Nexstim nTMS for the treatment of OCD

Target brain networks effectively

At Nexstim, we apply decades of expertise in neuroscience and imaging to support non‑invasive, non‑drug TMS treatment for OCD. Combining TMS with 3D brain imaging, we provide clinicians with navigated guidance to deliver the FDA‑cleared OCD treatment protocol with unsurpassed accuracy and precision. 

Transcranial magnetic stimulation (TMS) is a non‑invasive therapy that uses brief magnetic pulses to stimulate targeted areas of the brain. Because it does not involve medication, TMS is not associated with the systemic side effects that can occur with drug‑based treatments. Nexstim navigated TMS for the treatment of obsessive-compulsive disorder is an FDA‑cleared therapy option.

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What is SmartFocus® nTMS?

Nexstim NBS 6 with SmartFocus® nTMS technology uses sophisticated navigation tools to visualize the location, orientation and magnitude of the maximum stimulating electric field (E-field) induced when the TMS coil is activated. SmartFocus® nTMS takes into account the unique shape and conductivity of each patient’s brain and the positioning of the coil and uses this information to determine the location and orientation of the maximum induced E-field in the brain.

In addition, advanced algorithms enable the stimulation dose to be quickly and accurately determined for each patient using their own neurophysiological readings. This all makes Nexstim nTMS a truly personalized and accurate nTMS therapy.


SmartFocus® nTMS treatment offers the patient:

  • A measured and individualized dose of TMS
  • TMS with the accuracy demanded by brain surgeons
  • Treatment sessions personalized for the patient and his or her brain
  • Assurance the patient receives his or her prescribed dose every time
  • Unsurpassed safety and comfort

 

For clinicians, SmartFocus nTMS supports:

  • Real‑time visualization of coil position relative to individual anatomy
  • Consistent alignment with the planned stimulation site
  • Reproducible set-up and delivery across sessions
  • A navigated workflow designed to enhance confidence in protocol execution

Why Nexstim E-Field Navigated TMS is Different?

 

Coil navigation assumes that the stimulation projects perpendicularly from the coil. It does not account for the refraction of the stimulating electromagnetic field caused by bone and brain matter. Nexstim’s E-field navigation takes that refraction into account. Only through visualization of the stimulating E-field it is possible to achieve the precision and accuracy necessary to confirm the right dose is being delivered to the right location.

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Frequently Asked Questions about opening an nTMS clinic

Here are some answers to frequently asked questions we receive from physicians looking to open an nTMS clinic.

Indications for use and patient safety

INDICATIONS FOR USE

Obsessive-Compulsive Disorder (FDA clearance, for information on other regional clearances contact Nexstim):

Indications for use: NBS 6 is indicated as an adjunct for the treatment of adult patients suffering from obsessive-compulsive disorder (OCD).

Major Depressive Disorder (CE mark, FDA clearance, for information on other regional clearances contact Nexstim):

Indications for use: NBS 6 is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode. NBS 6 is intended to be use by trained clinical professionals.

Adolescent Major Depressive Disorder (FDA clearance, for information on other regional clearances contact Nexstim):

Indications for use: NBS 6 is indicated as an adjunct for the treatment of MDD in adolescent patients (age 15-21). 

Chronic Neuropathic Pain (CE mark, for information on other regional clearances contact Nexstim):

Intended purpose: In adult patients suffering from chronic unilateral neuropathic pain, NBS 6 is intended to provide electric field navigated noninvasive repetitive TMS stimulation as therapy to alleviate pain. NBS 6 is intended to be used by trained clinical professionals.

Nexstim NBS 6 is not cleared by the FDA for commercial use of the treatment of chronic pain in the United States, for investigational use only.

Pre-procedural Mapping (CE mark, FDA clearance, for information on other regional clearances contact Nexstim):

Indications for use: NBS 6 is indicated for noninvasive mapping of the primary motor cortex of the brain to its cortical gyrus. NBS 6 provides information that may be used in the assessment of the primary motor cortex for pre-procedural planning. NBS 6 is indicated for noninvasive localizations of cortical areas that do not contain essential speech function. NBS 6 provides information that may be used in pre-surgical planning in patients undergoing brain surgery. Intraoperatively, the localization information provided by NBS 6 is intended to be verified by direct cortical stimulation. NBS 6 is not intended to be used during a surgical procedure. NBS 6 is intended to be used by trained clinical professionals.

Post-operative Rehabilitation (CE mark, for information on other regional clearances contact Nexstim):

Intended purpose: NBS 6 is intended to be used for the treatment of surgically induced new or worsening post-operative motor deficits of the upper limb as an adjunct therapy for motor rehabilitation in adult patients having undergone brain tumor surgery. NBS 6 is intended to be used by trained clinical professionals.

Nexstim NBS 6 is not cleared by the FDA for commercial use of post-operative rehabilitation in the United States, for investigational use only.

NBS 6 THERAPY SHOULD NOT BE GIVEN TO

  1. Patients with non-removable conductive, ferromagnetic, or other magnetic-sensitive metal anywhere in the head or within 30 cm (12 in) of the stimulation coil. Examples include cochlear implants, implanted electrodes or stimulators, aneurysm clips or coils, stents, bullet fragments, ocular implants, and stents.
  2. Patients who have an active or inactive implanted device (including device leads), including deep brain stimulators, cochlear implants, cardiac pacemakers, and vagus nerve stimulators. Contraindicated use could result in serious injury or death.
  3. Patients with increased intracranial pressure or patients with intracardiac lines, intravenous pumps, or dose calculators. 

Failure to follow these restrictions could result in serious injury or death.

RISKS AND SIDE EFFECTS

Seizures (convulsions): Cortical magnetic stimulation runs the risk of inducing seizures; although they are rare. Under ordinary clinical use, the estimated risk of seizure is approximately 1 in 30 000 treatments (0.003%) or 1 in 1000 patients (0.1%). 

Headache: The most common side effects reported during clinical trials are mild headache (~50% of TMS treatment group) and scalp pain or discomfort (35.8%). In general, headache and pain on the stimulation site have been generally mild to moderate and occurring less frequently after the first week of treatment. The reason for headache may be the tension of scalp and neck muscles due to an uncomfortable and stressful situation.

Muscle Twitching:  You may feel twitches in the muscles of your arm, leg or face during the magnetic stimulation. This is a common sensation but not hazardous. The twitches will stop when the magnetic stimulation stops.

Skin Irritation:  There is a small risk of mild skin irritation at the location where the muscle electrode sensors have been placed, but this usually consists of minor redness that will go away quickly after they are removed.

Changes in hearing:  The loud “click” produced by the TMS stimulator can cause temporary hearing changes following treatment. This is prevented by wearing soft foam ear plugs during treatment. No problems with hearing due to TMS have ever occurred when earplugs have been properly worn.