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Why is SmartFocus TMS Different?

Why is SmartFocus TMS Different?

SmartFocusTM is truly personalized TMS therapy for each individual patient. Here is why SmartFocusTM is different than the others.

  • SmartFocusTM TMS by Nexstim is navigated TMS

In depression, activity of the left dorsolateral prefrontal cortex (DLPFC) is reduced (e.g. George et al, 1995). Stimulation of this area by rTMS increases the activity.

TMS with navigation enables accurate targeting of DLPFC. Without neuronavigation, the correct area is optimally targeted only in approximately 30% of patients (e.g. Herwig et al, 2001).

  • SmartFocusTM TMS is not like the others: It’s an E-field navigated TMS

When a TMS coil is activated, it produces a stimulating electric field (E-field) that can pass though the cortex. Researchers have shown that the location of this E-field in the cortex is dependent on both the conductivity, as well as the geometry, of the underlying brain tissues. This means it is dependent on the unique shape and conductivity of each patient’s brain.

The shape of the human head and brain is far from spherical. Calculating the E-field intensity that reaches the target within the brain requires sophisticated modelling of tissue geometry. The unique mathematical model used by Nexstim has been scientifically-validated to accurately determine the location and orientation of the maximum induced E-field in the brain. *

SmartFocusTM technology is capable of taking all this into consideration so that the user of the system can be confident that the E-field intensity will be calculated accurately, and the desired dose will be reliably delivered to the targeted cortical location, each and every time. Most importantly, the patient can be confident that he or she gets the treatment session personalized just for his or her brain.

  • With SmartFocus TM we also personalize the stimulation level

We are not only different because of the shape of our brain, but we also differ in the amount of stimulation necessary to communicate with neurons within the brain. With SmartFocusTM TMS we also personalize the stimulation level of the TMS therapy for each patient to prevent unnecessary over-stimulation.

With SmartFocus TM TMS, we first identify the area of the patient’s brain that controls hand movement. SmartFocus TM then uses an advanced algorithm to rapidly determine the optimal TMS stimulation intensity necessary to communicate with the hand motor neurons. This same intensity level, also known as the resting motor threshold (RMT), can be used as an accurate baseline to treat other regions of the brain.

  • SmartFocus TM enables treatments to be visualised in real-time

SmartFocus™ TMS creates a 3D model of the patient’s brain from an MRI head scan. Everything onwards can then be seen on the screen, including the motor mapping area, the right spot on DLPFC, and the stimulation level. What is most important: as the operator moves, turns or tilts the coil—even slightly—the system shows the updated location, orientation and E-field data in real time. It is assured that the patient receives stimulation within the correct area.

* Krieg S (Ed.), Navigated Transcranial Magnetic Stimulation in Neurosurgery, Springer International Publishing, 2017

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