Portable Neuromodulation Device May Improve Walking in MS Patients

A recent study suggests that MS patients can improve walking performance using a device called the Portable Neuromodulation Stimulator. By stimulating the tongue, researchers believe they can facilitate neuroplasticity in the motor nuclei of the cerebellum.

New research published in the Journal of Neuroengineering and Rehabilitation (Tyler et al., 2014) suggests that a device called the Portable Neuromodulation Stimulator (PoNS) may aid physical therapy in multiple sclerosis. The device has an array of electrodes that, when placed on the tongue, is thought to stimulate cranial nerves V and VII. The device’s proponents theorize that—when used in conjunction with exercise—PoNS facilitates neuroplasticity in motor functions through stimulation of the cerebellum via the cranial nerves.

The theory

The researchers believe that stimulating the tongue with the device excites cranial nerves V and VII, which run to the cerebellum. Through activating the motor centers of the cerebellum (the pons Varolii and the medulla), the researchers believe they can affect motor function. The timing of the pulses is thought to facilitate neuroplasticity, according to corresponding author Kimberly Skinner, PT.

According to the investigators, it’s important to do this all in conjunction with physical activity. “The brain and body must work at a level that is challenging in order to improve,” Skinner said to MSDF in an email.

fMRI studies by the same group suggest that the therapy works (Wildenberg et al., 2010). Using a similar method of neuromodulation, the team assessed postural sway in balance-impaired individuals who received the therapy versus those who did not. fMRI scans suggested that there was notable improvement in “visual sensitivity to optic flow,” according to the paper.