Can your brain heal itself after a stroke? – How to maximize your chances

Can your brain fix itself after a stroke? Hi, I'm Elise. I hold a clinical doctorate in occupational therapy, and I'm also a certified stroke rehabilitation specialist. Today, I'm gonna answer this question, and I'm also gonna give you practical tips on how to maximize your chances of brain healing after a stroke. Before we jump in, please make sure to support the channel however you can. Like this video, subscribe to the channel, become a channel member by clicking the join button, or leave us a super thanks by clicking in the YouTube bar below. All right, let's get into it. To answer this question, we need to know a little bit more about the brain and what's happening inside it when somebody has a stroke. Now, if you're already familiar with this information, go ahead and skip to this timestamp to get to the question and my practical tips. So, what is actually happening in the brain during a stroke? Well, the brain goes without oxygen for some period of time due to either a blood vessel being blocked, this is called an ischemic stroke, or a blood vessel rupturing, and this is called a hemorrhagic stroke. And the longer the brain goes without oxygen, the more damage is being done. And this is a problem because all of our body's tissues need oxygen to survive. You may have heard the phrase, time is brain, and this references the fact that every minute that a stroke goes untreated, 1.9 million neurons die. So, what ends up happening is, we have these neurons that die and then they're unable to talk with each other, to communicate. Now, in an uninjured brain, or in the unaffected areas of an injured brain, neurons talk to each other via chemical messengers or electrical impulses. And I'm not gonna get too in the weeds with this, but it is important to understand to have a conversation about brain healing. So, let me give you a quick example. Let's say that you want to scratch an itch on your face. Well, in order for this to occur, there are a lot of things that have to happen first. So, you initiate that thought, but then how does that message get to your hand and fingers to perform the action? Well, it's through neuronal communication. When we look at the anatomy of a neuron here, we see that we have the dendrites. The dendrite has these little branches that come off and they're basically the receiving department of the neuron. They take in the message or the messenger that another neuron is sending to them. It then kind of ships that down the rest of the body of the neuron to the axon. The axon kind of looks like this little tail and this helps to propagate that message down the rest of the neuron. Now, the neuron also has kind of these little branches on its tail and that actually connects to the next neuron's dendrite via what's called the neuronal synapse. And this is where either those chemical messengers are being sent or the electrical impulses are being sent. And that's how these messages are sent neuron to neuron to neuron. So, eventually that message gets to your arm and hand, you raise it up and you perform the scratching action. Now, when someone has had a stroke, this means that some neurons have died and some have become damaged. So, they're no longer able to communicate with each other or communicate in the same way that they did before. And this results in those kind of functional issues like one-sided weakness that we see after a stroke. Now, of course, depending on which side of the brain, which area, which lobe of the brain has been impacted, this will determine what specific issues someone is dealing with. So, for example, if your occipital lobe, which is on the back of the brain is impacted, your vision will also be impacted because that's where our visual cortices live. If you were impacted on your parietal lobe, you may have sensory issues after your stroke because that's where our primary sensory cortex is. So, knowing what we know about brain and neuron anatomy and functioning, can the brain heal itself after a stroke? The answer is yes, to an extent and with some caveats. While evidence shows us that neurogenesis or the formation of new brain cells is possible in a few certain areas of the brain, this is not the primary way that the brain tries to heal itself after a stroke. It's actually through a process called neuroplasticity. And this is the brain's amazing ability to adapt, change and reorganize in response to activity and stimuli. Facilitating neuroplastic changes in the brain is currently the best evidence that we have to treat post-stroke issues. And physiologically, neuroplasticity happens in a few different ways. One is through axonal sprouting. This is when neurons that are close to the damaged areas of the brain actually extend their axons to help try and take over some of those damaged areas functions. We also have a similar thing that happens with the dendrites called dendritic branching. And this is the growth of new dendritic branches to help form new connections and remodel existing ones. There's also cortical reorganization. And this is basically the brain just trying to reconfigure its neural networks so that the unaffected areas take over the damaged areas functions. And lastly, there is synaptic plasticity, which allows neurons to basically strengthen their connections in response to activity. This allows for the formation of memory and for learning. So this is actually a good news, bad news situation because we have two different types of plasticity. We have positive neuroplasticity, and we also have maladaptive neuroplasticity. So after a stroke, we're working to facilitate positive neuroplasticity, the creation of these new neural pathways to help restore lost functions. And it's especially important early on because we're also getting some spontaneous recovery in that first three to six months up to a year. So even though that heightened state of neuroplasticity that happens early on does end up slowing down, it doesn't mean that it stops. Neuroplasticity is happening throughout our lifetimes. That's how we continue to learn and remember things. However, on the flip side, the maladaptive neuroplasticity comes into play when we stop doing things or we stop trying. Our brain will actually prune away pathways that it deems aren't important anymore. And that's because we're not doing those things. So let's talk recovery. How do you maximize your chances of brain healing after a stroke? The first thing is to avoid maladaptive neuroplasticity. And this is typically in the form of something called learned non-use, where you learn to not use your affected abilities. Often we see this with somebody having a weaker side, less movement on one side. And so because it's easier and faster, you do things a lot of the time with your unaffected side. But we know that with neuroplasticity, if you don't use it, you will lose it. And so your brain will prune away those pathways. So keeping your affected abilities engaged in everything that you do is super, super important. Now, the second thing is consistency. And it feels like this is kind of basic, but I think it bears repeating. Consistency is key. You need to be engaging your affected abilities on a daily basis in your home rehab routine. This doesn't necessarily mean that you have to have a structured exercise routine every single day, although I do think that is an important piece of the puzzle. What that might mean is that you use your affected side or your affected abilities in your activities of daily life. Can you use your affected arm to hold a hairbrush while you brush your hair? Can you try to brush your teeth with your affected side or stabilize something on the counter? Wipe down the counter with a towel using your affected side. However you can get it involved is super important and doing it on a daily basis, consistency is key. Number three, intensity. The intensity of what you're doing matters. It is not enough to just sit in front of the television and randomly do some exercises and hope that that's gonna pay off for you. You need to have that mind-body connection or be trying to build it. Number four, repetitions. The more you do, the more progress that you'll make. Use it to improve it. Your brain will prioritize those pathways that are being used often. Now, repetitions are a little different than what we think of in traditional fitness. You know, when you're thinking about strength training or hypertrophy growing muscle. In stroke recovery, repetitions mean a lot of repetitions. We don't know the exact number, you know, based on evidence at this point, but we do know it takes hundreds, if not thousands of repetitions to create meaningful neuroplastic changes in the brain. So get in as many repetitions as you can. If you're in formal therapy, that's wonderful, but you have to be doing the work even outside of formal therapy if you really wanna see that progress happen. The fifth thing is salience. This means doing things that are important and meaningful to you. And that might seem a little woo-woo, but it's actually a neuroplasticity principle. Our brains like and prioritize pathways that are used often, that they're familiar with. So if you incorporate things that you find meaningful in your home rehab program, your brain is likely going to make those neuroplastic changes faster. And lastly, mindset. I've got two different points on this. And one is, try not to compare yourself to others in a detrimental way. Comparison can absolutely be the thief of joy where you might think, we're both six months out from our stroke, why am I not doing as much as that person? And stroke recovery is just so individual. It's so highly dependent on you as a person, the type of stroke you had, where it happened, how much help you got, how much rehab you had. So you can't compare apples to oranges. It's just not the same. You can use comparison as a motivator. If somebody's doing really well, and you're like, ah, that person is doing great, I'm gonna strive to be like that. I don't think that's a bad thing. The second component to mindset is to try to maintain a positive and optimistic attitude. And I don't mean blind positivity, just thinking that everything is perfect and wonderful, because you will hit backslides, you will hit plateaus. Those things are normal. But I don't want you to lose hope. When you lose hope, you stop trying. And when you stop trying, your brain stops prioritizing pathways. You have to keep trying, you have to keep moving, to keep going and pushing forward, to keep that brain making those neuroplastic changes and to continue on the healing process. Leave me a comment and let me know, what do you do to encourage brain healing after your stroke? And of course, a huge thank you to all of the donors who make this nonprofit possible, with a special thank you to Heather G., Ryan D., and Modus Nova, and our empowered tier on Patreon. Thank you all so much for watching. I'll see you next time.