them to transfer from the wheelchair to the bed.  But you have probably made it easier to learn that new skill.
  • INTERFERENCE. Plasticity in response to one experience can interfere with the acquisition of other behaviors.
    • Sometimes we are really good compensators.  And developing neural connections that help us compensate for lost function may actually interfere with the likelihood of developing a different neural connection related to that function.

There is a mountain of research and evidence on neuroplasticity to support the argument for cognitive and behavioral retraining in dementia.  Do not shy away from the discussion. The interventions may not be enough to reverse a progressive disease, but they may help with functional compensation, quality of life, and caregiver burden.

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