Clinical correlates of neural plasticity

The purpose of this article is to relate the concepts of mammalian nervous system plasticity to clinical practice. The clinical relevance of Dr. Bishop's four-part review of prenatal and postnatal maturation, function-induced plasticity, and nervous system regeneration is discussed. The scope of this paper is limited to the relationship between plasticity and 1) the pathogenesis of congenital malformations, 2) skill acquisition in the infant, and 3) functional recovery and treatment. Limitations in current clinical evidence for functional recovery are examined, and research questions that must be answered are presented. Clinical evidence of functional recovery coupled with current concepts of neural plasticity will provide information to determine the efficacy of treatment intervention for the neurologically handicapped. It is hoped that this discussion will encourage clinicians to renew their efforts to accurately document the clinical course of recovery and the treatment methods used to achieve this recovery and to report their findings.