This chapter will attempt to answer three questions: (1) what are the neuropsychological processes which may be involved in recovery of function following brain damage? (2) What are some of the courses of recovery following various types of brain damage? (3) Is there any evidence that neuropsychological rehabilitation can accelerate recovery?

What are the neuropsychological processes which may be involved in recovery of function following brain damage?

The cerebral cortex may show a greater degree of plasticity than has hitherto been recognized. Merzenich et al. (1984), for example, found that somatosensory fields in owl monkey altered in such a way as to apparently ‘use up’ space ‘Vacated’ by amputated fingers. Similarly, if the postcentral gyrus was damaged, they found a redistribution of receptive fields for other fingers so that they all ‘had a share’, albeit with less acuity because of having fewer representational neurons per finger. Jenkins et al. (1990) also demonstrated reorganization of the somatosensory fields after damage to somatosensory cortex in monkeys. Parts of the field which never before responded to specific fingers began to do so after the responsible areas were ablated. Also, simple, tactile training extensively altered the cortical maps. Many other studies have come to similar conclusions (e.g. Pons et al. 1991), but it is outwith the scope of the present chapter to review this literature in detail.

Animal studies also suggest that such plasticity can be influenced by post-damage experience (Gentile et al. 1978; Slavin et al. 1988), a finding with clearly important implications for human neurorehabilitation. Furthermore, Mayer et al. (1992) showed that rats given striatal neural transplants only benefited from the transplants when they were given the opportunity for learning.