Webinars and Talks on the Latest Advancements on nTMS

Nexstim Podium

Nexstim Webinars

We are bringing renowned speakers to you free of charge, pulling together some of the most exciting talks from the past few months and offering researchers and clinicians a virtual podium to showcase their most recent work live.

Webinars and Talks On-Demand

Have a look at our video offerings by topic:

 

If you would like us to notify you on topics of interest to you, please fill out the form at the bottom of this page

 

Interested in a live demo of nTMS?

Our team of physicians, researchers, and engineers is prepared to answer your questions. If you would like to learn more or set up a virtual demonstration for your team, please contact us at info@nexstim.com

Pain

Dr. Joshua Kuluva, MD:

Treating comorbid depression and pain with TMS

Dr. Joshua Kuluva showcases the comorbidity of depression and chronic neuropathic pain:

  • Learn more about depression-pain syndrome and neurobiological correlates
  • See how Dr. Kuluva treats patients at the Piedmont Neuroscience Center
  • See the results on pain scores and depression symptoms

Please note that Nexstim nTMS Systems do not have FDA clearance for the treatment of chronic neuropathic pain, for investigational use only.

 

 


Dr. Selja Vaalto, MD:

nTMS in Pain Therapy: Who to treat and best practice protocols

Dr. Selja Vaalto tells how nTMS is used in pain therapy in Helsinki University Hospital, Finland:

  • See the profiles of patients who responded to rTMS therapy for chronic neuropathic pain
  • Learn about primary and secondary targets
  • See how stimulation parameters vary depending on type of pain

Please note that Nexstim nTMS Systems do not have FDA clearance for the treatment of chronic neuropathic pain, for investigational use only.

Post-operative paresis

Dr. Sebastian Ille, MD:

Pioneering rTMS therapy in neurosurgery: a randomized double blinded trial

Dr. Sebastian Ille presenting the results of a randomized, double-blinded study on navigated rTMS therapy after neurosurgery: 

  • See how the team at TU Munich uses low frequency rTMS combined with physical therapy
  • Learn more about how the Fugl-Meyer Assessment score improves after treatment

Please note that Nexstim nTMS Systems do not have an FDA clearance nor a CE mark for postoperative paresis treatment. TU Munich is utilizing the Nexstim NBS System for post-operative paresis as a research utility only.

 

 


 

 

Prof. Dr. med. Sandro Krieg, MBA

Navigated TMS improves outcome of postsurgical paresis in glioma patients - A randomized, double-blinded therapy trial

Prof. Sandro Krieg, MD, discusses a recently published study that suggests that patients who suffer from a severe decline in hand function after brain tumor surgery can be treated post-operatively for 7 days with 15 minutes of nrTMS plus 30 minutes of physiotherapy, per day.

  • Understand how the 7-day protocol is implemented.
  • Learn the methodology behind the study protocol which stems from prior studies on stroke rehabilitation.
  • See detailed results comparing active and control groups using a variety of assessments.

Please note that Nexstim nTMS Systems do not have an FDA clearance nor a CE mark for postoperative paresis treatment. TU Munich is utilizing the Nexstim NBS System for post-operative paresis as a research utility only.


Dr. José Lavrador, MD

Navigated Repetitive TMS for Motor Rehabilitation: Anatomo-Functional Study and Clinical Implications

Dr. José Lavrador (MD) presenting on navigated repetitive TMS for motor rehabilitation:

  • Hear how the team at King's College used rTMS stimulation to promote rehabilitation of the upper limb motor area
  • Find out how nTMS and IOM were combined to predict outcomes
  • See videos of patients before and after undergoing rTMS treatment

Please note that Nexstim nTMS Systems do not have an FDA clearance nor a CE mark for postoperative paresis treatment. King's College Hospital is utilizing the Nexstim NBS System for post-operative paresis as a research utility only.

 

 

 


 

 

Dr. Sarah Prinsloo, PhD

Post-operative rehabilitation: learnings & outcomes

Dr. Sarah Prinsloo, PhD on post-operative rehabilitation: 

  • Hear about a recent study at MD Anderson Cancer Center, during which patients receive nTMS stimulation and physical therapy after brain surgery
  • See an AR-visualization of the surgical cavity with nTMS stimulation points
  • Learn how the team used nTMS combined with EEG to measure the effect of TMS on different cortical networks 

Please note that Nexstim nTMS Systems do not have an FDA clearance nor a CE mark for postoperative paresis treatment. MD Anderson is utilizing the Nexstim NBS System for post-operative paresis as a research utility only.

Pre-operative mapping

Prof. Dr. Bernhard Meyer, MD:

Getting away from awake surgery after 12 years of nTMS

Prof. Bernhard Meyer on getting away from awake surgery after 12 years of nTMS:

  • Hear how nTMS is used for risk assessment prior to neurosurgery
  • Find out when the team at TU Munich performs awake craniotomies as opposed to resections based solely on nTMS mapping
  • Learn more about how connectome analysis may provide additional stratification for awake vs. asleep surgeries

Dr. Francesco Vergani, MD:

Pre-surgical Motor Mapping as a Signature for Tumour Grading

Dr. Francesco Vergani, MD on pre-surgical motor mapping as a signature for tumour grading:

  • Hear how the team at King's College performs motor mappings
  • See the concordence of nTMS and DCS
  • Learn about the impact of glioma grading on the exitability of the motor cortex, assessed with nTMS

Prof. Dr. med. Sandro Krieg, MBA

How to use the nTMS data in the OR after risk assessment by presurgical tractography using navigated TMS maps in patients with highly motor- or language- eloquent brain tumors

Prof. Sandro Krieg, MD, discusses how to use nTMS data both pre-operatively and intra-operatively in an effort to achieve higher gross total resection rates and minimize post-operative deficits.

  • See how non-invasive nTMS motor and language mapping is being used pre-operatively and intra-operatively for brain tumor resection.
  • Learn how nTMS and nTMS-seeded DTI data enables clinicians to quantify surgery-related deficit risk pre-operatively.
  • See clinical evidence demonstrating the difference in outcomes for resections done with and without pre-operative nTMS.

 

 

 


 

 

PD Dr. med. Sebastian Ille

Non-invasive mapping for effective preoperative guidance to approach highly language-eloquent gliomas -- A new classification for language eloquence

Dr. Sebastian Ille, MD, discusses non-invasive nTMS language mapping and details the clinical workflow, including the pre- and intra-operative use of nTMS data results.

  • Details how non-invasive nTMS language mapping is being used clinically, both pre-operatively and intraoperatively, as well as in the research setting.
  • Learn how nTMS mapping has impacted clinical decision-making towards or against awake surgery.
  • Introduces a grading system to make language eloquence comparable between studies, cohorts, and individual patients.

Dr. Francesco Vergani, MD

TMS for Presurgical Mapping of Tumours in Eloquent Areas

Dr. Francesco Vergani, MD, tells in this webinar about the use of nTMS for presurgical mapping of tumours in eloquent areas in King's College Hospital, London:

  • See how nTMS, DTI, and intraoperative mapping can be integrated cohesively into the clinical workflow
  • Learn how the non-invasive nTMS measurement of cortical excitability levels relates to the WHO tumor grading scale
  • View case examples showing the benefits of nTMS on tumor patients and how the nTMS results can indicate surgery even in patients initially deemed inoperable

 

 

 


Professor Peter Vajkoczy, MD:

nTMS in Academic Neurosurgical Center - 10 year's experience

Professor Peter Vajkoczy, MD tells about their experiences on using nTMS at Charité – Universitätsmedizin Berlin:

  • Enabling safer and more aggressive approaches for neurosurgical and radiotherapy treatments
  • New indications explored, including neurovascular and degenerative cervical myelopathy cases
  • Take a glance at new methods for nTMS-seeded DTI for speech mapping

Professor Sujit Prabhu, MD:

Validation of Pre-Operative Language Mapping Modalities

Professor Sujit Prabhu, MD from MD Anderson Cancer Center tells about validation of pre-operative language mapping modalities:

  • See case studies comparing fMRI, nTMS, and DCS for language mapping
  • Is it safe to resect? A look into the value of negative predictive value

TMS Basics & Pediatrics

 

 

Dr. Melissa Tsuboyama:

Presurgical functional brain mapping with nTMS in children

Dr. Melissa Tsuboyama talks about TMS brain mapping for the pediatric population:

  • Learn how nTMS motor and language mapping can be used in the presurgical evaluation process

  • Find out how nTMS exams are conducted in practice and how children experience the exam

  • See case examples from Boston Children's Hospital


Dr. Alexander Rotenberg, MD:

TMS and Motor Mapping Fundamentals

Dr. Alexander Rotenberg, MD, tells in this webinar about TMS Motor Mapping:

  • History and fundamentals of motor mapping, including an overview of stimulation protocols and the neurophysiological basis for TMS evoked electric potentials

  • Discussion includes unique advantages of nTMS over other mapping techniques with regard to the pediatric community

  • Using TMS as a quantitative measure for target engagement in pharmacological evaluation studies

 

 


 

 

Dr. Shalini Narayana:

TMS Language Mapping in Children: Challenges and Opportunities

Dr. Shalini Narayana tells in this webinar about TMS language mapping in children:

  • Learn how nTMS language mapping plays a critical role in the presurgical evaluation process for young children.

  • See case examples and demonstrations that present how nTMS language mapping can be tailored to meet the needs of children.

  • Understand why the “negative predictive value” of nTMS language mapping is key for presurgical evaluation.

  • Click here for Speaker’s recent paper comparing MEG vs nTMS and here for additional literature on Nexstim language mapping.

     


Dr. James Wheless, MD:

Integrating TMS into Clinical Practice

Professor James Wheless, MD, tells in this webinar about the integration of TMS into clinical practice.

  • Compares the pre-surgical evaluation process for children with epilepsy, with and without nTMS

  • See case studies demonstrating where nTMS can validate surgical treatment when MEG and fMRI results remain inconclusive

  • Learn how nTMS graphical data can assist with risk/benefit discussions during patient family consultations

  • See examples of how the passive nature of nTMS motor mapping facilitates consistent and reliable results in young children

 

 

TMS-EEG

Prof. Laura Marzetti:

EEG functional connectivity to inform brain state dependent stimulation

Prof. Laura Marzetti presents on the combination of resting state EEG, TMS and EMG for brain state dependent stimulation:

  • Learn more about brain state dependent stimulation approaches
  • Learn more about motor network connectivity 
  • Hear more about Prof. Marzetti's plans for real time connectivity-based triggering

Please note that Nexstim nTMS Systems do not have an FDA clearance nor a CE mark for the use of TMS-EEG. The University of Chieti-Pescara is utilizing the Nexstim NBS System for TMS-EEG as a research utility only.

 

 


 

 

Adj. Prof. Pantelis Lioumis

nTMS-EEG mapping of different cortical networks

Adj. Prof. Pantelis Lioumis talks about mapping cortical networks with TMS-EEG: 

  • Understand the importance of navigation for TMS-EEG research
  • See how TMS-EEG can be used to study activation effects of brain networks
  • Hear more about multi-locus TMS research, currently conducted at Aalto University

Please note that Nexstim nTMS Systems do not have an FDA clearance nor a CE mark for the use of TMS-EEG. Aalto University is utilizing the Nexstim NBS System for TMS-EEG as a research utility only.


Silvia Casarotto, PhD / Sasha D'Ambrosio, PhD / Mario Rosanova, MD, PhD / Simone Russo, MD / Kevin Caulfield / Matteo Fecchio, PhD

TMS-EEG workshop (on-demand recording)

During this workshop, experienced researchers in the field perform a live measurement session with neuronavigated TMS-EEG. Their approach in this workshop represents a strategy for maximizing the impact of TMS on the cortex while minimizing the contribution of artifacts and confounding factors, thus ultimately facilitating the collection of reliable brain responses to direct and non-invasive perturbation of different cortical targets. 

  • See how to mask the coil's click with the help of a customized noise-masking generator (TAAC - TMS-Adaptable Auditory Control software tool) 
  • Learn how the quality of TMS-evoked EEG potentials can be effectively assessed during data collection through a dedicated real-time software tool (rt-TEP - real-time TMS-evoked EEG potential)

 

 

 


 

In the end of this live webinar a few more questions were asked but there was no time to answer them. You can find the questions and Dr. Casarotto's answers via this link in a written format.

Dr. Silvia Casarotto, PhD

How to collect and distinguish genuine EEG responses to nTMS

Dr. Silvia Casarotto, PhD, tells in this webinar about how to collect and distinguish genuine EEG responses to nTMS.

  • See how to optimize TMS parameters, such as stimulation intensity, based on real-time EEG feedback and reduce signal artifacts.
  • Learn pre-processing and post-processing steps that may reduce pulse and muscle artifacts.
  • Get a sneak peek at an upcoming software tool developed by the speaker that offers a customized display of TMS-EEG data in real-time.

 


Dr. Marcello Massimini, MD

How we can probe changes in cortical circuits with EnTMS-EEG

Dr. Marcello Massimini, MD, tells in this webinar about the use of E-field navigated TMS together with EEG to probe and examine changes in cortical circuits.

  • See how EnTMS-evoked EEG signals change characteristically under different states of vigilance and brain injury, including coma and stroke

  • Learn how EnTMS-EEG offers a reliable and repeatable brain-based index of consciousness, independent of sensory processing, executive and motor functions

  • Understand how EnTMS-EEG overcomes current challenges in assessing the level of consciousness in unresponsive patients and potentially offers a tool to predict functional outcomes and guide intervention

  • View videos demonstrating the set-up and implementation of EnTMS-EEG

 

 

 

 

 

In the end of this live webinar two more questions were asked but there was no time to answer them. You can find the questions and Dr. Massimini's answers via this link in a written format.

Spinal Cord Injury

Dr. Anastasia Shulga, MD:

Neurological motor rehabilitation: current status and latest protocol developments of spinal cord injury patients' rehabilitation with PAS

Dr. Anastasia Shulga, MD, talks about the combination of PAS (paired associative stimulation) with high-frequency PNS (peripheral nerve stimulation) and E-field guided high-intensity TMS as a potential therapy for spinal cord injury patients:

  • See before and after videos of patients suffering from spinal cord injury, showing restoration of upper and lower limb motor function after PAS
  • Learn which parameters the team at Helsinki University Hospital utilizes to achieve promising results
  • Hear about a currently ongoing, sham-controlled, double-blind, randomized clinical trial

 

 

Please note that Nexstim nTMS Systems do not have an FDA clearance nor a CE mark for spinal cord injury rehabilitation. Helsinki University Hospital is utilizing the Nexstim NBS System for chronic spinal cord injury therapy as a research utility only.


 

 

 

Dr. Anastasia Shulga, MD

Potential novel therapy for spinal cord injury patients — PAS with high-frequency PNS and E-field guided high-intensity TMS: success stories and future directions

Dr. Anastasia Shulga, MD, tells in this webinar about the use of PAS with high-frequency PNS and E-field guided high-intensity TMS for potential novel therapy for spinal cord injury patients:

  • Watch before and after videos of multiple SCI cases, demonstrating restoration of upper and lower limb motor function after PAS with nTMS

  • See how nTMS can allow one to target precisely defined motor cortex areas with corresponding nerves

  • Get a sneak peek at current and future projects, including a sham-controlled double-blind randomized clinical trial

 

Please note that Nexstim nTMS Systems do not have an FDA clearance nor a CE mark for spinal cord injury rehabilitation. Helsinki University Hospital is utilizing the Nexstim NBS System for chronic spinal cord injury therapy as a research utility only.

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Nexstim NBS 5 for Pre-Surgical Mapping: Indications for use

The Nexstim Navigated Brain Stimulation (NBS) System 5 is indicated for non-invasive mapping of the primary motor cortex of the brain to its cortical gyrus. The Nexstim NBS System 5 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 5, is indicated for non-invasive 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. Intra-operatively, the localization information provided by NexSpeech® is intended to be verified by direct cortical stimulation.

The Nexstim NBS System 5 and NBS System 5 with NexSpeech® are not intended to be used during a surgical procedure.

The Nexstim NBS System 5 and NBS System 5 with NexSpeech® are intended to be used by trained clinical professionals.

 

Nexstim NBS 6 for Depression Therapy: Indications for use

INDICATIONS FOR USE

CE mark and FDA clearance (K170902, K182700): Nexstim 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 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

INEFFECTIVE TREATMENT

There is no evidence that single therapy sessions would improve mood.  rTMS treatment effects in reducing depression are temporary, and patients may need to continue other forms of depression therapy. Relapse into depression is likely without follow-up treatment. Notify your doctor in case of worsening depression or suicidality. 

CAUTION: SPECIAL POPULATIONS

All patients must be screened for the characteristics listed in this section and excluded without clear benefit or compelling clinical reason.
The safety and effectiveness of Nexstim TMS treatment has not been established in the following patient populations:

  • Younger than 22 years or older than 70 years
  • Suicide plan or recent suicide attempt
  • History of concurrent use of electroconvulsive therapy (ECT) or vagus nerve stimulation (VNS)
  • Depression secondary to a general medical condition or substance-induced
  • Seasonal affective disorder
  • History of substance abuse, obsessive compulsive disorder, or post-traumatic stress disorder
  • A psychotic disorder, including schizoaffective disorder, bipolar disorder, or major depression with psychotic features
  • History of increased intracranial pressure or head trauma
  • Cardiac pacemakers, implantable cardioverter defibrillators, ocular implants, deep brain stimulators, vagus nerve stimulators, implanted medication pumps, intracardiac lines, or significant cardiac disease
  • Pregnant or nursing

Nexstim NBS 6 for Chronic Pain Therapy: Indications for use (CE mark) and patient safety

Nexstim NBS 6 is not approved by the Food and Drug Administration for commercial use of the treatment of chronic pain in the United States, for investigational use only.

CE mark Intended use

Nexstim NBS 6 for depression is intended to be used for treatment of major depressive disorder (MDD) by targeting and delivering non-invasive repetitive TMS stimulation to the patient's dorsolateral prefrontal cortex.

CE mark Indications for use

Nexstim NBS 6 is indicated for MRI-guided and electric field (or E-field) navigated, non-invasive, repetitive TMS stimulation (rTMS) of the motor cortex as therapy to alleviate chronic unilateral neuropathic pain in adult patients. Nexstim NBS 6 is intended to be used by trained clinical professionals. 

SAFETY

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.

The most common side effects reported during clinical studies (Lefaucheur et al., Nurmikko et al.) are: mild headache (25% of the TMS treatment group), sleepiness (38 %), and dizziness (15 %).

No severe adverse events were reported. Specifically, no seizures occurred.

In some patients with chronic neuropathic pain, the pain may transiently worsen after rTMS stimulation. The increase in pain sensation may last up to 1-2 days.

No adverse effects on hearing have occurred when ear protection has been properly worn.

No effects on cognitive function has been reported.

Clinical studies have reported no deaths in rTMS therapy. (Nurmikko et al.)