Brain Port

BrainPort® is a device that can compensate for lost eyesight. It can also help to improve your balance after a stroke, brain injury, and a range of vestibular disorders, e.g. Ménière’s disease.

BrainPort® enables the blind to ‘see’ by transforming images from a camera into pulses you can feel on your tongue.1 The intra-oral device, or ‘lollipop’, contains about 400 electrodes, each corresponding to a set of pixels in a camera. These create a ‘picture’. White pixels yield strong electrical signals that some say feel like champagne bubbles, while black pixels give no signal.2 You can learn to interpret the pulses as they change position and intensity until you can ‘see’ the images the camera is sending. This technology uses the tongue because it is more sensitive and a better electrical conductor than other areas of the body, such as the hands or the back.

Brain Port deviceThe device can also be used to address problems of balance. Sensors transmit information about the position of your head, the amount of pressure on your feet and other bodily positions and then relay the data to your tongue, where you learn to interpret your position in space and make the adjustments you need to stand straight, or to walk without fear of falling.

Developed by Wicab Inc., the BrainPort® is currently undergoing clinical trails. A researcher from the University of Wisconsin, Jack Sherman PhD, describes the experience of a patient with traumatic brain injury:

‘”The patient reported that using the BrainPort® helped not only with balance, but other areas in which he had deficits, including sensation, tremor and mental clarity,” says Sherman. “More importantly, the BrainPort® gave him hope.”’3

  • Possible benefits of BrainPort® for stroke

    The BrainPort® helps to restore balance after a stroke by taking measurements, such as the tilt of your head, and sending these measurements to an electrical stimulator on your tongue. For example, when your head tilts to the right, your tongue receives stimulation on the right and when your head is in the middle, you can feel the pulses in the middle of your tongue. After a while, your brain learns how to interpret these signals and you can correct your balance without thinking.

    ‘Wicab conducted a clinical trial with the balance device in 2005 with 28 subjects suffering from bilateral vestibular disorders (BVD). After training on BrainPort®, all of the subjects regained their sense of balance for a period of time, sometimes up to six hours after each 20-minute BrainPort® session. They could control their body movements and walk steadily in a variety of environments with a normal gait and with fine-motor control. They experienced muscle relaxation, emotional calm, improved vision and depth perception and normalized sleep patterns.’4

    Other trials have also shown that tongue stimulation can help people to improve their balance. For example, in 2007, a team of researchers tested 12 healthy adults to see if they could stand still with their eyes closed. The biofeedback on their tongue did help them to balance, although the team agreed that more research was necessary.5

    At the time of writing (October 2013) the BrainPort® V100 device is approved for sale in Canada and the European Economic Area. A demonstration project with 10 people began in Germany and distribution in Sweden and Italy are awaiting official approval. In the U.S. Wicab applied to the Food and Drug Administration in early 2013 but BrainPort® is still pursuing FDA clearance.

  • Arguments against using BrainPort® for stroke

    The clinical trials have not been completed (2010) and the FDA in America has not yet given its approval to the BrainPort® devices, but their application is still pending.

    The BrainPort® cannot be used at all times. Because the input device sits in the user’s mouth, it cannot be used when eating or speaking, for example.6

  • Case histories

    1. Cheryl Schlitz

    Perhaps the most famous case history is the story of Cheryl Schiltz, who is discussed by Norman Doidge in his book, The Brain that Changes Itself. He describes a woman who felt as though she was constantly falling, even when she was lying down.

    Cheryl lost her sense of balance when she took large doses of antibiotics to treat an infection after a hysterectomy. The vestibular system in her inner ear was so badly damaged that she had no idea whether she was standing, sitting, or lying down. This also affected her vision, as every object looked as though it was shaking. Her condition was untreatable until she went to see Paul Bach-y-Rita, a professor at the University of Wisconsin Medical School.

    Bach-y-Rita made a hat with sensors that could detect the position of her head and translate this information into messages that he could send to a small pad on her tongue. Doidge describes one session:

    ‘Cheryl puts on the hat and closes her eyes. She leans back from the table, keeping two fingers on it for contact. She doesn’t fall, though she has no indication whatsoever of what is up and down except the swirling of the champagne bubbles on her tongue. She lifts her fingers from the table. She’s not wobbling anymore. She starts to cry – the flood of tears that comes after a trauma; she can open up now that she has the hat on and feels safe. The first time she put on the hat, the sense of perpetual falling left her – for the first time in five years.’7

    Consequently, they discovered that the balancing effects lasted after Cheryl removed the hat. As the treatment progressed, she was able to balance for longer periods without the device:

    ‘Over the next year Cheryl wore the device more frequently to get relief and build up her residual effect. Her residual effect progressed to multiple hours, to days, and then to four months. Now she does not use the device at all and no longer considers herself a Wobbler.8

  • Notes and references
    1. a. ‘Vision substitution by tactile image projection’ by Bach-y-Rita, P., et al (1969). In Nature 221: 963-96.b. ‘Efficacy of electrotactile vestibular substitution in patients with peripheral and central vestibular loss’ by Bach-y-Rita, P, Danvilov YP et al. In Journal of Vestibular Research 2007; 17(2-3):119-130.
    2. Glenn B, ‘Wicab looks to launch one-of-a-kind ‘vision’ technology’. Medcity News 26-05-2010.
    3. ‘UW to Test BrainPort® Device for Patients with Stroke or Brain Injuries’ (4/28/2008) University of Wisconsin School of Medicine and Public Health, Medical Directions.
    4. HowStuffWorks “How BrainPort Works
    5. ‘A wireless embedded tongue tactile biofeedback system for balance control’ by Nicolas Vuillerme, Nicolas Pinsault et al. In Pervasive and Mobile Computing, Volume 5, Issue 3, June 2009, Pages 268-275
    6. Glenn B, ‘Wicab looks to launch one-of-a-kind ‘vision’ technology’. Medcity News 26-05-2010
    7. Norman Doidge, The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science (James H. Silberman Books) (2007) p.6
    8. Norman Doidge, The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science (James H. Silberman Books) (2007) p.10

Aviva Cohen is the author and CEO of Neuro Hero