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New Study Shows Long-Term Improvement with nTMS in Motor Function for Stroke Patients

Today only an average of 50% of stroke survivors recovers full use of their arm. A study from the Rehabilitation Institute of Chicago approached stroke rehabilitation through a new combination of therapies which produced significantly greater gains in their motor function 6 months post stroke. The series of combination therapy used non-invasive navigated transcranial stimulation (nTMS) along with occupational therapy (OT), opened the door to improving the quality of life for stroke survivors.

The study (presentation #152) presented Thursday at the American Heart Association (AHA) and the American Stroke Association’s (ASA) International Stroke Conference, yielded results from the active group of improved function by 13+ points in the UEFM score. It also showed over 80% of the active group received a clinically meaningful response rate. The results obtained in the Contrastim trial provide evidence that non-invasive neurostimulation has major potential for improving motor function in stroke sufferers.” – Jarmo Laine, MD, Nexstim VP of Medical Affairs

The Study (presentation #152):Dr. Richard Harvey and his team at the Rehabilitation Institute of Chicago (RIC) presented their research which took a look at the combination of non-invasive nTMS along with OT in post-stroke patients. “It helped me greatly. It’s just immeasurable the progress that I have made.” – Dwayne Nelson, Stroke Trial Patient

Treatment consisted of 20 minutes of pre-functional OT, 17 minutes of nTMS treatment, followed by 60 minutes of upper-limb task oriented OT. Patients received the standard treatment in the US, 3 visits per week for 6 weeks. They then returned for follow up visits at 1 week, 1 month, and 6 months. The study found that Nexstim’s non-invasive Navigated Brain Stimulation (NBS) System used as an adjunct to therapy promotes lasting improvements in patients motor function compared to the sham control group.

“What we found is that there are areas of the brain usually where the lesion is that are less active than they use to be, and there are actually areas on the brain on the opposite hemisphere, so the healthy area of the brain, that is more active than it used to be.” – Lynn Rogers, PhD, Director, Neuralplasticity Laboratory, RIC

The Technology:
The NBS System uses stereotactic MRI-guided transcranial magnetic stimulation (TMS) to non-invasively modulate precise areas of the motor cortex. The system’s e-field based targeting tool allows the therapist to accurately locate the patients exact stimulation location using technology similar to mapping the globe with a GPS. The nTMS was used to stimulate the patient’s non-injured hemisphere at a low frequency. The results regulated the excitability of the brain, which down-regulated the healthy side of the brain. Adding navigation to TMS is the key to finding the exact location and orientation of the e-field to the motor area that should be inhibited by stimulation. The stimulation is then accurately repeated in every session, assuring the dose is applied to the correct place. This targeted stimulation has been proven to correlate with DCS (Direct Cortical Stimulation – in the OR). “We are actually able to modulate healing, and I think this is the wave of the future.” – Dr. Richard Harvey, Medical Director, Center for Stroke Rehabilitation, RIC

About the International Stroke Conference:
The AHA and ASA present the annual International Stroke Conference, the world’s largest meeting dedicated to the science and treatment of cerebrovascular disease. The cutting-edge presentations selected attract researchers throughout the fields of cerebrovascular function and disease.

About The Rehabilitation Institute of Chicago:
The Rehabilitation Institute of Chicago (RIC) is the largest rehabilitation research enterprise in the world, and the nation’s #1-ranked provider of comprehensive physical medicine and rehabilitation care to patients from around the world. Ranked #1 by both U.S. News and World Report and the U.S. National Institutes of Health, RIC holds an unparalleled market distinction. Founded in 1954, RIC has been designated the “#1 Rehabilitation Hospital in America” by U.S. News & World Report every year since 1991.

About Nexstim:
Founded in 2000, Nexstim is committed to improving the quality of life of patients with significant unmet clinical needs. The advanced technology providing navigation to TMS has led to Nexstim being the world leader in image-guided TMS. Pioneering the technology for brain diagnostics Nexstim has received FDA-clearance of the NBS System for non-invasive pre-surgical mapping. The technology enables treatment of brain injury and disease using repetitive TMS (rTMS) with accurate and repeatable 3D-guidance of therapeutic electrical field. For more information, visit: www.nexstim.com

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