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  • "What makes this so special is the ability for it to define very small, precise cortical regions on the surface of the brain, and define individual components of function which is something we never could do before."

    Mitchel Berger, M.D.
    Chairman of the Department of Neurological Surgery, Director of the Brain Tumor Surgery Program, University of San Francisco

NexSpeech® with the NBS System 5 is a robust, intuitive technique for speech mapping and offers a noninvasive method to reliably determine non-eloquent speech areas prior to a surgical procedure.

NexSpeech® employs similar disruption techniques as direct cortical stimulation yet is completely noninvasive. The maps can be readily interpreted by physicians and shared with patients for improved dialogue and more informed decision making. Reliable information prior to the treatment decision may enable more patients to be offered a surgical option for brain tumors, and a more informed approach may lower risk of damage to eloquent cortex. NexSpeech® maps can also save significant operating room time.

Intra-cranial electric fields induced by trains of rTMS create a virtual lesion that can temporarily disrupt local cortical function resulting in speech errors. In a NexSpeech® mapping session, the patient performs a naming task of everyday objects. Visualization of the electric field in a 3D MRI rendering of the cortex helps the operator map the desired areas around the tumor. As the stimulation coil is moved over a presumed speech area, trains of rTMS are delivered. The rTMS is synchronized with each image and the patient’s behavior during the naming task is recorded on video for later analysis.

Compatible with Surgical Neuronavigators

After analysis of the behavioral responses to rTMS, the language mapping results are displayed in the 3D MRI rendering of the patient’s head. NexSpeech® reliably determines cortical locations not containing essential speech functions, resulting in a negative map of language eloquent regions. Like NBS motor maps, NexSpeech® maps can be seamlessly exported to other planning systems and surgical neuronavigation systems.

NexSpeech® mapping results can also be used as seed points for diffusion tensor imaging (DTI), giving better information on the white matter fiber tracts involved in language production.