The conference and plasticity

Lumbarspinectomy
Here is a challenging thought – in most chronic back pains, if you were to do the radical and thankfully untried surgery of lumbarspinectomy i.e. cut the whole lumbar spine out, there would probably still be pain experienced in the hole that was left. Not recommended!

Neuroplasticity
It’s all about neuroplasticity, a terribly trendy topic due to tons of research and great books like Norman Doidge’s “The Brain that Changes itself”. Plasticity is a recurring theme throughout the NOI conference and it constitutes a true revolution requiring a paradigm shift in rehabilitation. We need to be a bit careful with this term plasticity – there is a lot of pop plasticity around on the net, there is a growing “brain fitness” industry and “is my brain made out of plastic?” is just another question all youngsters have to answer, whilst the oldies may be thinking “if my brain is so plastic as the scientists tell us then, why can’t I change my habits?”

The plastic revolution
Plasticity is a bit hard to define (like placebo and gene). But the essence is that plasticity is a change in the brain location for processing and constructing information.

As far as revolutions go in the world of biology, the brain mapping (plasticity) revolution is right up there with mapping of the human genome. Still – the impact of this knowledge is really yet to fully impress on some areas of rehabilitation and hard wired clinical conservatives may struggle or think ‘that’s interesting’ and go back to where they were. The revolution impinges on a number of areas – just like colouring in as a kid made you focus on the picture, all the new colour fMRI pictures of the brain demand a new awareness of the organ. The impacts are also on notions of a new changeability of sensory states, of new looks at once hard to alter states such as CRPS, post spinal cord injury pain, tinnitus and brachial plexus lesions, of liberation from outdated prognostic limits set by gurus and poor science, of how plasticity occurs right through the lifespan, and of just how distributed and how overlapping the neurosignatures related to function are in the brain which makes you realise just how set up the brain is to be plastic.

It all links so strongly to context, the thing that constructs rich representations in the brain and allows brain outputs such as love and anger and pain and performance to be so different in time and place. And so therapeutic too – for example the therapeutic power of doing an activity or even thinking of an activity in a different knowledge context comes down to neuroplasticity or in other words running neurosignatures in different ways.

Sticking with science and the impact on a conference
Plasticity permeates our teaching and the NOI conference.

Hailing from Heidelberg, Herta Flor is one of the most established and renowned researchers in this area and we are thrilled that she will be speaking on Day 1 on ‘Brain Plasticity – Friend or Foe’. Plasticity can become a friend – think of great responses post stroke, but a foe too – think of spasticity and chronic widespread pain. One reason we asked Herta is that on many of her papers, you will read “we cite animal and human studies and we derive suggestions for innovative interventions”. Elspeth McLachlan also talks of the immune system in peripheral and central systems and links the immune system to plasticity changes. Talks on the physical aspects of the nervous system (Michel Coppieters) inevitably touch on plasticity and link to Mick Thacker’s ‘Movement as Antigen’ talk. Many of the workshops have a central theme of plasticity such as the graded motor imagery workshops, the education workshops such as Adriaan Louw’s workshop on education changing post operation pain behaviours, Sam Steinfeld’s neurodynamics workshop plays with plasticity as do the lunchtime workshops on illusions where you can temporarily lose a limb.

In the Images of Pain and the Brain exhibition where noted English artist and printmaker Chris Gollon will be exhibiting – the curator Juliet Gore commented “he depicts hands as the most prominent part of his body – a homuncular clue which for me at least has the effect of wanting me to put my hands in the ink as well.” Though artworks are usually made without a brief and come from a ‘gut’ feeling their links to brain plasticity is perhaps undeniable, as this process often relies on happy accidents or going where the materials lead you – monotypes being one of the most notorious of processes for this as the ink on the plate or glass leads you to see new images and takes you to new places. Perhaps this is why Chris prefers not to talk about his work publicly.

Three weeks out from the NOI conference. It looks like we will have a full house but there are some places still available for the conference in Nottingham and for the master classes in Dublin. But be quick!

Stay plastic!

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