PoNS ™: Portable Translingual Neurostimulation

The BART Foundation is adding Portable Translingual Neurostimulation technology to our roster of safe alternative therapies, which we believe may help brain injury survivors achieve better outcomes. At present, the only such device commercially available for use in the USA and Canada is the PoNS™ device (Portable Neuromodulation Stimulator).  Please scroll to the bottom of the page to watch a video that shows what the clinical trials of PoNS looked like.

What is this new PoNS™ technology?

The PoNS™ device is a portable, non-implantable device that delivers mild neuromuscular electrical stimulation to the upper surface of the patient’s tongue. It consists of a controller and a mouthpiece that connect by a cord.

The PoNS™ device gently stimulates the tongue’s surface, exciting the neural network flowing to the brain. This neural activity is believed to enable neuroplasticity, which may restore lost functions.

The BART Foundation’s priority is always the safety of any proposed alternative therapy. PoNS is safe, as shown by the approval of the FDA and Canada’s HPFP for use on conditions other than brain injuries. There is strong evidence of a positive effect on gait and balance deficits in patients with mild TBI and MS, hence FDA and Canadian approval for those specific conditions.

Other safe alternative therapies such as HBOT, biomodulation, and neurofeedback are FDA approved for conditions other than brain injury, so they may be prescribed by physicians off-label to treat brain injuries. Therefore, we believe that PoNS is another tool in the off-label arsenal which progressive physicians use to treat cognitive and other deficits post-brain injury.

What evidence supports its use as therapy for more global deficits in persons with TBI/ABI? One randomized controlled study showed that PoNS significantly enhanced attention and cognitive vigilance in healthy individuals. A second multicenter randomized controlled study of balance deficits among mild and moderate TBI survivors demonstrated improvements in balance but, unexpectedly, also improvements in sleep quality and diminished frequency of headaches. A case study of a soldier with severe TBI indicated increases in basic attention and cognitive processing. Finally, in a placebo-designed study of MS patients, results suggested that PoNS stimulation can enhance motor performance and working memory. PoNS can now finally be prescribed off-label for cognitive remediation in TBI/ABI patients. We believe it may be reasonable and prudent to try PoNS for cognitive and other deficits post-TBI/ABI since it is safe and there is mounting evidence of its effectiveness.

Unfortunately, the PoNS device is currently only available at major medical centers at a high cost, and more studies would certainly be most welcome. These concerns may be lessened over time if it is widely adopted in the States for its FDA approved applications to balance and gait deficits. We anticipate that as more patients try it for gait and balance issues, there may be increasing clinical evidence of cognitive and other improvements in brain injury survivors. Like other alternative therapies that may help BI survivors, it is impossible to predict precisely what improvements will result from using PoNS. As always, there is no guarantee that it will help in any particular case. After all, nothing is 100% safe and effective – not even aspirin or acetaminophen. Nevertheless, the PoNS™ device is a new and exciting tool in the arsenal of Hope. Good luck to us all.

Further reading about PoNS

Cognitive effects on healthy individualsStudy findings suggest differential learning effects due to neuromodulation consistent with increased attention and cognitive vigilance

Improved sleep and headaches Clinical trial of chronic gait and balance deficits due to TBI. Significant improvements were shown in balance and gait, in addition to improvements to headaches, sleep quality, and fall frequency

This is a case study of a soldier with severe TBI indicative of cognitive improvements with PoNS. In parallel with motor function improvements, vital signs were detected with significant basic attention and cognitive processing increases. These objective cognitive improvements corresponded with self-reported improvements, including a noteworthy and consistent reduction in ongoing symptoms of post-traumatic stress disorder (PTSD).

Cognitive effects on MS patients: In this placebo study of MS patients, the results suggest that PoNS stimulation can enhance motor performance and working memory while also driving neuroplasticity. 

Review of evidence and current applications to TBI, MS, and stroke.

This excellent video explanation of the PoNS™ device includes clinical trial protocols and possible applications to neurological conditions. 


Please read our Disclaimer Page again before using this resource guide.  There are no definitive, uniformly accepted standards for persons claiming to offer alternative therapies.  In some states anyone can hang out a shingle, even without suitable training or credentials, and claim to be a craniosachral worker, neuro-feedback practitioner, nutritionist or other therapist.  To address this critical pitfall we have consulted acknowledged thought leaders in each field, followed their guidance, and presented lists of practitioners that are likely to be well qualified.

Even then there are no guarantees. One should seek a frank discussion with each prospective physician or therapist in order to explore their background.  How long have they been practicing their specialty?  What prior experience do they have in treating patients with brain injuries?  Can they offer references or testimonials?   Nothing is 100 percent effective, not even aspirin or acetaminophen.  With alternative therapies, as with mainstream approaches, there is always an element of chance, luck, randomness.  What works brilliantly for one survivor, may not work for another, and we may never know why.  All one can do is try one’s best, and hope to be lucky.

We are unable to make specific referrals – not only for liability reasons, but also because we don’t personally know most of the practitioners. Please review their information posted and then call prospects to inquire how they might help your personal condition.  Most physicians and therapists will let you know if they feel they can help, or will offer an alternate suggestion.