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Summary - Optimizing Brain and Behavior (Incl. Lectures)
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This document contains all information from the PBL sessions (7 tasks) and lectures.
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TASK 1NEUROPLASTICITY
= The brain’s ability to reorganize in response to new experiences or pathological event.
LTP [Strengthening] and LTD [Maintaining]
Neurogenesis, axonal sprouting, synaptic pruning (excess synapses removed),
cortical remapping
Targeting synapses therapeutically: Disease modifying therapies (DMT’s)
Three main approaches to rehabilitation [Neurological and behavioral level]:
1. Compensation = surrounding areas get a bigger responsibility to maintain the
function (using existing pathways -> Strengthening)
Example: Impairment in language -> Formulaic expressions help alleviate
word-onset difficulties
2. Substitution = creating new pathways, another brain region taking over
Example: Sign language
3. Direct retraining = improving the affected area directly
Example: Recovery of the function -> Speech training/Exercises with a
speech therapist
Neuroplasticity can be negative: Pathological changes
Example: Hyperactive amygdala -> Anxiety
Hyperactivity = Excitotoxicity
Overcompensation: healthy brain regions are taking over & losing their
original function (e.g. senses, movement) -> Inability to selectively recruit
brain regions efficiently
BIOPSYCHOSOCIAL MODEL
= Looks at the interconnection between biology, psychology, and socio-
environmental factors. These models specifically examine how these aspects play a role
in a range of topics but mainly psychiatry, health and human development.
Considers a wide range of factors <-> Medically approach: Biological factor
Person-centered [Individually tailored]
Characteristic in (NEURO)REHABILIATION: Multidimensional holistic approach
Example: International Classification of Functioning (ICF) Model
Health condition = Disorder
Body functions and structures =
Symptoms
Participation = Restrictions in in
societal involvement (e.g.
occupational roles, family)
Environmental factors = Social
support
Personal factors = Characteristics
of individual (e.g. motivation, age,
gender, cognitive reserves)
Activities = How symptoms affect
patients’ ability to execute day-to-
day activities
,Challenges of using ICF in reality
o Need for mutual effort (all parties involved: clinician, patient, environment)
o Proper education
o Good communication within a multidisciplinary team
o Managing expectations (All parties)
o Time and money constraints
o Lengthy consent process
o Patient needs to be motivated for treatment
(NEURO)REHABILITATION
= A problem solving process that makes use of the biopsychosocial model [Person-
centered]
= Two-way, interactive process whereby people who are disabled by injury or disease
work together with professional staff, relatives, and members of the wider community to
achieve their optimum physical, psychological, social and vocational well-being.
Cognitive rehabilitation
= A process whereby people with brain injury work together with professional staff and
other to remediate or alleviate cognitive deficits arising from a neurological insult.
NR is broader: Concerned with the amelioration of cognitive, emotional,
psychosocial, and behavioral deficits caused by an insult to the brain [Centered on
a goal-planning approach]
Focus points:
o Work of all parties
o Important goals of the individual
o Real-life issues
Main characteristics of effective ‘rehabilitation’:
1. Context: Who may benefit, and does location matter?
2. Process: What are the common features of the process?
3. Interventions: What intervention s are used?
Aim: Improving patient’s quality of life
, Context Process Interventions
Rehabilitation benefits anyone Biopsychosocial model Exercise
with persistent disability = Characteristic 1. Muscular/physical
associated with an illness, Multidisciplinary team: activities that are
regardless of the underlying Rehabilitation depends upon a associated with increased
disease of disorder multidisciplinary team being energy consumption and
Example: Cardiac involved cardio-respiratory work
conditions, neurological Structured protocols 2. Performance of a specified
conditions etc. = Standardized way of activity, usually practicing
Rehabilitation is effective in approach the biomedical it to improve performance
most settings aspects of illness Education and self-
Example: intensive Person-centered [Individually management
care units, nursing Tailored] 1. Disease and management
homes, at home etc. of symptoms, and
Rehabilitation is likely to be medication
beneficial to a person with 2. Core self-management
disability at any stage of their skills
illness and whatever the 3. Exercise program
nature of their prognosis 4. Self-relaxation training
Rehabilitation is effective at
any age
, GOAL SETTING TO PLAN REHABILITATION
= Goals are important regulators and motivators of human performance and action, and
a desired outcome by which process can be measured.
Goal planning focuses on practical everyday problems, is tailored to individual
needs, and avoids the artificial distinction between many outcome measures
and real-life functioning
Principles involved in the goal-planning approach
A. The patient should be engaged in setting his/her goals
B. Goals set should be reasonable, and client centered
C. Patient’s behavior when a goal is reached should be described
D. The method to be used in achieving the goals should be defined in such a manner
that anyone reading the plan would know what to do
E. Goals should be specific and measurable, and have a definite deadline
Types of goals
a. Long-term = those that the patient/client is expected to achieve by the time of
discharge from the program
b. Short-term = the steps set each week/night in order to achieve the long-term
goals
SMART: Goals should be specific, measurable, achievable, realistic and timely
Involved: Clinician, patient, environment/family
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