Harnessing neuropasticity for clinical applications

BY Steven C. Cramer, John Q. Trojanowski, Wen G. Chen, Guinevere F. Eden, Suzanne Haber, Helen S. Mayberg, Mriganka Sur,     Bruce H. Dobkin, Judith M. Rumsey, Leonardo G. Cohen, Patricia Reuter-Lorenz, Edith V. Sullivan, Eberhard E. Fetz, Peter W. Kalivas,
Charles O’Brien, Ramona Hicks, Christopher deCharms, Rosemarie Filart, Bryan Kolb, Patrick S. McQuillen, Nicholas Schiff,
Sophia Vinogradov, Judy Cameron, Terence D. Sanger, Charles J. Duffy, Michelle Freund, Arthur F. Kramer, Ralph Nitkin, Anu Sharma,
Daofen Chen, Steven J. Grant, Minda Lynch, Alvaro Pascual-Leone, Lana Shekim, Michael Stryker

Neuroplasticity can be defined as the ability of the nervous system to respond to intrinsic or extrinsic stimuli by reorganizing its
structure, function and connections. Major advances in the understanding of neuroplasticity have to date yielded few established
interventions. To advance the translation of neuroplasticity research towards clinical applications, the National Institutes of
Health Blueprint for Neuroscience Research sponsored a workshop in 2009. Basic and clinical researchers in disciplines from
central nervous system injury/stroke, mental/addictive disorders, paediatric/developmental disorders and neurodegeneration/
ageing identified cardinal examples of neuroplasticity, underlying mechanisms, therapeutic implications and common denominators.
Promising therapies that may enhance training-induced cognitive and motor learning, such as brain stimulation and
neuropharmacological interventions, were identified, along with questions of how best to use this body of information to reduce
human disability. Improved understanding of adaptive mechanisms at every level, from molecules to synapses, to networks, to
behaviour, can be gained from iterative collaborations between basic and clinical researchers. Lessons can be gleaned from
studying fields related to plasticity, such as development, critical periods, learning and response to disease. Improved means of
assessing neuroplasticity in humans, including biomarkers for predicting and monitoring treatment response, are needed.
Neuroplasticity occurs with many variations, in many forms, and in many contexts. However, common themes in plasticity
that emerge across diverse central nervous system conditions include experience dependence, time sensitivity and the importance
of motivation and attention. Integration of information across disciplines should enhance opportunities for the translation
of neuroplasticity and circuit retraining research into effective clinical therapies.

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