Alvaro Pascual-Leone is Professor of Neurology and Associate Dean for Clinical and Translational Research, Harvard Medical School. He is also Director of the Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, United States.
Stimulating the Brain to Promote Health and Wellbeing
The human brain is made up of neurones, highly sophisticated and stable cellular structures. However, neurones are engaged in dynamically changing networks that provide a most energy efficient, spatially compact, and precise means to process input signals and generate adaptable responses to a changing environment. These networks can be charaterized in humans using neurophysiologic and neuroimaging techniques. Plasticity is an intrinsic property of such networks, and may be best conceptualized as evolution’s invention to enable the nervous system to escape the restrictions of its own genome (and its highly specialized cellular specification), and thus adapt to environmental pressures, physiologic changes, and experiences.
The brain is engage in external world perception and action, but also in ternal monitoring, enteroception and salutogenesis. Thus the brain plays a role in overall health. Plasticity mechansisms change across the lifespan and as such this can have an impact on the brain’s capacitiy to adpat to changes in and demands from the environment. However, these age-realted changes in efficacy of plasticity mechansms also result in a greater risk of general disease and disability.
Noninvasive brain stimulation (NBS) offers a means to selectively modulate activity across specific neural networks. This can be demonstrated in studies combining NBS with functional neuroimaigng (eg resting state functional connectivity MRI). NBS can prime neural networks and make them more receptive of plastic changes induced by cognitive training, thus enhancing desirable behavioral effects. NBS can also be used to promote consolidation of the effects of cognitive training. The combination of NBS with cognitive trainng is thus a promising approach to promote the efficacy of network modulation strategies in health and disease. Ultimately these multifactorial intervention approaches offer the promise of individualized, controlled guidance of brain activity to minimize functional consequences of insults, restore function, and prevent age-related decline.