title: Neuroplasticity: an appreciation from synapse to system.
abstract: OBJECTIVE
  To integrate our functional knowledge in neurorehabilitation with a greater understanding of commonly held theories and current research in neuroplasticity.
  
  
  METHODS
  Literature review.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Animal and human research.
  
  
  METHODS
  Interventions specific to application in humans: constraint-induced movement therapy, transcranial magnetic stimulation, and transcranial direct current stimulation.
  
  
  METHODS
  Cortical excitability, blood oxygen level-dependent signal, and functional outcomes.
  
  
  RESULTS
  There is increasing evidence elucidating the cellular and molecular mechanisms of plasticity of the nervous system including growth, modification, degradation, and even death of neurons. Some of these mechanisms directly correlate with therapy-induced behavioral changes, and all provide an understanding of the response of the nervous system to altered inputs. The understanding of neural correlates of behavior can then form the foundation for more productive, comprehensive interventions.
  
  
  CONCLUSIONS
  The focus of recent research surrounds translational projects aimed at enhancing clinical outcomes. Knowledge of mechanisms underlying this adaptability is the foundation for our treatments, diagnoses, and prognoses. The increasing understanding of the mechanisms underlying neuroplasticity can guide, direct, and focus the practice of current and future therapies to greater efficacy and better functional outcomes in clinical rehabilitation.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Program in Physical Therapy, University of Minnesota Medical School, Minneapolis, MN, USA. gillick@umn.edu
authors.forename: Bernadette T
authors.initials: BT
authors.lastname: Gillick
authors.forename: Lance
authors.initials: L
authors.lastname: Zirpel
mesh_terms: D000818:Animals; D000928:Antidepressive Agents / Q000494:pharmacology; D000697:Central Nervous System Stimulants / Q000494:pharmacology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009422:Nervous System Diseases / Q000503:physiopathology* / Q000534:rehabilitation*; D009473:Neuronal Plasticity / Q000502:physiology*; D018377:Neurotransmitter Agents / Q000502:physiology; D010812:Physical Stimulation; D013569:Synapses / Q000502:physiology; D050781:Transcranial Magnetic Stimulation
chemical_list: D000928:Antidepressive Agents; D000697:Central Nervous System Stimulants; D018377:Neurotransmitter Agents