The goal of optimizing restorative sprouting in Alzheimer's disease is based on the premise that sprouting is beneficial and is deficient in AD. The beneficial aspects of neuronal plasticity have been questioned, however, and other studies suggest that some aspects of sprouting may be exaggerated in AD and contribute to the formation of plaques, tangles, and other neuropathological hallmarks of this disorder. Manipulation of the sprouting response may represent a promising treatment strategy in AD, but whether the goal is to augment or impede sprouting may depend upon the extent of the damage and the severity of the disease state.