Neuroplasticity – How to Rewire Your Brain After a Stroke

For more than a century, the idea that our nervous systems can change throughout our lifespan has been widely examined. The chair of psychology at John Hopkins University from 1910-1941, Adolf Meyer, explained the concept of neuroplasticity, which allows us the opportunity to strengthen and change the neural pathways in our brains. We use the term neuroplasticity to describe the brain–and the nervous system are not static structures, but malleable or plastic. 

In the early 1980s, Neuroscientist Edward Taub researched monkeys and when sensory nerves were lost in one of their limbs, they invested more energy in the other arm to compensate. The neural pathways in the brain reflected these changes, showing weakened paths to the restricted arm, and strengthened paths to the functioning arm. This showed that physical movements are intentional and we have the ability to change how our brain is wired. This pertains to both healthy brains and brains that have experienced a loss of function, illustrating the principles of neuroplasticity and stroke recovery.

How Does Neuroplasticity Work?

The ability of the brain to regain function exists because of neuroplasticity. In the days following a stroke, brain recovery from stroke includes both intrinsic and extrinsic factors. Intrinsic factors include cells in the brain that repair damaged brain tissue. The individual nerve endings will begin to reconnect as the brain attempts to repair itself. This can be referred to as spontaneous recovery of some brain functions. 

Extrinsic factors include targeted exercises that help improve function, encouraging nerve cells to reconnect by stimulating their impulses. These exercises, through rehabilitative therapy, include those that call attention to the brain (interest), challenge the brain (intensity), and build or strengthen pathways in the brain (repetition). More can be learned about this concept and how to increase neuroplasticity after stroke here.

Neuroplasticity and Stroke

In the case of a person who has suffered a stroke, rehabilitative exercises must be customized to the person’s individual needs. The parts of the brain damaged by the stroke can be identified by instrumental exams such as MRIs, but also by specialized clinicians such as Speech-Language Pathologists and Occupational Therapists. These therapists can perform cognitive evaluations that test the brain’s abilities, detect where the deficits are located, and then customize a program to repair any damaged neural pathways, engaging in neuroplasticity stroke rehabilitation.

The implications of neuroplasticity are comforting when we consider people who have had strokes. When a stroke is severe enough, people can lose functional abilities. Some of these losses can include:

• Motor abilities (the ability to move body parts)
• Verbal and non-verbal communication
• Literacy (reading and writing)
• Auditory Comprehension (the ability to understand words or sounds)
• Memory skills
• Eating and swallowing (decreased ability to protect the airway)
• Recognition of people or everyday objects

Neuroplasticity offers us the opportunity to regain these functions with treatment programs designed to rewire the brain following a stroke. Examples of some programs are:

Physical Therapy: 

Exercises or stretching to regain motor control;
Aerobic exercise increases brain regulators that promote brain recovery.

Speech Therapy:

Exercises to improve speech, language, cognitive and swallowing deficits.

Gait Training Therapy:

Exercises focused on the lower extremities to help improve walking and balance.

Mirror Therapy:

Using a mirror to visualize a functioning part of the body and “trick” the brain into thinking the non-functioning side has also performed the movement, strengthening damaged neural pathways.

Constraint-Induced Movement Therapy (CIMT):

Restricting use of an affected body part to improve its contralateral function.

Transcranial Direct Current Stimulation (tDCS):

Target regions in the brain with weak electrical stimulation of synapses.

Brain-Machine Interface (BMI) and Brain-Computer Interface (BCI):

Using brain signals to control external assistive devices for communication or motor control.

Stem Cell Therapy:

Is There a Time Frame for Neuroplasticity After a Stroke?

Although recovery from a stroke is different for each person, the first six months following a stroke is when the greatest neuroplastic gains are observed. Rehabilitative therapy must begin as soon as possible following the stroke. After this period, recovery tends to slow down but can continue for years, which is why therapy that takes advantage of the brain’s plasticity during this period is critical for the best outcomes.

How Long Does it Take for the Brain to Rewire Itself After a Stroke?

As soon as rehabilitative therapies begin following a stroke, recovery of brain function can be observed. Even in the first few days following the stroke, many people show signs of recovery. Depending on the type of stroke, its severity, and where it occurred in the brain, we might see improved motor control, cognition, communication, and many other forms of functional ability return spontaneously. However, as stated above, each individual will experience recovery in a different way, and some functions will take weeks, months, or even years to return. Continued therapy will help, and there are many methods that can be used for optimal recovery.

How to Rewire your Brain after a Stroke: Tips and Exercises

Therapy with professionals is an integral part of recovery after a stroke. But there are also ways we can capitalize on neuroplasticity in our daily lives to continue learning and improving our brain’s function. Rewiring our brains can be as simple as practicing these simple and effective exercises:

• Use it or lose it: remember that unused skills whether physical or neurological will decline over time if they aren’t used regularly. This is particularly true of cognitive skills such as memory.
• Exercise (aerobic and non-aerobic) including chair exercises, walking, or stretching.
• Rest. A healthy balance of physical or cognitive exercise and rest will allow the brain to process new information and solidify its effects.
• Take a new route when walking, driving, or riding a bike.
• Socialize with friends or join a support group.
• Change where you sit during mealtimes at the table.
• Try using your non-dominant hand to perform tasks such as brushing your hair or teeth
• Eat a balanced diet that will provide needed nutrients to the brain and body.
• Learn a new skill: start with something simple such as a new craft or hobby, and if you’re ready for more challenging skills, try learning a new language or playing an instrument.

Books About Neuroplasticity

There are many books available to read on the subject of Neuroplasticity and how to get started on rewiring the brain. Don’t be intimidated—most are written in a way that is comprehensible to people who aren’t brain experts. Here’s a list of my favorites:

1. The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science by Norman Doidge, M.D. In this book, Norman Doidge takes us on a fascinating journey through the history of neuroscience and major discoveries along the way. He assembles personal accounts of people who have experienced major neurological setbacks and found the resilience–and scientific evidence–to begin healing their brains.
2. Soft Wired: How the New Science of Brain Plasticity can Change Your Life by Michael Merzenich, PhD. Dr. Michael Merzenich is a world authority on brain plasticity and has compiled all the information needed to improve neurological health. He even includes sections on how age, stress, and illness can affect the ability to remain in good cognitive health. The guide is geared towards people of any age who are interested in how to make the most of their brain.
3. Over My Head: A Doctor’s Own Story of Head Injury from the Inside Looking Out by Claudia L. Osborn. Dr. Claudia Osborn recounts her experience of head injury from the moment of regaining consciousness through a grueling recovery, to finding her new life. She uses plain language and some humor to explain the perception of a medical professional experiencing brain trauma which she knew much about, but not from the inside.

Final Words

Experiencing a stroke is a life-changing experience. At first, it’s difficult to imagine what kind of recovery is ahead—and where it ends. The answer is always the same: brain recovery is limitless. It can continue over the course of the lifespan and creating an environment rich with cognitive stimulation, challenges, and socialization is imperative to progress. Seeing a Speech-Language Pathologist or an Occupational Therapist for an evaluation of your abilities is an important step to recovery. Therapists will use evidence-based treatment plans to optimize your chances of improvement. If you or someone you love wants to make the most of treatment, talk to your therapist about how they’re including neuroplasticity into your treatment plan.

References

A brighter day for Edward Taub. (1997). Science, 276(5318), 1503. https://doi.org/10.1126/science.276.5318.1503a

Aderinto, N., Abdulbasit, M., Olatunji, G., & Adejumo, T. (2023). Exploring the transformative influence of neuroplasticity on stroke rehabilitation: a narrative review of current evidence. Annals of Medicine and Surgery, 85(9), 4425–4432. https://doi.org/10.1097/ms9.0000000000001137

Bhatnagar, S. C. (2002). Neuroscience for the study of communicative disorders. (2nd ed.). Lippincott Williams & Wilkins.

Doidge, N. (2009). The brain that changes itself [Dataset]. In PsycEXTRA Dataset. https://doi.org/10.1037/e671382011-001

Hara, Y. (2015). Brain plasticity and rehabilitation in stroke patients. Journal of Nippon Medical School, 82(1), 4–13. https://doi.org/10.1272/jnms.82.4

Lamb S. (2019). Neuroplasticity: a century-old idea championed by Adolf Meyer. CMAJ : Canadian Medical Association journal 191(49), E1359–E1361. https://doi.org/10.1503/cmaj.191099

Puderbaugh, M., & Emmady, P. D. (2023, May 1). Neuroplasticity. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557811/#:~:text=It%20is%20defined%20as%20the,traumatic%20brain%20injury%20(TBI).