1. CHALLENGING THE CONCEPTS OF LOCALIZATION AND RECOVERY OF BRAIN FUNCTION ReCBIR – Research Centre for Brain Injury Rehabilitation UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation UCN - The Unit for Cognitive Neuroscience Neuroplasticitet og rehabilitering efter hjerneskade – hjerneskadens mekanismer og behandling Jesper Mogensen, Professor Head of UCN (The Unit for Cognitive Neuroscience), Dep. of Psychol., University of Copenhagen Director of ReCBIR (Research Centre for Brain Injury Rehabilitation)

2. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 2 Den regionale specialisering af hjernen – funktionel lokalisation

3. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 3 FULD FUNKTIONEL GENOPRETNING TRODS KOMPLET SKADE AF HJERNESTRUKTURER (ALLOCENTRISK PLACE LEARNING) Mogensen et al. Brain Research Bulletin, 2004

4. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 4 ELLER GENOPRETNING? LOKALISATION ELLER? …

5. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 5 ALGORITHMIC STRATEGIES ELEMENTARY FUNCTIONS NEURAL SUBSTRATES BEHAVIOUR X UNDERLYING COGNITIVE MECHANISMS AS A AS C EF 1 EF 2 EF 3 EF 4 EF 5 EF 6 EF 7 EF 8 EF 9 EF 10 EF 1 1 EF 12 EF 13 EF 14 EF 15 I II III IVV VI VII VIII IX X XI XII XIII XIV XV Brain structure α Brain structure β Brain structure γ UNDERLYING NEURAL MECHANISMS

6. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 6 BDNF (Brain-Derived Neurotrophic Factor) samt andre trofiske faktorer …

7. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 7 TROFISKE FAKTORER

8. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 8 SPROUTING

9. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 9 MEKANISMER for NEURONDØD

10. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 10 BDNF og antidepressiva

11. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 11 HVAD PÅVIRKER HJERNENS PLASICITET? BDNF?

12. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 12 BDNF (Brain-Derived Neurotrophic Factor) samt andre trofiske faktorer ved hjerneskade Betydning i den akutte fase Betydning for langsigtet reorganisering

13. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 13 SKADER ved BLODPROP

14. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 14 MEKANISMER for NEURONSKADE ved TBI

15. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 15 BDNF (Brain-Derived Neurotrophic Factor) samt andre trofiske faktorer ved hjerneskade Betydning i den akutte fase Betydning for langsigtet reorganisering

16. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 16 Hvordan kan BDNF fremmes ?

17. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 17 BDNF og antidepressiva

18. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 18 Hvordan kan BDNF fremmes ? – andre muligheder?

19. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 19 BDNF ved motorisk aktivitet

20. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 20 BDNF

21. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 21

22. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 22

23. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 23 Food for Thought …

24. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 24

25. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 25

26. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 26 HVAD PÅVIRKER HJERNENS PLASICITET? Motion?

27. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 27 Aktivering/stimulation som terapeutisk metode ved hjerneskade

28. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 28

29. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 29

30. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 30 Tidlig eller sen ?

31. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 31

32. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 32

33. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 33

34. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 34 SEN ! Men …

35. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 35 Aktivering/stimulation som terapeutisk metode ved hjerneskade

36. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 36 Påtvunget eller frivillig ? Stress ?

37. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 37

38. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 38

39. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 39 Exercise after stress

40. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 40 FRIVILLIG ! Men …

41. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 41 Aktivering/stimulation som terapeutisk metode ved hjerneskade

42. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 42

43. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 43

44. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 44 Betydningen af stress

45. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 45

46. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 46

47. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 47 Støtte til funktionel genopretning og træning – samt måske ”skader” ved psykiske lidelser Farmakologi Aktivering/Stimulering

48. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 48 Farmakologisk støttet rehabilitering

49. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 49

50. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 50 Farmakologisk støttet rehabilitering Effekter af Erythropoietin (EPO)

51. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 51 EPO og BDNF

52. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 52 7 dage 30 dage Interaktioner

53. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 53 EPO og BDNF

54. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 54 Glutamat Betydning i den akutte fase Betydning for langsigtet reorganisering

55. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 55 SKADER ved BLODPROP

56. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 56

57. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 57 Glutamat - PIMSD

58. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 58 DEN DYNAMISKE HJERNE: HÅB OG UDFORDRINGER

59. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 59 Får vi en kopi af det mistede?

60. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 60 1. MODIFICATION OF DEGREE OF CONTRIBUTION TO TASK MEDIATION BY INDIVIDUAL STRUCTURES: Some structures exhibit increased or decreased levels of contribution to task mediation 2. TASK-DEPENDENT AND DISSIMILAR NEURAL SUBSTRATES: After a given lesion the functional recovery of various cognitive tasks is mediated by unique and dissimilar neural substrates 3. APPLICATION OF NEW COGNITIVE STRATEGIES: The fully posttraumatically recovered individuals solve the task by applying new strategies that are dissimilar to those applied pretraumatically PHENOMENA OF POSTTRAUMATIC RECOVERY

61. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 61 ALGORITHMIC STRATEGIES ELEMENTARY FUNCTIONS NEURAL SUBSTRATES BEHAVIOUR X UNDERLYING COGNITIVE MECHANISMS AS A AS C EF 1 EF 2 EF 3 EF 4 EF 5 EF 6 EF 7 EF 8 EF 9 EF 10 EF 1 1 EF 12 EF 13 EF 14 EF 15 I II III IVV VI VII VIII IX X XI XII XIII XIV XV Brain structure α Brain structure β Brain structure γ UNDERLYING NEURAL MECHANISMS

62. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 62

63. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 63 Får vi en kopi af det mistede? NEJ! Men kunne vi få det?

64. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 64 Hvordan er de basale netværk dannet oprindeligt?

65. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 65

66. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 66

67. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 67 ”Kritiske” perioder under udviklingen

68. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 68 CSPGs - stoffer fra gliaceller … CSPGs – chondroitin sulphate proteoglycans

69. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 69 Og så er der låst … … eller er der?!

70. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 70 NEUROGENESE I DEN VOKSNE HJERNE

71. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 71

72. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 72

73. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 73 CSPGs

74. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 74 Styrkelse af BDNF? Hæmning af CSPGs?

75. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 75 Fordele – og farer Hæmning af CSPGs?

76. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 76 Styrkelse af BDNF?

77. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 77 Aktivering/stimulation som terapeutisk metode ved hjerneskade

78. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 78

79. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 79 Hvad kan vi gøre for at få den bedste omformning af hjernen?

80. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 80 ALGORITHMIC STRATEGIES ELEMENTARY FUNCTIONS NEURAL SUBSTRATES BEHAVIOUR X UNDERLYING COGNITIVE MECHANISMS AS A AS C EF 1 EF 2 EF 3 EF 4 EF 5 EF 6 EF 7 EF 8 EF 9 EF 10 EF 1 1 EF 12 EF 13 EF 14 EF 15 I II III IVV VI VII VIII IX X XI XII XIII XIV XV Brain structure α Brain structure β Brain structure γ UNDERLYING NEURAL MECHANISMS

81. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 81

82. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 82 GENERALISERING … af træning?

83. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 83 GENERALISERING … og kan vi få virkeligheden ind i træningen? kan vi få træningen ud i virkeligheden?

84. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 84

85. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 85

86. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 86

87. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 87

88. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 88 Virkeligheden ind i træningen! Træningen ud i virkeligheden!

89. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 89 DEN DYNAMISKE HJERNE: HÅB OG UDFORDRINGER

90. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 90 I forskning og behandling – lad os gå direkte efter de optimale løsninger!

91. UCN - The Unit for Cognitive Neuroscience ReCBIR – Research Centre for Brain Injury Rehabilitation 91 TAK FOR I DAG!