Neuroplasticity and ALS: What the Latest Research Actually Shows
- The Neuroplasticity Alliance
- Mar 30
- 5 min read
Updated: Mar 31
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease that affects motor neurons—the nerve cells responsible for controlling movement, speech, and breathing (Amyotrophic Lateral Sclerosis).
In ALS, the cells that send messages from your brain to your muscles gradually stop working.
For decades, ALS has been viewed primarily through a lens of decline.
But neuroscience is beginning to shift that perspective:
Can the brain still adapt—even as parts of the system are degenerating?
This is where neuroplasticity becomes important.
Understanding the Balance: Degeneration vs. Neuroplasticity
ALS involves degeneration of upper and lower motor neurons, leading to progressive weakness (Hardiman et al., 2017).
At the same time, the nervous system retains the capacity for neuroplasticity—its ability to reorganize neural pathways in response to input and experience (Kleim & Jones, 2008).
Even as some pathways break down, the brain may try to reroute signals through other pathways. This doesn’t reverse ALS—but it can influence how function is maintained.
Breakthrough #1: Compensatory Plasticity in the Brain
Neuroimaging studies show increased activation in secondary motor regions in individuals with ALS (Turner et al., 2012).
This is known as compensatory plasticity.
The brain recruits adjacent or parallel neural networks to maintain motor output.
When one pathway weakens, the brain tries to “find another route” to keep movement going.
Breakthrough #2: Exercise as a Neuroplastic Stimulus
Exercise was once limited due to concerns about overuse fatigue.
More recent evidence suggests that moderate, individualized exercise can be beneficial and safe for many individuals (Dal Bello-Haas et al., 2018).
Exercise supports neuromuscular activation and may enhance synaptic signaling.
The right amount of movement helps the brain and muscles stay connected longer.
⚠️ Key principle: Dosing matters more than intensity.
Breakthrough #3: Respiratory Neuroplasticity Through Intermittent Hypoxia
One of the most promising areas of research is acute intermittent hypoxia (AIH).
This involves:
Short, controlled exposures to reduced oxygen
Alternating with normal oxygen levels
Research shows this can induce long-term facilitation in respiratory motor pathways (Nichols et al., 2021).
AIH strengthens synaptic connections in spinal circuits that control breathing, improving neural output to respiratory muscles.
Brief, controlled changes in oxygen levels can “train” the breathing system to respond more effectively.
This is particularly important in ALS, where respiratory function is a major factor in disease progression.
⚠️ Important distinction:This is currently studied in controlled clinical environments, not as a generalized or unsupervised intervention.
Breakthrough #4: Brain-Computer Interfaces (BCIs)
Brain-computer interfaces (BCIs) allow direct communication between the brain and external devices.
Recent studies have enabled individuals with ALS to produce speech through neural decoding (Willett et al., 2023).
Cortical activity is translated into language output using machine learning algorithms.
The brain can send signals directly to a computer to “talk,” even if the body can’t.
Breakthrough #5: Neuromodulation & Vagus Nerve Stimulation
Vagus Nerve Stimulation (VNS) is a neuromodulation technique that enhances neuroplasticity.
VNS increases the release of neuromodulators (like acetylcholine and norepinephrine), which facilitate synaptic plasticity and learning.
It helps the brain become more responsive and better able to form new connections.
While widely studied in stroke rehabilitation, its application in ALS is still emerging.
What This Means: A Shift in ALS Care
We are moving from a purely degenerative model → to a more dynamic systems-based approach.
Instead of focusing only on what is lost, we now explore:
How to support remaining neural pathways
How to enhance communication across systems
How to apply targeted inputs to influence function
We’re no longer just watching decline—we’re actively working with the system.
A New Way to Think About ALS
Old question:❌ “Can we stop ALS completely?”
New question:✅ “How do we help the brain and body function as effectively as possible for as long as possible?”
This includes:
Movement and motor engagement
Respiratory training
Communication technology
Neuromodulation
Personalized care strategies
Science + Possibility
ALS remains complex and serious.
But the science is evolving.
Neuroplasticity does not reverse ALS.But it offers something meaningful: The ability to influence function—even within limitation. And that shift changes how we design care—moving from passive management of decline to targeted strategies that support function, preserve capacity, and engage remaining neural networks.
About The Neuroplasticity Alliance (NPA)
The Neuroplasticity Alliance is dedicated to accelerating the adoption of discoveries in neuroscience and making them accessible to individuals, families, and providers. Through education and outreach, NPA bridges the gap between research and real-world application—empowering people with science-backed knowledge to support brain health and function.
Reference List: ALS & Neuroplasticity
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