Rehabilitation of brain damage: brain plasticity and principles of guided recovery.
Rehabilitation of the damaged brain can foster reconnection of damaged neural circuits; Hebbian learning mechanisms play an important part in this. The authors propose a triage of post-lesion states, depending on the loss of connectivity in particular circuits. A small loss of connectivity will tend to lead to autonomous recovery, whereas a major loss of connectivity will lead to permanent loss of function; for such individuals, a compensatory approach to recovery is required. The third group have potentially rescuable lesioned circuits, but guided recovery depends on providing precisely targeted bottom-up and top-down inputs, maintaining adequate levels of arousal, and avoiding activation of competitor circuits that may suppress activity in target circuits. Empirical data are implemented in a neural network model, and clinical recommendations for the practice of rehabilitation following brain damage are made.
Robertson
I H
IH
Department of Psychology, Trinity College Dublin, Ireland. ian.robertson@tcd.ie
Murre
J M
JM
D001245:Association Learning; D001930:Brain Injuries / Q000534:rehabilitation*; D009415:Nerve Net / Q000502:physiology*; D009473:Neuronal Plasticity; D011379:Prognosis