Nexstim NBS SystemBrain mapping with unparalleled
accuracy

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The preservation of essential brain functions remains one of the most crucial goals yet greatest challenges of neurosurgery. With navigated transcranial magnetic stimulation (nTMS), Nexstim has developed a unique approach to non-invasively map motor and language function helping neurosurgeons make the most informed decisions for each patient.

A map as unique as the patient

Nexstim has developed a unique approach to modelling and navigating the electric field generated by the stimulation coil—taking the patient’s individual brain anatomy into account. This method enables functional brain mapping with unparallelled accuracy, even in patients with lesion-induced reorganization or neurovascular uncoupling.

Guidance that lets you focus on what matters most

Usability is essential to allow clinicians to focus on their patients. The Nexstim nTMS system anticipates each step and guides the user seamlessly from data import to registration to performing the mapping to data export. Whether you're a seasoned user or just starting out, intuitive software and smart workflows keep the focus where it belongs.

Friendly even for the youngest patients

The non-invasive system and its ergonomic positioning offer flexibility for both the patient and operator. There is no sedation required, no need to remain still or be confined to a closed and isolating environment like an imaging scanner, making this approach ideal for everyone including pediatric patients.¹

The Nexstim NBS system: A unique, fully integrated platform

The hardware components of the Nexstim NBS system are precision-manufactured and designed to work together seamlessly.

Stimulation parameters, electric field navigation, and resulting EMG data are simultaneously visualized in the NBS software, enabling full control during mapping.

Insights
in real-time

The system includes a workstation, foot-pedal control, infrared tracking camera, EMG unit, stimulator, cooling unit, stimulating coil, audio and video recording unit for language mapping and electronically adjustable patient chair with optional monitor.

A fully
integrated system

The system includes a 6-channel EMG amplifier minimizing TMS-artefacts, and a software-based response-detection algorithm for computer-aided motor threshold determination.

EMG
analysis

Adhesive head tracker (manufactured by Nexstim) allows for free movement of the patient while maintaining mapping accuracy.

Flexibility
and comfort

The deep integration of all components results in a reliable system that is ready for instant use with synchronized data acquisition and no manual calibration steps.

Deep
integration

How nTMS maps with accuracy

Nexstim nTMS integrates navigated TMS with advanced electric field modeling. This enables the visualization of the induced electric field on the individual’s brain anatomy, allowing for accurate and reliable functional brain mapping.²Clinical studies in neurosurgery have validated that this technology achieves accuracy on the order of millimetres.³

TMS coil

Electric current in the coil generates a rapidly-changing magnetic field.

Magnetic field

The magnetic field noninvasively penetrates the skull and induces a focal electric field in the brain.

Electric field modeling

Considers patient’s individual anatomy and enables real-time visualisation of the induced electric field.

Electric field maximum

The location of the electric field maximum is computed patient-specifically. Here the neurons are most intensely stimulated. The resulting responses are stored in the nTMS map.

Preserving what is essential

Motor and language mapping with Nexstim nTMS helps surgeons
make informed decisions before surgery, increasing
resection rates and improving clinical outcomes.^4,5

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Nexstim nTMS and Brainlab ElementsA smooth workflow

Non-invasive motor and language mapping can be performed by one trained operator in a patient-friendly office environment.
You can export Nexstim nTMS results into Brainlab Elements software to enable function-based fiber tracking for preoperative planning.

MRI uploadGuided patient registrationMotor mappingResults analysisData export

MRI upload

Choose and upload suitable MRI data as a basis for brain mapping.

Language mapping workflow

Baseline acquisitionLanguage mappingResults analysisData export

Baseline acquisition

MRI data and patient registration are used from previous motor mapping, which allows for immediate baseline acquisition. The patient then names objects without stimulation. The objects the patient cannot name are removed from the stack, which can be customized for each patient.

We can’t predict the future, but we have a pretty good idea of where it’s headed.

Seamless data flow across systems

Connectivity is fundamental to making clinical workflows seamless and efficient. The NBS system is an open platform allowing smooth data handling and efficient sharing across hospital networks.

Direct access to PACS

Load patient data easily with PACS connectivity.

Smooth patient and data selection

Search the patient list and review available MRI scans to select the most suitable dataset.

Impact across the workflow

Export nTMS data in DICOM format, which integrates seamlessly with Brainlab Elements or other treatment planning systems and software.

One system for multiple disciplines

The Nexstim NBS system is a versatile platform designed to support a wide range of clinical and research applications, from neurosurgery, neurology and psychiatry to exploring new frontiers in neuroscience research. The NBS system brings confidence, accuracy, and flexibility to your workflow.

Navigated repetitive TMS (rTMS)

Navigated repetitive TMS (rTMS) is emerging as a powerful, non-invasive, and drug-free approach to help treat major depressive disorder and chronic neuropathic pain.⁶

The neuromodulation module

The neuromodulation module based on electric-field-targeted rTMS includes targeting tools such as atlases and functional imaging overlays. This enables clinicians to target stimulation accurately, improving reproducibility and therapeutic outcomes.

Clinically approved stimulation protocols

Clinically approved stimulation protocols and a versatile protocol editor with a wide range of stimulation parameters, including intermittent theta burst protocols, allow for individualized treatments.

Experience innovation up close. See brain mapping with Nexstim nTMS in action

Request a personalized demo to witness how nTMS can empower you in precise planning to improve clinical outcomes.

See disclaimers

Narayana S. et al., Clinical Utility of Transcranial Magnetic Stimulation (TMS) in the Presurgical Evaluation of Motor, Speech, and Language Functions in Young Children With Refractory Epilepsy or Brain Tumor: Preliminary Evidence, Front Neurol. 2021 May 19:12:650830
Krieg S., E-field vs line navigation, Navigated Transcranial Magnetic Stimulation in Neurosurgery. p 14-18 Springer, 2017
Raffa G. et al., The role of navigated transcranial magnetic stimulation for surgery of motor-eloquent brain tumors: a systematic review and meta-analysis. Clin Neurol Neurosurg. 2019 May: 180:7-17
Krieg S. et al., Preoperative motor mapping by navigated transcranial magnetic brain stimulation improves outcome for motor eloquent lesions. Neuro Oncol. first published online February 9, 2014
Frey D., Navigated transcranial magnetic stimulation improves the treatment outcome in patients with brain tumors in motor eloquent locations. Neuro Oncology 2014 Oct; 16(10): 1365–1372
Not yet commercially available in several countries (CE mark available), for investigational use in those countries only. Please contact your sales representative.
Not yet commercially available in several countries. Please contact your sales representative.

Nexstim NBS SystemBrain mapping with unparalleledaccuracy