Disrupting the brain to guide plasticity and improve behavior.

Neurones may be highly stable and nonplastic cellular structures, but they are engaged in dynamically changing, intrinsically plastic neural networks that provide a most energy efficient, spatially compact, and precise means to process input signals and generate adaptable responses to a changing environment. Neural plasticity is evolution's invention to enable the nervous system to escape the restrictions of its own genome (and its highly specialized cellular specification) and thus adapt to environmental pressures, physiologic changes, and experiences. At neural system level two steps of plasticity can be identified: unmasking existing connections that may be followed by establishment of new ones possibly even with integration of new neural structures and neurons. In any case, plastic changes may not necessarily represent a behavioral gain for a given subject, as they represent the mechanism for development and learning, as much as a cause of pathology and disease. The challenge is to learn enough about the mechanisms of plasticity to be able to guide them, suppressing changes that may lead to undesirable behaviors while accelerating or enhancing those that result in a behavioral benefit for the subject or patient. Neurostimulation, including noninvasive brain stimulation techniques, provide an opportunity to modulate brain plasticity in a controlled and specific manner. Such interventions to guide behavior or treat pathological symptomatology might be more immediate in their behavioral repercussion and thus more effective than approaches intent on addressing underlying genetic predispositions.