Cranial Nerve Noninvasive Neuromodulation in Adults With Neurological Conditions: Protocol for a Scoping Review

Abstract

Background Cranial nerve noninvasive neuromodulation (CN-NINM) via translingual nerve stimulation (TLNS) is a promising new intervention combined with neurological rehabilitation to improve outcomes for persons with neurological conditions. A portable neuromodulation stimulation (PoNS) device rests on the tongue and stimulates cranial nerves V and VII (trigeminal and facial nerves, respectively). Emerging evidence suggests that CN-NINM using the PoNS device, combined with targeted physical therapy, improves balance and gait outcomes but has not yet been comprehensively reviewed. Objective This review will describe CN-NINM via TLNS and its applications, effects, and implications for rehabilitation science in adult populations with neurological conditions. We will identify how CN-NINM via TLNS is currently being incorporated into neurological rehabilitation and identify gaps in evidence with respect to this novel technology. Methods Joanna Briggs Institute methodology will be used to conduct this scoping review. Electronic databases MEDLINE, AMED, CINAHL, Embase, and Web of Science will be searched, as well as gray literature databases ProQuest, DuckDuckGo, and Google. Studies published in English and French between 2000 and 2021 will be included. Two reviewers will independently screen all titles and abstracts and full-text papers that meet the inclusion criteria. Data will be extracted and collated in a table to synthesize the results. Extracted data will be reported in a comprehensive summary. Results The final manuscript is intended for submission to an indexed journal in September 2021. Conclusions This scoping review will be the first, to our knowledge, to address the current evidence on CN-NINM. The results will inform the use of CN-NINM in neurological rehabilitation and the development of recommendations for future research. Trial Registration Open Science Framework 10.17605/OSF.IO/XZQFM; https://osf.io/xzqfm International Registered Report Identifier (IRRID) PRR1-10.2196/29965

Real world evidence of improved attention and cognition during physical therapy paired with neuromodulation: a brain vital signs study

“…In individuals with mild-to-moderate traumatic brain injury, balance was shown to be both improved and sustained after treatment [TBI; (Tyler et al, 2019;Ptito et al, 2021)]. Recent work in individuals with Multiple Sclerosis [MS; (Tyler et al, 2014)], or stroke has demonstrated the potential for TLNS/PT rehabilitation that spans multiple clinical populations (Danilov et al, 2007;Galea et al, 2017;Leonard et al, 2017;Boughen et al, 2022). Further, within the growing real world clinical experiences, incidental observations of cognitive and mental health improvements have often been reported by clinicians and patients alike (Frehlick et al, 2019;Smith et al, 2020).…”