Regrowing Brain Cells: Post-Stroke Recovery And Brain Plasticity

The brain has an extraordinary ability to heal itself after a stroke, thanks to neuroplasticity – its ability to reorganise neurons in response to learning or experience. This allows stroke survivors to make astonishing recoveries, but the brain typically does not heal on its own. Consistent repetitive practice of tasks involving affected functions is the best way to spark neuroplasticity and healing within the brain.

Neuroplasticity refers to the brain's ability to form new neural pathways and transfer functions once held in damaged parts of the brain to new, healthy areas. The brain is composed of billions of neurons, each of which are connected to up to 10,000 other neurons, resulting in a network of over 100 trillion neural connections. These connections are pathways in the brain that retrieve and store information. When a stroke occurs, these connections are destroyed, resulting in lost functions.

The brain can fully or partially recover these functions through neuroplasticity, but this process needs to be activated. While some individuals experience spontaneous recovery, the most effective way to activate neuroplasticity is through consistent repetitive practice. Therefore, it is essential to regularly practice tasks involving affected functions to spark neuroplasticity and help the brain heal itself after a stroke.

Brain repair through neuroplasticity

Neuroplasticity refers to the brain's ability to restructure or rewire itself when adapting to change. The brain can continue to develop throughout life in response to stimulation, environmental changes, and individual experiences. This ability to adapt and change is known as neuroplasticity, and it is why many stroke survivors are able to make astonishing recoveries.

The brain is composed of billions of neurons, each of which are connected to up to 10,000 other neurons. This results in a network of over 100 trillion neural connections. These connections are pathways in the brain that retrieve and store information. When a stroke occurs, part of the brain becomes damaged, and many of these connections are destroyed, resulting in lost functions.

Activating neuroplasticity through repetition

Through a process called neurogenesis, some cells in the brain grow and heal, particularly during the early years. New neurons and new connections between existing ones are created. Every new experience, from grabbing a coffee at an unfamiliar cafe to hiking a mountain in a new country, can impact the brain and create new connections. Repeating an action reinforces these connections.

Massed practice creates new pathways

When exercises and activities are performed, the brain creates new pathways in response to the experience. These new pathways make it easier for the brain to retain and access information. When a specific task is practiced repetitively, the associated neural pathways are reinforced, making the task easier to perform.

Preventing learned non-use

While neuroplasticity can help the brain heal after a stroke, the adaptive rewiring that occurs is not always beneficial. When survivors practice exercises with poor form or consistently avoid tasks involving affected functions, maladaptive plasticity may occur. For example, if a survivor is unable to use their right hand for daily activities and starts using only their left hand regularly, the brain will eventually "forget" how to use the right hand, leading to a condition known as learned non-use.

Rewiring the brain to restore abilities

By focusing on highly repetitive exercises and task-specific training during stroke rehabilitation, survivors can activate neuroplasticity and help the brain heal. Through neuroplasticity, the brain is able to repair lost connections, relearn certain activities, and prevent further loss of function.

Enhancing neuroplasticity

While spontaneous recovery is possible, consistent repetitive practice of tasks involving affected functions is the best way to spark neuroplasticity and healing within the brain. This includes task-specific training and repetitive actions, as well as a stimulating environment and adequate sleep.

The role of growth and differentiation factor 10 (GDF10) in brain repair

Growth and differentiation factor 10 (GDF10) is a molecule that plays a key role in brain repair mechanisms following a stroke. GDF10 is involved in the process of axonal sprouting, which is

Brain exercises for stroke recovery

Brain exercises are a vital part of stroke recovery, as they can help improve cognitive functions such as memory, problem-solving, and the ability to think clearly. Here are some brain exercises that can aid in stroke recovery:

• Card Matching: A visual memory game where cards are placed face down and players try to find matching pairs. This can be modified by using fewer pairs for those with more advanced cognitive impairments.
• Alphabetize Sentences: Choose a sentence and rewrite the words in alphabetical order. This can be simplified by organizing the letters of one word instead of a whole sentence.
• Counting Money: Counting a handful of random coins to improve quantitative reasoning.
• Brain Teasers: Activities such as Sudoku, word searches, and crossword puzzles improve concentration, attention, memory, analytical and quantitative reasoning.
• Visuospatial Processing Games: Apps like "What's the Difference" challenge players to find small differences between two similar pictures, enhancing perceptual skills.
• Simon Memory Game: A game that focuses on memory skills by highlighting a pattern of colours for players to recall.
• Board and Card Games: Classic games like Checkers, Connect Four, and Rumikub can improve deductive reasoning, divided attention, and organization.
• Cooking: Following a recipe improves sequencing, memory, and problem-solving skills.
• Cognitive Therapy Apps: Apps like the CT Speech & Cognitive Therapy App include exercises chosen by experts to target specific cognitive areas.
• Mindfulness: Practicing mindfulness can improve attention, mental flexibility, and information processing while reducing stress and anxiety.
• Drawing, Colouring, and Painting: These activities stimulate creativity, analytical skills, hand-eye coordination, and can help with emotional expression.
• Music: Listening to music can aid concentration and generally improve mood and outlook. Singing along to songs can also be less challenging for those with language problems.
• Dancing: Dancing strengthens the body and helps with motor coordination.
• Sign Language: Learning sign language can enhance memory skills and provide a means of communication for those with speech impairments.
• Arts and Crafts: Projects like scrapbooking, sewing, and knitting encourage creativity, manual dexterity, muscle coordination, and emotional expression.

Brain supplements for stroke recovery

The brain has an extraordinary ability to heal itself after a stroke through neuroplasticity, which refers to the brain's ability to reorganise neurons in response to learning or experience. While spontaneous recovery is possible, consistent repetitive practice of tasks involving affected functions is the best way to spark neuroplasticity and healing.

Vitamins and Supplements

Vitamins and supplements can help boost brain health and aid stroke recovery, but it is important to consult with a physician before adding supplements to your diet as they can interfere with your medication.

Vitamin D

Vitamin D is one of the best vitamins for stroke recovery. Deficiency is associated with worse outcomes and risk factors like hypertension, obesity, and diabetes. Supplementing with vitamin D has shown significant improvement in stroke outcomes. It can also provide neuroprotective, neuromuscular, and osteoprotective benefits, reducing cognitive and functional impairments.

Probiotics

Probiotics are the "good" bacteria that comprise your microbiome, which influences brain health and function via the gut-brain axis.

Vitamin B12

Vitamin B12 boosts the function and development of the brain and nerve cells, encouraging neuroplasticity. It also helps with the formation of neurotransmitters, chemical messengers that transmit impulses between neurons. Deficiency is associated with a type of inflammation that damages the blood vessels.

Vitamin B3 (Niacin)

Vitamin B3, or niacin, enhances neuroplasticity and may improve "good" cholesterol levels, which are low in stroke survivors.

DHA (Docosahexaenoic Acid)

DHA is an essential omega-3 fatty acid for healthy brains. It is critical for brain growth and maintenance of normal brain function in adults and may reduce stroke risk factors like hypertension and atherosclerosis.

Coenzyme Q10 (CoQ10)

CoQ10 is a powerful antioxidant that protects from free radicals associated with cardiovascular disease and provides heart health benefits. Low CoQ10 levels are associated with greater tissue damage to the brain during a stroke.

Vitamin C

Vitamin C deficiency may be a risk factor, especially for hemorrhagic strokes. It may aid in reducing plaque buildup in the arteries.

Folic Acid, Vitamin B-6, and Betaine

Certain B vitamins and betaine may help lower levels of the amino acid homocysteine, which is linked to an increased risk of stroke.

Herbal Supplements

Herbal supplements may improve blood circulation in the brain and help prevent another stroke. These include ashwagandha, garlic, Asian ginseng, gotu kola, turmeric, and pomegranate.

Massage

Massage can help increase blood flow to an affected area, especially for stroke-related muscle problems, and improve motor function and reduce muscle spasticity.

Acupuncture

Acupuncture may help ease pain and manage muscle problems affected by stroke. It is considered safe when applied by an experienced and licensed practitioner.

Tai Chi

Tai chi may support stroke prevention and recovery by improving balance, muscle strength, and motor function.

External Counterpulsation (ECP)

ECP treatments may encourage recovery by creating a massage-like sensation and helping blood flow to the brain.

Stroke recovery stages

The recovery process after a stroke is gradual and unique to each individual. Doctors use stages to measure the recovery process. The Brunnstrom Approach, developed by physical therapist Signe Brunnstrom, breaks down how motor control can be restored throughout the body after a stroke. The approach outlines seven stages of stroke recovery:

• Flaccid Paralysis: This is the initial period of shock immediately after a stroke, where there is a complete lack of voluntary movement due to nerve damage.
• Onset of Spasticity: Some muscles may now tighten involuntarily in response to stimuli, but the person may have difficulty relaxing them. Minimal voluntary movements may be present.
• Increased Spasticity: Spasticity in the muscles increases and peaks during this stage. It is caused by damage to nerve pathways and results in stiff and tight muscles that can interfere with movement, speech, or cause discomfort and pain.
• Decreased Spasticity: Involuntary muscle tightening decreases, and the brain gets better at sending signals to specific muscles to move them voluntarily. The person regains control, mostly in the extremities, and has a limited ability to move normally.
• Increased Complex Voluntary Movements: With involuntary muscle tightening minimized, the person becomes more capable of performing complex muscle movements voluntarily. Abnormal movements also start to decline.
• Spasticity Disappears, and Coordination Returns: The person's control of their movements is almost fully restored. Involuntary muscle tightening disappears, and their movements become more coordinated.
• Normal Function Returns: In this final stage, the person regains full function in the areas affected by the stroke. They can now move their arms, legs, hands, and feet in a controlled and voluntary manner.

It is important to note that the recovery timeline can vary, but the first three months after a stroke are typically the most critical for recovery, with the most significant improvements occurring during this period. Starting rehabilitation as soon as possible is vital for stroke recovery. The rehabilitation team may include physiatrists, neurologists, physical and occupational therapists, speech-language pathologists, and nurses.

While physical, occupational, and speech therapies remain key components of stroke rehabilitation, new and innovative techniques are also being explored to enhance recovery. These include noninvasive brain stimulation (NIBS) and technology-assisted rehabilitation.

The brain's ability to heal itself after a stroke is referred to as neuroplasticity, and it is why many stroke survivors go on to make astonishing recoveries. Consistent repetitive practice of tasks involving affected functions is key to activating neuroplasticity and promoting healing.

Frequently asked questions