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Enhancing neurorehabilitation by targeting beneficial plasticity

Neurorehabilitation is now one of the most exciting areas in neuroscience. Recognition that the central nervous system (CNS) remains plastic through life, new understanding of skilled behaviors (skills), and novel methods for engaging and guiding beneficial plasticity combine to provide unprecedente...

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Autores principales: Wolpaw, Jonathan R., Thompson, Aiko K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10338914/
https://www.ncbi.nlm.nih.gov/pubmed/37456795
http://dx.doi.org/10.3389/fresc.2023.1198679
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author Wolpaw, Jonathan R.
Thompson, Aiko K.
author_facet Wolpaw, Jonathan R.
Thompson, Aiko K.
author_sort Wolpaw, Jonathan R.
collection PubMed
description Neurorehabilitation is now one of the most exciting areas in neuroscience. Recognition that the central nervous system (CNS) remains plastic through life, new understanding of skilled behaviors (skills), and novel methods for engaging and guiding beneficial plasticity combine to provide unprecedented opportunities for restoring skills impaired by CNS injury or disease. The substrate of a skill is a distributed network of neurons and synapses that changes continually through life to ensure that skill performance remains satisfactory as new skills are acquired, and as growth, aging, and other life events occur. This substrate can extend from cortex to spinal cord. It has recently been given the name “heksor.” In this new context, the primary goal of rehabilitation is to enable damaged heksors to repair themselves so that their skills are once again performed well. Skill-specific practice, the mainstay of standard therapy, often fails to optimally engage the many sites and kinds of plasticity available in the damaged CNS. New noninvasive technology-based interventions can target beneficial plasticity to critical sites in damaged heksors; these interventions may thereby enable much wider beneficial plasticity that enhances skill recovery. Targeted-plasticity interventions include operant conditioning of a spinal reflex or corticospinal motor evoked potential (MEP), paired-pulse facilitation of corticospinal connections, and brain-computer interface (BCI)-based training of electroencephalographic (EEG) sensorimotor rhythms. Initial studies in people with spinal cord injury, stroke, or multiple sclerosis show that these interventions can enhance skill recovery beyond that achieved by skill-specific practice alone. After treatment ends, the repaired heksors maintain the benefits.
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spelling pubmed-103389142023-07-14 Enhancing neurorehabilitation by targeting beneficial plasticity Wolpaw, Jonathan R. Thompson, Aiko K. Front Rehabil Sci Rehabilitation Sciences Neurorehabilitation is now one of the most exciting areas in neuroscience. Recognition that the central nervous system (CNS) remains plastic through life, new understanding of skilled behaviors (skills), and novel methods for engaging and guiding beneficial plasticity combine to provide unprecedented opportunities for restoring skills impaired by CNS injury or disease. The substrate of a skill is a distributed network of neurons and synapses that changes continually through life to ensure that skill performance remains satisfactory as new skills are acquired, and as growth, aging, and other life events occur. This substrate can extend from cortex to spinal cord. It has recently been given the name “heksor.” In this new context, the primary goal of rehabilitation is to enable damaged heksors to repair themselves so that their skills are once again performed well. Skill-specific practice, the mainstay of standard therapy, often fails to optimally engage the many sites and kinds of plasticity available in the damaged CNS. New noninvasive technology-based interventions can target beneficial plasticity to critical sites in damaged heksors; these interventions may thereby enable much wider beneficial plasticity that enhances skill recovery. Targeted-plasticity interventions include operant conditioning of a spinal reflex or corticospinal motor evoked potential (MEP), paired-pulse facilitation of corticospinal connections, and brain-computer interface (BCI)-based training of electroencephalographic (EEG) sensorimotor rhythms. Initial studies in people with spinal cord injury, stroke, or multiple sclerosis show that these interventions can enhance skill recovery beyond that achieved by skill-specific practice alone. After treatment ends, the repaired heksors maintain the benefits. Frontiers Media S.A. 2023-06-29 /pmc/articles/PMC10338914/ /pubmed/37456795 http://dx.doi.org/10.3389/fresc.2023.1198679 Text en © 2023 Wolpaw and Thompson. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Rehabilitation Sciences
Wolpaw, Jonathan R.
Thompson, Aiko K.
Enhancing neurorehabilitation by targeting beneficial plasticity
title Enhancing neurorehabilitation by targeting beneficial plasticity
title_full Enhancing neurorehabilitation by targeting beneficial plasticity
title_fullStr Enhancing neurorehabilitation by targeting beneficial plasticity
title_full_unstemmed Enhancing neurorehabilitation by targeting beneficial plasticity
title_short Enhancing neurorehabilitation by targeting beneficial plasticity
title_sort enhancing neurorehabilitation by targeting beneficial plasticity
topic Rehabilitation Sciences
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10338914/
https://www.ncbi.nlm.nih.gov/pubmed/37456795
http://dx.doi.org/10.3389/fresc.2023.1198679
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