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Diagnosing and healing the brain more effectively

Nexstim’s NBS System was recently cleared by the Food and Drug Administration in the US for use in the assessment of the primary motor cortex for pre-procedural planning. This makes Nexstim the first-ever company able to sell TMS-based technology to hospitals for clinical diagnostic purposes

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 a 3D model of the patient’s brain and displays it on the system’s computer screen.

A standard stereotactic navigation system, comprising a camera and optical trackers, allows the operator to guide the coil over the head, knowing where it is in relation to the brain structure 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.

A new version of the NBS System was launched in September 2010. Known as System 4.0, this combines MRI-guided TMS with EMG measurement and incorporates DICOM export to surgical planning systems, surgical navigators, and microscopes. Fully self-contained and mobile, the new system does not require a dedicated room or fixed installation and takes up less than 0.6 m2 of floor space.

New non-invasive options

Nexstim’s NBS System is the first solution to offer high levels of accuracy and confidence for cortical mapping and complex neurodiagnostics, together with uniquely integrated systems for maximum ease of use.
While it has long been known that the human brain has an immense capability to adapt to new demands, such as learning new skills, it has only been discovered recently that our ability to overcome the consequences of unexpected brain illness or trauma is heavily dependent on the same capability.

Studies have shown that repetitive TMS – based on short bursts of 5-10 Hz stimulation – can ‘knock out’ a stimulated spot of the brain responsible for specific actions, such as speech, on a temporary and fully reversible basis. With its NBS technology, Nexstim has a significant opportunity to help the natural healing processes of the brain in a number of fields. NBS can be used to help stroke patients recover more rapidly and even regain the use of a paralysed arm or leg, for example.

Installed at over 60 hospitals worldwide, the NBS System is now in clinical use for planning brain surgery, with additional diagnostic applications including stroke. The ability of NBS to target stimulation within the brain very precisely and reproducibly opens the door for new, non-invasive therapy options for a wide range of brain injuries and diseases, including stroke rehabilitation, depression, and pain.

> Henri Hannula
(Published in HighTech Finland 2011)