Neuroplasticity, Neurorehabilitation, and New Hope for Brain-Injured Persons


December 2020

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In the last twenty-five years, treatment for Traumatic Brain Injury (TBI) has stagnated, which has relegated many TBI survivors to permanent disability or premature death. The reasons for this stagnation are arguably historical. In the mid nineteenth century, Paul Pierre Broca established localization theory, which holds that certain cognitive functions are located within specific areas of the brain. The cultural adoption of localization theory ultimately led to brain mapping in the late nineteenth and early twentieth century, still in use today, which attempts to physically map the purported area of the brain where certain cognitive functions occur. In the twentieth century, a nihilistic attitude developed among physicians concerning the possibility of successful treatment of TBI, which is chronicled in first person TBI patient narratives analyzed in this dissertation. Therapeutic nihilism toward TBI continued and was exacerbated when the evidence-based medicine paradigm was developed and culturally adopted by the medical establishment and clinical researchers in the 1990s. In 2017, the Lancet Neurology Commission argued that the culture of evidence-based medicine and a lack of recognition of the complexity and heterogeneity of TBI by medical professionals and researchers has led to the stagnation of TBI treatment in recent decades. The Commission has advocated for a precision-based medicine (individualized) and multidisciplinary approach to TBI treatment. In the last half of the twentieth century, evidence began to emerge validating neuroplasticity, the idea that the human brain can heal after insult or injury, and treatments can now be individualized based upon neuroplastic principles that provide hope for the brain injured.



Health Sciences, Health Care Management, Health Sciences, Rehabilitation and Therapy, Biology, Neuroscience