JP6717824B2 - 様々な刺激系列による効果的な非侵襲性神経刺激のためのデバイスおよびソフトウェア - Google Patents
様々な刺激系列による効果的な非侵襲性神経刺激のためのデバイスおよびソフトウェア Download PDFInfo
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- A61N1/36103—Neuro-rehabilitation; Repair or reorganisation of neural tissue, e.g. after stroke
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36135—Control systems using physiological parameters
- A61N1/36139—Control systems using physiological parameters with automatic adjustment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36146—Control systems specified by the stimulation parameters
- A61N1/36167—Timing, e.g. stimulation onset
- A61N1/36178—Burst or pulse train parameters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N2/00—Magnetotherapy
- A61N2/004—Magnetotherapy specially adapted for a specific therapy
- A61N2/006—Magnetotherapy specially adapted for a specific therapy for magnetic stimulation of nerve tissue
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Description
(i)感覚刺激、すなわち、内耳の音響刺激、網膜の視覚刺激のような受容器官の生理的刺激、または、皮膚、皮下組織、筋肉および腱の受容器官の機械的(例えば振動触覚)もしくは熱的刺激、
(ii)例えば、電流(例えば経皮電気刺激)、磁場(経皮磁気刺激)または超音波による末梢神経(および関連受容器官)の刺激、ならびに
(iii)例えば、電流(例えば外頭蓋または経頭蓋神経刺激)、磁場(経頭蓋磁気刺激)または超音波による脳または脊髄の刺激によって実施することができる。
個々の刺激間の間隔τk+1−τkが十分に大きければ、刺激前範囲、すなわち、それぞれの刺激を印加する前の範囲内で、平均刺激応答は得られない(非特許文献5参照)。平均刺激応答を検出することができるとき、すなわち、ゼロとは異なる刺激応答が刺激後範囲、すなわち、t>0の範囲内で見出されるときに、位相リセットを決定することができ、t=0は、それぞれの刺激の開始時刻を表す。これは、視覚検査によって判定することができる。これは、
または
の刺激前分布が観察され、特性しきい値、例えば、
の刺激前分布の99パーセンタイルまたは単純にその最大値が決定されるという点において、装置2、特に制御ユニット10によって行うこともできる。ここで、例えば、刺激後応答の量が、原則的にまたは所定の最小時間、例えば、20msにわたってこの特性しきい値を超える場合、ゼロとは異なる平均応答が存在する。この場合、位相リセットが存在し得る。すなわち、刺激強度は、刺激後応答がゼロラインと異なるまでの程度に増大される必要があることになる。単純であるが、実際に証明されている、本明細書において提示されている方法に加えて、当業者に知られている他の統計テストを、信号分析に使用することができる。
ρ(t)が、例えば、(ある時点において、または、例えば20ms幅の小さい時間窓内で)ρ(t)の刺激前分布の最大値または99パーセンタイルを超えるときに、位相リセットが存在する。
Claims (14)
- ニューロン(31)を刺激する装置(1、2)であって、
複数の刺激チャネル(12〜15)において刺激(22)を生成する非侵襲性刺激ユニット(11)であり、前記刺激(22)がそれぞれの異なる点において前記刺激チャネル(12〜15)を介して患者の脳および/または脊髄(30)内のニューロン集団(31)を刺激するように構成されている、非侵襲性刺激ユニット(11)と、
前記刺激ユニット(11)が刺激(22)の系列を繰り返し生成するように、前記刺激ユニット(11)を制御する制御ユニット(10)と
を備え、
系列内で前記刺激(22)が生成される前記刺激チャネル(12〜15)の順序は、順次生成される少なくとも20系列にわたって一定のままであり、その後変更される、ニューロン(31)を刺激する装置(1、2)。 - 前記刺激(22)は、音響、視覚、触覚、振動、熱的、嗅覚、味覚、経皮電気、経皮磁気、経頭蓋電気および/もしくは経頭蓋磁気刺激、ならびに/または、超音波刺激である、請求項1に記載の装置(1、2)。
- 前記系列は、連続するサイクルを含む時間パターンにおいて生成され、それぞれの刺激(22)系列は、前記サイクルの少なくともいくつかにおいて生成される、請求項1または2に記載の装置(1、2)。
- それぞれのサイクル内で正確に1つの刺激(22)系列が生成されるか、または、刺激が生成されないかのいずれかである、請求項3に記載の装置(1、2)。
- 連続するnサイクルの間に刺激(22)が生成され、後続するmサイクル中に刺激は生成されず、このパターンは周期的に継続され、nおよびmは負でない整数である、請求項3または4に記載の装置(1、2)。
- 系列内で前記刺激(22)が生成される前記刺激チャネル(12〜15)の前記順序が、順次生成される少なくとも20系列にわたって一定のままであり、その後変更されるパターンは、複数回繰り返される、請求項1〜5のいずれか一項に記載の装置(1、2)。
- 前記刺激(22)は、前記複数の刺激チャネル(12〜15)を介して前記患者に適用されるときに、前記ニューロン集団(31)の病的に同期した振動性の活動を抑制するように構成されている、請求項1〜6のいずれか一項に記載の装置(1、2)。
- 1サイクルの継続時間は実質的に、前記ニューロン(31)の前記病的な振動の平均周期に対応する、請求項7に記載の装置(1、2)。
- 前記刺激ユニット(11)は、それぞれの刺激チャネル(12〜15)において生成される前記刺激(22)が、前記ニューロン集団(31)のそれぞれのサブ集団(32〜35)を刺激し、このサブ集団(32〜35)の前記ニューロン活動の位相をリセットするように構成されている、請求項1〜8のいずれか一項に記載の装置(1、2)。
- 前記刺激ユニット(11)は、各刺激チャネル(12〜15)においてそれぞれの系列内で正確に1つの刺激(22)を生成する、請求項1〜9のいずれか一項に記載の装置(1、2)。
- 正確に1つの刺激(22)は正確に1つのパルス列である、請求項10に記載の装置(1、2)。
- 前記刺激(22)によって刺激される前記ニューロン集団(31)のニューロン活動を再現する測定信号(23)を記録する測定ユニット(16)を備える、請求項1〜11のいずれか一項に記載の装置(2)。
- 前記制御ユニット(10)は、前記制御ユニット(10)が前記測定信号(23)を参照して、前記刺激されているニューロン集団(31)の同期の程度が、前記刺激(22)の印加によって少なくとも1つの所定のしきい値だけ低減されないと判定するときに、系列内で前記刺激(22)が生成される前記刺激チャネル(12〜15)の順序が一定である、前記連続的に生成される系列の数を拡大するように構成されている、請求項12に記載の装置(2)。
- データ処理システム内で実行するためのソフトウェアであって、
非侵襲性刺激ユニット(11)を制御するための制御信号を生成し、前記刺激ユニット(11)は、複数の刺激チャネル(12〜15)において刺激(22)を生成し、前記刺激(22)は、それぞれの異なる点において前記刺激チャネル(12〜15)を介して患者の脳および/または脊髄(30)内のニューロン集団(31)を刺激し、前記制御信号は、
前記刺激ユニット(11)が、刺激(22)の系列を繰り返し生成し、
系列内で前記刺激(22)が生成される前記刺激チャネル(12〜15)の順序が、順次生成される少なくとも20系列にわたって一定のままであり、その後変更されるように、前記刺激ユニット(11)を制御する、データ処理システム内で実行するためのソフトウェア。
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DE102014117427.5A DE102014117427B4 (de) | 2014-11-27 | 2014-11-27 | Vorrichtung zur effektiven nicht-invasiven Neurostimulation mittels variierender Reizsequenzen |
PCT/EP2015/077802 WO2016083520A1 (de) | 2014-11-27 | 2015-11-26 | Vorrichtung und verfahren zur effektiven nicht-invasiven neurostimulation mittels variierender reizsequenzen |
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US20170325718A1 (en) * | 2016-05-12 | 2017-11-16 | Bragi GmbH | Neuropathic Diagnosis and Monitoring Using Earpiece Device, System, and Method |
CN109475732A (zh) * | 2016-07-13 | 2019-03-15 | Gsk消费者健康有限公司 | 用于自动化补偿针对诸如昼夜节律之类的时间波动的经皮电神经刺激的装置和方法 |
US20210401664A1 (en) * | 2017-07-28 | 2021-12-30 | The Board Of Trustees Of The Leland Stanford Junior University | Safe and efficient vibrotactile multi-channel stimulation for the treatment of brain disorders |
US11318277B2 (en) * | 2017-12-31 | 2022-05-03 | Neuroenhancement Lab, LLC | Method and apparatus for neuroenhancement to enhance emotional response |
DE102018104515B4 (de) * | 2018-02-28 | 2021-12-09 | Prof. Dr. Fischer AG | Vorrichtung zur transkraniellen Magnetstimulation |
US20210260375A1 (en) * | 2018-06-22 | 2021-08-26 | Gretap Ag | Medical treatment device and method for stimulating neurons of a patient to suppress a pathologically synchronous activity thereof |
EP3846895A1 (en) * | 2018-09-03 | 2021-07-14 | Gretap AG | Medical treatment device and method for stimulating neurons of a patient to suppress a pathologically synchronous activity of the neurons |
TWI677321B (zh) * | 2018-09-07 | 2019-11-21 | 陳韋達 | 用於頭痛疾患的大腦皮質興奮與抑制能力量測系統 |
US11701293B2 (en) | 2018-09-11 | 2023-07-18 | Encora, Inc. | Apparatus and method for reduction of neurological movement disorder symptoms using wearable device |
US11839583B1 (en) | 2018-09-11 | 2023-12-12 | Encora, Inc. | Apparatus and method for reduction of neurological movement disorder symptoms using wearable device |
EP3937877A4 (en) * | 2019-03-11 | 2022-12-21 | Regents of the University of Minnesota | SYSTEMS AND METHODS FOR COMBINED ULTRASOUND AND ELECTRICAL STIMULATION TO TREAT A SUBJECT |
RU194111U1 (ru) * | 2019-04-26 | 2019-11-28 | Общество с ограниченной ответственностью "Альматек" | Устройство управления устройством предъявления электрических импульсов при транслингвальной нейростимуляции |
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US11413425B2 (en) | 2019-05-24 | 2022-08-16 | Neuroenhancement Lab, LLC | Device, system, and method for reducing coronasomnia to enhance immunity and immune response |
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EP3838334A1 (en) * | 2019-12-18 | 2021-06-23 | ONWARD Medical B.V. | System for providing stimulation |
US11896852B2 (en) | 2020-12-21 | 2024-02-13 | Xerox Corporation | Closed-loop non-invasive transcranial stimulation and neural activity recording system and method |
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DE102004025945A1 (de) * | 2004-05-27 | 2005-12-29 | Forschungszentrum Jülich GmbH | Verfahren und Vorrichtung zur Entkopplung und/oder Desynchronisation neuronaler Hirnaktivität |
US8700167B2 (en) * | 2006-12-22 | 2014-04-15 | Ebs Technologies Gmbh | Apparatus and method for stimulating a brain of a person |
DE102008015259B4 (de) * | 2008-03-20 | 2010-07-22 | Anm Adaptive Neuromodulation Gmbh | Vorrichtung und Verfahren zur auditorischen Stimulation |
DE102009015723B4 (de) | 2009-03-31 | 2013-12-19 | Forschungszentrum Jülich GmbH | Stimulationselektrode |
DE102010000390A1 (de) * | 2010-02-11 | 2011-08-11 | Forschungszentrum Jülich GmbH, 52428 | Vorrichtung und Verfahren zur Behandlung eines Patienten mit Vibrations-, Tast- und/oder Thermoreizen |
DE102010016404A1 (de) * | 2010-04-12 | 2012-12-27 | Forschungszentrum Jülich GmbH | Vorrichtung und Verfahren zur konditionierten desynchronisierenden nicht-invasiven Stimulation |
US9878161B2 (en) * | 2011-04-29 | 2018-01-30 | Medtronic, Inc. | Entrainment of bioelectrical brain signals |
DE102012002436B4 (de) | 2012-02-08 | 2014-08-21 | Forschungszentrum Jülich GmbH | Vorrichtung zur Eichung einer nicht-invasiven desynchronisierenden Neurostimulation |
DE102012005030B4 (de) * | 2012-03-12 | 2016-06-16 | Forschungszentrum Jülich GmbH | Vorrichtung und Verfahren zur Stimulation mit Thermoreizen |
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