The ability of the human brain to grow new cells, to repair damaged cells, and to re- organize the function of different parts of the brain are all characteristics of a process called neuroplasticity. This process of repair and reorganization is a new scientific fact, elegantly demonstrated by brain scanning techniques, such as functional MRI and PET scans. It is one of the most important medical discoveries of the past 50 years. It offers new hope to people with a wide variety of neurological problems and even provides hope of improved or restored brain function to the aging baby boomer. But it is a new truth and new truths are hard to swallow, particularly in the relatively conservative arena of medicine. The German philosopher, Arthur Schopenhauer, eloquently described the process of accepting a new truth.
“All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as self-evident.”
In the field of adult neurology, neuroplasticity has made it through the first 2 stages and is on its way to widespread acceptance. In Dr. Norman Doidge’s book, “The Brain That Changes Itself”, he describes cutting edge treatments that are changing lives now and slowly changing the standard approach to common brain problems such as stroke. The future for adults with brain injuries or disease is not what it used to be.
Unfortunately, for a child with cerebral palsy or other early-acquired brain injury, the future is still what it used to be. Commonly accepted medical wisdom states that cerebral palsy cannot be cured. Cerebral palsy, the “incurable” brain injury, ranks at the bottom of the heap in both public and private dollar funding available for either cure or care. This attitude is surprising. A poor outcome for the child with cerebral palsy is not what you would expect from animal studies. It has been demonstrated in many species that young animals recover faster and more completely than adult animals. If cerebral palsy truly cannot be cured, then we would have to believe that:
Adult rat brains recover
Baby rat brains recover better
Adult human brains recover
Baby human brains do not recover
What a paradox! Adult humans can recover, why not children? It is just not logical to hold to the belief that the young of the human species has different mechanisms of brain recovery than the adult. An adult human with a mild hemiplegic stroke, affecting one arm and leg, can expect to recover most, if not all, of their pre-stroke function. Complete recovery or cure has been documented in up to 30% of first time ischemic strokes. Based on current neuroscience, a child with a similar mild hemiplegic stroke should also have a great shot for cure. But they don’t! The child with a young growing brain has hemiplegic cerebral palsy for life. To add insult to injury, parents who want a cure for their children are deemed to be unrealistic or in denial of reality.
In the evolution of science, what we believe to be true will change, as new facts are uncovered. The new fact of human neuroplasticity is widely accepted by the scientific community and is the focus of innovative experiments in the fields of basic and applied neuroscience and cognitive psychology. Adult brains are capable of recovery and baby brains are also capable of recovery. To claim otherwise is both illogical and unsupported by current neuroscience knowledge. Not only do baby brains recover to some extent after an early insult, but they also continue to grow and change with experience throughout life. The problem that neuroplasticity presents is that this one concept changes many of the underlying assumptions of the field and demands an entirely new model of care for children. Neuroplasticity is a true “game changer” for the pediatric rehabilitation world.