Neuroplasticity is the brain’s ability to form new connections (rewire) after a brain injury or a stroke. Recovery of motor (movement) function after a stroke involves relearning motor skills using this idea of neuroplasticity.  Furthermore, this idea of brain rewiring is the foundation that supports most stroke rehabilitation interventions. And therefore it is an absolutely critical concept for all stroke survivors and their family members to understand. But before we get into the “nitty-gritty” of what this term means and how it applied to you, it is best to understand a little bit of the brain’s anatomy.

Brain Anatomy

The brain is made up of two hemispheres, right and left.

image of the brain and two hemispheres

The brain is made up of different areas that are responsible for different “functions” in the body.

different brain functions

The brain is made up of millions of nerves that communicate with each other to carry out these functions.

image of the brain and the nerve network

A single nerve communicates with another nerve via a threadlike structure called an axon.

nerve and synapse image

Do nerves regenerate after a stroke?

The way that nerves “regenerate” after a stroke is through a process called axonal sprouting.  Basically, healthy nerves will grow a new axon and “re-supply” the dead nerve. In other words, a healthy nerve will take over the “workload” of the dead nerve.

Can the brain rewire itself after a stroke?

Brain plasticity is a term that describes all of the changes that go on in the nervous system throughout the entire lifespan.  The brain’s ability to do this is the mechanism by which we adapt to new situations and learn new information. There is a consensus in the literature that neuronal “plastic” processes (brain re-organization) are heightened after damage to brain tissue.  So basically without you doing anything at all, there is a certain level of brain reorganization that would automatically occur. That being said, there is also a ton of literature that talks about activity dependent neuroplasticity. This is a form of brain reorganization (structural changes) that occur as a result of new experiences. 

How do you rewire your brain after a stroke? 

The best way to get brain rewiring in the damaged area is to force use of the involved arm and leg. Forcing use of the involved arm and leg is almost like demanding the damaged nerves to “turn on”. In simple terms this will (hopefully) get healthy nerves in the area to send over some resources and “turn these nerves on”. This would be what we would call that axonal sprouting mentioned earlier. 

Neuroplasticity and post-stroke rehabilitation

Some therapies that demonstrate how this works is contraint induced movement therapy (CIMT) .  This treatment is an example of forced use of the invoved arm and there is strong evidence that axonal sprouting does occur. 

Do all stroke survivors reach full recovery?

This is a tricky question. Every stroke is different and therefore how much someone will recover after a stroke will be different for each person. The goal of stroke recovery is to optimize this process of neuroplasticity and axonal sprouting. The more intentional someone is about “waking up” the involved arm and the involved leg, the more the brain will try and find ways to get healthy nerves to supply the nerves that used to be responsible for moving the arm and the leg.

Now it is important to note, this does not only apply to movement. This also applies to speech and thinking tasks. The more you challenge the damaged areas of the brain, the more the brain will want to find a way to restore these functions. Pretty cool, right? Not gonna lie, I think the human brain is pretty darn amazing.