Neuroplasticity

Neuroplasticity — the brain's ability to rewire itself after injury  is the scientific foundation of aphasia recovery after stroke. But most survivors never hear the word explained in plain language. Angie breaks down what neuroplasticity actually feels like from the inside, using real-life analogies from her own stroke recovery. Dr. Seles translates the neuroscience: how repetition, novel activity, and structured therapy drive the brain changes that support language recovery. For stroke survivors rebuilding communication skills and for SLPs designing evidence-based treatment plans  this episode makes the science usable.

Angie shares the analogy of what aphasia feels like and how doing repetitive or new activities helped her stroke recovery. Dr. Seles shares the importance of Use It or Lose It and how your daily routine can strengthen neural connections in the aging brain.

Finally, because neuroplasticity is activity driven, we do exercises that may leave Brain  Friends with new connections....or not

Show Notes: Brain Games

6 Brain Exercises for NEUROPLASTICITY | Step 2 of Brain Education

https://www.cognitiverecoverylab.com/seles

https://aphasia.org/stories/announcing-the-davetrina-seles-gadson-health-equity-grant-program/

Our beloved colleague, Dr. Davetrina Seles Gadson, passed away January 11, 2025. Dr. Gadson was an extraordinary speech-language pathologist and neuroscience researcher who devoted her energy to studying health disparities in aphasia recovery. She was a fierce advocate for improving services for individuals with aphasia, particularly Black Americans. Her research transformed our understanding of these health disparities and shed light on how we can address them. We were privileged to have Dr. Gadson as a cherished member of our lab community for four years, first as a postdoctoral fellow and then as an Instructor of Rehabilitation Medicine. She was still a close collaborator and friend to many of us at the time of her passing. Dr. Gadson was an incredible person—compassionate, inspiring, and full of life. Her dedication to advancing equity in aphasia recovery and her profound impact on our community will never be forgotten. We are committed to honoring her memory by continuing to push our field forward and fight for equitable services for all people with aphasia. 

Transcript

Copy Transcript Copied

SPEAKER_00 0:00

Welcome to Brain Friends, where two neural nerds talk all things aphasia, language recovery, culture, and community. I am Dr. Daktrina Celeste Gatson, a clinical speech language pathologist and neuroscientist.

SPEAKER_04 0:13

And I am Angie Cawthorn, stroke survivor and aphasia advocate. Welcome to our show. Welcome to Brain Friends.

SPEAKER_00 0:24

We want to thank all of our listeners for downloading the podcast. We appreciate everyone listening. So please tell a friend to tell a friend that we are here. And we are. Exactly.

SPEAKER_04 3:33

Exactly. Because sleeping is important. I love a good nap. I slept a lot when I first had my stroke. Um I couldn't help it actually. My um my battery was just, I was drained all the time. I was exhausted all the time. And uh the doctors actually can told me to um to sleep as much as possible. And, you know, uh didn't put me on bed rest, but they didn't have to. Because when you have a stroke, your body's trying to, I guess, re-align itself, and it you you need rest in order for that to happen, for that neuroplasticity to take place.

SPEAKER_00 4:13

Right, right. And the the other key thing about neuroplasticity is that it's activity driven. And so that's where you know that phrase of use it or lose it comes into play. And so the more you're able to create frequency um in an activity or intensity in an activity, the more you really are strengthening those new connections or forming new connections.

SPEAKER_04 4:42

Okay. So I was right to play Madden and 2K after my stroke because it helped me strengthen my hand and eye coordination. Yes. So exactly. So shout out to EA Sports. Y'all should be sponsors. Anyway, we can where y'all at?

SPEAKER_00 5:02

I'm trying to help y'all out.

SPEAKER_04 5:04

All I do is shout these cats out anyway. But no, I think I I and it's um amazing to me how much um I couldn't absorb then that I look back on a game that I did play and I'm like, I didn't even know the man could do that. But I because I couldn't deal with all the things that it allows you to do, but what I could do was just focus on my hand and our coordination with the game, and I think it really did help a lot, um, you know, with uh my coordination. Yeah. Absolutely. Well, let me ask you another question. With people with aphasia, how can we use neuroplasticity to improve our communication? Is there a way that it can be uh I there's no other way to ask that. How can people with neuroplastic how can we use neuroplasticity to improve our communication?

SPEAKER_00 6:10

That's a good question, Angie. So when we think about neuroplasticity, um ways to promote brain plasticity depends on the experience you have. Um, and experiences really help prime the brain and shape the brain. And so by that I mean um either in your routine, making sure that the experiences and the actions that you have created within your um routine are positive, are healthy. Um, and those types of things help prime the brain. Um, other ways you could do it is repeating an activity.

SPEAKER_05 6:51

Hmm.

SPEAKER_00 6:52

Repeating an activity, like editing a podcast. Like, okay, like editing a podcast. Come on, editor. Like that's you. That's you. Get up. And so, even in that, when when I say repeating an activity, either you know, if it's something that you used to do and you're not able to do as well anymore, the more you repeat that activity and try to perform that activity, that can help uh create those new pathways or strengthen those pathways that are dead. Um, in your case, one of the things that you're doing that makes it so awesome by editing the podcast is you're creating new connections because you're doing something new. And the more you do it, the stronger those connections get.

SPEAKER_04 7:48

Wow. And so when I was doing reclaiming my spot at church, that was the stuff that was the things that I used to do that I'm trying to get back and get better at. And that's a different type of connection versus me doing something new, and it's also new inf inf it's always a new episode that I'm editing. Like I'm not re-editing episode two. It's always new. So I'm always getting new pathways or those pathways that are being worked out are being strengthened because I'm kind of I'm digging in, as it were.

SPEAKER_00 8:32

Right, right. Cause if you because if you think about it, even how you were saying, you know, doing new things versus doing the things that you used to do, um, it's kind of like even with the word or saying a word, if you have a word in your vocabulary and because of aphasia, that pathway to that word is dead, the more you use different strategies to get to that word, the quicker you might be able to retrieve that word. Let me break down what I mean by that. So if you are trying to describe, you know, church for an example, um, and you start by saying, you know, you may usually go there on Sunday, it's a building, people of faith go there, and you're describing that word. Um, it's helping to create or something like that. There you go, exactly. You're naming these other words that are associated with it, you're helping to your brain re-carve out a quick way to get to the word church.

SPEAKER_04 9:41

Well, let me ask you this. When I did do that without um it wasn't an option to have to talk around the word because the word I wanted wasn't an option. I'm gonna back out of that question because I don't even know how to ask it. Okay. Um well, one thing we do need to do, we need to work on this icebreaker. We ain't do no icebreakers. We just out here.

SPEAKER_00 10:12

Look, honey, we got in and got got straight to talking about neuroplasticity and all the things.

SPEAKER_04 10:18

Ain't had no garnish. We just out here eating all the all the entree, no appetizers, nothing.

SPEAKER_00 10:28

Yeah, let's let's do a delayed recall of three words.

SPEAKER_04 10:33

Okay, and that works by you and I give each other three words. We're gonna wait five minutes and then see if we can recall those words. Yes. Okay, I will get a timer. You got my words ready? I got your words ready.

SPEAKER_00 10:50

You got you ready? Your three words are frog, tea, pillow.

SPEAKER_04 10:59

Frog, tea, and pillow. Yes. Okay. Your three words are jacket, compassion, point.

SPEAKER_00 11:17

Jacket, I'm sorry, jacket, compassion, and what was the last one? Point. Point. Okay, jacket, compassion, point. Yep. Okay. Clock is going.

SPEAKER_04 11:33

Okay. So can neuroplasticity be measured or quantified? Like, is there a way to is there a way to measure how much better you're doing?

SPEAKER_00 11:46

Yeah. So when we think about temporary or short-term um memory types of ways that neuroplasticity is quantified, those changes are more synaptic changes, where when we think about long-lasting changes, and those are going to be more structural new connections that are happening. And so that's why it's important to, like I said, I feel like I'm a uh I keep saying the same thing, but it's really, really important to repeat a behavior because that's what can help re rewire and make those connections stronger.

SPEAKER_04 12:29

So practice, practice, and then when you're done with that, practice some more.

SPEAKER_00 12:34

Right.

SPEAKER_04 12:35

Just keep uh digging the well and just keep digging the well, just keep going. Okay.

SPEAKER_00 12:42

Yeah, because plasticity is not limited in age. And so I think that that's why the idea that the client can continue to get better is so important because of that plasticity. But it also means that you might not get the best plasticity changes based off of what you do in therapy alone. And that's where home exercise programs and practicing at home is really important to strengthening whatever new types of connections or information is given at the therapy level. Like doing your homework. Honey, you gotta do that homework.

SPEAKER_04 13:23

You gotta do that homework. Like you just can't just show up at the office. Sometimes you gotta put a network at the house. Yes. It's important. You have to, it's the extra work you put in is where you're gonna make your gains. You know, I did a lot of work with um, you know, with uh research, and it's made a huge difference in my rate of speed and my uh speaking talking is good better than it was without it. It was it was actually pretty terrible without it. But um you know, everybody's different, and I had two small strokes, relatively small, to like, you know, it wasn't like I didn't lose consciousness or anything when I say when I say it was small. But yeah, I think the neuroplasticity part is the only part that matters because that's where your healing comes from. Right. That's where getting better is that's where that's where it all stems from. But what kind of gets me is that it was never really talked about. It's it's like go to therapy. Um, and I remember they used to say they used to be like six months, and whatever you didn't get back, you weren't going to get anything back. But that's not true. That's um just a horrible myth that kind of pushed out there, but um you have to keep going.

SPEAKER_00 14:46

Yeah, and I think some of that too is just knowledge and understanding. So there is what what we call a spontaneous recovery period, and so sometimes I think that people get mixed up or don't have the clear understanding of, you know, you have the spontaneous recovery period, which means after that injury, why stroke, I mean, why sleep and therapy is so important because the brain will do some of its own recovering. But then, you know, after that three to six month period, that's where the plasticity will continue to go, but you really have to step it up and make sure that you're doing those things to support repetition and intensity.

SPEAKER_04 15:35

You know, I love a good analogy. So it's like if you've got um uh a weight reduction surgery, you still have to do to keep it with diet and exercise. You have to continue to put that work in and put that work in.

SPEAKER_00 15:52

You gotta put that work in, guys. Right, right. Or even if you're, you know, even without the weight reduction, if you're trying to build muscle in the gym, right? You can't just go and lift the weights two times a week for 60 minutes and expect to see that muscle is gonna take what you're doing at home, like the diet and the continued weight lifting.

SPEAKER_04 16:17

So that's why it's not working for me. Uh-oh. So I just learned something. Listen, I gotta get it together. That's what I heard. Did my little two I come on, Bill. A trainer. No. Uh-oh. I didn't, I I ain't doing what so I shouldn't make this pie tonight. Listen, that's what I heard.

SPEAKER_00 16:32

You didn't bring you didn't bring me. I I knew I was gonna get a pie. Let me let me give you my three words before I forget. I've been holding these words in my head. All right, yeah, you go. Okay. Um, my three words were see, um point, compassion. Wow. Point, compassion, and jacket, jacket, jacket, compassion, and point. Yes. Um, what are your three words? That ain't drink. No, that's just frog and pillow.

SPEAKER_04 17:54

Oh, I don't know. Yeah, I got nothing. Something you drink. Tea? Mm-hmm. Okay, okay. Well, you you know, you drinking it right in front of me like that's pay attention, it's like don't listen. Come on, man.

SPEAKER_00 18:15

This thing that I'm drinking that has steam coming from it.

SPEAKER_04 18:18

It has like steam on your face, and it's brown. It's tea. It ain't coffee, but yeah, that is.

SPEAKER_00 18:26

I did pretty good. I mean, I think we both kind of had a I mean, two out of three, okay? What? And I had two strokes, you're about to leave me alone. Do best I can out here. So that delayed memory recall, there are different strategies that you know we use in order to support our memory, which is one of the strategies that I used with that, even though I only remembered two out of three, was to associate it with something. And so two of the items, yeah, I just had, but the last one I I couldn't get. So I appreciate I appreciate the uh the tip, even though I mean I do see the jacket right behind me. Yeah, dude. Yeah, it is. Listen, listen.

SPEAKER_04 19:13

I I said hello to the jacket because the jacket needs to be recognized and honored. The thing is everything. You walked into that conference and owned the room. You just owned the room and brought so much light, the vibration was on tilt. On tilt. And when people don't want to leave, that's a great thing.

SPEAKER_00 19:42

That's a great, that's a great thing.

SPEAKER_04 19:44

That is an awesome thing. Well, let me ask you. I know I'm like, let me ask you another silly question. Um they don't say there's no such thing as a silly question.

SPEAKER_00 19:53

You know I was about to, but I didn't want you to edit out my comment as well.

SPEAKER_04 19:58

Because there is silly questions, but what's what can people with aphasia do specifically to increase their own neuroplasticity? Is there anything specific that they can do um to kind of foster um bringing along neuroplasticity?

SPEAKER_00 20:24

Yeah, so I think there are a couple of things. One is to definitely keep your brain busy and healthy. And when I say busy, I don't mean be a busybody. Okay. Okay. Right. I mean doing things that create that that call for mental exchange, mental interaction. Um, and so what that doesn't mean is just sitting and watching TV, because that could be a very passive type of activity. But things like um either playing cards or puzzles or art music exercise, uh, a lot there's some research out that shows cross-crawl exercises, um, exercises to where you'll take one part of your body to cross over to the other side. So like if you're like what? Talk to me. So like if you take your right arm and touch your left leg.

SPEAKER_04 21:26

All right, first of all, I don't have any mandury on. That's what tells me my right from my left. So hold all right, so my right hand. Okay, what do you want me to do?

SPEAKER_00 21:34

And touch your and touch your left leg.

SPEAKER_04 21:38

Okay.

SPEAKER_00 21:39

Yeah, so that type, those types of exercises are called cross crawl exercises, and they're they integrate both hemispheres of the brain um by strengthening the network and communication of the corpus colossum. Oh, okay. So those are just different. Different types of you know, if you something specific that you that you can do, but I do have some brain exercises for neuroplasticity that I pulled for us to do together. Oh, okay. How much what are we looking like on time? We have some time. We have about seven minutes.

SPEAKER_04 22:17

All right, so we'll do those. And I did have another question for you. I am you well. So with me doing the editing for the podcast, I noticed it's become easier. Um, like I remember more than I did, and it's becoming a little bit easier for me, and that's the neuroplasticity, right?

SPEAKER_00 22:46

Right, exactly. So, be in the beginning, you know, it might have been a little easier as you went back to it because it was those short synapses and connections that were being formed, and now what's happening because of the repetition and the frequency that you're doing it, those long-lasting um new connections are now forming, and that's why it's easier um for you. And then you see, I get excited, and then you know, even when you try something new with it, rather you're editing out something that you know one of us should have. Um, or adding something, that's when it might be a shorter connection because it's newer. But once it's getting easier, then that's a great sign that those long-term connections are happening.

SPEAKER_04 23:48

Okay, because I was you I when I use like different tracks or I want to do something different, it's um becoming easier for me. And it's and then the funny thing is, and then Audacity actually changed the platform look of their app. So after I got all used to it, they threw me a little, and I was like, uh oh. But I still, you know, still gotta plug through. But yeah, they changed the entire interface, and I'm like, oh man. But it's good because you know it's not that different, but it's different enough that it makes me think a little bit more, and um, is a little more tiring, yeah. But I do feel that it's um a great exercise, and everybody should have you should always have an exercise, even if it's just a word search or something like that, uh playing cards, Uno, um of course 2K Xbox, get at me, but whatever. You should have something that really does help with those connections. That part, that part okay. But I wanna do, I wanna do the thing. Go, go, go.

SPEAKER_00 25:05

Okay. So the first exercise is make two fists with hands facing you. Okay. Extend your left thumb and your right pinky to the left.

SPEAKER_04 25:27

Okay.

SPEAKER_00 25:28

Now switch back and forth.

SPEAKER_04 25:32

That's that's not I'm that's I don't know what's going on. My middle finger won't go down. How do I win?

SPEAKER_02 25:46

Uh put your middle finger down.

SPEAKER_05 25:52

How about it?

SPEAKER_00 25:54

Your left your left thumb left thumb and your right pinky.

SPEAKER_04 26:00

Right. Okay.

SPEAKER_00 26:01

Now switch back and forth.

SPEAKER_04 26:03

And I'm already messing it up.

SPEAKER_00 26:04

Right? Me too.

SPEAKER_04 26:06

It's not happening, right?

SPEAKER_00 26:07

Okay. Okay, let's do another one. Okay. The other one is try it's called triangle and circle. So draw a circle in the air with your left hand. Okay. Draw a triangle with your right hand. Same time.

SPEAKER_04 26:32

I'm making all I'm doing is octagon. I am giving you octa all of the octagons. Everybody's getting an octagon.

SPEAKER_00 26:45

Oh my gosh. So those are the exercises? Those are two-brain neuroplasticity exercises. Um Okay. Okay. To do at your your own leisure.

SPEAKER_04 26:58

Do at your leisure. So, but playing like spades would be good for neuroplasticity. That's what I'm hearing. I'm saying I'm hearing cutting that book. Look.

SPEAKER_00 27:09

Yes, yes. So that type of activity um would be great. Learning a new language is always great. Or learning a new like activity. So if you know, if you if you have a sport that you haven't played before, whether it's golf or I don't know, tennis, you know what you want to do.

SPEAKER_04 27:31

Right. Right, right. Whatever you enjoy or you think you might enjoy, try it. Right, right, right. If you think you might enjoy cooking, then start cooking.

SPEAKER_00 27:40

Doing right, even that type of stuff. And so I think the thing that's really important, especially as your brain is recovering, is that especially because with people with aphasia or um anytime you're in a rehabilitation space, is that you used to be able to do it. So at one point, those connections have been formed. And so, you know, part of it is either doing it more and doing it often, so you can reform those connections and help your brain create a detour or form new connections by doing new things.

SPEAKER_04 28:18

Like when I couldn't tie my shoe. And now I can actually tie my shoe, but I couldn't tie my shoe. Um, and I just had to keep trying.

SPEAKER_00 28:28

And that was the rewiring that you were having to rewire.

SPEAKER_04 28:32

Yeah, and that's the part that you get um, that's the discouraging part. That's the part that if I can tell and inspire somebody, push through. Just keep trying. Just keep trying, just push through. And it does get better because who tied their shoe this morning? I did. Okay, come on. Come on, shoe. Now that being that being said, I did wear the wrong size shoe after my stroke. Um uh we went to the store and got me some shoes, and I wound up wearing uh first of all, I wear a size eight. I picked up a size 11. Oh. And I wore a size 11. I didn't realize, but they were slide-in shoes, and I thought they were the most comfortable things. Yeah, well, because they're a size 11.

SPEAKER_00 29:19

Did you have feet swelling? No. Oh, you were just you were just walking around with big shoes on.

SPEAKER_04 29:25

I had no idea. And then I went to go um to go replace them. They said, What side, what size shoe do you have on? I'm like, 11. I don't wear no 11. But um, but because now, you know, nowadays nobody measures your shoe. You go in, you find your shoe, you go up to the register, you pay for it. I but because I was so out of, you know, I'd had a stroke. And like I said, you don't know what you don't know until you go to reach for a size eight, you pick up an 11 and wear it for six months, and don't even know that you're wearing the wrong size shoe. Wow. Listen, it was the most comfortable shoe I've ever had, so maybe I need to be stop pretending like I wear an eight and recognize that maybe, maybe I am a nanana at a minimum. Let them toes breathe. I don't even know. But yeah, so neuroplasticity, is there anything else that you want to share about neuroplasticity that I did not ask you that I need to know? That the people what the people need to know now, what they need to know, Dr. Celeste.

SPEAKER_00 30:36

Um, I think I got it all. I the the biggest thing is just that plasticity is not limited in age. I think I said that. And the more you repeat and direct your attention toward a thing, that activity can be we uh rewired. Yeah, neuroplasticity changes happen all the time, but the magnitude depends on how much activity the brain receives.

SPEAKER_04 31:00

Making new connections, getting new routes to get places in the brain, rewiring that Google Maps in your brain, even turning the Google Maps off in the car helps.

SPEAKER_00 31:16

Yes, yes. Now that's a tip that I have. I mean, definitely for all individuals in building neuroplasticity, which is turn off your GPS sometimes. Use your brain to help recall where to go.

SPEAKER_04 31:34

Right, right, because you have to um use it or lose it. Use it or lose it, stay up on these things and don't take it for granted because the stronger those connections are, I well, I should ask the question, I shouldn't just assume, the stronger the connections are from before onset uh might be a precursor to how well you do after stroke, or is that now?

SPEAKER_00 32:03

Ooh, that's good. Um, so what some of the research has shown in regards to that is that you know, we all we all have I always use this analogy that if you take care of yourself now, how basically how you take care of yourself is how you age. So if you're, you know, in your 30s, 40s, you're taking care of yourself versus the individual that's not taking care of their self, you already start at a lower position when you're not taking care of yourself. And then you have a lifetime event happen, whether it is a stroke, traumatic brain injury, dementia, whatever, heart attack, whatever, heart attack, whatever, and you drop. Okay, that functioning level drops. And so if you're already using healthy behaviors and healthy habits, then your brain is a little healthier at onset. And so there may be some stronger plasticity there, uh, because your brain is already primed for some of those experiences. And so definitely it's so important to have those healthy behaviors and habits, even without injury.

SPEAKER_04 33:18

Okay. And that's like what you eat, what you put in your body, the health care that you're getting. Um, and you said uh previous times, if you're not happy with your care team, switch them.

SPEAKER_00 33:31

Yeah. Get new ones. The stress, all of the, you know, of course, stress is something that we have, but I think the more that you're able to find ways to de-stress, to um, whether it's meditation, whether it's yoga, rather, you know, whatever your behavior is that is healthy. Right, right, exactly, can be supportive.

SPEAKER_01 33:58

It's not with you. Look, we have it's time to go. It's time to go.

SPEAKER_04 34:07

Thank you guys for listening. Tell a friend, share this episode. It's so important. If you've had somebody who's um needs uh the good word on the earth plasticity, they've had a brain injury, they were in an accident, something like that. Share this episode with the laugh.

SPEAKER_02 34:29

I feel like that was like the church laugh that you know, like I'm trying not to laugh, but because I know I'm gonna get pumped if I laugh out loud in church. But I couldn't hold it in. Um I just love our time together.

SPEAKER_03 34:49

Alright then. We the best. I love it. Thank you guys for listening. Bye.