[Neuronal plasticity and the scientific bases of neurohabilitation].

Introduction: The validity of methods of neurological habilitation and rehabilitation has long been questioned by a large proportion of the medical profession. This sceptical attitude was partly due to lack of scientific confirmation of the theories on which methods of habilitation-rehabilitation were based, and the absence of reliable studies of the follow-up of such treatment, designed on strict statistical criteria.

Development: Advances in recent years in understanding neuronal plasticity have permitted better understanding of the mechanisms which come into action following brain damage and the factors which help or hinder recovery, and the various possible patterns involved in the reorganization of neuronal circuits. A review of studies of animal experiments, and recently in humans (using techniques of functional imaging and magnetic exploration) show that by sensory stimulation and exercise it is possible to modify the structure and function of the brain, after its somatotopical organization, increase synaptic connections, influence the orientation of the dendrites, number of receptors etc. There are critical periods in development during which these plastic properties of the brain become fully developed and subsequently the possibility of recovery is considerably less.

Conclusions: The findings of neurobiological investigation show that there are good prospects for the recovery of a damaged nervous system by means of embryonic neurone implantation, axon bridges, transference of genes producing trophic factor, enzymes, neurotransmitters etc. In any case, therapeutic intervention and rehabilitation teaching continue to be useful for the functional recovery of these patients.