Brain Plasticity and Contribution of the Emotional Brain to Neural Remodelling after Injury

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Background

Background:
Whether developmental, post-traumatic or degenerative, several major neurological diseases lead to long-term disability, which stems mainly from cognitive and psychomotor impairment, with dramatic psychosocial consequences. The management of severe disabilities is often ineffective, but when beneficial, the mechanisms of action leading to the favourable outcome are often unclear. Current theories emphasize the importance of the brain connectome, that the emergence of brain functions depends on the interactions of multiple regions in networks. The impairments seen in disabled individuals would reflect disturbances of neural networks that result from diffuse damage to white matter connections between brain areas, which mainly determines clinical outcome. For example, in the case of a patient with severe head trauma, an impairment in the control of the anticipation of a task, which results in profound disturbance of activities of daily living and which normally requires both motor and cognitive abilities prior to the action, would come from disrupted interactions between several regions of the cerebral cortex and the cerebellum.

One of the fundamental properties of the brain is its ability to change in response to a wide range of information, including that generated by an injury. This inherent brain plasticity should promote at least some functional restitution following injury. However, although spontaneous mechanisms of repair may take place, they are almost never sufficient to support a significant and definitive recovery. According to previous research, experiences that are most relevant to the individual are likely to produce much faster and profound brain remodelling than those that are less relevant. The emotional and/or physical intensity of the experience, and/or its frequency, may also be crucial. In patients where self-awareness is not profoundly altered, it is reasonable to assume that highly emotionally charged experiences may represent a high psychological load that brings relevance to the therapeutic intervention. For example, the perception of an independent, balanced, stable and regular locomotion by a patient with serious motor impairment, through virtual reality, hippotherapy, robotic aids, may consolidate the various somatosensory components that are necessary for the reconstruction of a body image and of the self, and may reinforce the relevance of the experience.

In current neurological practice, physicians are often faced with patients pushing themselves beyond their limits, an attitude that has sometimes a substantial impact on their functional outcome. Indeed, for the individual and their brain, relevant and enjoyable life activities can rank among the most powerful sensory, motor, cognitive, and emotional experiences. A common feature of all these is the capacity to evoke and regulate emotions, modifying or influencing the neuroendocrine and autonomic nervous systems, enhancing cognitive and overall brain functioning by engaging multiple temporal, frontal, parietal, cerebellar and limbic structures. A crucial question remains whether the emotional brain is a key actor that reshapes relevant neural networks. If such a powerful driver for brain plasticity can be mobilised, then it is vital that practitioners use it for neurorehabilitation. Since our current therapeutic arsenal is rather limited and inefficient, novel rehabilitation strategies to replace or complement traditional methods are urgently needed.

Details for authors:
The scope of the Research Topic covers the most prevalent neurological and neuropsychiatric developmental, post-traumatic and degenerative diseases. We welcome Original Research, Review, Systematic Reviews, Methods and Protocols, and Hypothesis and Theory papers, in addition to other article types.

Keywords: Neurological Diseases, Long-Term Disability, Brain Plasticity, Emotional Brain, Neurorehabilitation

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