Brain plasticity and cognitive neurorehabilitation.

Neuropsychological or cognitive rehabilitation has undergone a considerable theoretical and practical development as a specialised field of research and clinical application in its own right. Its possibilities of intervention have been considerably expanded after the abandonment of a wrong belief in the immutability of the central nervous system and the growing evidence in favour of the existence of a considerable degree of neuroplasticity even in the mature and aged brain. Modulation of synaptic transmission and synaptogenesis, the staple mechanism of neuroplasticity in development, maturation and learning, is also assumed by most to underlie functional recovery in the damaged central nervous system. In order to achieve a true scientific rationale for neurological and neuropsychological rehabilitation, it will be necessary to fully understand the actual overlaps and the actual differences between the mechanisms of repair and reorganisation after brain damage and those of physiological development and normal learning.