J Neurol Neurorehabil Res 2017 Volume 2 Issue 1 39 http://www.alliedacademies.org/neurology-and-neurorehabilitation-research/ Case Report Case Description The primary subject matter of this case concerns a new approach to neurorehabilitation using trans-lingual neuro-stimulation (TLNS) Technology. Secondary issues examined include the recovery and enhancement of cognitive functioning in a subject with chronic stroke. The case has a diffculty level of four, appropriate for senior level courses who have already covered the topics of neurorehabilitation and neuroplasticity. The case is designed to be taught in one class hour and is expected to require zero hours of outside preparation by students, aside from foundational knowledge of neurorehabilitation techniques and neuroplasticity mechanisms. Case Synopse Cognitive impairment is a typical consequence of many neurological disorders. It is generally accepted that most improvement for an individual affected by stroke occurs within the frst year following the stroke. However, our research shows that it is possible to rehabilitate chronic defcits that result from stroke. TLNS Technology uses a combination of targeted physical exercises and guided meditation with electrotactile stimulation to the tongue with a PoNS TM device. The TCNL completed a 15-month intervention for an 80-year-old woman, 4 years after her stroke. Cognitive improvement was measured using the Stroke Impact Scale (SIS) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The “Memory and Thinking” domain on the SIS demonstrated a 47.3% improvement from baseline. All components of the RBANS improved as a result of the intervention as well, ranging from 10% to 42% improvement from baseline. Recovery demonstrated TLNS stimulation dependence, such that performance across all parameters improved in the frst seven months of the intervention, declined during the withdrawal period, and improved again when the intervention was reinstated. We hypothesize that the benefcial effects observed in this case study result from lasting and cumulative neuroplastic changes (functional, synaptic and neuronal) in the brainstem and cerebellum on the cellular and neural network levels, elicited by powerful fow of neural impulses (spikes) from the tongue. This case demonstrates that TLNS balance and gait training can be used to recover and improve cognitive functioning in individuals with chronic stroke. These fndings present a new non-invasive brain stimulation technique with applications in cognitive and rehabilitative neurosciences. Additional research is necessary to understand the potential mechanisms of this phenomenon and optimize effciency of the intervention. Cognitive enhancement exciting discovery using trans-lingual neuro-stimulation. Dafna Paltin, Mitchell Tyler, Yuri Danilov University of Wisconsin, Madison, USA Accepted on April 24, 2017 Case Body Purpose Trans-lingual neuro-stimulation (TLNS) Technology combines pulsed electrical stimulation of the tongue with specially- designed sensory-motor conditioning exercises to effect rehabilitation of balance, posture, and gait symptoms resulting from neurological disorders. The goal of this research was to investigate how neurostimulation can facilitate physiotherapy in the rehabilitation of chronic stroke symptoms. It is important to note that no special cognitive training was applied in this study. Introduction Cognitive impairment is a typical consequence of many neurological disorders. It is generally accepted that most improvement for an individual affected by stroke occurs within the frst year following the stroke. However, our research shows that it is possible to rehabilitate stroke symptoms from the chronic stage of stroke. TLNS Technology, generally used to rehabilitate balance, posture, and gait, has a surprising impact on the recovery of cognitive function. In a case of chronic stroke, cognitive improvement was an exciting secondary result of a routine procedure designed to rehabilitate balance and gait, without any additional specifc training. TLNS Technology uses a combination of physical exercises and meditation with electrotactile stimulation to the tongue with a PoNSTM device. “Other existing neurostimulation techniques fall into one of two categories; invasive and non-invasive. Invasive techniques, such as deep brain stimulation (DBS) and vagus nerve stimulation (VNS), present a growing treatment option predominantly for neuropsychiatric disorders [1,2]. However, these techniques are rarely applied in treatments after stroke. Reports of disturbing side effects from DBS and VNS treatment have accumulated over time [3-6]. And treatment effects are limited to the severity of symptoms and time since injury. Due to the cost and invasiveness of DBS and VNS, there have been no human studies in healthy adults. Alternatively, TLNS treatment is cost-effective, non-invasive, and is yet to be limited by symptom severity. On the contrary, patients with more severe the symptoms typically experience more improvement using TLNS [7-9]. Non-invasive brain stimulation techniques have shown similarly promising potential to modulate brain plasticity in humans. In stroke specifcally, both sensorimotor and higher- order cognitive impairments, such as aphasia and neglect, have demonstrated varying degrees of recoverability [10]. However,