Rehabilitation of brain damage: brain plasticity and principles of guided recovery

Psychol Bull. 1999 Sep;125(5):544-75. doi: 10.1037/0033-2909.125.5.544.


Rehabilitation of the damaged brain can foster reconnection of damaged neural circuits; Hebbian learning mechanisms play an important part in this. The authors propose a triage of post-lesion states, depending on the loss of connectivity in particular circuits. A small loss of connectivity will tend to lead to autonomous recovery, whereas a major loss of connectivity will lead to permanent loss of function; for such individuals, a compensatory approach to recovery is required. The third group have potentially rescuable lesioned circuits, but guided recovery depends on providing precisely targeted bottom-up and top-down inputs, maintaining adequate levels of arousal, and avoiding activation of competitor circuits that may suppress activity in target circuits. Empirical data are implemented in a neural network model, and clinical recommendations for the practice of rehabilitation following brain damage are made.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Association Learning
  • Brain Injuries / rehabilitation*
  • Nerve Net / physiology*
  • Neuronal Plasticity*
  • Prognosis