Helius -Model PoNS -Portable Neuromodulation Stimulator Device

PoNS used in conjunction with supervised therapeutic exercises is referred to as PoNS Therapy™.

The PoNS is an authorized medical device in the US. The PoNS device is indicated for use as a short-term treatment of gait deficit due to mild to moderate symptoms from multiple sclerosis (MS) and is to be used as an adjunct to a supervised therapeutic exercise program in patients aged 22 and older by prescription only.

PoNS™ is an authorized medical device commercially available in Canada intended for use as a short-term treatment (14 weeks) of gait deficit due to mild to moderate symptoms from MS and is to be used in conjunction with physical therapy. The device is also intended for use as a short-term treatment (14 weeks) of chronic balance deficit due to mild to moderate traumatic brain injury (mmTBI) and is to be used in conjunction with physical therapy.

PoNS® is authorized in Australia (AUS TGA) as a non-implantable neurostimulator intended for short-term use by healthcare professionals as an adjunct to a therapeutic exercise program to improve balance and gait. It is not yet commercially available.

PoNS Scientists

This novel way to apply the concept of neuroplasticity to rehabilitation is the brainchild of scientists at the University of Wisconsin-Madison Tactile Communication and Neurorehabilitation Laboratory (TCNL).

Scientific Theory: Amplifying the Brain’s Ability to Heal Itself

The PoNS device is based on almost 40 years of research in the field of neuromodulation—the use of external stimulation to intentionally change and regulate the electrochemical environment of the brain. It is believed that neuromodulation enhances neuroplasticity, the brain’s ability to restructure or relearn in response to new experiences, sensory input, and functional demands. Research has shown that the process of neuroplasticity underlies all cerebral learning, training and rehabilitation.

In clinical studies, the PoNS device coupled with targeted functional therapy (together PoNS® Treatment) induces neuroplasticity. Therapy consists of targeted physical, occupational and cognitive exercises, based on the patient’s deficits.

Research shows that electrical stimulation of the tongue (translingual neurostimulation – TLNS) stimulates two major cranial nerves: the trigeminal (the nerve responsible for sensations in the face, biting and chewing) and the facial (the nerve responsible for motor control of most of the muscles of facial expression). The electrical stimulation of the cranial nerves creates a flow of neural impulses that are then delivered directly into the brain stem—the main control center for many life functions, including sensory perception and movement. From the brain stem, these impulses travel throughout the brain and activate or reactivate neurons and structures involved in human function—the cortex, spinal cord and potentially the entire central nervous system.

Researchers believe that this sustained stimulation initiates a sequential cascade of changes in the actual interconnected nuclei, or the neuronal network, that are at the core of major anatomical components of the brain.

Based on this theory, it is believed that neuromodulation induced by the PoNS device, combined with functional therapy, may be applied to improve a large variety of neurological symptoms. For more detailed information, download the PoNS fact sheet from the Media Resources page.

At Helius, we pride ourselves on being at the forefront of developing technology that is essential in addressing the needs of neurological disorders that effect movement and coordination.

The Scientific Theory: Improve Impaired Function by Stimulating Cranial Nerves via the Tongue
Our technology is based on almost 60 years of research in the field of neuromodulation—the use of external stimulation to regulate the electrochemical environment of the brain.

In clinical studies, the PoNS device coupled with targeted functional therapy (together PoNS Therapy™) induces neuroplasticity. PoNS Therapy consists of balance and gait training and breathing and awareness exercises, as well as other neurorehabilitation exercises.

The Brainchild
This novel way to apply the concept of neuroplasticity to rehabilitation is the brainchild of scientists at the University of Wisconsin-Madison Tactile Communication and Neurorehabilitation Laboratory (TCNL).

Studying Correlation of Sensory Motor Cranial Nerves and Function
It is believed that neuromodulation triggers neuroplasticity, the brain’s ability to restructure or relearn in response to new experiences, sensory input, and functional demands.

Understanding the Role of Neuroplasticity in Functional Rehabilitation
Through extensive research, the role of neuroplasticity in functional rehabilitation for gait and balance is now better understood. Research results have shown that the process of neuroplasticity underlies all cerebral learning, training, and rehabilitation.

Physical therapy exercise may trigger neurostimulation mechanisms that deliver signals to specific neurological sites in the body.

This process, known as therapeutic neuromodulation, leads to alteration of nerve activity that can help modulate abnormal neural pathways’ behavior caused by the disease process and re-establishing neural balance.

Neuromodulation can promote changes in neural activity and induce mechanisms of neural network repair, called adaptive changes, which can compensate for the disrupted functional processes, which is the effect of neuroplasticity.

The PoNS Device and how trigeminal translingual delivery of therapy activates mechanisms that result in neuroplasticity.

Why the tongue?
The tongue, which has a large cortical representation, is innervated in the front two-thirds by branches of the trigeminal and facial nerves with direct connections to the brainstem.

The trigeminal nerve (lingual)
Responsible for sensations in the face, biting and chewing

The facial nerve (chorda tympani)
Responsible for motor control of most of the muscles of facial expression

The electrical stimulation of the cranial nerves creates a flow of neural impulses that are then delivered directly into the brain stem—the main control center for many life functions, including sensory perception, movement, and balance.

Clinical evidence suggests that PoNS Therapy™ (PoNS device plus physical therapy) can exert neuromodulation effects by the translingual stimulation of the trigeminal and facial nerve branches.

Brainstem Activity Modulation
Brainstem activity leads to upregulation of cortical activity that mediates function. The 2 cranial nerves (trigeminal and facial) have direct connections with specific areas of the brainstem (in the pons varolii and the medulla) and, consequently, promote activation of target regions in the cerebral cortex, including the left motor cortex, the bilateral anterior cingulate, and the dorsolateral prefrontal cortex areas.

Triggering Neuroplastic Changes in the Brain Over Time
With sustained neuromodulation, the brain, through neuroplasticity, may consolidate these adaptive changes and “learn” to employ the new compensatory mechanisms and pathways to improve or regain control of the impaired function.

Continuous translingual neuromodulation, over 14 weeks of physical therapy, is likely to induce neuroplastic changes that help replace impaired corticospinal pathways and deliver the signal to the spinal cord. This neuroplastic process may ultimately be responsible for improved function and consolidated therapeutic effects over the treatment period.