Temporal Factors

Lesions of the brain early in life have effects that differ from those that occur in adulthood. Functional results can be either better or worse, depending on the age at injury and on the area injured. Furthermore, the age at which the lesion occurs may influence motor as well as behavior lesion effects. Damage in infancy yields more profound socioemotional effects than does damage in adulthood. Compensatory mechanisms do not always operate to ensure recovery of functions after early brain damage.

Early lesions (such as in persons with congenital hemispherectomy), resulting in acquisition of language in the right hemisphere, may interfere with right hemisphere nonverbal functions due to the "crowding effect''; this may be a case of functional plasticity being oflimited advantage to individuals with regard to total cognitive capacities.

Tactile stimulation with premature babies leads to faster growth. Similarly, tactile stimulation of brain-lesioned laboratory rats led to unexpectedly large attenuation of the behavioral deficits, correlated with reversal of atrophy of cortical neurons normally associated with these lesions. Both premature infants and laboratory rats have in common that both are in impoverished environments. Thus, the positive responses with tactile stimulation can be considered to be related to an improvement in the direction of a normal environment.

Reorganization and recovery of function does not cease at any arbitrary time, such as 6 months; the potential can exist for many years after injury. It is becoming an important area in the field of neurologic rehabilitation since it appears that, in humans, specific late (postacute) rehabilitation programs are necessary to exploit that potential.

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