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Leading the way in navigated stimulation of the brain

With over 100 installations worldwide, Nexstim’s NBS System is playing a growing role in helping plan critical brain surgery – and opening up the way for new, non-invasive therapy in areas such as depression, stroke rehabilitation, and pain management.

Nexstim’s Navigated Brain Stimulation (NBS) System employs transcranial magnetic stimulation (TMS) generated by a small electromagnetic coil held close to the head to gently stimulate precise areas of the cortex of the brain and measure the resulting effect on the central nervous system and peripheral nerves. Using information acquired from a separate standard head MRI scan, the NBS System generates and displays a 3D model of the patient’s brain.

A standard stereotactic navigation system, comprising a camera and optical trackers, allows the operator to guide the coil over the head, knowing where the stimulating electrical field is targeted in the brain at all times. Thanks to a special pair of glasses fitted with optical markers for tracking patient movement and adjusting measurements accordingly, the procedure is virtually stress-free for the patient.

The latest version of the NBS System combines MRI-guided TMS with EMG measurement and incorporates DICOM export to surgical planning systems, surgical navigators, and microscopes. It also features NexSpeech®, a unique method that extends the application of the NBS System to pre-surgical localisation of speech areas in the human cortex. As a result, the NBS System now has the potential to help lower the risk of damage to the speech eloquent cortex, as well as shorten operating times. Even more importantly, it could well allow more patients with brain tumours to benefit from surgery.

New hope for people suffering strokes and severe depression

Nexstim recently took its technology another step further with the launch of the Navigated Brain Therapy (NBT) System, the first CEapproved personalised magnetic stimulation solution for treating severe depression and for use in stroke rehabilitation work. The NBT System is the first in what promises to be a new line of therapy products from Nexstim.

The unique navigation feature of NBT enables the user to visualise the electric field inside the patient’s brain and target therapy directly to the cortical structures believed to be crucial for the control of mood and associated with depression. This eliminates the unscientific ‘hit and miss’ errors inherent in other devices and enables treatment sessions to be exactly replicated for each and every patient.

Non-invasive, navigated brain therapy has been shown to be safe, well-tolerated, and free of the side-effects frequently associated with oral antidepressants. A course of therapy with NBT is a painless outpatient procedure and is typically performed in the physician’s office.

Navigated brain therapy has also been shown to be effective in improving paretic limb function in stroke patients. A study by the Research Institute of Chicago has shown that 80% of stroke patients treated with navigated brain therapy, together with conventional physiotherapy, improved in a clinically meaningful way six months after treatment, compared to only 20% of patients who received conventional physiotherapy and sham stimulation. 

The new NexSpeech® module enables the NBS System to produce a map of cortical areas vital for speech and motor functions, which can then be displayed in a patient’s MRI.

> Henri Hannula
(Published in HighTech Finland 2013)