Pilot studies lift off in depression and pain

Lighthouse | 25 September 2020

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  • Nexstim has confirmed that two pilot studies, in severe depression and chronic neuropathic pain, using accelerated iTBS protocols with its NBT SmartFocus navigated TMS (transcranial magnetic stimulation) system will be starting at two leading Finnish university hospitals.
  • Accelerated iTBS (intermittent theta burst stimulation) is a form of rTMS (repetitive TMS) where stimulation is given several times per day for one week. It is particularly suited for in-patient therapy. In contrast, conventional TMS therapy involves stimulation given once daily over several weeks.
  • The depression pilot study is being carried out at Kuopio University Hospital. The accelerated iTBS protocol will be tested in 10 severe depression patients and the results compared with 10 patients treated by conventional TMS. The patient treatments are expected to complete by end-2020, with study results announced soon after completion.
  • The pain pilot study will start at Helsinki University Hospital, where the accelerated iTBS protocol will be tested in 5-10 patients with treatment-resistant chronic neuropathic pain and who have not benefitted from prior 10 Hz rTMS treatment targeted to the motor cortex. Patient treatment will begin in Q420, with an expectation that the study will complete in H121. Again, study results will be announced as soon as possible post-completion.
  • These pilot studies exploring the potential of new accelerated therapy protocols in severe depression and chronic neuropathic pain could be the first step to entering a new and attractive in-patient TMS market.

Trinity Delta view: Embarking on pilot studies using accelerated iTBS treatment protocols is one of Nexstim’s strategic goals for 2020 (outlined in detail in our August 2020 Update). NBT’s highly accurate mapping capabilities, and the FDA approval of the three-minute Thetaburst protocol in 2019, means it is well-suited to use in intensive treatment protocols. These pilot studies in chronic pain and severe depression, at leading Finnish medical centres, will build the currently limited clinical evidence base for an intensive TMS approach in difficult-to-treat patient groups. NBT is already CE marked for both chronic pain and depression, and FDA approved in depression (but not yet FDA approved for pain). Should these pilot studies generate evidence of improved patient outcomes, this should increase the NBT market opportunity extending it into the hospital in-patient setting and also provide compelling differentiation over competing TMS systems. We currently value Nexstim at €32.2m, equivalent to €0.07 per share.


25 September 2020

Market Cap€15.4m
Primary exchangeHelsinki
Corporate clientYes

Company description

Nexstim is a targeted neuro-modulation company that has developed a proprietary navigated rTMS platform for use in diagnostics (NBS) and therapeutics (NBT). NBS is used in planning brain surgery while NBT is focused on depression and chronic pain. FDA approval for depression was given in 2017, and the focus is on its commercial roll out in the US, Europe and Asia.


Lala Gregorek
+44 (0) 20 3637 5043

Franc Gregori
+44 (0) 20 3637 5041


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