The reorganized brain: How treatment strategies for stroke and amblyopia can inform our knowledge of plasticity throughout the lifespan

Neural plasticity plays a crucial role in human development. During development, neural networks are shaped by experience-dependent processes that selectively strengthen and prune connections so that those that remain match the environment and process it optimally. Over time, neural connections become more stable, forming widely distributed, interconnected networks involving balanced excitation and inhibition and structural stabilizers like myelin. It was long believed that the potential for organization or reorganization existed only during early development. However, the successful treatments for adults with stroke or amblyopia discussed in this issue suggest that the potential for significant reorganization persists well into adulthood. Thus, development can be thought of as the stabilization of connections to match the current environment but with considerable residual plasticity that can be revealed if there is a shift in the excitatory: inhibitory balance or the removal of the structural stabilizers.