The concept that children have greater capacity to learn and adapt to their environment compared to adults is based on observations that children have superior ability to learn a second language or operate a musical instrument more efficiently and more importantly, the ability to recover, to a certain extent, after brain injury.
This ability to remodel and change, also known as neuroplasticity, is the cornerstone of brain maturation, and is thought to be enhanced during specific periods called “critical and sensitive periods” of brain development.
Abnormal neuroplasticity is implicated in many brain disorders in children including intellectual disabilities, cerebral palsy, epilepsy, attention deficit hyperactivity disorder (ADHD) and autism.
To improve neurological dysfunction in these disorders and with advances in technology, researchers are now able to “induce” remodeling, to a certain degree, in the brain at deep and superficial levels using electrical and magnetic field stimulation devices such as deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS). While these methods are well studied in adults, their use in children with is still in infancy.
In this article, we characterize and outline the different types of neuroplasticity in children in health and disease including neuroplasticity that enables children to acquire skills and achieve milestones (developmental neuroplasticity), neuroplasticity that result in developmental disabilities (impaired developmental neuroplasticity), neuroplasticity after intense musical practice (adaptive neuroplasticity), neuroplasticity after brain injury or brain surgery (reactive neuroplasticity), and neuroplasticity that gets “out of control” as seen in some seizure syndromes (excessive or destabilizing neuroplasticity) and finally, neuroplasticity that puts the young brain at higher risk for further injury (the brain’s Achilles tendon).
We then discuss the crucial role of “critical and sensitive periods” in controlling and shaping the brain’s ability to change in children at different time points and in different brain networks. We also refer to data from animal studies and studies in adult subjects to showcase that it is possible to modulate the timing of these periods in order to lend more time for other interventions to take place.
Based on that, we hypothesize that identifying and understanding what “opens and closes” these periods in some children with brain disorders such as seizures, cerebral palsy and other neurodevelopmental disorders or after brain injury might open “windows of opportunity” to apply therapies that are not commonly seen in adult brain.
By understanding how neuroplasticity works and when is it enhanced, it is foreseeable in the near future that we would be able to identify which and when some brain disorders are more amenable to rehabilitation or brain stimulation-based techniques. Careful timing of interventions might allow for greater improvements in clinical outcomes.
Citation: Ismail FY, et al. (2016). Cerebral plasticity: Windows of opportunity in the developing brain. European Journal of Paediatric Neurology. Doi: http://dx.doi.org/10.1016/j.ejpn.2016.07.007
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