Translingual Neuromodulation – The PONS System

What is PoNSTM?

The Portable Neuromodulation Stimulator (PoNSTM) is a non-invasive medical device. It is the neurostimulation of the tongue (translingual) in a non-invasive manor that is intended to promote neuroplasticity after brain injury, including concussion. This device would maximize the process of reorganization and adaptation of neurons in order to optimize their communications to improve functional recovery after an injury or a disorder of the central nervous system.

If you want to know more about Neuroplasticity, this article may interest you!


How does the PoNSTM system work?

The PoNSTM delivers electrical stimulation through the tongue to activate the fibers of the trigeminal and facial cranial nerves and thus stimulate the neural networks going to the brainstem and the cerebellum.

The brain stem makes it possible to control, among other things, the respiratory rate and the heart rate, but above all it allows the transmission of information between the other structures of the central nervous system, such as the brain, the spinal cord and the cerebellum.

The cerebellum, on the other hand, plays an essential role in motor control and allows the coordination of movements and balance.

What does science say regarding this type of neuromodulation?

Combined with physical therapy and targeted exercises, PoNSTM could optimize the learning effect of rehabilitation1 by leading to functional improvements in gait and balance2. Over the past decade, translingual neurostimulation has been the subject of several scientific studies aimed at observing its impact on walking and balance in people with neurological disorders.

Studies focusing on the effects of translingual stimulation on gait and balance disorders following stroke3 and mild to moderate head trauma4 show an increase in postural stability and coordination in the individuals observed. Also, an improvement in walking5, motor performance, working memory while promoting neuroplasticity6 have been observed in people with multiple sclerosis after the implementation of an intervention combining physical therapy and PoNSTM. Although the results of these studies are encouraging and Health Canada has approved the use of the PoNSTM for the population of people with mild to moderate multiple sclerosis7 and mild to moderate traumatic brain injuries including concussion, it is however necessary to be cautious! This research is generally not done on large cohorts and other ongoing studies on a larger scale are awaited.

Who can use PoNSTM type neuromodulation?

At Neuro-Concept, a meticulous analysis of your condition is made to validate your eligibility for the protocol because not all neurological conditions can benefit from it. Our multidisciplinary expertise (occupational therapist, kinesiologist and physiotherapist), our advanced experience with neurological clients and the combined use of our technologies including the PoNSTM with targeted exercises, allow us to make tailor-made protocols adapted to your needs and to respond adequately to the clinical goals. Given the portability of the device, for remote clients who cannot go to the center, we have designed a 100% online protocol.

Several side effects not targeted by the protocol were also observed in clients such as a decrease in anxiety or an increase in attentional focus following an intervention using the PoNSTM.

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References :

1Villamar, M.F., Portilla, A.S., Fregni, F., Zafonte, R. et al. Noninvasive brain stimulation to modulate neuroplasticity in traumatic brain injury. Neuromodulation. 2011;15:326-38.

2Papa, L., LaMee, A., Tan, C.N., Hill-Pryor, C. Systematic review and meta-analysis of noninvasive cranial nerve neuromodulation for nervous system disorders. Arch Phys Med Rehabil. 2014;95(12):2435-43.

3Galea, M.P., Eduardo Cofr. Lizama, L., Bastani, A., Panisset, M.G, Khan, F. Cranial nerve non-invasive neuromodulation improves gait andbalance in stroke survivors: a pilot randomised controlled trial. Brain Stimul. 2017;10(6):1133-35.

4Tyler, M., Skinner, K., Prabhakaran, V., Kaczmarek, K., Danilov, Yu. Translingual neurostimulation for the treatment of chronic symptoms due tomild-to-moderate traumatic brain injury. Arch Rehabil Res Clin Transl. 2019;1(3-4):100026.

5Tyler, M.E., Kaczmarek, K.,Rust, K.L., Subbotin, A.M., Skinner, K.L., Danilov, Yu.P. Non-invasive neuromodulation to improve gait in chronic multiple sclerosis: a randomized double blind controlled pilot trial. J Neuroeng Rehabil. 2014;11:79.

6Leonard, G., Lapierre, Y., Chen, J-K, Wardini, R., Crane, J., Ptito, A. Noninvasive tongue stimulation combined with intensive cognitive and physical rehabilitation induces neuroplastic changes in patients with multiple sclerosis: a multimodal neuroimaging study. Mult Scler J Exp Transl Clin. 2017;3(1):2055217317690561.