CN113813509A - Method for accurately positioning transcranial magnetic stimulation target point by using magnetic resonance external marker point - Google Patents
Method for accurately positioning transcranial magnetic stimulation target point by using magnetic resonance external marker point Download PDFInfo
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- CN113813509A CN113813509A CN202110977440.2A CN202110977440A CN113813509A CN 113813509 A CN113813509 A CN 113813509A CN 202110977440 A CN202110977440 A CN 202110977440A CN 113813509 A CN113813509 A CN 113813509A
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- 238000000034 method Methods 0.000 title claims abstract description 32
- 238000011491 transcranial magnetic stimulation Methods 0.000 title claims abstract description 23
- 239000003550 marker Substances 0.000 title claims description 12
- 230000000638 stimulation Effects 0.000 claims abstract description 18
- 210000004556 brain Anatomy 0.000 claims abstract description 10
- 238000003384 imaging method Methods 0.000 claims abstract description 8
- 238000002595 magnetic resonance imaging Methods 0.000 claims abstract description 5
- 210000003625 skull Anatomy 0.000 claims description 18
- 238000010422 painting Methods 0.000 claims description 10
- 239000000463 material Substances 0.000 claims description 9
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- 230000001054 cortical effect Effects 0.000 claims description 3
- 229930003427 Vitamin E Natural products 0.000 claims description 2
- 238000009500 colour coating Methods 0.000 claims description 2
- WIGCFUFOHFEKBI-UHFFFAOYSA-N gamma-tocopherol Natural products CC(C)CCCC(C)CCCC(C)CCCC1CCC2C(C)C(O)C(C)C(C)C2O1 WIGCFUFOHFEKBI-UHFFFAOYSA-N 0.000 claims description 2
- 239000000049 pigment Substances 0.000 claims description 2
- 229940046009 vitamin E Drugs 0.000 claims description 2
- 235000019165 vitamin E Nutrition 0.000 claims description 2
- 239000011709 vitamin E Substances 0.000 claims description 2
- 238000004040 coloring Methods 0.000 claims 2
- 230000009286 beneficial effect Effects 0.000 abstract description 3
- 238000005516 engineering process Methods 0.000 abstract description 3
- 238000004519 manufacturing process Methods 0.000 abstract description 2
- 230000006872 improvement Effects 0.000 description 6
- 230000004048 modification Effects 0.000 description 3
- 238000012986 modification Methods 0.000 description 3
- 210000005036 nerve Anatomy 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 239000007787 solid Substances 0.000 description 2
- 238000011282 treatment Methods 0.000 description 2
- 208000020401 Depressive disease Diseases 0.000 description 1
- 208000021384 Obsessive-Compulsive disease Diseases 0.000 description 1
- 230000033228 biological regulation Effects 0.000 description 1
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- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000005674 electromagnetic induction Effects 0.000 description 1
- 238000011337 individualized treatment Methods 0.000 description 1
- 238000004080 punching Methods 0.000 description 1
- 230000008685 targeting Effects 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N2/00—Magnetotherapy
- A61N2/02—Magnetotherapy using magnetic fields produced by coils, including single turn loops or electromagnets
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Abstract
The invention relates to a method for accurately positioning a transcranial magnetic stimulation target point by adding a mark point capable of magnetic resonance imaging in a target brain area of a subject, and acquiring a structural magnetic resonance image with an imaging mark to position the target point. And manufacturing a coil mold according to the distances between the stimulation target point and at least four imaging marks closest to the stimulation target point, and accurately positioning the stimulation target point in actual operation. Compared with the existing target location technology without a navigation system, the method can improve the accuracy of guiding the target, does not need to use the navigation system, and can quickly locate the individual target. Compared with the existing frameless navigation method, the method does not need to use a large amount of equipment, has low price, simple and convenient operation and time saving, and is beneficial to clinical and transcranial magnetic stimulation of a large number of testees.
Description
Technical Field
The invention belongs to the technical field of clinical and scientific research transcranial magnetic stimulation, and particularly relates to a method for accurately positioning a transcranial magnetic stimulation target point by using a magnetic resonance external marker point.
Background
Transcranial Magnetic Stimulation (Transcranial Magnetic Stimulation) is a non-invasive nerve regulation and control technology, and is based on Faraday's law of electromagnetic induction to intervene in brain function. Has been clinically used for treating depression, obsessive-compulsive disorder, pain and other diseases. The existing simple positioning method mostly adopts a probability-based targeting method, and does not consider individual anatomical variability. For example, the "5 cm method" or the international 10-20 brain electrical system and its derivative systems used for the treatment of depression. The individual brain image and the nerve navigation system are combined, so that the stimulation accuracy can be improved, and the clinical treatment effect can be improved. The existing accurate positioning method is to utilize frameless stereotactic of a three-dimensional camera system, can simultaneously track the position of a marker, and can carry out accurate real-time positioning by marking the positions of a transcranial magnetic stimulation coil and the head of a subject. However, the existing accurate positioning method is high in price and complex in operation, and is not beneficial to individualized treatment of a large number of clinical patients.
Disclosure of Invention
Aiming at the problems in the prior art, the invention aims to provide a method for accurately positioning a transcranial magnetic stimulation target point by adding a magnetic resonance mark point. And manufacturing a coil mold according to the distances between the stimulation target point and at least four imaging marks closest to the stimulation target point, and accurately positioning the stimulation target point in actual operation.
The invention is realized by the following technical scheme:
1) the method comprises the following steps that a subject wears a special elastic cap, firstly, color marking is carried out on the surface of the skull through a hole attached to the elastic cap, and then a plurality of positions are marked randomly in the approximate range of a target brain area on the elastic cap by using a material capable of magnetic resonance imaging;
2) the subject performs magnetic resonance scanning to obtain a structural magnetic resonance image;
3) determining a superficial cortical stimulation target point, and calculating the position of the corresponding skull surface projection target point;
4) selecting the positions of a plurality of (not less than four) reference marks closest to the projection target point, painting color on the surface of the skull by using a color painting pen through the elastic cap, and removing the elastic cap;
5) calculating the distance between the projection target point and the selected color coating mark, overlapping the projection target point with the theoretical focus position of the coil, and designing an individual coil mold;
6) and printing an individualized paper coil mould by adopting a material which is not easy to tear. According to the prompt of the position of the mold, making a hole with a color mark, and closely attaching the mold to the skull of a testee by overlapping the position of the mold and the color mark on the head of the testee in real space;
7) and flattening the die, and completely coinciding the coil with the die.
As an improvement, the elastic cap in the step 1) is a special elastic cap, is closed and is thin, holes are respectively attached to the front, the back, the left and the right of the elastic cap and the top of the head, and color marking is carried out on the surface of the skull through the holes so as to ensure that the relative position of the elastic cap and the skull of the subject does not move in the scanning process.
As a modification, the material for imaging the marker in step 1) includes but is not limited to vitamin E, and can be visualized in a magnetic resonance scan, including but not limited to adding the marker in the approximate range of the target brain area of the subject.
As an improvement, step 3) determining a stimulation target point in the superficial cortex based on the individualized magnetic resonance image of the subject by using open source software, wherein the stimulation target point is in the range of a target brain area and is less than 3 centimeters away from the surface of the skull; the closest point of the skull surface to the stimulation target is selected as the projection target, the location of which allows transcranial magnetic stimulation.
As a modification, the step 4) includes but is not limited to using a Mark pen to carry out color painting, the color painting pigment is harmless to human bodies and is not easy to wash off, and the color painting mark can be carried out through an elastic cap.
As an improvement, step 5) selects a plurality of (not less than four) nearest reference markers, wherein three imaging patch marker points are required to determine the stimulation target position according to a triangulation method; in the present invention, at least four marker points are selected to more accurately stimulate the target location.
As an improvement, the distance measured in the step 6) is a craniofacial distance, and the mold is an individualized paper coil mold.
As an improvement, in the step 7), for the convenience of multiple stimulation positioning, the coil mould material is not easy to tear, and a reference mark point and a stimulation target point position prompt are attached. After punching at the prompting position, determining the position of the mold by overlapping the position of the mold and the position of the painted marking point of the real space subject, and tightly fitting the mold on the skull of the subject.
Compared with the existing target location technology without a navigation system, the method can improve the accuracy of guiding the target, does not need to use the navigation system, and can quickly locate the individual target. Compared with the existing frameless navigation method, the method does not need to use a large amount of equipment, has low price, simple and convenient operation and time saving, and is beneficial to clinical and transcranial magnetic stimulation of a large number of testees.
Drawings
FIG. 1 is a schematic representation of an elastomeric cap mark and an imaging mark of the method of the present invention;
FIG. 2 is a schematic view of a coil mold according to the method of the present invention.
Detailed Description
The invention is described in further detail below with reference to the accompanying drawings in order to better understand the technical solution.
The invention relates to a method for accurately positioning a transcranial magnetic stimulation target point by adding a mark point to magnetic resonance. The target point is accurately positioned in actual operation through the distance between the target point and a plurality of (not less than four) imaging mark points which are closest to the target point.
The invention discloses a method for accurately positioning transcranial magnetic stimulation targets by adding mark points to magnetic resonance, which specifically comprises the following steps:
1) as shown in figure 1, the subject wears a special elastic cap, holes are respectively attached to the front, back, left and right sides and the top of the head, and the surface of the skull is painted with a color mark A, a triangle in figure 1, through the holes so as to ensure that the relative positions of the elastic cap and the skull of the subject are not moved in the scanning process. Randomly marking a plurality of positions, marked B, with hollow circles in figure 1, in the approximate range of the target brain region on the elastic cap by using a material capable of magnetic resonance imaging;
2) the subject performs magnetic resonance scanning to obtain a structural magnetic resonance image;
3) determining a superficial cortical stimulation target point, and calculating the position of the corresponding skull surface projection target point;
4) as shown in fig. 1, selecting at least four reference marks B closest to the projection target point, painting color on the surface of the skull by using a mark C, which is a solid circle in fig. 1, through an elastic cap, and removing the elastic cap;
5) calculating the craniofacial distance between the projection target point and the selected mark C, overlapping the projection target point and the theoretical focal position of the coil, and designing an individual coil mold as shown in figure 2;
6) and printing an individualized paper coil mould by adopting a material which is not easy to tear. According to the prompt of the position of the mold, making a hole with a color mark, a mark D, a solid circle in the figure 2, and closely attaching the mold to the skull of the testee by overlapping the mold and the position of the color mark D on the head of the testee in the real space;
7) and flattening the die, and completely coinciding the coil with the die.
Finally, it should be noted that: although the present invention has been described in detail with reference to the foregoing embodiments, it will be apparent to those skilled in the art that changes may be made in the embodiments and/or equivalents thereof without departing from the spirit and scope of the invention. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (8)
1. The method for accurately positioning the transcranial magnetic stimulation target point of the magnetic resonance external marker point is characterized by comprising the following steps of:
1) a subject wears a special elastic cap, and a plurality of positions are randomly marked by using a material capable of magnetic resonance imaging in the approximate range of a target brain area on the elastic cap to form a reference marking point;
2) a subject performs magnetic resonance scanning to obtain a structural magnetic resonance image so as to locate a target point;
3) determining a superficial cortical stimulation target point, and calculating the position of the corresponding skull surface projection target point;
4) selecting at least four reference mark positions closest to the projection target point, painting color to the surface of the skull through the elastic cap by using a painting tool to form a painting color mark, and removing the elastic cap after painting color;
5) calculating the distance between the projection target point and the selected color coating mark, overlapping the projection target point with the theoretical focus position of the coil, and designing an individual coil mold;
6) printing a coil mold, and closely fitting the mold to the skull of the subject by overlapping the mold and the position of the reference mark of the subject in real space;
7) and flattening the die, and completely coinciding the coil with the die.
2. The method for accurately positioning the transcranial magnetic stimulation target point with the externally added magnetic resonance marker points as claimed in claim 1, wherein the special elastic caps in the step 1) are provided with holes respectively at the front, back, left and right sides and at the top of the head, and are closed and thin.
3. The method for accurately locating transcranial magnetic stimulation targets with external magnetic resonance markers as claimed in claim 1, wherein the magnetic resonance imaging material in step 1) includes but is not limited to vitamin E, and can be visualized in a magnetic resonance scan.
4. The method for accurately locating the target of transcranial magnetic stimulation according to claim 1, wherein the structural magnetic resonance image in step 2) is an image of the brain of the subject with imaging marker information attached thereto.
5. The method for accurately locating a transcranial magnetic stimulation target according to claim 1, wherein the target for stimulation of the target brain region in step 3) is located in a superficial cortex less than 3 cm from the surface of the skull, and projecting the target allows transcranial magnetic stimulation.
6. The method for accurately positioning the transcranial magnetic stimulation target point with the externally added mark points according to claim 1, wherein the coloring pigment of the coloring tool in the step 4) is harmless to human bodies, is not easy to wash and fade, and can be colored and marked through an elastic cap.
7. The method for accurately locating a transcranial magnetic stimulation target spot with an externally applied marker point of magnetic resonance as claimed in claim 1, wherein the distance between the projection target spot and the selected color-coated mark in step 5) is a craniofacial distance, and the individualized coil mold is a paper coil mold.
8. The method for accurately locating the transcranial magnetic stimulation target point with the added magnetic resonance mark points as claimed in claim 1, wherein the coil mold material in the step 6) is not easy to tear, and the coil mold is attached with a reference mark point and a stimulation target point position prompt.
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| CN202110977440.2A CN113813509A (en) | 2021-08-24 | 2021-08-24 | Method for accurately positioning transcranial magnetic stimulation target point by using magnetic resonance external marker point |
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| CN202110977440.2A CN113813509A (en) | 2021-08-24 | 2021-08-24 | Method for accurately positioning transcranial magnetic stimulation target point by using magnetic resonance external marker point |
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Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20090187062A1 (en) * | 2006-04-18 | 2009-07-23 | Osaka University | Fixture of the Head for Transcranial Magnetic Stimulation and Transcranial Magnetic Stimulator |
| CN105617532A (en) * | 2016-02-16 | 2016-06-01 | 深圳英智科技有限公司 | TMS (transcranial magnetic stimulation) positioning method and system |
| CN106693183A (en) * | 2016-12-24 | 2017-05-24 | 安徽安壹心理咨询有限公司 | Transcranial magnetic stimulation re-positioning clamping sleeve |
| CN207012186U (en) * | 2016-12-27 | 2018-02-16 | 北京大学深圳医院 | Simple MRI Naoliqing capsule devices |
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2021
- 2021-08-24 CN CN202110977440.2A patent/CN113813509A/en active Pending
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20090187062A1 (en) * | 2006-04-18 | 2009-07-23 | Osaka University | Fixture of the Head for Transcranial Magnetic Stimulation and Transcranial Magnetic Stimulator |
| CN105617532A (en) * | 2016-02-16 | 2016-06-01 | 深圳英智科技有限公司 | TMS (transcranial magnetic stimulation) positioning method and system |
| CN106693183A (en) * | 2016-12-24 | 2017-05-24 | 安徽安壹心理咨询有限公司 | Transcranial magnetic stimulation re-positioning clamping sleeve |
| CN207012186U (en) * | 2016-12-27 | 2018-02-16 | 北京大学深圳医院 | Simple MRI Naoliqing capsule devices |
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