Mind over matter
27 June 2014
Last update: 27/06/14 09:32
The June International Psychogeriatrics Article of the Month is entitled ‘Mind over matter – what do we know about neuroplasticity in adults?’ by Vyara Valkanova, Rocio Eguia Rodriguez and Klaus P. Ebmeier
Until recently the capacity of the human brain for structural and functional reorganization (brain plasticity) was considered to be limited to critical periods during development. Neuroimaging provides a non-invasive window into the living brain and has been used to study different aspects of brain plasticity during the learning of new skills or after novel experiences. We reviewed the strongest neuroimaging evidence for experience-dependent plasticity in adult humans, and therefore focused on longitudinal studies only (i.e. participants are scanned before and after different interventions, and then the images are compared).
We identified 36 studies that employed different types of training, such as juggling, exercising working memory, meditation, learning abstract information (studying for exams), and aerobic exercise. Although different patterns of results were found, there was consistent evidence that the brain (gray as well as white matter – brain cells as well as neuronal connections) retains much greater plasticity in adults (<75 years old) than is traditionally thought.
Before such research results can be translated into medical practice, there are many questions that still need to be answered. We currently do not know enough about the type and duration of the interventions that are effective, about the upper limits of improvement, how gains can be maintained, and most importantly the exact relationship between structural change and functional improvement. Further, all reviewed studies are in healthy individuals, while the impact of such interventions in patients with dementia is less well studied.
Future research will need to include larger samples and standardised training protocols to allow comparison of studies done at different research centres. Animal studies combining imaging with histological studies [detailed microscopic analysis] can be very useful in understanding the cellular mechanisms underlying learning, which is important when devising effective interventions. Finally, a multimodal imaging approach, where measures derived from complementary imaging modalities is likely to play a major role in increasing our understanding of brain plasticity. It is possible today, for example, to examine the volume of brain grey matter, the quality of anatomical connections between different areas of the brain and the degree of cooperation between different regions of the brain during the same examination, in other words to examine structural and functional brain connectivity. We know now that even the adult brain has a significant potential to change and compensate for any damage, for example after a stroke. Research in this area will have important implications for our ability to harness the natural self-healing and compensation properties of our brains to the greatest effect, in neurodegenerative diseases such as the dementias.
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Thank you, Klaus Ebmeier, for your “Mind Over Matter” blog last June. To add to the categories of those whose experience might provide additional evidence for neuroplasticity in adults, one can consider psychiatrically as well as developmentally disabled adults who have dealt with their disabilities over the course of long medical interventions and/or concurrent practice of faith in a healing God, either or both to the point at which they have become survivors who have returned to mainstream activity in society to further contribute value to its treasury of mental-health wealth. In this vein, untapped epidemiological study population opportunities for after-the-fact (retrospective) longitudinal studies might actually exist to which an investigator can devise and apply a meta-analysis study plan which couples (1) the existence of ‘old’ MRI scans of the brain that had been taken of patients suffering from acute depression or anxiety (for example) who at early stages of their pathologies had been looking for organic causes to explain the etiology of their conditions so that effective treatments could have been planned, with (2) the restoration of mental health (often, years later) to the extent that a significant measure of cognitive and other function (e.g., major life activities as defined in the U.S.’s 1990 ADA law, including thinking) has returned, as evidenced by good grading scores tallied on the basis of accepted performance criteria. Even to simply suggest that such studies could be conducted legitimately could help to give to chronic adult sufferers of mental disabilities a greater hope that one day it will no longer be a societal norm for the so-called non-disabled part of the general population to sting the mentally disabled portion with the pain and frustration of the stigma of themselves (the disabled) thus irrationally and unjustly adjudged as the 21st-century’s corps of untouchables. Underlying this comment reponse is the hypothesis that we all have the potential to be neuroplastic, to thus be learners and thinkers, as we are all human persons, whether mentally disabled or not and whatever our age might be.