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My brain injury in 2000 affected my balance and gait. Doctors assessed it by asking me to walk across a small room and back again. Aside from that observational method, which would not have apprised them of my habit of veering to the curb or having to consciously move my legs to walk, no diagnostic tool was used to assess my balance. In addition, no clinic provided treatment. Both approaches failed me, although receiving neurostimulation in the form of brain biofeedback and audiovisual entrainment probably assisted my balance recovery.

Today, treatment is available.

The University of Wisconsin-Madison Tactile Communication and Neurorehabilitation Laboratory (TCNL) developed a prescription neuromodulation device that, along with tailored in-clinic and at-home training, improves or restores balance and gait. In 2018, Health Canada approved the Portable Neuromodulation System (PoNS) as a Class II non-implantable medical device for 14-week treatment for chronic balance deficit due to mild-to-moderate traumatic brain injury (TBI). Recently, the FDA did as well.

I became aware of neuromodulation of the brain through the tongue during a webinar hosted by the Brain Injury Society of Toronto after the COVID-19 pandemic started. PoNS therapy fills the gap in brain injury treatment by targeting balance and gait impairments caused by multiple sclerosis, TBI, bilateral vestibular loss, stroke, balance impairment, and spinal cord injury.

According to Dr. Norman Doidge, author of The Brain’s Way of Healing, neuromodulation is the brain’s internal ability to restore “the balance between excitation and inhibition in the neural networks.”

Neurostimulation can trigger 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, directly but noninvasively, the brain. PoNS uses the tongue.

First, the mouth maintains a constant pH and temperature in a protected environment. Saliva is an excellent conduit for electrical impulses to travel from the PoNS’s electrode array along nerve fibers to the brain.

Second, according to a 2018 systemic study of the tongue, the tongue has an extensive and highly organized representation in “multiple levels in the brain (cortex, mesencephalon, medulla oblongata, and limbic system),........

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