Is recovery possible?

Brain injury differs from all other kinds of injury that people can get. The consequences of brain injury are different for every one. Some people have very little consequences. Others loose awareness of being alive. Full recovery is possible, but rarely occurs.

There are no percentages and figures about people wíth and wíthout residual effects. What is known is that there are always broken axons (brain connections) and that brain cells have possibly died.

The influence of the injured cells and connections depends on the nature and the location of the injury but for example also on the overall health of the injured person. Some functions are much easier restored than others.

Maybe this is because these functions are easily adopted by other areas that are uninjured.  In some areas of the brain, allthough up to 95 % of the connections are broken, still more or less normal performance can be seen. A little bit more injury, however, can be catastrophic.

It has been shown that very few people completely recover from brain injury. It is not like a disease for which recovery is possible. ABI professionals (neurologists and neuropsychologists) know all about it. It is also found that recovery can continue for a long time. Years after the injury originated recovery may still occur.

Doctors do not dare make any predictions about the extent to which recovery of brain injury is possible. It is known that the following factors possibly influence the extent to which recovery is possible.

Note! None of these factors is all decisive. For example, about the third factor (motivation / perseverance) there is a Dutch expression meaning ‘If you want something, you can do it’. This expression is not applicable to people having brain injury. Motivation / perseverance alone is not enough and too much of it can cause exhaustion!

Some of the factors are trainable, but many are not.

• Condition of the brain and medical history.

Has the brain been injured before? Have there been small infarcts? Diabetes, high blood pressure, poor blood, poor physical condition: an athlete probably has more chance of recovery than someone who hardly did any sport, excessive alcohol or drug use, had much anesthetic or depression, severe insomnia or lung problems in history.

• Age: the younger you are, the more likely to recover.

• Motivation: the will to fight you back. (But what is broken is broken).

• The severity (size and location) of the injury.

• The question whether a brain injury that involves something for which years of training is required. Something that has taken many years to develop will not be repaired in a short time. An example is: speech.

Difference between Neurogenesis and Neuroplasticity

Neurogenesis refers to the creation of new neurons in the brain. This process occurs primarily in specific areas, such as the hippocampus, which is involved in learning and memory. Neurogenesis is therefore about the growth of new brain cells.

Adults continue to produce new brain cells (neurogenesis), but this process is insufficient to fully repair damage to the brain and the central nervous system (CNS).

Nevertheless, neurogenesis can contribute to initiating the recovery process after a brain injury. Regeneration refers to the regrowth of damaged or lost body parts.

Neuroplasticity relates to the brain's ability to adapt and change, for example by forming new connections between existing neurons. This occurs, for instance, when learning new skills or recovering from brain damage. Neuroplasticity is essentially about adapting and rearranging your brain cells and how they work together.

Brain cells (neurons) and their connections change constantly. This makes it possible to learn new things, remember them, develop new skills, and in some respects, recover from brain injury.

Until recently, it was assumed that the brain developed only during pregnancy, that is, before birth. We now know that new brain cells are constantly being produced by special cells in the ventricles.

New neurons arise during learning and memory development.

A stimulating environment and physical activity can contribute to this process of new neuron production.

In certain brain regions, the brain is able to form new connections between the remaining cells.

This process, also known as neuroplasticity, enables humans to learn, recover from certain brain damage, and develop new skills.

NB!

New brain cells are formed primarily in the temporal lobe and the frontal lobe of the brain. However, no new brain cells are created in the primary visual cortex, the area that processes images.

New habits and different thoughts can contribute to quality of life. New thoughts and skills actually pave new paths.

Repetition and practice strengthen these pathways and form new habits. Old pathways are then used less and weaken over time.

Every time we think, feel, or do something, we STRENGTHEN a neural connection.

Limits to neuroplasticity

However, there are limits to the possibilities of neuroplasticity.

Exercising can be beneficial, but realize that there are also limits to what can be regained. Listen to your therapists regarding this.

There is a saying that applies to skills to a certain extent as well: "When you do not use it, you lose it." If you do not use a skill, you can lose it.
Even when the recovery of function comes to an end, many people with injury prove to be creative in shifting their focus to what *is* possible.

TCDS

Research into TCDS (Transcranial Direct Current Stimulation) is currently being conducted in the Netherlands (see here). TCDS is a form of brain stimulation in which brain tissue just below the skull is stimulated by means of electrodes, so that healthy parts of the brain take over tasks from the damaged parts.
At present, the research focuses on motor skills, everything related to a person's movement. In the future, this could potentially be expanded to other brain functions.

Respect!!

Living with a brain injury is 24/7 top-level sport.