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  • "For surgeons, we’re going to be able to see the function well before we see the brain. And that’s going to make a huge impact on the outcome of the procedure."

    Mitchel Berger, M.D.
    Chairman of the Department of Neurological Surgery, Director of the Brain Tumor Surgery Program, University of California, San Francisco
  • "The integration of Navigated Brain Stimulation into the surgical workflow crucially improves preoperative planning,patient counseling, and surgical procedures."

    Thomas Picht, M.D.
    Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Germany
  • "Navigated Brain Stimulation is a standard of care in our department."

    Sandro M. Krieg, M.D.
    Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich

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The NBS System 5 is a Revolutionary Noninvasive Device for Presurgical Mapping

Navigated Brain Stimulation (NBS) by Nexstim, is the only CE marked and FDA cleared noninvasive solution to presurgical mapping of the motor cortex. The NBS System 5 adds navigation to transcranial magnetic stimulation (nTMS), creating a precise map of the eloquent cortex superimposed on a patient specific MRI.

NBS accurately locates the stimulating electric field (E-field) in the cortex, with the proven accuracy of direct cortical stimulation (DCS)1. The stereotactic camera provides visualization of the induced E-field, which is displayed in a 3D rendering of the individual patient’s MRI. Placing surface electrodes on the desired muscles, the 6-channel EMG records motor evoked potentials (MEPs) amplitudes and latencies. As the TMS coil is moved over the patient’s head, the operator can see, in real-time, the E-field location, strength and direction in the 3-D intracranial rendering, creating a map of the cortical somato­topy.

The patient’s motor responses are clearly marked as pegs color coded as a heat scale. Each mapping session can be stored to precisely replicate any session at a later date. The NBS System’s mapping results can be exported via DICOM to planning systems or directly into the neuronavigator. In the OR, Navigated Brain Stimulation maps help optimal placement of DCS electrodes and facilitates surgical guidance.

The Difference is Accuracy

Noninvasive Navigated Brain Stimulation has been shown to identify the motor eloquent cortex with +/- 2mm of direct cortical stimulation.1

Preserving what is Vital

Multiple clinical studies have proven that Navigated Brain Stimulation, as an adjunct to direct cortical stimulation, results in a 40% increase or greater, in the rate of gross total resection.2

Patient Experience

The NBS System’s mapping provides a completely noninvasive, safe and comfortable presurgical mapping experience for the patient. Mapping procedures are straight forward and can be performed in a hospital or office environment.

Increase in Gross Total Resection Rate

The Nexstim NBS System is indicated for noninvasive mapping of the primary motor cortex of the brain to its cortical gyrus. The NBS System provides information that may be used in the assessment of the primary motor cortex for pre-procedural planning.

Nexstim NexSpeech®, when used together with the NBS System, is indicated for noninvasive localization of cortical areas that do not contain essential speech function. NexSpeech® provides information that may be used in pre-surgical planning in patients undergoing brain surgery. Intraoperatively, the localization information provided by NexSpeech® is intended to be verified by direct cortical stimulation.

The Nexstim NBS System and NBS System with NexSpeech® are not intended to be used during a surgical procedure. The NBS System and NBS System with NexSpeech are intended to be used by trained clinical professionals.

References:

1 Preoperative multimodal motor mapping: a comparison of magnetoencephalography imaging,navigated transcranial magnetic stimulation, and direct cortical stimulation By: Phiroz E. Tarapore, M.D., Mitchel S. Berger, M.D., et. al Journal of Neurosurgery. 2012 Aug;117(2):354-62. doi: 10.3171/2012.5.JNS112124

2 Navigated transcranial magnetic stimulation improves the treatment outcome in patients with brain tumors in motor eloquent locations By: Frey D, P Vajkoczy, T Picht, et. al Neuro-Oncology. 2014 Jun 12. pii: nou110.

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