Treatment
Somatosensory stimulation
Specific stimulation of brain regions
What is Somatosensory stimulation?
Somatosensory Evoked Potentials (SSEP) is a neurophysiological assessment technique that measures the rate and quality of electrical information transmitted from a peripheral nerve to the parietal or somatosensory cortex. This assessment technique is used to identify neurological disorders.
Over the decades, however, researchers realized that this assessment technique could facilitate neuroplasticity through the manipulation and adaptation of somatosensory maps. This via a non-invasive, electrical, neuromuscular stimulator that delivers an asymmetric biphasic pulse to a specific point on the skin.
This therapy is called noninvasive neuromodulation (NINM), or more specifically, repetitive peripheral somatosensory stimulation (RPSS). Regardless of what it is called, the stimulation does not cause pain, but instead is reported to feel like a slight tapping, tingling or pounding over the contact point.
Why is somatosensory stimulation important?
The target area of the brain, called the somatosensory system, consists of modalities of touch, vibration, temperature, pain and kinesthesia (sense of movement). Because perception of all external and internal stimuli is integrated in the brain, the evoked potentials generated in the periphery are transmitted through pathways in receptors in the skin, nuclei in the spine, brain stem, thalamus and cerebral cortex, among others.
A topographical map, known as the homunculus, is located in the primary somatosensory cortex (parietal lobe), as well as in the primary motor cortex (frontal lobe). It represents the amount of cortex assigned to a specific body part and its specific function.
It is important that these body maps be accurate because of the many sequential areas related to, coordinated with or integrated with the sensations mentioned above. These areas include, but are not limited to, the vestibular system (balance/perceptual movement), frontal lobe (executive function/motor planning), posterior parietal cortex (spatial orientation) and cerebellum (motor coordination).
Functional impairment in any of these areas can cause these maps to be altered, skewed or misrepresented. This results in symptoms of spatial disorientation, postural abnormalities, dizziness, oculomotor dysfunction, movement disorders and/or motor planning.
Your road to recovery
One week of intensive treatment
Step 1
The Functional Neurological Examination (FNE)
You tell us about your complaints. We will ask you the necessary questions about this and do a complete Neurological Examination. We determine if you are a suitable candidate for our treatment.
Step 2
Advanced Machine Testing (quantification)
Based on Step 1, we determine what test are necessary to quantify the underlying cause of the symptoms. To do this, we use a range of computer-controlled equipment.
Step 3
Rehabilitation week (in 5 days)
We address the problems. Through an individual program specifically tailored to your problems, we bring back function during an intensive week of treatment.
Step 4
Aftercare
After the 5-day intensive treatment week, we will give you homework assignments. These are exercises that further promote your recovery. We are happy to keep an eye on these developments with you.
How does somatosensory stimulation work?
In addition to modulating and correcting somatotopic maps, research has shown that NINM stimulation also has a positive effect on cognitive states, blood pressure/autonomic function and on balance and stability. When NINM stimulation is applied to specific areas, such as locations on the face, it can even promote visual acuity.
This phenomenon occurs through a series of reflex arcs that integrates into the brainstem, the primary area for consciousness and autonomic regulation. Located on the palmar, thumb side of the wrist, the median nerve, when stimulated, provides peripheral access to the Ascending Reticular Activating System (consciousness center) in the brainstem.
It stands to reason, therefore, that stimulation of this pathway has been shown to be sufficient to cause clinical improvement, in many conditions involving altered states of consciousness. Think, for example, of Alzheimer’s disease and even in patients in a coma.
The trigeminal nerve, originating in the brain stem, innervates the face through three separate branches. Stimulation of any of these branches (ophthalmic, maxillary, mandibular) stimulates a reflex known as the trigeminal cardiac reflex (TCR).
Within seconds of initiation or stimulation, potent and differential activations of sympathetic pathways are activated, attenuating physiological homeostatic responses such as baroreceptors and chemoreceptor reflexes for blood pressure regulation.
What can somatosensory stimulation be used for?
Stimulation of the tongue has been shown to stimulate an area of the brainstem, specifically in the area of the pons. This region is important because of the nuclei that originate here, including vestibular, trigeminal and solitary nuclei.
The trigeminal nuclei receive somatosensory information from the tongue, while the solitary nuclei receive information about taste. Because of such complex and coordinated interactions between these structures, SSEP to the tongue may be involved in resolving various symptoms.
These are symptoms such as hypersensitivity to visual stimuli in balance, anxiety disorders, balance disorders in migraine disorders and interoception (physiological sense of well-being).
What to expect during treatment
What can you expect after treatment?
After treatment during our intensive treatment week, you can expect quick to very quick results. It is likely that you will still be tired for the first few days/weeks because your brain needs to process all the activity of the past week. However, your brain is resilient and adapts well due to its neuroplasticity. You may be a little more irritable during this period and sometimes experience mild headaches. However, this is temporary; there are no permanent side effects. With the passage of time, these symptoms will disappear and you will begin to notice more and more the effect of the therapy.
