TLNS vs PoNS: how the devices compare
People searching for "PoNS alternative" or "devices like PoNS" are usually asking one of three questions: is there a translingual neurostimulation device for a condition that PoNS® does not cover, is there one available outside the United States and Canada, and is there one that costs less than $28,000. This page answers all three with verifiable facts. PoNS® and RehaLine's TLNS system are two devices built on the same technology from the same scientific school; they differ in indications, geography, price and treatment model.
One technology, two devices
Translingual neurostimulation (TLNS) — earlier called cranial nerve non-invasive neuromodulation, CN-NINM — was developed at the Tactile Communication and Neurorehabilitation Laboratory (TCNL) of the University of Wisconsin–Madison by the group of Paul Bach-y-Rita, Yuri Danilov, Mitchell Tyler and Kurt Kaczmarek. PoNS® (Portable Neuromodulation Stimulator) was the first device to bring the method to market; it was developed by Helius Medical Technologies and, since April 2026, belongs to Bioness Medical. RehaLine's TLNS system is a separate device developed by a team from the same scientific line: Yuri Danilov, senior scientist of TCNL and co-author of the key TLNS publications, is the scientific lead of our program. Both devices deliver patterned electrical stimulation to the tongue during therapeutic exercise; the underlying mechanism, session length (20 minutes) and the principle of combining stimulation with training are the same. Read more about the method on our TLNS page.
Side-by-side comparison
| Parameter | PoNS® (Bioness Medical) | RehaLine TLNS system (4STIM) |
|---|---|---|
| Regulatory status | FDA-cleared (USA): gait deficit in mild-to-moderate multiple sclerosis (adults 22+), and, since 2026, chronic gait deficit after stroke. Health Canada: multiple sclerosis, traumatic brain injury, stroke. | Registered in Russia, Mexico (COFEPRIS), Uzbekistan and New Zealand; registration in progress in Brazil, Vietnam and the Philippines. Not FDA-cleared; not offered for sale in the USA. |
| Indications in clinical use | Multiple sclerosis, stroke, traumatic brain injury (Canada) | Cerebral palsy, stroke, traumatic brain injury, multiple sclerosis, vestibular and postural disorders; Parkinson's disease and cerebellar ataxia on the basis of clinical experience (no controlled trials yet) |
| Age of patients | Adults only | Adults and children from 2 years (pediatric program; controlled study of 134 children with cerebral palsy) |
| Where treatment is available | United States and Canada, through authorised clinics | Countries listed above — RehaLine clinics in Moscow and Tashkent and partner clinics; medical-travel program for patients from other countries |
| Treatment model | 14-week program: in-clinic phase followed by home use; prescription only | Supervised phase in the clinic (1–2 weeks), then home use with remote supervision; the device stays with the patient for repeat courses |
| Price of the device | List price $28,270 (controller $19,580 + mouthpiece $8,690); cash-pay price $24,029.50, per the manufacturer's FAQ | Several times lower; the price of a course depends on the country and program — request a quote |
| Evidence base of the technology | Shared: the TLNS literature — two randomized TBI trials (44 and 122 patients), MS pilot trials and a 2026 negative RCT, stroke pilot RCT, pediatric CP study. See all 54 publications. | |
Sources for the PoNS® column: the manufacturer's "Frequently asked questions" page (ponstherapy.com), FDA 510(k) records, Health Canada device licence. We update this table when these sources change; if you find an outdated figure, write to info@4stim.com.
What this means for a patient
If you live in the United States or Canada and have multiple sclerosis or a chronic stroke gait deficit, PoNS® is the device that is cleared for you, and a local PoNS clinic is the right first call. If your condition is not on that list — cerebral palsy in a child, Parkinson's disease, a vestibular disorder, or traumatic brain injury outside Canada — or you live in a country where PoNS® is not sold, RehaLine's TLNS program is the way to get the same technology. Describe your case to our Telegram assistant; a specialist will tell you whether TLNS is indicated and where the nearest course is.
What this means for a clinic or distributor
A clinic that wants to add TLNS to its services outside the USA and Canada can obtain the equipment, the treatment methodology and staff training from RehaLine as one program, starting with a 90-day clinical pilot. Details are on the partnership page.
Frequently asked questions
Is the RehaLine device a copy of PoNS®?
No. It is an independent device from a team of the same scientific school. Its electronics, electrode array and stimulation protocols are its own; the physiological principle — translingual stimulation combined with exercise — is common to the whole TLNS field.
Can I buy the RehaLine device in the United States?
No. The device is not cleared by the U.S. FDA and is not offered for sale in the United States. Patients from the USA can take a course in one of our clinics or in a partner clinic in a country where the device is registered.
Is the treatment the same as PoNS Therapy®?
The structure is similar: 20-minute sessions of stimulation combined with targeted exercises, a supervised phase and a home phase. Our protocols are adapted to each indication, including a pediatric protocol organised in 10-day cycles.
Why is the price so different?
Different cost structure: our device is produced and registered outside the U.S. medical-device pricing system, the program is delivered through our own and partner clinics rather than a distributor network, and the device is designed to stay with the patient for repeat courses instead of being re-issued per program.
PoNS® and PoNS Therapy® are trademarks of their respective owner. 4STIM and RehaLine Group are not affiliated with Bioness Medical, Helius Medical Technologies or their partners. Product names are used only to identify the products being compared. The RehaLine TLNS device is not cleared by the U.S. FDA and is not offered for sale in the United States.