Background and Purpose: Traumatic brain injury (TBI) can lead to movement and balance deficits. I... more Background and Purpose: Traumatic brain injury (TBI) can lead to movement and balance deficits. In addition to physical therapy, brain-based neurorehabilitation efforts have begun to show promise in improving these deficits. The present study investigated the effectiveness of translingual neural stimulation (TLNS) on patients with mild-to-moderate TBI (mmTBI) and related brain connectivity using a resting-state functional connectivity (RSFC) approach. Methods: Resting-state images with 5-min on GE750 3T scanner were acquired from nine participants with mmTBI. Paired t-test was used for calculating changes in RSFC and behavioral scores before and after the TLNS intervention. The balance and movement performances related to mmTBI were evaluated by Sensory Organization Test (SOT) and Dynamic Gait Index (DGI). Results: Compared to pre-TLNS intervention, significant behavioral changes in SOT and DGI were observed. The analysis revealed increased RSFC between the left postcentral gyrus and left inferior parietal lobule and left Brodmann Area 40, as well as the increased RSFC between the right culmen and right declive, indicating changes due to TLNS treatment. However, there were no correlations between the sensory/somatomotor (or visual or cerebellar) network and SOT/DGI behavioral performance. Conclusions: Although the limited sample size may have led to lack of significant correlations with functional assessments, these results provide preliminary evidence that TLNS in conjunction with physical therapy can induce brain plasticity in TBI patients with balance and movement deficits. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Journal of NeuroEngineering and Rehabilitation, 2014
BackgroundThis study sought to examine the effect of targeted physical therapy with and without c... more BackgroundThis study sought to examine the effect of targeted physical therapy with and without cranial nerve non-invasive neuromodulation (CN-NINM), on the walking ability of people with MS who exhibited a dysfunctional gait. We hypothesized that subjects who received electrical stimulation would have greater improvement than those who had a control device after a 14-week intervention. Gait disturbance is a common problem for people with multiple sclerosis (MS). Current management may include exercise, pharmacology, functional electrical stimulation, compensatory strategies, use of assistive devices, and implanted electrical devices. We have developed an effective rehabilitative strategy using neuromodulation of the cranial nerves via electrical stimulation of the tongue to enhance the plasticity of the brain.MethodsThe study is a within-subject blinded randomized control design. Twenty chronic MS subjects with an identified gait disturbance were assigned to either an active or con...
Abstract
Purpose: To investigate the acceptability, efficacy, and effect duration of translingu... more Abstract
Purpose: To investigate the acceptability, efficacy, and effect duration of translingual neurostimulation (tens) plus standard therapeutic exercise program (tep) to improve motor skills in children with cerebral palsy (cp).
Methods. Participants aged 2–17 years (n = 134) diagnosed with spastic diplegia cp with coordination and mobility symptoms were enrolled at sestroretsk city hospital 40. Participants were offered one of two treatment regimens either tep plus tlns with the portable neuromodulation stimulator (pons™) – experimental arm or tep alone (control). The treatment course continued for ten days (2 weeks, excluding two weekend days). In the experimental group and tep, tlns was applied twice a day, 20 minutes each during exercises, morning, and afternoon, at least 3 hours between sessions. Assessments before and after therapy courses measured spasticity, balance, and motor skills. Either treatment could be repeated several times (6–12 months between courses). All children were assessed before and after a course round of therapy using standard scales for spasticity, balance, and motor skills (ashworth scale, berg scale, gross motor function classification system, functional movement screen).
Results: Both groups of patients showed improvement; however, the improvement was significantly more significant in the experimental group across all scales, observed in all ages, and largely sustained for 6–12 months.
Conclusions. Tlns plus tep can be considered as a novel and promising strategy to improve neurorehabilitation outcomes in children with cp, offering broad implications for the development and use of tlns in cp.
Keywords: translingual neurostimulation, cerebral palsy, neuroplasticity, balance, vestibular function, motor skills.
Two emerging noninvasive neurostimulation technologies, based on electrocutaneius stimulation of ... more Two emerging noninvasive neurostimulation technologies, based on electrocutaneius stimulation of the tongue (CN-NINM) and the neck (SYMPATOCORRECTION) are presented. Currently, two portable devices were developed and introduced in clinical practice: PoNS TM (portable neurostimulator) and SYMPATOCOR. Both technologies are complements of each other and demonstrate perspectives in various applications for purpose of neurorehabilitation and neurological symptoms management in such difficult rehabilitation areas, as traumatic brain injury, stroke, Parkinson's disease, multiple sclerosis and many other neurological disorders.
High-resolution functional magnetic resonance imaging (fMRI) can be used to precisely identify bl... more High-resolution functional magnetic resonance imaging (fMRI) can be used to precisely identify blood oxygen level dependent (BOLD) activation of small structures within the brainstem not accessible with standard fMRI. A previous study identified a region within the pons exhibiting sustained neuromodulation due to electrical tongue stimulation, but was unable to precisely identify the neuronal structure involved. For this study, highresolution images of neural activity induced by optic flow were acquired in nine healthy controls and nine individuals with balance dysfunction before and after information-free tongue stimulation. Subjects viewed optic flow videos to activate the structures of interest. Sub-millimeter in-plane voxels of structures within the posterior fossa were acquired using a restricted field of view. Whole-brain functional imaging verified that global activation patterns due to optic flow were consistent with previous studies. Optic flow activated the visual associat...
Two emerging noninvasive neurostimulation technologies, based on electrocutaneius stimulation of ... more Two emerging noninvasive neurostimulation technologies, based on electrocutaneius stimulation of the tongue (CN-NINM) and the neck (SYMPATOCORRECTION) are presented. Currently, two por-table devices were developed and introduced in clinical practice: PoNSTM (portable neurostimula-tor) and SYMPATOCOR. Both technologies are complements of each other and demonstrate pers-pectives in various applications for purpose of neurorehabilitation and neurological symptoms management in such difficult rehabilitation areas, as traumatic brain injury, stroke, Parkinson’s disease, multiple sclerosis and many other neurological disorders.
Management of cerebral palsy is an actual problem of modern medicine. A new direction of neuroreh... more Management of cerebral palsy is an actual problem of modern medicine. A new direction of neurorehabilitation, intensively discussed in modern science and practice, includes various types of electrical stimulation. Constant stimulation of the nervous system is one of the most popular ways to activate neural networks in order to activate the brain and initiate neuroplasticity processes. Participants in the experiment were children with cerebral palsy, spastic diplegia form at the age of 6 to 19 (n=6) (mean age 17,9 ± 5,6 years). All subjects underwent standard treatment, including massage, therapeutic gymnastics simulators, robotic mechanotherapy, etc., which lasted 20-25 minutes with neurostimulation of the brain (using a PoNS device). All subjects underwent a functional brain imaging (MRI) before and after neurostimulation course. Results indicate positive dynamics in all subjects: most of them learned walking without aids, decreased muscle tonus and improvement in balance, coordina...
RUSSIAN NEUROSURGICAL JOURNAL named after professor A. L. Polenov, 2021
PURPOSE. to investigate the acceptability, efficacy, and effect duration of translingual neurosti... more PURPOSE. to investigate the acceptability, efficacy, and effect duration of translingual neurostimulation (TLNS) plus standard therapeutic exercise program (TEP) to improve motor skills in children with cerebral palsy (CP). Methods: Participants aged 2-17 years (n = 134) diagnosed with spastic diplegia CP with coordination and mobility symptoms were enrolled at Sestroretsk City hospital № 40. Participants were offered one of two treatment regimens: either TEP plus TLNS with the Portable Neuromodulation Stimulator (PoNS™) - experimental arm or TEP alone (control). the treatment course continued for ten days (2 weeks, excluding two weekend days). In the experimental group and TEP, TLNS was applied twice a day, 20 minutes each during exercises, morning, and afternoon, at least 3 hours between sessions. Assessments before and after therapy courses measured spasticity, balance, and motor skills. Either treatment could be repeated several times (6-12 months between courses). All children were assessed before and after a course round of therapy using standard scales for spasticity, balance, and motor skills (Ashworth scale, berg scale, Gross motor function Classification System, functional movement Screen). Results: Both groups of patients showed improvement; however, the improvement was significantly more significant in the experimental group across all scales, observed in all ages, and largely sustained for 6-12 months. CONCLUSIONS. TLNS plus TEP can be considered as a novel and promising strategy to improve neurorehabilitation outcomes in children with CP, offering broad implications for the development and use of TLNS in CP.
Background: In a recent high-profile case study, we used functional magnetic resonance imaging (f... more Background: In a recent high-profile case study, we used functional magnetic resonance imaging (fMRI) to monitor improvements in motor function related to neuroplasticity following rehabilitation for severe traumatic brain injury (TBI). The findings demonstrated that motor function improvements can occur years beyond current established limits. The current study extends the functional imaging investigation to characterize neuromodulation effects on neuroplasticity to further push the limits. Methods: Canadian Soldier Captain (retired) Trevor Greene (TG) survived a severe open-TBI when attacked with an axe during a 2006 combat tour in Afghanistan. TG has since continued intensive daily rehabilitation to recover motor function, experiencing an extended plateau using conventional physical therapy. To overcome this plateau, we paired translingual neurostimulation (TLNS) with the continuing rehabilitation program. Results: Combining TLNS with rehabilitation resulted in demonstrable clini...
Gait and balance disorders are common among individuals who have experienced a mild to moderate t... more Gait and balance disorders are common among individuals who have experienced a mild to moderate traumatic brain injury (TBI). However, little is known about how the neuromuscular control of gait is altered following a TBI. Investigate the relationship between lower limb muscle activation patterns and chronic gait deficits in individuals who previously experienced a mild to moderate TBI. Lower extremity electromyographic (EMG) signals were collected bilaterally during treadmill and overground walking in 44 ambulatory individuals with a TBI >1 year prior and 20 unimpaired controls. Activation patterns of TBI muscles were cross-correlated with normative data from control subjects to assess temporal phasing of muscle recruitment. Clinical assessments of gait and balance were performed using dynamic posturography, the dynamic gait index, six-minute walk test, and preferred walking speed. TBI subjects exhibited abnormal activation patterns in the tibialis anterior, medial gastrocnemius...
Background and Purpose: Traumatic brain injury (TBI) can lead to movement and balance deficits. I... more Background and Purpose: Traumatic brain injury (TBI) can lead to movement and balance deficits. In addition to physical therapy, brain-based neurorehabilitation efforts have begun to show promise in improving these deficits. The present study investigated the effectiveness of translingual neural stimulation (TLNS) on patients with mild-to-moderate TBI (mmTBI) and related brain connectivity using a resting-state functional connectivity (RSFC) approach. Methods: Resting-state images with 5-min on GE750 3T scanner were acquired from nine participants with mmTBI. Paired t-test was used for calculating changes in RSFC and behavioral scores before and after the TLNS intervention. The balance and movement performances related to mmTBI were evaluated by Sensory Organization Test (SOT) and Dynamic Gait Index (DGI). Results: Compared to pre-TLNS intervention, significant behavioral changes in SOT and DGI were observed. The analysis revealed increased RSFC between the left postcentral gyrus and left inferior parietal lobule and left Brodmann Area 40, as well as the increased RSFC between the right culmen and right declive, indicating changes due to TLNS treatment. However, there were no correlations between the sensory/somatomotor (or visual or cerebellar) network and SOT/DGI behavioral performance. Conclusions: Although the limited sample size may have led to lack of significant correlations with functional assessments, these results provide preliminary evidence that TLNS in conjunction with physical therapy can induce brain plasticity in TBI patients with balance and movement deficits. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Journal of NeuroEngineering and Rehabilitation, 2014
BackgroundThis study sought to examine the effect of targeted physical therapy with and without c... more BackgroundThis study sought to examine the effect of targeted physical therapy with and without cranial nerve non-invasive neuromodulation (CN-NINM), on the walking ability of people with MS who exhibited a dysfunctional gait. We hypothesized that subjects who received electrical stimulation would have greater improvement than those who had a control device after a 14-week intervention. Gait disturbance is a common problem for people with multiple sclerosis (MS). Current management may include exercise, pharmacology, functional electrical stimulation, compensatory strategies, use of assistive devices, and implanted electrical devices. We have developed an effective rehabilitative strategy using neuromodulation of the cranial nerves via electrical stimulation of the tongue to enhance the plasticity of the brain.MethodsThe study is a within-subject blinded randomized control design. Twenty chronic MS subjects with an identified gait disturbance were assigned to either an active or con...
Abstract
Purpose: To investigate the acceptability, efficacy, and effect duration of translingu... more Abstract
Purpose: To investigate the acceptability, efficacy, and effect duration of translingual neurostimulation (tens) plus standard therapeutic exercise program (tep) to improve motor skills in children with cerebral palsy (cp).
Methods. Participants aged 2–17 years (n = 134) diagnosed with spastic diplegia cp with coordination and mobility symptoms were enrolled at sestroretsk city hospital 40. Participants were offered one of two treatment regimens either tep plus tlns with the portable neuromodulation stimulator (pons™) – experimental arm or tep alone (control). The treatment course continued for ten days (2 weeks, excluding two weekend days). In the experimental group and tep, tlns was applied twice a day, 20 minutes each during exercises, morning, and afternoon, at least 3 hours between sessions. Assessments before and after therapy courses measured spasticity, balance, and motor skills. Either treatment could be repeated several times (6–12 months between courses). All children were assessed before and after a course round of therapy using standard scales for spasticity, balance, and motor skills (ashworth scale, berg scale, gross motor function classification system, functional movement screen).
Results: Both groups of patients showed improvement; however, the improvement was significantly more significant in the experimental group across all scales, observed in all ages, and largely sustained for 6–12 months.
Conclusions. Tlns plus tep can be considered as a novel and promising strategy to improve neurorehabilitation outcomes in children with cp, offering broad implications for the development and use of tlns in cp.
Keywords: translingual neurostimulation, cerebral palsy, neuroplasticity, balance, vestibular function, motor skills.
Two emerging noninvasive neurostimulation technologies, based on electrocutaneius stimulation of ... more Two emerging noninvasive neurostimulation technologies, based on electrocutaneius stimulation of the tongue (CN-NINM) and the neck (SYMPATOCORRECTION) are presented. Currently, two portable devices were developed and introduced in clinical practice: PoNS TM (portable neurostimulator) and SYMPATOCOR. Both technologies are complements of each other and demonstrate perspectives in various applications for purpose of neurorehabilitation and neurological symptoms management in such difficult rehabilitation areas, as traumatic brain injury, stroke, Parkinson's disease, multiple sclerosis and many other neurological disorders.
High-resolution functional magnetic resonance imaging (fMRI) can be used to precisely identify bl... more High-resolution functional magnetic resonance imaging (fMRI) can be used to precisely identify blood oxygen level dependent (BOLD) activation of small structures within the brainstem not accessible with standard fMRI. A previous study identified a region within the pons exhibiting sustained neuromodulation due to electrical tongue stimulation, but was unable to precisely identify the neuronal structure involved. For this study, highresolution images of neural activity induced by optic flow were acquired in nine healthy controls and nine individuals with balance dysfunction before and after information-free tongue stimulation. Subjects viewed optic flow videos to activate the structures of interest. Sub-millimeter in-plane voxels of structures within the posterior fossa were acquired using a restricted field of view. Whole-brain functional imaging verified that global activation patterns due to optic flow were consistent with previous studies. Optic flow activated the visual associat...
Two emerging noninvasive neurostimulation technologies, based on electrocutaneius stimulation of ... more Two emerging noninvasive neurostimulation technologies, based on electrocutaneius stimulation of the tongue (CN-NINM) and the neck (SYMPATOCORRECTION) are presented. Currently, two por-table devices were developed and introduced in clinical practice: PoNSTM (portable neurostimula-tor) and SYMPATOCOR. Both technologies are complements of each other and demonstrate pers-pectives in various applications for purpose of neurorehabilitation and neurological symptoms management in such difficult rehabilitation areas, as traumatic brain injury, stroke, Parkinson’s disease, multiple sclerosis and many other neurological disorders.
Management of cerebral palsy is an actual problem of modern medicine. A new direction of neuroreh... more Management of cerebral palsy is an actual problem of modern medicine. A new direction of neurorehabilitation, intensively discussed in modern science and practice, includes various types of electrical stimulation. Constant stimulation of the nervous system is one of the most popular ways to activate neural networks in order to activate the brain and initiate neuroplasticity processes. Participants in the experiment were children with cerebral palsy, spastic diplegia form at the age of 6 to 19 (n=6) (mean age 17,9 ± 5,6 years). All subjects underwent standard treatment, including massage, therapeutic gymnastics simulators, robotic mechanotherapy, etc., which lasted 20-25 minutes with neurostimulation of the brain (using a PoNS device). All subjects underwent a functional brain imaging (MRI) before and after neurostimulation course. Results indicate positive dynamics in all subjects: most of them learned walking without aids, decreased muscle tonus and improvement in balance, coordina...
RUSSIAN NEUROSURGICAL JOURNAL named after professor A. L. Polenov, 2021
PURPOSE. to investigate the acceptability, efficacy, and effect duration of translingual neurosti... more PURPOSE. to investigate the acceptability, efficacy, and effect duration of translingual neurostimulation (TLNS) plus standard therapeutic exercise program (TEP) to improve motor skills in children with cerebral palsy (CP). Methods: Participants aged 2-17 years (n = 134) diagnosed with spastic diplegia CP with coordination and mobility symptoms were enrolled at Sestroretsk City hospital № 40. Participants were offered one of two treatment regimens: either TEP plus TLNS with the Portable Neuromodulation Stimulator (PoNS™) - experimental arm or TEP alone (control). the treatment course continued for ten days (2 weeks, excluding two weekend days). In the experimental group and TEP, TLNS was applied twice a day, 20 minutes each during exercises, morning, and afternoon, at least 3 hours between sessions. Assessments before and after therapy courses measured spasticity, balance, and motor skills. Either treatment could be repeated several times (6-12 months between courses). All children were assessed before and after a course round of therapy using standard scales for spasticity, balance, and motor skills (Ashworth scale, berg scale, Gross motor function Classification System, functional movement Screen). Results: Both groups of patients showed improvement; however, the improvement was significantly more significant in the experimental group across all scales, observed in all ages, and largely sustained for 6-12 months. CONCLUSIONS. TLNS plus TEP can be considered as a novel and promising strategy to improve neurorehabilitation outcomes in children with CP, offering broad implications for the development and use of TLNS in CP.
Background: In a recent high-profile case study, we used functional magnetic resonance imaging (f... more Background: In a recent high-profile case study, we used functional magnetic resonance imaging (fMRI) to monitor improvements in motor function related to neuroplasticity following rehabilitation for severe traumatic brain injury (TBI). The findings demonstrated that motor function improvements can occur years beyond current established limits. The current study extends the functional imaging investigation to characterize neuromodulation effects on neuroplasticity to further push the limits. Methods: Canadian Soldier Captain (retired) Trevor Greene (TG) survived a severe open-TBI when attacked with an axe during a 2006 combat tour in Afghanistan. TG has since continued intensive daily rehabilitation to recover motor function, experiencing an extended plateau using conventional physical therapy. To overcome this plateau, we paired translingual neurostimulation (TLNS) with the continuing rehabilitation program. Results: Combining TLNS with rehabilitation resulted in demonstrable clini...
Gait and balance disorders are common among individuals who have experienced a mild to moderate t... more Gait and balance disorders are common among individuals who have experienced a mild to moderate traumatic brain injury (TBI). However, little is known about how the neuromuscular control of gait is altered following a TBI. Investigate the relationship between lower limb muscle activation patterns and chronic gait deficits in individuals who previously experienced a mild to moderate TBI. Lower extremity electromyographic (EMG) signals were collected bilaterally during treadmill and overground walking in 44 ambulatory individuals with a TBI >1 year prior and 20 unimpaired controls. Activation patterns of TBI muscles were cross-correlated with normative data from control subjects to assess temporal phasing of muscle recruitment. Clinical assessments of gait and balance were performed using dynamic posturography, the dynamic gait index, six-minute walk test, and preferred walking speed. TBI subjects exhibited abnormal activation patterns in the tibialis anterior, medial gastrocnemius...
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Papers by Yuri Danilov
Purpose: To investigate the acceptability, efficacy, and effect duration of translingual neurostimulation (tens) plus standard therapeutic exercise program (tep) to improve motor skills in children with cerebral palsy (cp).
Methods. Participants aged 2–17 years (n = 134) diagnosed with spastic diplegia cp with coordination and mobility symptoms were enrolled at sestroretsk city hospital 40. Participants were offered one of two treatment regimens either tep plus tlns with the portable neuromodulation stimulator (pons™) – experimental arm or tep alone (control). The treatment course continued for ten days (2 weeks, excluding two weekend days). In the experimental group and tep, tlns was applied twice a day, 20 minutes each during exercises, morning, and afternoon, at least 3 hours between sessions. Assessments before and after therapy courses measured spasticity, balance, and motor skills. Either treatment could be repeated several times (6–12 months between courses). All children were assessed before and after a course round of therapy using standard scales for spasticity, balance, and motor skills (ashworth scale, berg scale, gross motor function classification system, functional movement screen).
Results: Both groups of patients showed improvement; however, the improvement was significantly more significant in the experimental group across all scales, observed in all ages, and largely sustained for 6–12 months.
Conclusions. Tlns plus tep can be considered as a novel and promising strategy to improve neurorehabilitation outcomes in children with cp, offering broad implications for the development and use of tlns in cp.
Keywords: translingual neurostimulation, cerebral palsy, neuroplasticity, balance, vestibular function, motor skills.
Purpose: To investigate the acceptability, efficacy, and effect duration of translingual neurostimulation (tens) plus standard therapeutic exercise program (tep) to improve motor skills in children with cerebral palsy (cp).
Methods. Participants aged 2–17 years (n = 134) diagnosed with spastic diplegia cp with coordination and mobility symptoms were enrolled at sestroretsk city hospital 40. Participants were offered one of two treatment regimens either tep plus tlns with the portable neuromodulation stimulator (pons™) – experimental arm or tep alone (control). The treatment course continued for ten days (2 weeks, excluding two weekend days). In the experimental group and tep, tlns was applied twice a day, 20 minutes each during exercises, morning, and afternoon, at least 3 hours between sessions. Assessments before and after therapy courses measured spasticity, balance, and motor skills. Either treatment could be repeated several times (6–12 months between courses). All children were assessed before and after a course round of therapy using standard scales for spasticity, balance, and motor skills (ashworth scale, berg scale, gross motor function classification system, functional movement screen).
Results: Both groups of patients showed improvement; however, the improvement was significantly more significant in the experimental group across all scales, observed in all ages, and largely sustained for 6–12 months.
Conclusions. Tlns plus tep can be considered as a novel and promising strategy to improve neurorehabilitation outcomes in children with cp, offering broad implications for the development and use of tlns in cp.
Keywords: translingual neurostimulation, cerebral palsy, neuroplasticity, balance, vestibular function, motor skills.