Co-registering the MRI and the patient’s head
SmartFocus® TMS creates a 3D model of the patient’s brain from an MRI head scan. With the patient comfortably seated, the MRI is co-registered to the patient’s head using the tracking system with Nexstim’s unique forehead tracker. When resting the coil against the patient’s head, the system now visualizes the coil and the E-field overlaid on the 3D model of the brain. As the coil is moved, the magnitude (V/m) and orientation of the E-field relative to the cortex are dynamically calculated and displayed in real time.
Determining the patient’s motor threshold
Place EMG electrodes over hand muscles. Using single-pulse TMS to accurately locate the thumb representation area in the primary motor cortex. The SmartFocus® TMS software quickly guides the operator to determine an optimized intensity of TMS dose for the patient’s individual cortical excitability.
Localizing the left DLPFC
The published, science-based algorithm allows accurate and reliable identification of the left DLPFC (dorso-lateral prefrontal cortex) in the brain on the system screen. The left DLPFC is the validated target in the cortex for treating depression.
The coil is aligned to the target and then locked in place for the treatment session. The system delivers the prescribed dose of TMS pulses while the system operator monitors treatment precision. The operator has on-screen visual feedback at all time—in real time.
The SmartFocus® TMS system automatically stores the target-finding, dose-defining and other settings needed to personalize the TMS therapy for the patient in the future. In subsequent treatment session, SmartFocus® TMS guidance software helps the system operator ensure the patient receives the same optimized dose at the same location and in the same orientation—every time.
*Mylius V, Ayache SS et al., Neuroimage. 2013 Sep;78:224-32