Professionally, this is very interesting. Children on the neurospectrum most often also have a language development disorder, which in turn affects the development of both motor and social skills in early childhood and adolescence. If this area could be activated, it would be a massive breakthrough. I think I’ll add this to my portfolio.
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A quick Google search revealed that lawyers were present when the Brainlab agreement was made.
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Did the lawyers have other things to do?
This probably isn’t related to Nexstim in any way. It’s not even about TMS equipment.
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Seen on LinkedIn;
Last week was a milestone for me personally and for Brainlab: I had the privilege of visiting our partner Nexstim at their headquarters in Helsinki.
In November 2024, Brainlab and Nexstim – a pioneer in non-invasive brain mapping technology using navigated transcranial magnetic stimulation (nTMS) – signed a development and distribution cooperation agreement.
We at Brainlab are convinced of the value of nTMS in preserving neurological function in brain surgery patients. Our partnership offers an incredible opportunity to stretch the boundaries of neurosurgery, neurophysiology, and neuroscience.
During my visit, I was inspired by interactive discussions, insightful presentations, and live demonstrations showcasing Nexstim’s world-leading technology and the exciting potential we have together to develop innovative solutions and improve neurosurgical workflows.
Thank you to Mikko Karvinen, CEO of Nexstim, Henri Hannula, CCO of Nexstim, Joonas Juokslahti, CFO of Nexstim, and the entire Nexstim team for the warm welcome and inspiring collaboration. I look forward to the journey ahead as we work together to shape the future of health technology.
CEO Rainer Birkenbach
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Positive. LinkedIn;
Publication of results from a new multicenter study!
Researchers from Neurochirurgische Klinik Universitätsklinikum Heidelberg, TUM Universitätsklinikum Klinikum rechts der Isar, Charité - Universitätsmedizin Berlin, King’s College Hospital, London, and the neurosurgery departments of MD Anderson Cancer Center have just published the results of a multicenter study in which they investigated whether navigated rTMS could be used to treat patients suffering from postoperative upper limb paresis after glioma surgery.
A total of 135 patients from four hospitals were included, of whom 51 patients were treated in RCT studies (30 treatment group, 21 placebo group) and 84 in prospective, single-arm studies. Patients underwent either low-frequency contralesional nrTMS or sham stimulation, followed by physiotherapy. Their outcome was assessed on postoperative days 1, 7, and 3 months.
The results showed that rTMS improved function:
British Medical Research Council (7 days: OR 3.28; 95% confidence interval: 1.08–9.99; 3 months: OR 2.03, 95% confidence interval: 0.65–6.39)
Karnofsky Performance Scale (7 days: mean difference (MD) 11, 95% confidence interval: 2–19; 3 months: MD 11, 95% confidence interval: 2–20)
Fugl-Meyer Assessment (7 days: MD 0.28, 95% confidence interval: -0.34-0.9; 3 months: MD 0.14, 95% confidence interval: -0.52-0.81)
Researchers also reported a stronger treatment effect for patients with proven ischemia on postoperative MRI.
According to the researchers, these multicenter data confirm the positive therapeutic effect of navigated rTMS in reducing transcallosal inhibition with a remarkably low NNT - especially if it is due to ischemia.
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The same in Finnish: in the treatment of postoperative upper limb paralysis, nav rTMS was effective, especially if the cause was a functionally mediated inhibition of the corpus callosum caused by a circulatory disorder.
But the real matter is, I recall Mikko promised a new strategy for Nexstim for the beginning of this year, as the previous five-year period ended in 2024. So it could come any morning, and in light of recent deals, it is hoped that there will be enough ambition, both in the heavily partnered pre-surgical side and especially in the therapy remaining in their own hands!
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Regarding the competitor landscape, Neuronetics’ stock price has risen more than fivefold from $0.61 in November, and today’s price is $3.21. In my opinion, no significant news has emerged, and my confidence in the quality of their operations is still not enough to believe that the company will necessarily stay afloat for very long. Neuronetics’ losses have been very severe; for example, in Q3/2025, with a revenue of 18.5 million, they incurred a loss of 13.3 million. Even with those numbers, Neuronetics’ market capitalization is 176 million dollars, while Nexstim’s market capitalization, which has presumably turned profitable, is a mere 56 million dollars.
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The Indian sales permit will probably play a bigger role than I even imagined. In Brainsway’s investor materials, they have estimated that India would have over half more depression patients than in all of Europe. Let’s hope that deals start coming from that direction this year. The country has approximately 900,000 millionaires, and their number is also growing by approximately 22% annually according to forecasts. Of course, a million-dollar fortune is not needed for TMS treatment, but mainly as a reminder to myself that purchasing power certainly exists in the country.
Brainsway investor presentation: https://investors.brainsway.com/static-files/80194fba-52bb-4ac6-a096-168fc384e8df
Number of millionaires in India: https://indianexpress.com/article/trending/top-10-listing/top-10-countries-adding-millionaires-at-a-rapid-pace-9599207/
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I continue to wonder about Neuronetics’ rise. Neuronetics issued guidance for this year on January 13, and since then, the share price has doubled in a couple of weeks. In that guidance, they stated they plan for operations to turn cash flow positive in Q3/2025. Time will tell how the plan materializes, but the market reaction has been quite strong.
We eagerly await Nexstim’s announcement regarding last year and guidance for this year. The stock has indeed been hit quite hard in the past couple of weeks, and yesterday, after a little thought and research, I had to buy more for my own portfolio.
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This might not strictly belong to this topic, but since Trump’s term began, shares have been sold to the bid side - sometimes at regular intervals and in packages of the same size. I wonder if that has now stopped, as the month comes to an end. It will be interesting to see how the ownership list has changed.
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The impact of those Trump threats on Nexstim will probably remain quite limited. As I understand it, Nexstim’s devices are still manufactured by the subcontractor, Fortune 500 US company Sanmina Corporation, and although the devices have apparently been manufactured at the Haukipudas factory until now, Sanmina also has extensive factories in the United States. Therefore, moving the production of devices sold to the US market is probably not a very difficult trick. In any case, they will probably have to reconsider the production side at the latest when Sinaptica receives FDA approval for the sale of its devices and the production need increases many tens of times compared to the current level.
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I’m not an expert on import tariffs, but using common sense, tariffs raise the buyer’s price, so in some cases, it might make a domestic product a better deal for a US customer. However, in the health technology sector, a product’s suitability for its purpose is a more important factor than price; there isn’t a “race to the bottom” competitive dynamic. So, it might not affect anything at all, neither deal volumes nor margins.
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Behind the share price decline of recent weeks were Kyösti Kakko’s share transactions, as K22 Finance Oy sold as many as 35,000 shares in January, which is roughly the same amount as the number of shares of Joensuun Kauppa Ja Kone Oy increased in December (33,737 pcs).
In connection with the share issue directed at Brainlab, the June convertible bond was converted into new shares at a subscription price of €4.58. Kakko thus cashed in on those shares.
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Exactly three weeks until the release of the 2024 financial statement and half-year report (H2).
I wonder if the strategy update promised by @Mikko_Karvinen_Nexst will still appear before the H2 report
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This is what I’m looking forward to more than the financial statement; the financial statement itself is unlikely to bring any major surprises, but I’m very interested, for example, in how much the Brainlab collaboration frees up resources for the therapy business and how ambitiously it will be scaled up.
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The financial statement is not the most significant thing, of course, but I do consider it important for the future. According to my own rough estimates, the result should already be a few hundred thousand in the black with the reported sales. If this is the case, then it at least creates faith in the future for me, that with core operations, without Brainlab and Synaptica, we can reach profitability.
I myself also, of course, expect a longer-term strategy and guidance for this year. Hopefully, the situation is such that they dare to provide bold guidance.
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A lot of interesting things will happen again in the next couple of months that will move the story forward.
In February:
On the 27th, last year’s results will be announced. Some people expect the result to still be slightly negative, as the deal with Brainlab, for example, surely involved one-off costs for lawyers and consultants. Some expect the result to be barely positive, and some expect a very positive result driven by a good sales spurt at the end of the year.
In March:
At some point in March, the first testing device is estimated to be delivered to Sinaptica Therapeutics. If this device is deemed to meet their needs, Sinaptica will presumably place an additional order for 19 devices on a fast schedule, so that these devices can be delivered, and they can start the third phase of the FDA process already this year, as planned.
On the 6th, the 2024 annual report will be published, which will further shed light on last year’s events.
On the 27th, there will be a general meeting, where some guidelines for the future may possibly be provided. Neuronetics, for example, guided that their business would turn cash flow positive in the third quarter of this year, and spurred by that information, the share price has quintupled from its November lows. It will be interesting to see if Nexstim dares to give more concrete guidance than last year’s “the company’s comparable revenue grows and operating profit improves.”
At some point in the near future, Nexstim’s updated strategy will also be published, and by then, of course, we’ll keep our fingers crossed that the insider prepares some licensing deal that we don’t know about. Otherwise, one might have imagined the insider also being on the buying side even at these prices. There is still a lot of untapped potential in many areas. In addition to completely new applications, there are many applications where TMS treatment has already been proven to be an effective method, but Nexstim has not yet sought approvals for the device itself. TMS treatment has been proven to be an effective method, for example, for quitting smoking and treating other addictions, anxiety, etc.
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From LinkedIn;
Are you interested in how navigated transcranial magnetic stimulation (nTMS) can improve post-surgical paresis in brain tumor patients?
Watch this 30-minute webinar with Seattle Science Foundation neurosurgeons Sandro Krieg, Tizian Rosenstock, and Francesco Vergani. The researchers shared their approach in evaluating whether nTMS can be used to treat neurosurgical patients suffering from post-surgical paresis.
Moderators Randy D’Amico, Chris Cifarelli, and Jason Sheehan led an active discussion. Topics included:
Multicenter study on post-surgical paresis
How nTMS has transitioned from purely preoperative to perioperative use
The potential of nTMS in restoring motor and language areas
Opportunities to use nTMS in language rehabilitation
The effectiveness of nTMS in different patient subgroups and recurrent tumors
To the webinar: LinkedIn
#neurosurgery #braintumors #nTMS #brainmapping #paresis #postsurgicalparesis #aphasia #neurorehabilitation
For research use only - Not FDA approved and not CE marked
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