In recent years, tools have been introduced to allow surgeons to monitor and display the position of their instruments on 3D MR images of their patients in real time. The surgeons use the images as an interactive guide during the procedure. These neuronavigation tools are often referred to as Frameless Stereotaxy or Image-Guided Surgery.
While these tools have revolutionized neurosurgery, their high cost has limited their application to the operating room.
Brainsight™ TMS brings the power of frameless stereotaxy outside the operating room, at a cost which greatly improves accessibility. The simplest description of Brainsight™ TMS is an image-guided tool to assist in the positioning of a transcranial magnetic stimulator (TMS) coil over a subject's brain, a technique called Image-Guided TMS. Brainsight™ TMS includes the software, position sensor and all the related hardware (except the stimulator) to perform Image-Guided TMS.
Small objects, called trackers, are attached to the TMS coil, and the subject. These trackers are monitored, or "seen" by an optical position sensor. This information is send to a computer which, after a calibration procedure, displays the position and orientation of the coil on the subject's MRI.
| Step 1: Pick Your Target
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Use the anatomical display, or overlay functional image information over the anatomical images to select the anatomy to stimulate.
Import coordinates obtained from your favourite analysis software into Brainsight™ by registering your software's coordinate space to the Brainsight™ coordinate space.
Use the MNI305 registration assistant to display and use MNI coordinates.
Use the new grid tool to easily lay down an entire grid of points on the cortex for mapping studies.
Use the annotation or the trajectory tool to define and store targets before the subject arrives.
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| Step 2:Position Your Coil |
| A curvilinear reconstruction can be performed in minutes and provides an intuitive and informative display. The location of the coil and the target can be displayed in real time over the 3D surface.
In the trajectory view, the vertical line represents the stimulation axis. Move your coil so that the vertical line crosses the target, where "X" marks the spot.
Use the new bull's-eye view to easily and quickly position your coil over the target.
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Use the head holder apparatus
to provide a platform to comfortably
hold the subject's head still
and the coil in place during
the stimulation run. |
| Step 3: Record Your Results |
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In addition to the real-time coil location display, the location of the coil can be recorded at any time for later review and correlation with stimulus results.
You can export any image from the Brainsight™ display to a PICT file for use in print or slides. For a more detailed presentation, you can record any view to a QuickTime™ movie and replay sequences using a movie player or embed the movie in a PowerPoint™ or other live computer generated presentation software.
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