TWI677321B - Cerebral cortex excitation and inhibition capacity measurement system for headaches - Google Patents
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Abstract
一種用於頭痛疾患的大腦皮質興奮與抑制能力量測系統，供分析一患者的一腦部中大腦皮質的興奮與抑制能力，該量測系統包括：至少一個儲存單元，供儲存至少一組判斷模型；至少一個外部電刺激單元，供連接至該患者的皮膚及輸出複數成對的低刺激性電訊號；複數個量測單元，抽樣擷取上述腦部的大腦皮質響應上述低刺激性電訊號所發的腦波訊號，其中上述腦波訊號包括至少一第一反應訊號和至少一第二反應訊號；一處理分析單元，供減噪處理上述腦波訊號，獲得至少一興奮特徵值與至少一抑制特徵值；及一判斷單元，輸出一比對資訊。 A cerebral cortex excitation and inhibition capacity measurement system for headaches, for analyzing the cerebral cortex excitation and inhibition capacity in a brain of a patient, the measurement system includes: at least one storage unit for storing at least one set of judgments Model; at least one external electrical stimulation unit for connecting to the skin of the patient and outputting a plurality of pairs of low-irritation electrical signals; a plurality of measurement units for sampling and extracting the cerebral cortex of the brain in response to the low-irritation electrical signals The transmitted electroencephalogram signal, wherein the electroencephalogram signal includes at least a first response signal and at least a second response signal; a processing analysis unit for noise reduction processing the electroencephalogram signal to obtain at least one excitation characteristic value and at least one Suppress the characteristic value; and a judgment unit, which outputs a comparison information.
Description
本發明是有關於一種大腦皮質興奮與抑制能力量測系統，尤其是一種用於頭痛疾患的大腦皮質興奮與抑制能力量測系統。 The invention relates to a cerebral cortex excitation and inhibition capacity measurement system, in particular to a cerebral cortex excitation and inhibition capacity measurement system for headaches.
頭痛疾患是全世界盛行率最高且造成最多失能的慢性疾病，其中常有高比例合併精神共病症，然而，根據世界衛生組織的統計，有將近半數的患者並沒有適當的被診斷或治療，因此，直接與間接所造成的問題，對個人生活功能及社會經濟的影響甚鉅。 Headache is the chronic disease with the highest prevalence and the most disability in the world. Often, a high proportion of them are associated with psychiatric comorbidities. However, according to the World Health Organization, nearly half of the patients are not properly diagnosed or treated. Therefore, the problems caused directly and indirectly have a huge impact on personal life functions and socio-economics.
習知的頭痛診斷方式，需要病人自訴頭痛的症狀，一方面患者的主觀認知未必精準，再方面許多相異的病因都會導致近似的症狀，單憑患者的敘述，容易造成頭痛類型判斷的錯誤；而頭痛的嚴重度，臨床上需透過患者為期一個月以上的頭痛日記的記錄，方能確立，但是患者是否能每次即時記錄，頭痛強度、發生部位和疼痛時間長短的比較是否客觀，都會影響判斷的正確性；再者，患者的常規治療預後好壞也不是完全相同，針對每一患者的療程變化，都關係著整體治療策略的規劃。 The conventional method of diagnosing headaches requires patients to report their own symptoms of headaches. On the one hand, the subjective cognition of patients may not be accurate, and on the other hand, many different causes will lead to similar symptoms. Based on the patient's description, it is easy to cause errors in the type of headache; The severity of headache can only be established clinically through the patient's headache diary for more than one month, but whether the patient can record it immediately and whether the comparison of headache intensity, occurrence location and pain duration is objective will affect the The correctness of the judgment. Moreover, the prognosis of patients with conventional treatment is not the same. The change of the treatment course for each patient is related to the overall treatment strategy planning.
大腦皮質內神經細胞之間傳遞訊號的物質為神經傳導物質，負責釋放抑制性神經傳導物為抑制性神經元，而釋放興奮性神經傳導物為興奮性神經元。抑制性神經傳導物例如有GABA(gamma amino butyric acid)、甘氨酸(glycine)等；興奮性神經傳導物例如有如乙烯膽鹼 (acetylcholine)、穀氨酸鹽(glutamate)、正腎上腺素(noradrenaline)、多巴安(dopamine)、血清素(serotonin)等。 Substances that transmit signals between nerve cells in the cerebral cortex are neurotransmitters, responsible for releasing inhibitory neurotransmitters as inhibitory neurons, and releasing excitatory neurotransmitters as excitatory neurons. Inhibitory neurotransmitters include GABA (gamma amino butyric acid), glycine, etc .; excitatory neurotransmitters include, for example, vinylcholine (acetylcholine), glutamate, noradrenaline, dopamine, serotonin, and the like.
神經傳導物質由突觸前神經末梢釋出，之後會活化下一個神經元的受體並促使細胞去極化(Excitatory)(興奮性突觸後電位)或過極化(inhibitory)(抑制性突觸後電位)。去極化會促使動作電位之發生，代表皮質同步活化能力強；反之，過極化則具抑制動作電位的效果，代表皮質去同步活化能力強。動作電位(Action potential)是一種從細胞本體傳至軸突末端的電化學衝動，由動作電位可以得知大腦皮質神經元的電生理特徵，也就是皮質同步活化和皮質去同步活化的程度。 Nerve-conducting substances are released from presynaptic nerve endings, which then activate the receptors of the next neuron and promote cell depolarization (excitatory post-synaptic potential) or inhibition (inhibitory synapse) Aftertouch potential). Depolarization promotes the occurrence of action potentials, which means that the cortex has a strong ability to synchronize activation; conversely, overpolarization has the effect of suppressing action potentials, which means that the cortex has a strong ability to synchronize activation. Action potential is an electrochemical impulse transmitted from the cell body to the end of the axon. From the action potential, the electrophysiological characteristics of cerebral cortical neurons can be known, that is, the degree of cortical synchronization activation and cortical desynchronization activation.
近年來研究報告指出，許多頭痛患者都有中樞敏感化的特徵，患者的感覺皮質，對於外部刺激的處理異常，是重要的病理特徵之一。然而，目前在預測和治療頭痛疾患上，以外部刺激的方式搭配大腦皮質的活化量測，仍無精確且定量化的標準量測方法。 In recent years, research reports have pointed out that many headache patients have the characteristics of central sensitization, and the patient's sensory cortex is abnormal in processing external stimuli, which is one of the important pathological features. However, at present, in predicting and treating headache disorders, there is still no accurate and quantitative standard measurement method in combination with activation measurement of the cerebral cortex by external stimulation.
換言之，一個創新的大腦皮質興奮與抑制能力量測系統，對於頭痛程度的量測與預後的預測，可以提供一種定量化量測的客觀數值標準，不僅藉由提供適當資訊而提高後續診斷與治療的品質與精準性，且藉由適當的儀器設備，讓此種量測具有操作的便利性，讓資訊取得方便、迅速且成功率高，就是現在醫療儀器設備中，最迫切需要解決的問題。 In other words, an innovative measurement system of cerebral cortex excitement and inhibition capacity can provide an objective numerical standard for quantitative measurement of headache severity measurement and prognosis, not only by providing appropriate information to improve subsequent diagnosis and treatment. The quality and accuracy of the instrument, and the use of appropriate equipment to make this measurement convenient for operation, to make information easy, fast, and highly successful, are the most urgent problems in medical equipment.
鑑於上述問題，本發明的主要目的在提供一種大腦皮質興奮與抑制能力量測系統，使用外部刺激，量測大腦皮質在受刺激情況下，腦波的興奮特徵值及抑制特徵值，獲得客觀具體的數據資料，作為醫療人員 評估患者頭痛的程度、類型以及發作次數的參考。 In view of the above problems, the main object of the present invention is to provide a measurement system of cerebral cortex excitement and inhibition ability, which uses external stimuli to measure the cerebral cortex's excitation characteristic value and inhibition characteristic value in the case of stimulation, to obtain an objective specific Data, as medical staff A reference for assessing the extent, type, and frequency of headaches in patients.
本發明的另一目的，在提供一種大腦皮質興奮與抑制能力量測系統，藉由簡便且科學化的量測裝置，使得腦波的興奮特徵值及抑制特徵值量測更為便利，不僅易於取得客觀數據資料，且成功率較高。 Another object of the present invention is to provide a cerebral cortex excitation and inhibition capacity measurement system. By using a simple and scientific measurement device, the measurement of brain wave excitation characteristic values and suppression characteristic values is more convenient, and it is not only easy. Obtain objective data and high success rate.
本發明的再另一目的，在於提供一種大腦皮質興奮與抑制能力量測系統，可透過穿戴裝置本體對患者電流刺激，並擷取腦波訊號，並可連線雲端伺服器進行後續的分析及運算處理，達到縮小系統體積的目的。 Yet another object of the present invention is to provide a cerebral cortex excitement and inhibition capacity measurement system, which can stimulate the patient's current through the wearable device body, capture brain wave signals, and connect to a cloud server for subsequent analysis and Calculation processing to achieve the purpose of reducing the system volume.
本發明的又另一目的，在提供一種大腦皮質興奮與抑制能力量測系統，藉由將每一個病患腦波的興奮特徵值及抑制特徵值和判斷模型進行比對，獲得具有客觀意義的比對資訊，降低單純依賴病患主訴判斷的誤判風險。 Yet another object of the present invention is to provide a cerebral cortex excitation and inhibition capacity measurement system. By comparing the excitation characteristic value and the inhibition characteristic value of each patient's brain wave with a judgment model, an objectively significant Compare information to reduce the risk of misjudgment that relies solely on the patient's principal complaint judgment.
為達上述目的，本發明提供一種用於頭痛疾患的大腦皮質興奮與抑制能力量測系統，供分析一患者的一腦部中大腦皮質的興奮與抑制能力，該量測系統包括：至少一個儲存單元，供儲存至少一組判斷模型；至少一個外部電刺激單元，供連接至該患者的皮膚及輸出複數成對的低刺激性電訊號；複數個量測單元，供當上述腦部的大腦皮質接收上述成對的低刺激性電訊號而活化時，抽樣擷取上述腦部的大腦皮質響應上述低刺激性電訊號所發的腦波訊號，其中上述腦波訊號包括至少一第一反應訊號和至少一跟隨前述第一反應訊號的第二反應訊號；一處理分析單元，供減噪處理上述腦波訊號，並依照上述第一反應訊號和第二反應訊號的振幅以及兩反應振幅比值，獲得至少一興奮特徵值與至少一抑制特徵值；及一判斷單元，將上述興奮特徵值與上述抑制特徵值和上述判斷模型比對，並輸出 一比對資訊。 In order to achieve the above object, the present invention provides a cerebral cortex excitement and inhibition capacity measurement system for headache disorders, for analyzing the cerebral cortex excitation and inhibition capacity in a brain of a patient. The measurement system includes: at least one storage A unit for storing at least one set of judgment models; at least one external electrical stimulation unit for connecting to the skin of the patient and outputting a plurality of pairs of low-irritation electrical signals; a plurality of measurement units for acting as the cerebral cortex of the above-mentioned brain When receiving the pair of low-irritation electrical signals for activation, the brain cortex of the brain in response to the low-irritation electrical signals is sampled and extracted, wherein the brain-wave signals include at least a first response signal and At least one second response signal following the first response signal; a processing analysis unit for noise reduction processing of the brain wave signal, and obtaining at least one of the first response signal and the second response signal according to the amplitude of the first response signal and the second response signal and a ratio of the two response amplitudes An excitation characteristic value and at least one suppression characteristic value; and a judging unit, combining the excitation characteristic value and the suppression characteristic value Model than the determination and output One match.
在本發明之一實施態樣中，進一步包括一穿戴裝置本體，供設置上述外部電刺激單元、上述量測單元及該網路傳輸單元，其中該處理分析單元和該判斷單元設置於該雲端伺服器，該腦波訊號透過該網路傳輸單元傳送至該雲端伺服器進行計算上述興奮特徵值與上述抑制特徵值。 In an embodiment of the present invention, a wearable device body is further provided for setting the external electrical stimulation unit, the measurement unit, and the network transmission unit, wherein the processing analysis unit and the judgment unit are provided on the cloud servo. The brain wave signal is transmitted to the cloud server through the network transmission unit to calculate the excitation characteristic value and the suppression characteristic value.
相較於習知技術，本發明揭露的大腦皮質興奮與抑制能力量測系統，透過成對的低刺激性電訊號進行外部刺激，誘發患者腦部神經元活化的振幅變化，根據所擷取的腦波訊號，分析患者大腦皮質的同步活化能力，得到興奮特徵值以及抑制特徵值，一方面獲得客觀數據資料，並且藉由簡單的穿戴裝置，便利地獲取腦波訊號，提高量測成功率。尤其藉由與判斷模型進行比對，輸出對於頭痛類型、頭痛嚴重程度和治療預後狀況等有關的客觀比對資訊，讓醫療人員可以大幅降低以往單純依賴患者主訴而判斷的誤判風險，並進一步藉此擬定治療策略，減緩患者因頭痛疾患造成的影響。本發明的量測系統更透過雲端伺服器與多個穿戴裝置連線，雲端伺服器可以同時處理多個穿戴裝置所傳送的腦波訊號，藉此讓患者可以使用較輕便的穿戴裝置便可達成分析頭痛的病症狀況，另方面，降低醫院建置醫療設備及本地伺服器的成本。 Compared with the conventional technology, the cerebral cortex excitation and inhibition capacity measurement system disclosed by the present invention performs external stimulation through paired low-stimulus electrical signals, and induces changes in the amplitude of neurons activation in the patient's brain. EEG signals, analyze the patient's cerebral cortex's simultaneous activation ability, get excitation characteristic values and inhibition characteristic values, on the one hand, obtain objective data, and by simply wearing the device, easily obtain EEG signals, and improve the measurement success rate. In particular, by comparing with the judgment model and outputting objective comparison information on headache type, headache severity, and treatment prognosis, medical personnel can greatly reduce the risk of misjudgment based on the patient's main complaint in the past, and further borrow This proposed treatment strategy slows down the effects of headaches in patients. The measurement system of the present invention is further connected to multiple wearable devices through a cloud server. The cloud server can simultaneously process brain wave signals transmitted by multiple wearable devices, thereby enabling patients to use lighter wearable devices. Analyze the symptoms of headaches. On the other hand, reduce the cost of medical equipment and local servers in the hospital.
10‧‧‧大腦皮質興奮與抑制能力量測系統 10‧‧‧ Cerebral cortex excitation and inhibition capacity measurement system
1、23‧‧‧電刺激貼片 1. 23‧‧‧ Electric Stimulation Patch
2、24‧‧‧腦波紀錄貼片 2, 24‧‧‧ brainwave documentary patch
9‧‧‧患者 9‧‧‧patient
11、21‧‧‧外部電刺激單元 11, 21‧‧‧ external electrical stimulation unit
12、22‧‧‧量測單元 12, 22‧‧‧ measurement unit
13‧‧‧顯示單元 13‧‧‧Display unit
14‧‧‧輸入介面 14‧‧‧ input interface
15、25‧‧‧處理分析單元 15, 25‧‧‧ processing analysis unit
16、26‧‧‧判斷單元 16, 26‧‧‧ Judgment unit
17、27‧‧‧網路傳輸單元 17, 27‧‧‧ network transmission unit
18、28‧‧‧儲存單元 18, 28‧‧‧ storage unit
19‧‧‧回授單元 19‧‧‧ feedback unit
20‧‧‧穿戴裝置本體 20‧‧‧ Wearable device body
29‧‧‧雲端伺服器 29‧‧‧ Cloud Server
30‧‧‧網際網路 30‧‧‧Internet
31‧‧‧處理器 31‧‧‧Processor
101~106‧‧‧第一實施例步驟 101 ~ 106‧‧‧Steps of the first embodiment
201~206‧‧‧第一實施例步驟 201 ~ 206‧‧‧ First Step
圖1為本案大腦皮質興奮與抑制能力量測系統的第一較佳實施例之系統架構示意圖。 FIG. 1 is a schematic diagram of a system architecture of a first preferred embodiment of the cerebral cortex excitation and inhibition capacity measurement system.
圖2為圖1實施例中大腦皮質興奮與抑制能力量測系統的實施示意圖。 FIG. 2 is a schematic diagram of the cerebral cortex excitation and inhibition capacity measurement system in the embodiment of FIG. 1.
圖3為本案大腦皮質興奮與抑制能力量測系統的建立流程圖。 Figure 3 is a flowchart of the establishment of the cerebral cortex excitation and inhibition capacity measurement system.
圖4為本案大腦皮質興奮與抑制能力量測系統的評估步驟流程圖。 Figure 4 is a flowchart of the evaluation steps of the cerebral cortex excitation and inhibition capacity measurement system.
圖5為本案大腦皮質興奮與抑制能力量測系統的第二較佳實施例之系統架構示意圖。 FIG. 5 is a schematic diagram of a system architecture of a second preferred embodiment of the cerebral cortex excitation and inhibition capacity measurement system.
圖6為圖3實施例中大腦皮質興奮與抑制能力量測系統的實施示意圖。 FIG. 6 is a schematic diagram of the cerebral cortex excitation and inhibition capacity measurement system in the embodiment of FIG. 3.
以下藉由特定的具體實施例說明本發明之實施方式，熟悉此技藝之人士可由本說明書所揭示之內容輕易地瞭解本發明之優點與功效。 The following describes the embodiments of the present invention through specific embodiments. Those skilled in the art can easily understand the advantages and effects of the present invention from the content disclosed in this specification.
本說明書所附圖式所繪示之結構、比例、大小等，均僅用以配合說明書之揭示內容，以供熟悉此技藝之人士瞭解與閱讀，並非用以限定本發明可實施之限定條件，任何結構之修飾、大小之調整或比例關係之改變，在無實質變更技術內容下，當亦視為本發明可實施之範疇。 The structures, proportions, sizes, etc. shown in the drawings in this specification are only used to match the disclosure of the description for those familiar with this technology to understand and read. They are not intended to limit the restrictive conditions that the present invention can implement. Any modification of the structure, adjustment of the size, or change of the proportional relationship shall be regarded as the scope in which the present invention can be implemented without substantially changing the technical content.
本發明用於頭痛疾患的大腦皮質興奮與抑制能力量測系統的第一較佳實施例如圖1和圖2所示，大腦皮質興奮與抑制能力量測系統10包括外部電刺激單元11、量測單元12、顯示單元13、輸入介面14、處理分析單元15、判斷單元16、網路傳輸單元17、儲存單元18和回授單元19。本例中患者9具有頭痛疾患的問題，但無法清楚確定頭痛疾患的類型以及頭痛疾患的發作詳細情況，因此藉由大腦皮質興奮與抑制能力量測系統10，量測並提供客觀數據，協助評估頭痛疾患情況，以利提高診斷與治療的品質與精準性。 The first preferred embodiment of the cerebral cortex excitation and inhibition capacity measurement system for headaches according to the present invention is shown in FIG. 1 and FIG. 2. The cerebral cortex excitation and inhibition capacity measurement system 10 includes an external electrical stimulation unit 11 and measurement. The unit 12, the display unit 13, the input interface 14, the processing analysis unit 15, the judgment unit 16, the network transmission unit 17, the storage unit 18, and the feedback unit 19. In this case, patient 9 has the problem of headache, but the type of headache and the details of the onset of headache cannot be clearly determined. Therefore, the cerebral cortex excitement and inhibition capacity measurement system 10 is used to measure and provide objective data to assist in evaluation. Headache conditions to improve the quality and accuracy of diagnosis and treatment.
首先，請一併參照圖3中判斷模型的建立流程圖，在本例中，判斷模型是由累積眾多頭痛疾患患者的資料而建立，透過建立適當數目的 母體樣本判斷模型，可供後續比對參考，協助界定頭痛疾患的類型，並提供比對資訊。如步驟101，本例中外部電刺激單元11具有兩片電刺激貼片1分別黏貼於要進行頭痛疾患取樣的患者9左右手的手指皮膚上，外部電刺激單元11朝向電刺激貼片1施以電流刺激，電流的大小以受試者能感覺到刺激，卻不造成疼痛的範圍內，在此稱為低刺激性電訊號。在本例中，刺激的模式為每次給予兩個間隔500毫秒的成對的脈衝訊號，兩個脈衝訊號的強度相同，且每對刺激與下一次的刺激之間，間隔至少8秒，藉此誘發患者9大腦皮質神經元活動，產生的皮質活化振幅改變。 First, please refer to the flowchart for establishing the judgment model in Fig. 3. In this example, the judgment model is established by accumulating data of a large number of patients with headaches. By establishing an appropriate number of The maternal sample judgment model can be used as a reference for subsequent comparisons to help define the type of headache and provide comparison information. As shown in step 101, in this example, the external electrical stimulation unit 11 has two electrical stimulation patches 1 adhered to the finger skins of the left and right hands of a patient 9 who is to be sampled for a headache, and the external electrical stimulation unit 11 applies the electrical stimulation patches 1 toward the electrical stimulation patch 1. Current stimulation. The magnitude of the current is within the range that the subject can feel the stimulus without causing pain. This is called a low-irritation electrical signal. In this example, the mode of stimulation is to give two pairs of pulse signals at intervals of 500 milliseconds each. The strength of the two pulse signals is the same, and the interval between each pair of stimuli and the next stimulus is at least 8 seconds. This induces 9 cortical neuron activity in patients, resulting in changes in the amplitude of cortical activation.
當外部電刺激單元11進行電流刺激的同時，如步驟102，量測單元12透過黏貼於頭皮上的兩片腦波紀錄貼片2，以600Hz的頻率進行取樣，擷取患者9腦部的大腦皮質響應上述低刺激性電訊號所發的腦波訊號，腦波訊號包括第一反應訊號和第二反應訊號，由於脈衝訊號的刺激，通常會活化大腦皮質，使大腦皮質因為活化而產生響應，發出可偵測的腦電波變化。因此，成對的低刺激性電訊號中，第一個脈衝訊號將會刺激誘發第一反應訊號，而第二個脈衝訊號則誘發第二反應訊號。 When the external electrical stimulation unit 11 is performing current stimulation, as in step 102, the measurement unit 12 samples two brain wave recording patches 2 adhered to the scalp at a frequency of 600 Hz to capture the brain of the patient 9 brain The cortex responds to the above-mentioned low-irritation electrical signals. The electroencephalogram signals include the first response signal and the second response signal. The stimulation of the pulse signal usually activates the cerebral cortex, which causes the cerebral cortex to respond due to activation. Send out detectable changes in brain waves. Therefore, in a pair of low-irritation electrical signals, the first pulse signal will stimulate the first response signal, and the second pulse signal will induce the second response signal.
當大腦皮質神經元細胞反應良好，則第一反應訊號強度會達到一定振幅，依照此響應的振幅大小，可以獲得一個興奮特徵值；相對地，在例如本例的500毫秒間隔之後，立即施加第二個脈衝訊號，神經元細胞則會反向抑制其活化，使得跟隨第一反應訊號的第二反應訊號振幅應該要降低，至少不會大於第一反應訊號；所以，依據第二反應訊號相對於第一反應訊號的振幅比值，可以獲得一個抑制特徵值。 When the cerebral cortical neuron responds well, the intensity of the first response signal will reach a certain amplitude. According to the amplitude of this response, an excitatory characteristic value can be obtained. In contrast, after the 500 millisecond interval in this example, the first Two pulse signals, the neuron cell will inhibit its activation in the opposite direction, so that the amplitude of the second response signal following the first response signal should be reduced, at least not greater than the first response signal; therefore, according to the second response signal relative to The amplitude ratio of the first response signal can obtain a suppression characteristic value.
為降低環境的雜訊影響干擾，在收集約80-100個成對刺激的 反應訊號且到達對應的記錄時間後停止記錄，並將相關資料儲存於儲存單元18中。如步驟103，再透過處理分析單元15將腦波訊號進行去雜訊處理，在本例中，除要濾除非腦波訊號的高頻和低頻成分，並且將前述80-100組的反應訊號進行疊加及平均，藉此提高腦波訊號的訊雜比，再如步驟104，分析大腦皮質活化振幅改變，得到上述對應的興奮特徵值與抑制特徵值。 In order to reduce the impact of environmental noise, about 80-100 pairs of stimuli were collected. The recording is stopped after responding to the signal and reaching the corresponding recording time, and the relevant data is stored in the storage unit 18. In step 103, the brain wave signal is de-noised through the processing and analysis unit 15. In this example, the high-frequency and low-frequency components of the brain wave signal are filtered, and the 80-100 response signals are processed. Superimpose and average to increase the signal-to-noise ratio of the brain wave signal, and then, according to step 104, analyze the change in activation amplitude of the cerebral cortex to obtain the corresponding excitation characteristic value and inhibition characteristic value.
腦區的興奮度高，代表於電流刺激後，皮質同步活化能力強，因而產生高的腦波振幅，反之，興奮度低則為皮質同步活化能力差。抑制能力則代表皮質於重複刺激下的內在自動皮質去同步活化的程度，若成對刺激的第二反應訊號與第一反應訊號的比值越小或差值越大，代表抑制能力高，反之則是抑制能力差，因此，雖然本例中是以比值方式計算抑制特徵值，但熟悉本技術領域人士可以輕易推知，以第一反應訊號作為標準，取得第一反應訊號和第二反應訊號的差值作為抑制特徵值的計算標準亦無不可。 The high degree of excitement in the brain area indicates that the cortical synchronization activation ability is strong after current stimulation, which results in high brain wave amplitude. Conversely, the low excitability indicates poor cortical synchronization activation ability. Inhibition capacity represents the degree of intrinsic autocortical desynchronization of the cortex under repeated stimulation. If the ratio of the second response signal to the first response signal of the paired stimulus is smaller or the difference is larger, it means that the inhibition capacity is high, otherwise It is a poor suppression ability. Therefore, although the suppression characteristic value is calculated in a ratio manner in this example, those skilled in the art can easily infer that the difference between the first response signal and the second response signal is obtained by using the first response signal as a standard. The value is also used as a calculation standard for the suppression characteristic value.
當興奮特徵值和抑制特徵值過小或過大且超出合理範圍，本例中的大腦皮質興奮與抑制能力量測系統10，則可由處理分析單元15依據特徵值的大小，指令回授單元19，調整外部電刺激單元11所輸出低刺激性電訊號的強度：若特徵值過小，則調增電流或調增輸出時間；若特徵值過大，則調降電流或調降輸出時間。再如步驟105，由判斷單元16將興奮特徵值和抑制特徵值代入邏輯回歸演算法，進行多變數模型與迴歸分析，並可選擇地如步驟106依結果建立判斷模型並儲存於儲存單元18。 When the excitation characteristic value and the suppression characteristic value are too small or too large and exceed a reasonable range, the cerebral cortex excitation and suppression capacity measurement system 10 in this example can be adjusted by the processing analysis unit 15 according to the size of the characteristic value and instructing the feedback unit 19 to adjust The intensity of the low-stimulus electric signal output by the external electrical stimulation unit 11: if the characteristic value is too small, the current or the output time is increased; if the characteristic value is too large, the current or the output time is decreased. In step 105, the judging unit 16 substitutes the excitatory characteristic value and the inhibiting characteristic value into a logistic regression algorithm to perform a multivariate model and regression analysis. Alternatively, in step 106, a judgment model is established according to the result and stored in the storage unit 18.
大腦皮質興奮與抑制能力量測系統10中，作為樣本的資料達一定的數量時，藉由母體數目達到一定門檻，此判斷模型對於評估頭痛患 者的頭痛疾患亦可具有一定的客觀參考價值。本例中，將藉由已經輸入不同類型、嚴重度和預後程度的多位患者所對應的興奮特徵值與抑制特徵值，所建立出的判斷模型為參考，進行如圖4所示的步驟流程，步驟201時，欲進行頭痛疾患評估的患者9僅需將腦波紀錄貼片2貼於頭皮並將電刺激貼片1貼合於手指皮膚，隨後進行步驟202，透過量測單元12約15分鐘的誘發腦波記錄後，接收患者9的腦波訊號，在步驟203，以處理分析單元15將該腦波訊號進行去雜訊及濾波處理的處理，再於步驟204，由處理分析單元15計算出大腦神經元活化的興奮特徵值與抑制特徵值，步驟205時，判斷單元16即可將興奮特徵值與抑制特徵值和判斷模型進行比對，最終於步驟206輸出比對資訊，提供頭痛疾患的可能類型數據資料，提供比對資訊，協助醫療人員研判該病患是屬於偏頭痛、緊縮性頭痛或其他病症，以及頭痛疾患可能的發作頻率以及建議的常規治療方式。 In the cerebral cortex excitement and inhibition capacity measurement system 10, when the sample data reaches a certain amount, the number of mothers reaches a certain threshold. This judgment model is useful for assessing headaches. Patients' headache may also have some objective reference value. In this example, the excitatory feature values and suppression feature values corresponding to multiple patients with different types, severity and prognosis have been input, and the established judgment model is used as a reference, and the step flow shown in FIG. 4 is performed. At step 201, the patient 9 who wants to evaluate the headache condition need only apply the electroencephalogram recording patch 2 to the scalp and apply the electrical stimulation patch 1 to the finger skin, and then proceed to step 202, passing the measurement unit 12 about 15 After the evoked electroencephalogram recording of one minute, the electroencephalogram signal of the patient 9 is received, and in step 203, the electroencephalogram signal is processed by the processing and analysis unit 15 for denoising and filtering, and then in step 204, the processing and analysis unit 15 Calculate the excitation feature value and inhibition feature value of brain neuron activation. At step 205, the judgment unit 16 can compare the excitation feature value with the inhibition feature value and the judgment model, and finally output comparison information at step 206 to provide headaches. Data on the possible types of the disease, providing comparison information, and assisting medical staff to determine whether the patient is a migraine, astringent headache or other condition, and the possible onset of the headache condition Conventional treatment rates and recommendations.
本例中顯示單元13可為液晶螢幕、LED或可外接顯示裝置的連接埠，用於輸出或顯示上述腦波訊號、上述興奮特徵值、上述抑制特徵值、該腦部的頭痛疾患或比對資訊等參考資訊，以利頭痛患者和醫生評估病症狀況。輸入介面14可供輸入外部電刺激單元11的參數設定，以及患者9的個人資訊，例如姓名、年齡、身高、體重或血壓值等，讓判斷單元16可以進一步參考患者9的個人資訊，以增加比對資訊的其他參考數據。網路傳輸單元17可供傳輸上述腦波訊號、上述興奮特徵值、上述抑制特徵值以及頭痛疾患的相關資訊至網際網路、伺服器或智慧型裝置，供儲存資訊或分享資訊用。 In this example, the display unit 13 may be a liquid crystal screen, an LED, or a port that can be connected to an external display device, and is used to output or display the brain wave signal, the excitation characteristic value, the suppression characteristic value, the headache or comparison of the brain. Information and other reference information to help headache patients and doctors evaluate the condition. The input interface 14 can be used to input the parameter settings of the external electrical stimulation unit 11 and the personal information of the patient 9, such as name, age, height, weight, or blood pressure value. The judgment unit 16 can further refer to the personal information of the patient 9 to increase Other reference data for comparison information. The network transmission unit 17 is capable of transmitting the above-mentioned brainwave signals, the above-mentioned excitation characteristic values, the above-mentioned suppression characteristic values, and related information about headaches to the Internet, a server, or a smart device for storing or sharing information.
本發明用於頭痛疾患的大腦皮質興奮與抑制能力量測系統 的第二較佳實施例如圖5和圖6所示，本例中的醫療可以配置於移動式車輛，藉以提供例如偏鄉醫療服務，且因為到偏遠地區義診時，無法像門診一樣，每一診間配置單一套量測設備，逐一對病患量測。故在本例中，是以多組儀器，同步測試多位頭痛疾患病患的情況，利用在雲端的伺服器集中運算，可大幅降低購置運算伺服器的成本以及減少儀器佔據的空間。大腦皮質興奮與抑制能力量測系統包括穿戴裝置本體20、外部電刺激單元21、量測單元22、網路傳輸單元27、雲端伺服器29、處理分析單元25、判斷單元26和儲存單元28。本例中外部電刺激單元21、量測單元22、網路傳輸單元27和處理器31設置於穿戴裝置本體20；處理分析單元25、判斷單元26和儲存單元28在本例中則是設置於雲端伺服器29。 Measuring system for cerebral cortex excitement and inhibition ability for headaches The second preferred embodiment is shown in FIG. 5 and FIG. 6. The medical treatment in this example can be configured in a mobile vehicle to provide, for example, medical services in a rural area. The clinic is equipped with a single set of measurement equipment to measure patient by patient. Therefore, in this example, multiple sets of instruments are used to simultaneously test the situation of multiple headache patients. The centralized computing of servers in the cloud can greatly reduce the cost of purchasing computing servers and reduce the space occupied by the instruments. The cerebral cortex excitation and inhibition capacity measurement system includes a wearable device body 20, an external electrical stimulation unit 21, a measurement unit 22, a network transmission unit 27, a cloud server 29, a processing analysis unit 25, a judgment unit 26, and a storage unit 28. In this example, the external electrical stimulation unit 21, measurement unit 22, network transmission unit 27, and processor 31 are disposed on the wearable device body 20; the processing analysis unit 25, determination unit 26, and storage unit 28 are disposed in this example. Cloud server 29.
穿戴裝置本體20可透過例釋為具無線網路傳輸功能的網路傳輸單元27連線至網際網路30，再由網際網路30與雲端伺服器29連線。當欲獲得患者的頭痛疾患病狀的客觀量測數據或比對資訊，藉以提供醫療人員該病患的可能頭痛類型、發作頻率、預後效果等參考數值訊息時，患者僅需將穿戴裝置本體20配戴至頭部，將電刺激貼片23貼合於身體皮膚並將腦波紀錄貼片24緊貼頭部肌膚，由外部電刺激單元21進行電流刺激來誘發腦部訊號，再由量測單元22擷取腦部受電流刺激時的腦波訊號。當擷取到患者的腦波訊號後，便透過網路傳輸單元27傳送至雲端伺服器29。處理器31是用於腦波訊號的相關處理和傳輸，讓穿戴裝置本體20可以將腦波訊號傳送到雲端伺服器29。 The wearable device body 20 can be connected to the Internet 30 through a network transmission unit 27 having a wireless network transmission function, and then the Internet 30 and the cloud server 29 are connected. When the objective measurement data or comparison information of the headache condition of the patient is to be obtained, so as to provide the reference value information of the patient's possible headache type, the frequency of the attack, and the prognostic effect, the patient only needs to wear the device body 20 Wear it to the head, attach the electrical stimulation patch 23 to the body skin and hold the electroencephalogram recording patch 24 against the head skin. The external electrical stimulation unit 21 performs current stimulation to induce brain signals, and then measures The unit 22 captures brain wave signals when the brain is stimulated by a current. After the brain wave signals of the patient are captured, they are transmitted to the cloud server 29 through the network transmission unit 27. The processor 31 is used for related processing and transmission of the electroencephalogram signal, so that the wearable device body 20 can transmit the electroencephalogram signal to the cloud server 29.
所接收到的腦波訊號會儲存於雲端伺服器29中的儲存單元28，再由處理分析單元25及判斷單元26進行如前例的處理，輸出頭痛疾患 的比對資訊。醫生或患者就可以透過電腦或智慧型裝置連線至雲端伺服器29，查看上述相關資訊，如可能的頭痛類型、發作頻率或建議的治療方式。 The received electroencephalogram signal will be stored in the storage unit 28 in the cloud server 29, and then processed by the processing analysis unit 25 and the judgment unit 26 as in the previous example to output a headache. Match information. The doctor or patient can then connect to the cloud server 29 through a computer or smart device to view the relevant information above, such as possible headache types, frequency of attacks, or recommended treatments.
本例中透過雲端伺服器29集中處理多個穿戴裝置本體20所傳送，藉此減小量測系統在使用者一端的體積，而多個穿戴裝置本體20以同一個雲端伺服器29進行運算分析，也可以降低架構運算裝置的成本。 In this example, the cloud server 29 is used to centrally process the transmissions of multiple wearable device bodies 20 to reduce the volume of the measurement system at the user's end. The multiple wearable device bodies 20 use the same cloud server 29 for calculation and analysis. , Can also reduce the cost of the architecture computing device.
綜上所述，本發明所提供之大腦皮質興奮與抑制能力量測系統，記錄並且擷取頭痛患者於接受外部電刺激後的誘發腦波訊號，利用腦波的神經元同步活化振幅值與成對刺激的振幅變化，計算其興奮與抑制性特徵值，獲知大腦感覺皮質的功能。據此，可提供客觀的參考數據資料，協助醫療人員客觀評斷頭痛疾患患者為哪一類型、頭痛疾患的嚴重程度與建議的治療方法，並進一步制訂個人化治療，以減少醫療負擔。 In summary, the cerebral cortex excitement and inhibition capacity measurement system provided by the present invention records and captures brain wave signals induced by headache patients after receiving external electrical stimulation, and uses the neurons of brain waves to synchronize the amplitude and For the amplitude change of the stimulus, calculate its excitatory and inhibitory characteristic values, and learn the function of the brain's sensory cortex. Based on this, objective reference data can be provided to assist medical personnel to objectively judge the type of headache patients, the severity of the headache diseases and the recommended treatment methods, and further develop personalized treatments to reduce the medical burden.
惟以上所述者，僅為本發明之較佳實施例而已，不能以此限定本發明實施之範圍，凡是依本發明申請專利範圍及說明書內容所作之簡單的等效變化與修飾，皆應仍屬本發明涵蓋之範圍內。經過本發明較佳實施例之描述後，熟悉此一技術領域人員應可瞭解到，本案實為一新穎、進步且具產業實用性之發明，深具發展價值。 However, the above are only the preferred embodiments of the present invention and cannot be used to limit the scope of implementation of the present invention. Any simple equivalent changes and modifications made in accordance with the scope of the patent application and the contents of the description of the present invention should still be used. It is within the scope of the present invention. After describing the preferred embodiment of the present invention, those familiar with this technical field should understand that this case is a novel, progressive, and industrially applicable invention, and has great development value.
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| TW107131460A TWI677321B (en) | 2018-09-07 | 2018-09-07 | Cerebral cortex excitation and inhibition capacity measurement system for headaches |
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| TWI677321B true TWI677321B (en) | 2019-11-21 |
| TW202010470A TW202010470A (en) | 2020-03-16 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US9265931B2 (en) * | 2006-09-21 | 2016-02-23 | Neuropace, Inc. | Treatment of language, behavior and social disorders |
| US20170368342A1 (en) * | 2014-11-27 | 2017-12-28 | Forschungszentrum Juelich Gmbh | Device and method for effective non-invasive neurostimulation by means of varying stimulus sequences |
| CN107647847A (en) * | 2016-07-26 | 2018-02-02 | 纽沃凯生物科技（深圳）有限公司 | Depth of sleep monitoring method and Depth of sleep monitor |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9265931B2 (en) * | 2006-09-21 | 2016-02-23 | Neuropace, Inc. | Treatment of language, behavior and social disorders |
| US20170368342A1 (en) * | 2014-11-27 | 2017-12-28 | Forschungszentrum Juelich Gmbh | Device and method for effective non-invasive neurostimulation by means of varying stimulus sequences |
| CN107647847A (en) * | 2016-07-26 | 2018-02-02 | 纽沃凯生物科技（深圳）有限公司 | Depth of sleep monitoring method and Depth of sleep monitor |
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