Restarting Your Brain Through The Tongue: The Science Of PoNS Therapy
NEUROSCIENCE FINDS
Shirin Dhankhar
7/26/20264 min read
Your brain runs on electricity. Every thought, every stab of pain, every flutter of anxiety is a signal traveling along a wire. Pain like chronic or motor or sensory changes this interconnected system. It can be associated with a software problem in the brain: a bug needed to be fixed or a noise to be shut down. This is where Portable Neuromodulation Stimulator, or PoNS for short comes into play. Created by Yuri Danilov, Mitchell Taylor, and Kurt Kaczmarek, PoNS is an orally applied therapy delivered by neurostimulation to reduce symptoms. Gait and balance problems associated with Multiple Sclerosis (MS), Chronic Stroke, Traumatic Brain Injury (TBI) are tackled by the device whereas it is still in the experimental phases in relation to Parkinson’s. When used together with physical rehabilitation exercises, PoNS improves gait in people with mild to moderate MS symptoms.
Did you know that your tongue has nerves that connect to your brainstem? PoNS targets sensory nerve endings on the tongue to activate new pathways to the brain, modifying and correcting how the neurons are firing. It consists of two parts: a stimulating electrical mouthpiece with a rectangle-shaped tab that lies on your tongue, and a controller that goes around your neck. These are connected with an electrical cord. The flat part has 144 electrodes on its underside, which fire off electric pulses for 20 minutes, in triplets, at frequencies designed to turn on as many nerves as possible In scientific terms, this is known as cranial nerve noninvasive neuromodulation via translingual nerve stimulation. Not to worry, you don’t need these complex tongue twister terms to understand how PoNS works. This is broken down into 4 steps:
Stimulation of the tongue:
The trigeminal and face cranial nerves, which are related to the tongue, are stimulated when the PoNS is activated by the electrodes on the mouthpiece sending mild electrical impulses.
Brain Nerves:
The brain's movement control centers — the brainstem and cerebellum — receive a stream of neural impulses from the electrical stimulation of these cranial nerves.
Brainstem:
Many parts of the brain, including interneurons and cortex structures important in human function, can be activated concurrently by electrical signals that enter the brain stem.
Neuroplasticity:
PoNS and physical rehabilitation activities cause a series of alterations in various parts of the brain during the course of 14 weeks of therapy. Applying PoNS therapy consistently produces a long-lasting neuromodulatory impact that leads to neuroplastic alterations. According to Yuri Danilov, there are 4 types of plastic changes:
Functional Neuroplasticity: this occurs within minutes, rectifying a physiological imbalance in the excitation-inhibition systems that produces symptoms.
Synaptic Neuroplasticity: this occurs from several days up to several weeks, making new and more lasting synaptic connections between neurons. According to Yuri, it might also boost the electrical signal, increase the size and quantity of synapses, and improve the efficiency of conduction along the nerve axon.
Neuronal Neuroplasticity: this occurs after a month or more of activation, involving change throughout the neuron. Activating neurons consistently over twenty-eight days allows them to begin to produce new proteins and internal structures.
Systemic Neuroplasticity: this occurs many months to several years only after all the previous plastic changes have stabilized, the new networks have consolidated — making the system fully functioning and self-correcting without the device.
Now that we know the basics of how it works, let’s discuss the advantages and disadvantages of using PoNS in patients.
Of course, all theories and models are good enough, but real life stories are just as important to assess PoNS positive outcomes. Below are three anecdotes from Norman Doidge’s ‘The Brain’s Way Of Healing’ where patients were diagnosed with MS, stroke, and Parkinson’s respectively.
Multiple Sclerosis:
Max Kurz, a researcher at the University of Nebraska Medical Center, conducted a study on a device aiding movement for diverse MS patients. In two weeks of training, eight subjects significantly improved their mobility, with many who initially used canes walking faster and longer. Some patients reported unexpected improvements in unrelated MS symptoms, such as bladder control and sleep. Notable results emerged from Kim Kozelichki, who, despite severe MS challenges, regained balance and mobility after using the device. Initially unable to walk independently, she progressed to jogging and playing tennis again. While cognitive issues and fatigue persist, Kim enjoys a more functional life with her husband, participating in activities they once shared, indicating a renewed sense of hope and quality of life.
Stroke:
Mary Gaines, a 54-year-old from Manhattan, suffered a major left-hemisphere stroke in 2007 that resulted in right-side weakness and severe language issues. Post-stroke, she experienced sensory overload and struggled with essential daily tasks, leading to isolation. After enduring years of rehabilitation with limited success, she discovered a treatment lab in Madison with PoNS. Remarkably, on the second day of treatment, she felt significant cognitive improvements and regained her ability to process stimuli effectively. After two weeks, she returned home with PoNS that transformed her life, restoring her ability to enjoy daily activities and read. Although she still experiences weekly migraines, Mary now embraces life with enthusiasm, practicing yoga and enjoying her newfound freedom.
Parkinsons:
Anna Roschke, diagnosed with Parkinson's disease for twenty-three years, experienced severe symptoms including immobility and speech difficulties. Doctors in Germany had given up on further treatment, but after being brought to Wisconsin, she used a PoNS device. Within two weeks, her speech and walking improved remarkably; she no longer needed a walker. Now active, she bakes for her grandchildren and enjoys the park, surprising her son Victor with her revitalized abilities despite still having Parkinson's disease.
Looking into the future, there are proposals of other possible targets for PoNS technology, including eye movement disorders, cognitive function, self-reported bladder function, and tremors. The need for more evidence is an important theme that emerges from the current literature describing the PoNS device, particularly randomized controlled trials that can adequately assess its efficacy. Furthermore, there is a demand for broader insurance access and commercial scale up to a global market. It's not a miracle cure, but for many, it's a meaningful step toward reclaiming mobility and quality of life.