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  • "It assures me that what I am going to be doing that day or the next day is going to be as safe as possible, and create the greatest advantage to helping that patient without risking deficit."

    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. The detailed NBS maps open the door to surgery for many patients who are currently denied surgical treatment and enable more extensive resections - while at the same time leading to better neurological outcomes."

    Thomas Picht, M.D.
    Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Germany
  • "Navigated Brain Stimulation is a standard of care in our department. Moreover, since we were able to show that the presurgical mappings increase the extent of resection and reduce surgery-related paresis, the NBS data is also used for decision making in our neurosurgical tumor board and for outpatient consultation."

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

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.

In a recent study of 250 consecutive patients, presurgical mapping with Navigated Brain Stimulation enabled a more aggressive surgical strategy in more the 75% of the cases. The same study using navigated TMS (nTMS) disproved suspected involvement of primary motor cortex in over 25% of the cases, expanding surgical indication by 14.8%. Concluding that the integration of nTMS into the surgical workflow crucially improves pre-operative planning, patient counseling, and surgical procedures. Leading to longer progression-free survival rates and better neurological outcomes by expanding the indications and extent of resection.3

The Difference is Accuracy

Noninvasive Navigated Brain Stimulation has been proven 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 35% increase or greater, in the rate of gross total resection.2,3


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.


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 Preoperative motor mapping by navigated transcranial magnetic brain stimulation improves outcome for motor eloquent lesions By: Krieg SM, Ringel F, el. al Neuro-Oncology. 2014 Feb 9.

3 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.