Abstract
Sustaining brain and cognitive function across the lifespan must be one of the main biomedical goals of the twenty-first century. We need to aim to prevent neuropsychiatric diseases and, thus, to identify and remediate brain and cognitive dysfunction before clinical symptoms manifest and disability develops. The brain undergoes a complex array of changes from developmental years into old age, putatively the underpinnings of changes in cognition and behavior throughout life. A functionally “normal” brain is a changing brain, a brain whose capacity and mechanisms of change are shifting appropriately from one time-point to another in a given individual's life. Therefore, assessing the mechanisms of brain plasticity across the lifespan is critical to gain insight into an individual's brain health. Indexing brain plasticity in humans is possible with transcranial magnetic stimulation (TMS), which, in combination with neuroimaging, provides a powerful tool for exploring local cortical and brain network plasticity. Here, we review investigations to date, summarize findings, and discuss some of the challenges that need to be solved to enhance the use of TMS measures of brain plasticity across all ages. Ultimately, TMS measures of plasticity can become the foundation for a brain health index (BHI) to enable objective correlates of an individual's brain health over time, assessment across diseases and disorders, and reliable evaluation of indicators of efficacy of future preventive and therapeutic interventions.
Highlights
WHY ASSESS BRAIN PLASTICITY ACROSS THE LIFESPAN According to the World Health Organization, neuropsychiatric disorders affect one out of every five people over the course of their lives and represent the main cause of lifelong disability worldwide
We argue that transcranial magnetic stimulation (TMS), combined with other neurophysiologic or neuroimaging modalities, such as electromyography (EMG), electroencephalography (EEG), or functional magnetic resonance imaging, is useful for this purpose
Brain Health Index (BHI) The brain health index (BHI) aims at integrating TMS-driven measures of brain plasticity in a thorough characterization of how the dynamics of local and network brain plasticity are, on one hand, able to sustain healthy functionality throughout life and how they may become impaired leading to neuropsychiatric diseases and disorders, and, on the other hand, how genetic and environmental factors, and their interactions, may influence the course of changes in the mechanisms of brain plasticity across the lifespan
Summary
WHY ASSESS BRAIN PLASTICITY ACROSS THE LIFESPAN According to the World Health Organization, neuropsychiatric disorders affect one out of every five people over the course of their lives and represent the main cause of lifelong disability worldwide. The risk of neuropsychiatric disorders increases with age, and the world’s population is rapidly growing and aging (Christensen et al, 2009). We face an expanding risk of neuropsychiatric ageassociated disorders, including Alzheimer’s disease (AD) (Alzheimer’s Association, 2012), the impact of which cannot be overstated. One of the most compelling biomedical goals of the twenty-first century must be to Frontiers in Neuroscience www.frontiersin.org
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