Neurosoft Information

 

Purpose

This page provides basic information regarding the EMG hardware and software for the Neurosoft TMS machines.

 

VERIFY EMG System   

 

The pictures above show how the cables should be connected to the EMG unit.

No buttons on the EMG unit need to be used during TMS sessions.

 

  1. This cable connects the Neurosoft stimulator with the laptop. The other end of this cable should be plugged into a USB port on the laptop
  2. This is the power cable. The other end of this cable should be plugged into a power outlet. 

 

  1. These are the USB inputs into the laptop. One of these cables will be coming from the Neurosoft stimulator, and one will be coming from the EMG unit. 
  2. This is the laptop power cable. The position of it may differ on the laptop supplied to you.
  3. The cable connecting the EMG unit with the laptop. 

 

Neurosoft EMG Software

The pictures below explain the role of the important buttons in the Neurosoft EMG software.

Home page

1. Pressing the “MEP status” button will start a new TMS session and you’ll be prompted to enter the participant’s code. Ignore where it asks about adding a picture from a camera. TMS sessions in the Neurosoft software are referred to as exams.

2. Data from saved TMS sessions can be opened by double clicking them on the right side of the screen. Single clicking files and hitting “exam export” will export all frames from the TMS session.

 

TMS Session page

1. Impedance monitoring displays how much noise is present in the traces for each muscle in real-time. Before any TMS is delivered these should be flat lines as shown in the picture because this indicates the traces are free from biological and non-biological noise. The presence of noise should also be checked throughout the TMS session by observing the EMG traces. Please see the EMG Technique module for how to determine whether noise present is biological or non-biological. Changing the y-axis scale for impedance monitoring from 200 microvolts to 50 microvolts can be useful for troubleshooting noise issues. The buttons for changing the y-axis scale can be found in the top right corner of the impedance monitoring window.

2. The top trace shows the EMG trace for the ECR muscle, and the bottom trace shows the FDI muscle. The number before the muscle name indicates the frame number, which in this example is frame 14.

3. Starts/stops impedance monitoring displaying at the bottom of the screen. If monitoring is turned off then each EMG trace should still be checked to make sure there is no biological or non-biological noise present.

4. Pressing this button will show you the impedance as a numerical value for each muscle. Good impendence is indicated by a green circle. If impendence is too high you need to determine if the issue is due to biological or non-biological noise and then attempt to troubleshoot it.

5. Closes and gives the option of saving the current TMS session. Should only be used at the end of the TMS session.

6. These buttons provide different ways of viewing the EMG traces such as changing the distance between traces, superimposing all traces together, or viewing all traces on the same window. These buttons are not necessary to use but can be helpful for determining MEP status.

7. Used to change the X and Y axis scale if desired. By default the x-axis is set so one unit on the screen is 5 ms, and the y-axis is set so one unit on the screen is 50 microvolts. We recommend not changing the scales during the TMS session.

8. Information for each trace are shown on the right of the screen, and the most important detail is the stimulus intensity used. To see further details for every EMG trace press CTRL + U.


Do not worry about the buttons on the screen not explained here, you shouldn’t need them for TMS for PREP2. 

 

Neurosoft Traces Viewing Options

The short video below summaries how changing the visualization of EMG traces in the Neurosoft software can assist with MEP status determination. Please note the closed captions were automatically generated and are highly inaccurate. 

 

 

Neurosoft File Export

Once a TMS session is completed it should be saved and closed. All TMS traces can now be exported. Please follow the instructions below for how to do this.

On very rare occasions TMS data may not save correctly in the Neurosoft software. Please ensure that when you finish a patient TMS session and save the data, that you quickly open and check the data looks correct because if the data didn’t save correctly or traces are missing then you can quickly re-test the patient as they are still present and prepped for TMS.

1. Go back to the Neurosoft home screen and select the TMS session which you want to export data from.

2. Hit the “exam export” button and choose where to save the file. The data should be saved as a .NSPACK file. This file can be emailed to people if needed