my Brain injury in 2000 it affected my balance and walking. The doctors assessed this by asking me to walk through a small room and back again. Apart from this observational approach, no diagnostic tool was used to assess my balance, which would not have accounted for my tendency to turn sideways or to consciously move my legs. In addition, there is no treatment in any clinic. Although I received neurostimulation in the form of both approaches, I failed brain biofeedback and audiovisual engagement It must have helped to restore balance.
Treatment is available today.
The Tactile Communication and Neurorehabilitation Laboratory (TCNL) at the University of Wisconsin-Madison has developed a prescription neuromodulation device that improves or restores balance and gait along with customized in-clinic and home training. in 2018Health Canada has approved the Portable Neuromodulation System (PoNS) as a Class II non-implantable medical device for the 14-week treatment of mild to moderate chronic balance deficits. traumatic brain injury (TBI). Recentlythe The FDA did also.
I learned about neuromodulation of the brain through language during a webinar hosted by the Toronto Brain Injury Society. COVID 19 a pandemic has begun. PoNS therapy fills a gap in brain injury treatment by targeting the resulting balance and gait disturbances multiple sclerosis, TBIbilateral vestibular loss, stroke, imbalanceand spinal cord injury.
According to Dr. Norman Doidge, author The brain’s healing pathwayneuromodulation is the brain’s intrinsic ability to “rebalance between excitation and inhibition.” nervous networks.”
Neurostimulation can induce neuromodulation, which improves brain regulation. The location of neurostimulation varies from treatment to treatment. The ones I’ve used stimulate through the eyes, ears, skin, and brain directly but non-invasively. PoNS uses language.
Why language?
First, the mouth maintains a constant pH and temperature in a protected environment. Saliva is an excellent conduit for electrical impulses to travel along nerve fibers from the array of PoNS electrodes to the brain.
Second, than Systematic language learning in 2018language “has a broad and highly organized representation at multiple levels of the brain (cortex, mesencephalon, medulla oblongata, and limbic system), with the highest specificity and integration at the cortical level.”
In 2010 pilot studyWildenberg et al. found that “simple electrical tongue stimulation, devoid of exogenous environmental information, can produce persistent rewarding behavioral effects.” Previous studies have found similar results “in assessing the effectiveness of electrical stimulation through the tongue combined with head position information.”
Installing a PoNS device anterior posterior surface of the tongue non-invasively stimulates cranial nerve V (trigeminal nerve) and cranial nerve VII (facial nerve). Stimulated neurons transmit impulses to the brainstem (pons varoli and medulla) and cerebellum. through self regulationthese brain regions change according to the activity carried out during the neuromodulation of the cranial nerves.
These properties make the tongue an ideal site for PoNS neurostimulation. Apparently, electrical impulses feel like champagne bubbles.
As with other neurostimulation and neuromodulation treatments, the authors found that clinicians should balance training so that it challenges the person for maximum performance, but does not cause the person to become overly fatigued. This approach of combining tasks or activities with neurostimulation is consistent with other approaches to restoring healthy function, e.g. with tDCS. Training includes movement, balance, gait, cognitive and breathing work and awareness. In addition to warm-up exercises to stimulate the brain, these activity components are performed simultaneously using the PoNS device.
Clinics using the PoNS device determined the optimal training time per day for each segment of training. Therapy involves regular and progressive updates as clients improve and adapt so that the level of difficulty remains constant relative to their improvement for therapy to be beneficial.
Like other neurostimulation and neuromodulation therapies, PoNS therapy works in various injuries and diseases because it activates the homeostatic regulation of modulated neural networks. In his 2015 book, Doidge noted that TCNL reported no side effects. This finding is consistent with other noninvasive neurostimulation and neuromodulation therapies that are prescribed according to clinical guidelines and have few or no side effects when administered.
Clinical studies continue to prove the effectiveness of this therapy.
Although they are not without side effects, two issues hinder access to PoNS therapy: cost and the ability to follow a home-training prescription.
Private insurance may cover (some of) the cost, but Medicare in Canada does not unless it is part of an inpatient, outpatient rehabilitation. As far as I know, neurostimulation of any kind is not provided as part of standard neurorehabilitation covered by Medicare.
The biggest problem is that people with brain injuries may not be able to do homework as prescribed unless they have help with the task. In order to regenerate neurons and restore neural networks, the treatment must be applied to the person and carried out for the required period of time. This means that there will be more fatigue than before the time is up. As I found Lindamood-Bell Visualization and Verbalization Training (or any cognitively challenging task), the urge to quit before I’m even halfway through becomes unbearable. But the coach knew how to keep me on task. Without this support, I may not have made it to the training time I needed.
In addition, impatience with PoNS therapy may lead to skipping warm-up exercises and the environment can be confusing.
For these reasons, a person with a brain injury who lives alone and/or does not support exercise at home may require daily clinic visits to encourage the client to complete their daily routine for full benefit.
Studying how a person with a brain injury can receive PoNS therapy and stroke is another way health professionals can help their clientshelping them to overcome the deficits associated with brain injury as much as possible can help them improve their health, improve their quality of life and ultimately improve their mental health.
Copyright ©2026 Shireen Anne Jeejeebhoy
