Neuroplasticity, from a clinician’s view, is the ability of the brain to change and heal itself. From a scientific perspective, neuroplasticity is the brain's ability to affect the synaptic transmission of information in response to external stimuli.
In this article, we will address:
What neuroplasticity is
How neuroplasticity is being used to heal mild traumatic brain injury (concussions)
What to prioritize if you want to encourage neuroplasticity at home.
At our concussion treatment center, we work with patients whose symptoms didn’t go away with rest and time. Neural plasticity is at the center of their recovery journeys. The brain’s ability to heal with therapy brings hope to our patients and to anyone else who has sustained a brain injury. Even those without injury or trauma can find an improved quality of life through neuroplasticity.
If you’re experiencing symptoms that won’t resolve after an mTBI, you’re not alone. And you’re not crazy. On average, our patients improve by 75% after treatment at our center specializing in neuroplasticity-driven therapy. To see if you are eligible for treatment, sign up for a free consultation.
What Is Neuroplasticity?
The Oxford Dictionary defines neuroplasticity as “the ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury.” That said, the exact definition of neuroplasticity and all of the mechanisms behind it aren’t exactly settled science.
From a patient’s perspective, neuroplasticity is the brain’s ability to heal following injury when prompted by the right external stimuli. Most of the patients we see have sustained damage to neurovascular coupling (NVC) pathways resulting from one or more concussions.
Neurovascular coupling (NVC) is the connection between neurons and blood vessels.
What does that mean, exactly? NVC refers to the connection between your neurons and the blood vessels that supply them with oxygen. Healthy neural connections will send chemical and electrical signals to “call” for oxygen whenever they need to complete a process; in response, more blood will flow to the region to provide that oxygen.
Neuroplasticity and Concussions
But in the regions damaged by a concussion, that communication between brain cells and the blood vessels that supply them can be disturbed. Sometimes, the brain might signal for too little oxygen to perform its task (hypoactivity); in other cases, it might signal for (and receive) more oxygen than required, overtaxing your system and causing it to ‘burn out’ more quickly (hyperactivity).
With the right therapy, we can promote neuroplasticity in the affected neural network. This helps the brain to correct its signaling and use the right region for the right process and in the right way. Because of neural plasticity, your brain can restore connections to make that change happen.
Neuroplasticity can work for or against you. If the brain re-trains itself in response to a persistent negative behavior or stimulus, that can make your condition worse. Likewise, neuroplasticity can be harnessed to heal and lessen your symptoms — if you know what you’re doing. To understand how we use therapy to promote neuroplasticity, let’s examine a common routine our patients use while at our clinic.
Every morning, the day begins with thirty minutes of cardio exercise, or exercise that raises your heart rate. Cardio jumpstarts your body and your brain, ensuring there is plenty of oxygen available for your brain to use in the following therapy.
This results in what we call the post-exercise cognitive boost (PECB). Not only does your body feel better, but with all the extra blood and energy available to the brain, the brain functions better. So right after cardio is the perfect time to begin cognitive therapy.
For example, Cognitive FX patient Sam Gray found this occupational therapy exercise to be memorable: balancing on the flat side of a Bosu ball while a trainer had him name a fruit for every other letter of the alphabet, beginning with the letter Z… All while they tossed a football back and forth.
Balancing on a BOSU ball is just one part of one type of therapy offered at Cognitive FX.
In his case, balancing on the BOSU ball was activating a subcortical region of the brain. The exercise targeted areas involved in visually assessing his environment, maintaining balance, and seeing himself in relation to the space around him.
Then, on the ball, he had to throw a football back and forth with his therapist, an ever-moving, circling target. That activated areas involved in processes like visual tracking, visual search, hand-eye coordination, depth perception, and more.
Finally, the exercise included a memory recall aspect. In his case, it was naming fruits beginning with the letter Z, but it could be about anything from food to famous people. The idea is to perform activities that challenge the brain while also forcing multisensory systems to engage.
Obviously, the exercise described is more complex than something you might do on your first day of therapy. But it illustrates just how much you can do to engage brain plasticity.
Note: The above story is just one example of one fraction of a therapy appointment that we use to help concussion patients rewire their brains and heal from injuries. If you want to learn more about whether you could benefit from this treatment, schedule a free consultation.
Pacing Is Key to Good Neuroplasticity Therapy
Neuroplasticity rehabilitation is a stepwise process. You don’t jump into the hardest “brain training” exercises on day one. And you also don’t want to go from one cognitive exercise to another without rest.
In our practice, patients cycle through physical exercise, cognitive exercise, and rest multiple times throughout the day. You prepare the body with cardio, activate the brain as much as you can, and then rest until you’re able to do it all over again. Patients cycle through increasingly harder therapies throughout the course of a week.
It’s critical to have more than just one or two therapy sessions per week if you want the brain to use plasticity to heal itself.
How Do We Know Neuroplasticity Therapy Works?
Patients self-report symptom improvement before and after treatment, and the results are remarkable. But we don’t have to rely only on patient reports: We use fNCI to see that neuroplasticity is real and that it works.
fNCI stands for “functional neurocognitive imaging.” It’s a type of functional MRI (which stands for “magnetic resonance imaging”) that shows blood flow in the brain. Brain activity is inferred by identifying areas with more blood flow. Patients do cognitive tasks during the scan, and we can see if each brain area involved in completing that task is calling for and using oxygen.
fNCI (as in the example above) allows us to see the results of neuroplasticity treatment at Cognitive FX in action.
Thanks to this technology, we’re able to see and target the specific regions affected by your injury. We also compare pre-treatment and post-treatment scans to verify NVC changes and recovery. For example, 95% of our patients show statistically significant improvement on their post-treatment scan. And, on average, they show over 75% improvement on their final scan.
Is There Anything Neuroplasticity Healing Can’t Fix?
Neuroplasticity cannot be used to revive dead tissue in the brain, but it can be used to form pathways around it. There are a number of conditions and symptoms — such as Alzheimer’s disease or major traumatic brain injury — that we do not treat in our clinic, but other clinics use neuroplasticity to improve the lives of those who suffer from these more severe conditions.
But for most patients with mild traumatic brain injuries, understanding neuroplasticity can guide rehabilitation and facilitate improvement in symptoms stemming from the injury, ranging from attention difficulties to balance issues to headaches. Cognitive function is significantly improved by therapy in most patients. However, there are some symptom categories we can’t specifically target and/or for which research is still nascent, such as migrainous headaches, primary mental health disorders, and hormone dysregulation.
Neuroplasticity for Depression, Anxiety, Anger, and More
Our treatment plan is not designed to help with depression, anxiety disorders, or learning disorders that began before your injury. But any emotional symptoms that arose after your brain injury could improve if they are tied to the change in your quality of life due to injuring those areas of the brain.
The catch here is that there is very little research connecting neuroplasticity and improved emotional symptoms. Clinically, we have seen many patients’ emotional symptoms improve. But we don’t have a full understanding of why that is, and cannot make the claim that neuroplasticity is the direct cause for their improvement.
Neuroplasticity for Hormone Dysregulation
This image highlights the pituitary gland. Injuring the pituitary gland during a concussion can result in hormone dysregulation.
We often see patients who have many of the “traditional” post concussion symptoms along with hormone problems. Maybe your cortisol levels get inexplicably low, without necessarily being in adrenal failure territory. Maybe your child suddenly stopped growing, and you’ve since learned that they aren’t producing enough growth hormone. Maybe you’re tired all the time and found out that low thyroid hormone is contributing to the problem.
If so, you’re in good company. There is a growing body of new research from clinical trials, research universities, and more to show that concussions can also cause hormone dysregulation (i.e., hormones that aren’t at the levels they should be when they need to be) due to changes in the function of either the pituitary gland or the hypothalamus.
In many cases, these hormones being “off” can cause many of the symptoms associated with post-concussion syndrome, from difficulty sleeping to exhaustion. But because research affirming that concussions can cause hormone dysregulation is so new, we don’t have a way to treat these difficulties using neuroplasticity.
For some patients, hormone levels may improve after getting treatment for other parts of the brain. But many still need replacement hormones to finish the job. While we don’t prescribe those ourselves, we do refer patients to a local endocrinologist for assistance whenever they need it.
As we continue research, we hope to discover new and better ways to help these patients recover and thrive after treatment.
Ways to Get the Most Out of Neuroplasticity Healing
No matter where you go for treatment, there are a few ways to get the most out of your therapy sessions.
Embrace the will to make a change. We’re not talking about optimism vs. pessimism here. But it helps tremendously if you consciously choose to do everything you can to get better. By cultivating the belief that you can and will change, you help your brain do what it needs to heal.
Positive thinking alone can’t heal the human brain. But when it’s combined with therapy that drives neuroplasticity in a positive direction, it’s a very powerful component in recovery.
Have a support system in place. You don’t have to have amazing family and friends to recover, but having one or two people you can rely on during recovery makes a big difference. Could someone in your life travel with you to treatment? If not, are there ways they can help you prepare before you leave and readjust when you return?
Focus on addictions first. Major addictions to drugs or alcohol can seriously inhibit treatment efficacy. We recommend that patients resolve existing addictions to the extent they are able before pursuing treatment. Otherwise, they are usually unable to give treatment their full attention — and their recovery suffers as a result.
Even hitting the caffeine too hard can make treatment difficult. We strongly recommend discussing and addressing addictions before starting treatment, no matter where you choose to go for help.
What You Can Do at Home
Solving Sudoku puzzles probably won’t result in brain changes and new connections from neuroplasticity.
While you can’t treat a brain injury alone, you can help your brain be at its best with certain practices. Contrary to popular belief, solving Sudoku puzzles won’t really keep an adult brain “plastic.” And it certainly won’t resolve symptoms from a concussion.
But there are things you can do at home to encourage a healthy brain prone to neuroplasticity.
Here’s a short list:
Get enough sleep. This is by far the most important item on the list. Getting enough rest means your brain will be ready to change and heal.
Eat better. Avoid excessive amounts of alcohol and caffeine, as these affect your brain. Try to incorporate healthy, unprocessed or “whole” foods into your diet as much as possible.
Reduce stress. Stress is linked to the top six leading causes of death in the United States. It also inhibits neuroplasticity. At the risk of sounding like every other doctor you’ve spoken to, find ways to reduce stress in your life. Your brain will thank you.
Learn something new. We’re not just talking about a fact per day. Learning new skills that really challenge you — such as a new language, dance, knitting, etc. — can do amazing things for your brain plasticity.
If you’ve sustained a mild traumatic brain injury — concussion or otherwise — and experience symptoms that won’t resolve on their own, neuroplasticity could be the key to your recovery. You’re not alone, and you’re not crazy. On average, our patients improve by 75% after treatment at our center specializing in neuroplasticity-driven therapy. To see if you are eligible for treatment, sign up for a free consultation.
About Dr. Alina Fong PhD
Alina K. Fong received her PhD in Clinical Neuropsychology with an emphasis in neuroradiology from Brigham Young University. She received the national American Psychological Association Clinical Neuropsychology Division 40 Graduate Student Research Award in 2004 for her research on "Cortical Sources of the N400 and 'The N400 Effect." Dr. Fong's interest in brain mapping soon turned to functional MRI, and since then, her research efforts have been focused on the clinical applications of fMRI.