WO2015122506A1 - コイル装置及び経頭蓋磁気刺激システム - Google Patents
コイル装置及び経頭蓋磁気刺激システム Download PDFInfo
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- WO2015122506A1 WO2015122506A1 PCT/JP2015/054036 JP2015054036W WO2015122506A1 WO 2015122506 A1 WO2015122506 A1 WO 2015122506A1 JP 2015054036 W JP2015054036 W JP 2015054036W WO 2015122506 A1 WO2015122506 A1 WO 2015122506A1
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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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- 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
Definitions
- the present invention relates to a coil device that generates a magnetic field, and a transcranial magnetic stimulation system using the coil device.
- Transcranial magnetic stimulation is a technique in which neurons are stimulated by generating an electric current in the brain by electromagnetic induction.
- a fluctuating magnetic field is formed by applying an alternating current or a predetermined current waveform to a stimulation coil placed on the skin of the head and affected by the fluctuating magnetic field. Then, an eddy current in the opposite direction to the coil current is induced in the brain, and the action potential is generated by stimulating the neuron with the eddy current.
- Transcranial magnetic stimulation is used for clinical tests such as measurement of nerve conduction velocity and brain function research.
- the conventional magnetic stimulation apparatus since the conventional magnetic stimulation apparatus has a weight of about 70 kg and requires electric work for installation, it can be used only in a well-equipped medical institution.
- treatment by a skilled medical worker is necessary.
- the present inventors have developed the magnetic stimulation apparatus shown in FIG. 3 and have already filed patent applications regarding the magnetic field generating coil and positioning improved to the 8-character type (WO2010 / 147064, Patent Publication 2012-125546).
- transcranial magnetic stimulation therapy currently, as a stimulation coil for magnetic stimulation, the circular coil and 8-shaped coil shown in Fig. 4, four-leaf coil, Hesed coil, coil with many small circular coils arranged on the head surface, etc.
- Various shapes have been proposed, and currently circular coils and 8-shaped coils are mainly used.
- the 8-shaped coil is a part of two circular coils that are partially overlapped.
- By applying an electric current to these circular coils in the opposite direction eddy currents are concentrated directly under the intersection of the coils to stimulate local stimulation. Is possible.
- it may be effective to stimulate in a wider range, as opposed to local stimulation.
- a coil in which stimulation is concentrated locally it is required to accurately determine the position to the target site, and in this case, it is necessary to perform accurate positioning by a navigation system or the like.
- a navigation system for determining the stimulation position by the hands of non-medical workers is also underway.
- a patient first wears glasses with a magnetic sensor in a hospital, and performs calibration using a permanent magnet in order to wear the glasses at the same position every time.
- the doctor specifies the optimal stimulus position by a method of synthesizing the MR image and the optical tracking coordinate system, and records the optimal stimulus position and random position data within a range of 5 cm around it. By recording the surrounding position data, it is possible to visually know where the coil is currently when the patient determines the coil position.
- At home treatment first calibrate the glasses.
- the three-dimensional position is measured by comparing the position of the permanent magnet mounted on the stimulation coil with the data.
- the guidance error in this navigation system is a maximum of 5 mm from the optimal stimulation position, while the 8-shaped coil described above is treated when the irradiation site (optimum stimulation position) is within 5 mm. It is possible to stimulate the target site effectively. For this reason, when using a treatment device that performs magnetic stimulation with an 8-shaped coil at the stimulation position induced using the navigation system, the site to be irradiated (optimum stimulation position) may not fall within the stimulation effective range of the treatment coil. Therefore, it is difficult to accurately stimulate the treatment area. Therefore, for example, when there is a site to be irradiated within 10 mm, it is necessary to develop a coil capable of generating eddy currents uniformly over a wider range so that the target site can be stimulated therapeutically effectively. Has been.
- the present inventors propose a novel dome-shaped coil device in order to realize a stimulation coil having high robustness (that is, an eddy current can be generated uniformly over a wider range).
- the eddy current density and the stimulation range were examined for the simple model and the conventional coil device. Based on the results of this study, we investigated the eddy current density and stimulation range for the dome-type coil device of the present invention.
- Equation 2 is established between the eddy current je and the magnetic field.
- ⁇ 0 is the permeability of vacuum.
- Ohm's law (Formula 3) holds between the eddy current and the electric field E.
- ⁇ is the brain conductivity.
- the vector potential Ae of the magnetic field generated by the eddy current and the vector potential Ac of the magnetic field generated by the coil are related to the electric field as shown in Equation 5 by Faraday's law.
- the vector potential of the magnetic field generated by the coil is calculated by Equation 6 according to Bio-Savart's law. Is done.
- Equation 4 Substituting Equations 5 and 6 into Equation 4 yields the following equation.
- Equation 8 the complex field A * (x, y, z) can be defined by Equation 8.
- the capacitance of the capacitor was set to 180 ⁇ F, and the pulse width was set to 298 ⁇ s when the 8-shaped coil used for determining the reference parameters was connected.
- the voltage value is set for a current slew rate that reaches the stimulation threshold of the primary motor area for 6 subjects (see Table 1) (when a current of one cycle of a sine wave is applied to the coil to generate a magnetic field) , The slope of this current rise (or the increase in current per hour).
- Table 1 shows that if the current slew rate is 110.5 A / ⁇ s (see Equation 10), 97.7% of people reach the stimulation threshold.
- a hemispherical conductor with a diameter of 200 mm was placed 1 cm away from the center of the coil.
- the conductivity was set at 0.1065 S / m, equal to that of gray matter at 3.36 kHz.
- other biological tissues such as the skull and the air layer were collected and modeled as an insulating layer with a diameter of 400 mm. Since this air layer is large enough to attenuate the magnetic field, it is considered that no distortion of the magnetic field occurs in the vicinity of the coil.
- the model as a whole has about 20000 contacts and 100000 elements.
- the eddy current density, the spread of the current density in the direction parallel and perpendicular to the coil conductor, and the coil inductance were evaluated.
- a value just below the coil center considered to be the maximum value was used.
- a width that is half of the maximum value of the current density with respect to the brain model surface was used.
- the inductance of the coil was calculated from Equation 12 using the total of magnetic field energy in the air region after analysis only in the air region.
- the dome-shaped coil shown in Fig. 6 as a coil that has high robustness against positioning errors and a coil that can perform magnetic stimulation over a wider range.
- this dome-shaped coil it is considered that by changing the cross-sectional area, the eddy current density can be maintained while reducing the inductance, and the range in which the eddy current density flows can be widened.
- a simple model shown in FIG. 7 was used.
- This simple model is based on the design parameters of the 8-shaped coil shown in FIG. 8 prototyped by the present inventors, uses a conductor having a width of 6 mm and a height of 2 mm, and the conductor spacing is equal to the 8-character coil.
- the width 5mm the coil width is 97mm
- the horizontal length is 112mm, which is equal to the diameter of the 8-character coil
- the square cross-sectional area of the simple model has half the outer diameter of the 8-character coil.
- the reference parameters were determined by setting the vertical length to 27 mm and the number of turns to 20 times equal to an 8-character coil so as to be equal to the cross-sectional area of the circle.
- the coil width is 49.55mm to 154mm
- the horizontal length is 52mm to 175mm
- the vertical length is 15mm to 39mm
- the number of turns is varied from 10 to 30 times independently. It was.
- the coil width was constant and the conductor spacing was changed according to the number of turns.
- the results when each parameter is changed are shown in FIGS.
- the shaded frame in the figure represents the desired inductance range of 5.63 ⁇ H to 12.6 ⁇ H.
- the change in the horizontal size shows little change in the spread of the eddy current with respect to the large change in inductance, and the eddy current density increases as the horizontal direction increases.
- the change in vertical size has little effect on the spread of eddy currents, but only the current density is affected. The larger the vertical direction, the larger the current density.
- the number of turns has little effect on the spread of eddy current, but the eddy current density increases as the number of turns increases.
- the results of analysis of a conventional 8-character coil under the same conditions showed that the eddy current density was 24.32 A / m2, the eddy current spread was 4.29 cm x 7.55 cm, and the inductance was 9.71 ⁇ H.
- FIGS. 13 to 15 show the eddy current distribution of the 8-shaped coil, the coil for which the reference parameter is set, and the coil that is most effective. Although the maximum eddy current density was inferior to that of the 8-shaped coil, eddy currents could be generated over a wide range, which is the purpose of this study.
- the coil width greatly affects the spread of the eddy current.
- the spread of the eddy current increases with the coil width, but the eddy current density decreases rapidly. This is presumably because the magnetic flux leaks from between the conductors due to the increased conductor spacing, and the change in the magnetic flux passing through the living body is reduced.
- the spread of eddy currents does not substantially change in the three parameters of the horizontal length, the vertical length, and the number of turns of the conducting wire, but the eddy current density increases as the inductance increases.
- the change in the maximum current density per inductance is compared.
- FIG. 17 shows an analysis result of the 8-shaped coil and the most effective coil shown in FIG. 16 with a sectional view of the eddy current density distribution inside the conductor. From this result, it can be seen that the dome-shaped coil can generate an eddy current deeply in a wider range than the 8-shaped coil.
- a dome-shaped coil was modeled based on the analysis results of the simple model.
- the coil used was a four-turn model with a horizontal length of 117 mm, a width of the upper and lower conductors of 34 mm, and a conductor spacing of 3 mm.
- the horizontal length as shown in FIG. 20 is 112 mm
- the vertical length is 39 mm
- the coil width is 97 mm
- 20 times We modeled the dome-shaped coil of the winding and analyzed under the same analysis conditions.
- Table 3 shows a comparison of the analysis result of the coil shown in FIG. 16 that is most effective in the simple model and the analysis result of the dome-shaped coil shown in FIG. From this result, although the maximum eddy current density is reduced by using the dome type, the inductance is considerably reduced. Therefore, the maximum eddy current can be increased by increasing the inductance by changing the parameters when fabricating the dome type coil. The density is expected to be the same value as the simple coil. Further, from the eddy current distribution as seen from the coil side shown in FIG. 21, the anisotropy is reduced in the spread of the eddy current distribution as compared with the simple coil, and the eddy current can be generated more uniformly over a wide range. I understand.
- the inductance can be greatly suppressed by changing the radius of the upper arc. This is consistent with the initial assumption in the proposal of a dome-shaped coil that “generates eddy currents uniformly over a wider range while suppressing inductance”.
- the upper and lower conductive wires have the same curvature in two horizontal directions. Assuming this, it can be seen that the parameters are reduced to three: the number of turns, the length in the vertical direction, and the curvature of the upper conductor.
- the present invention proposes a dome-shaped coil as a new stimulation coil that is highly robust against positioning errors, and analyzed the eddy current density, eddy current spread, and inductance for each parameter change using a simple model. Based on the results of the simple model, a dome-shaped coil model was prepared and the analysis results were compared. As a result, the coil designed this time can generate eddy currents in a wider range than the 8-coil, and by using a dome shape, inductance is suppressed while maintaining induction of eddy currents over a wide range. I found out that I could do it.
- the present invention has been made based on the above findings, and is a coil device used for transcranial magnetic stimulation treatment that is placed on the surface of the head and stimulates neurons by generating an electric current in the brain by electromagnetic induction.
- a transcranial magnetic stimulation system having a coil device, A winding frame having a neutral shaft connecting the center of gravity in a transverse section and a cylindrical surface surrounding the neutral shaft; Comprising a coil made of a conductive wire wound around the cylindrical surface around the neutral axis;
- the cylindrical surface includes an inner surface portion disposed near the head surface in use, a first direction parallel to the neutral axis, and a second direction orthogonal to the first direction. Having an outer surface portion that draws a convex curved surface projecting outward;
- the neutral axis draws a convex curve protruding from the inner surface portion toward the outer surface portion.
- the coil device of the present invention configured as described above is arranged so as to face the inner surface portion of the coil device and the patient's head surface when in use.
- a magnetic field is formed inside the coil.
- This magnetic field extends along the neutral axis of the reel and is deflected so as to gradually approach the patient's head from the center of the reel toward the end of the reel corresponding to the shape of the reel. Released from the part.
- the emitted magnetic field travels toward the patient's head and generates eddy currents uniformly over a wide area in the patient's head.
- the inner surface portion is a curved surface that is recessed concavely toward the inside of the cylindrical surface. According to this coil device, the coil device can be placed almost exactly on the surface of the patient's head, so that the positioning accuracy of the coil device is further improved and the magnetic field emitted from the coil is efficiently applied to the patient's head. Can be collected.
- the inner surface portion is a flat surface.
- the cylindrical surface has an end cross section on one end side and the other end side of the neutral shaft smaller than a center cross section located at the center on the one end side and the other end side. .
- a cross section of the cylindrical surface is configured to gradually become smaller from the central cross section toward the end cross section.
- the neutral axis is preferably an axis passing through the centroid or the center of gravity of the cross section of the cylindrical surface.
- the winding frame may be either a hollow member extending along the neutral axis or a solid member.
- FIG. 1 is a diagram showing a transcranial magnetic stimulation system according to the present invention.
- FIG. It is a figure which shows the magnetic stimulation apparatus of the system shown in FIG. It is a figure which shows the drive circuit of the system shown in FIG.
- FIG. 25 is a longitudinal sectional view [FIG. 25A], a transverse sectional view [FIG. 25B] of the coil unit shown in FIG. 22, and a plan view partially cut away [FIG. 25C]. It is the longitudinal cross-sectional view [FIG.26 (a)] of a coil unit of Embodiment 2, and a cross-sectional view [FIG.26 (b)].
- FIG. 27 is a longitudinal sectional view (FIG. 27A) and a transverse sectional view (FIG.
- FIG. 28 is a perspective view (FIG. 28A), a transverse sectional view (FIG. 28B), and a longitudinal sectional view (FIG. 28C) of a coil device according to another embodiment of the present invention.
- FIG. 29A is a diagram for explaining design parameters to be optimized for the dome-shaped coil of the present invention [FIG. 29A], and a spherical conductor for evaluating various characteristics of the dome-shaped coil of the present invention.
- FIG. 29 illustrates a brain model (FIG. 29B).
- the dome-shaped coil of this invention it is a figure which shows the various characteristic values of a coil when each design parameter is changed, and an induction electric field strength distribution. It is the figure which showed the induction electric field distribution of the dome shape coil of this invention using the numerical brain model.
- a transcranial magnetic stimulation system (hereinafter simply referred to as “system”) 1 is a magnetic stimulation that applies magnetic stimulation to the brain of a patient 2 supported by a support mechanism (eg, chair, bed) (not shown).
- a device 3 is included.
- the magnetic stimulation device 3 includes a coil unit (coil device) 4 that forms a dynamic magnetic field for applying magnetic stimulation to a specific part of the brain of the patient 2.
- the coil unit 4 is preferably supported by an appropriate support unit (not shown) so that it can move along the head surface of the patient 2 and can be positioned at an arbitrary position.
- the coil unit 4 includes a coil 5 (see FIG. 25).
- the coil 5 is connected to the drive unit 7 via a cable 6.
- the drive unit 7 includes a drive circuit 8 (see FIG. 24) described below, and a coil 5 is connected to the drive circuit 8.
- the drive circuit 8 uses the output from the power supply circuit 12 that converts the output voltage of the power supply 11 to a desired voltage, the booster circuit 13 that boosts the output of the power supply circuit 12, and the output from the booster circuit 13.
- a capacitor 14 that accumulates, a resistor 15 that adjusts the current flowing through the capacitor 14, and a semiconductor switch 16 that operates the output from the capacitor 14 at a predetermined timing to form a predetermined current.
- the current adjusted by the semiconductor switch 16 Is applied to the coil 5.
- the current applied to the coil is not only a current (AC) whose flow direction changes periodically with time, but also a current whose flow direction is constant and whose magnitude varies periodically (so-called “ It should be understood to include pulsatile flow)).
- the coil unit 4 has a winding frame 21 made of a nonmagnetic electrically insulating material.
- the reel 21 is composed of a bottom wall 22 disposed near the patient's head 10 in the use state shown in FIG. 22 and a ceiling wall 23 disposed away from the patient's head 10 in the use state.
- the cylindrical member is provided with a neutral shaft 24 extending in the left-right direction in FIG.
- the bottom wall 22 has a flat plate shape.
- the ceiling wall 23 has a convex dome shape toward the direction from the bottom to the top (direction away from the head) of FIGS. 25 (a) and 25 (b). Specifically, as shown in FIG.
- the cross section of the ceiling wall 23 along the vertical plane including the neutral axis 24 draws a convex curved surface upward, as shown in FIG. 25 (b).
- the cross section of the ceiling wall 23 along the vertical plane perpendicular to the neutral axis 24 also has a convex curved surface upward.
- the cylindrical surface 25 which connected the outer surface part 22a of the bottom wall 22 and the outer surface part 23a of the ceiling wall 23 forms the conducting wire winding surface mentioned later.
- the neutral shaft 24 is a line connecting centroids (centers of gravity) defined on the cross section of the cylindrical surface 25.
- the bottom wall 22 and the ceiling wall 23 are provided with hooks (flanges) 26 extending in a direction away from the neutral shaft 24 (outside) at both ends of the reel 21 (left and right ends in FIG. 25A).
- the collar 26 may be continuous around the neutral axis 24 or may not be continuous (that is, it may be intermittent).
- the reel 21 having such a configuration is, for example, two divided pieces divided along virtual lines 27 and 28 shown in FIGS. 25A and 25B, or a bottom wall 22 and a ceiling wall 23. It is preferable to form a combination of two divided pieces divided along the connecting portion or three or more divided pieces divided at an appropriate cross section.
- the coil 5 is configured by winding a conducting wire 31 around a neutral shaft 24 around a conducting wire winding surface of the winding frame 21 (outer peripheral surfaces of the bottom wall 22 and the ceiling wall 23).
- the cross section of the coil 5 (cross section perpendicular to the neutral axis) is small at both ends of the winding frame 21 and has the maximum size at the center. Therefore, the magnetic field formed inside the coil 5 when a current is applied to the coil 5 converges from the center portion toward the end portion, and the converged magnetic field moves toward the extension line of the neutral shaft 24, that is, In use, it is released towards the patient's head.
- the periphery of the coil 5 is covered with a nonmagnetic electrically insulating material.
- the bottom coil portion 41 disposed on the bottom wall 22 is covered with a bottom housing portion 42 and the ceiling disposed on the ceiling wall 23.
- the coil part 43 is covered with a ceiling housing part 44.
- the bottom housing portion 42 and the ceiling housing portion 44 need not be formed of the same material, and may be formed of different materials. In this case, for example, the bottom housing portion 42 can be formed of a thin and flexible insulating sheet.
- the ceiling housing portion 44 is preferably formed of a rigid material.
- the bottom housing portion 42 and the ceiling housing portion 44 may be formed by, for example, integrally molding a resin around the coil 5, or the bottom housing portion 42 and the ceiling housing portion 44 that are separately formed may be formed. It may be assembled around the coil 5.
- the ceiling housing portion 44 is preferably provided with a handle 51 for an operator (not shown) to move the coil unit 4 while holding it.
- the handle 51 can be formed of a hollow member, and the cable 6 can be disposed therein.
- the bottom surface (bottom housing portion 42) of the coil unit 4 is disposed at an appropriate location on the patient head surface during use.
- a predetermined alternating current or pulsating current is applied to the coil 5 from the drive circuit 8 of the drive unit 7.
- a periodically changing magnetic field is formed inside the coil 5.
- This magnetic field is formed along the neutral axis 24 of the reel 21 and gradually approaches the patient's head from the center of the reel 21 toward the end of the reel 21 corresponding to the shape of the reel 21.
- the magnetic field emitted from the end of the coil 5 travels toward the patient's head.
- eddy currents are uniformly generated over a wide area in the patient's head. Therefore, even if the position of the coil device is slightly deviated from the target position, an eddy current can be reliably generated at the target site.
- FIG. 26A to FIG. 26C show the coil unit 104 of the second embodiment.
- the bottom wall 22 of the winding frame 21, particularly the outer surface portion 22 (winding frame outer surface) of the bottom wall 22 in contact with the coil 5, as in the ceiling wall 23 of the winding frame 21, extends from the bottom to the top of the figure. It is recessed in a concave shape toward the direction (the direction away from the head).
- the vertical plane including the neutral axis 24 and the cross section of the bottom wall along the vertical plane perpendicular to the vertical axis depict a curved surface that is concaved upward.
- the curvature of the outer surface portion 22 is smaller than the curvature of the outer surface portion 23 a (winding frame outer surface) of the ceiling wall 23.
- the coil 5 is arranged in a curved shape following the curved bottom wall 22, and the curved bottom housing portion 42 covers the outside.
- the curvature of the curved surface, particularly the curvature of the bottom housing portion 42 of the outermost layer, preferably substantially matches the shape of the head to which the coil unit 104 is applied.
- Other configurations are the same as those of the first embodiment.
- the coil unit 104 of the second embodiment configured as described above, the coil unit 104 can be almost exactly along the surface of the patient's head, so that the positioning accuracy of the coil unit 104 is further improved. Further, since the curvature of the neutral axis is further increased as compared with the first embodiment, more magnetic fields can be collected in the patient's head, and treatment can be performed more efficiently.
- FIGS. 27A and 27B show the coil unit 204 of the third embodiment.
- the outer surface of the bottom housing portion 42 (the surface facing the patient's head) is recessed in a concave shape in the direction from the bottom to the top (the direction away from the head).
- the bottom surface of the bottom housing portion 42 along the vertical plane including the neutral shaft 24 and the vertical plane orthogonal thereto forms a curved surface that is concaved upward. It is preferable that the curvature of the curved surface, particularly the curvature of the bottom housing portion 42 of the outermost layer substantially matches the shape of the head to which the coil unit 204 is applied.
- Other configurations are the same as those of the first embodiment.
- the coil unit 204 of the second embodiment configured as described above, the coil unit 204 can be placed almost exactly on the surface of the patient's head, so that the positioning accuracy of the coil unit 204 is further improved.
- the winding frame is a hollow cylindrical member, but it may be a solid cylindrical member having no space between the bottom wall and the ceiling wall.
- FIGS. 28A to 28C show a coil unit 304 having a crescent-shaped cross section according to the fourth embodiment.
- the coil unit 304 has a winding frame 321 made of a nonmagnetic electrically insulating material and having a substantially crescent-shaped cross section.
- the reel 321 is a cylindrical member composed of a bottom wall 322 arranged near the patient's head 10 in use and a ceiling wall 323 arranged away from the patient's head 10 in use.
- a neutral shaft 324 extending in the left-right direction in FIG.
- the bottom wall 322 has a curved surface that is recessed in a concave shape in the direction from the bottom to the top (the direction away from the head).
- the ceiling wall 23 has a convex curved surface in the direction from the bottom to the top (the direction away from the head) of FIG. More specifically, as shown in FIGS. 28A and 28B, on the vertical plane orthogonal to the neutral axis 324, the cross sections of the bottom wall 322 and the ceiling wall 323 both have a convex curved surface facing upward. ing. Further, the left and right connecting portions of the bottom wall 322 and the ceiling wall 323 form a smooth curved surface.
- a cylindrical surface 325 having a substantially crescent-shaped cross section connecting the outer surface portion 322a of the bottom wall 322 and the outer surface portion 323a of the ceiling wall 323 forms a conductive wire winding surface described later.
- the neutral shaft 324 is a line connecting centroids (centers of gravity) defined on the cross section of the cylindrical surface 325.
- the bottom wall 322 and the ceiling wall 323 are provided with hooks (flanges) 326 extending in the direction away from the neutral shaft 324 (outside) at both ends of the winding frame 321 (left and right ends in FIG. 28C).
- the collar 326 may be continuous around the neutral shaft 324 or may not be continuous (that is, it may be intermittent).
- the reel 321 having such a configuration includes, for example, a plurality of divided pieces divided along a cross section including the neutral shaft 324, or a plurality of divided pieces divided along a cross section orthogonal to the neutral shaft 324. It is preferable to form in combination.
- the coil 305 is configured by winding a conducting wire 331 around a neutral shaft 324 around a conducting wire winding surface 325 of the winding frame 321 (an outer surface portion 322a of the bottom wall 322 and an outer surface portion 323a of the ceiling wall 323).
- the periphery of the coil 305 is covered with a nonmagnetic electrically insulating material.
- the bottom coil portion 341 disposed on the bottom wall 322 is covered with the bottom housing portion 342 and the ceiling disposed on the ceiling wall 323.
- the coil portion 343 is covered with a ceiling housing portion 344.
- the bottom housing portion 342 and the ceiling housing portion 344 need not be formed of the same material, and may be formed of different materials.
- the bottom housing portion 342 can be formed of a thin and flexible insulating sheet.
- the ceiling housing portion 344 is preferably formed from a rigid material.
- the bottom housing portion 342 and the ceiling housing portion 344 may be formed by, for example, integrally molding a resin around the coil 305, or the bottom housing portion 342 and the ceiling housing portion 344 formed separately may be formed. It may be assembled around the coil 305.
- the ceiling housing portion 344 is provided with a handle for an operator (not shown) to move the coil unit 304 while holding it.
- the bottom surface (bottom housing portion 342) of the coil unit 304 is placed at an appropriate location on the patient's head surface during use. Be placed.
- a predetermined alternating current or pulsating current is applied to the coil 305 from the drive circuit 8 of the drive unit 7.
- a periodically changing magnetic field is formed inside the coil 305.
- This magnetic field is formed along the neutral axis 324 of the winding frame 321.
- the magnetic field emitted from the coil 305 travels toward the patient's head and generates eddy currents uniformly over a wide area in the patient's head.
- the winding frame 321 is represented such that the neutral shaft 324 draws a straight line, but the winding frame 321 has a convex curve with the neutral shaft facing upward. It may be configured.
- the outer shape of the bottom housing part can also be configured so as to draw a convex curved surface with the central part in the long axis direction upward, so that the bottom surface of the bottom housing is almost flush with the patient's head surface. be able to.
- the bottom wall 322 of the winding frame 321 is configured such that the central portion in the width direction draws a convex curve upward.
- the coil is arranged in a straight line along the bottom portion 322, while the bottom surface of the bottom housing is formed in a convex shape with its central portion in the width direction facing upward (that is, , The center of the width direction is made thin and both sides are made thick), so that the bottom surface of the bottom housing can be made to fit the patient's head surface almost exactly.
- the outer shape of the bottom housing portion may be configured such that the central portion in the major axis direction draws a convex curved surface.
- each part of the coil device in the first to fourth embodiments described above are determined according to the specifications required for the coil device.
- (a) the length in the neutral axis direction of the coil affects the spread of eddy current
- (b) the height of the coil affects the density of eddy current.
- (C) the curvature (diameter) of the ceiling coil portion affects the inductance
- (d) the length of the coil in the width direction orthogonal to the neutral axis affects the eddy current density
- (e) the number of turns of the coil Affects eddy current density Therefore, it is preferable to consider these elements (a) to (e) when actually designing the coil device.
- the coil is formed by winding a conductive wire having a rectangular cross section of 6 ⁇ 2 mm, and the number of turns of the coil is 20 turns.
- the conducting wire is wound so as to be in contact with the scalp having a radius of 100 mm.
- the design parameters to be studied to obtain the optimal design value of the dome-shaped coil are: A: Coil width, B: Coil height, C: Coil upper conductor radius (outside It is appropriate to use three (curvature) (FIG. 29A), and these three parameters are independent of each other. Further, the spacing between the conductors on the side in contact with the scalp is determined from the determined coil width A.
- the present inventors independently developed a numerical model of the coil and the brain. That is, as shown in FIG. 29B, the brain is modeled as a spherical (spherical) conductor having a diameter of 200 mm.
- the conductivity of this brain model was 0.11 S / m based on the gray matter conductivity at 3.4 kHz (S. Gabriel, R. W. Lau, and C. Gabriel, Phys. Med. Biol. 41, 2231 (1996 )).
- the coil model is placed 10 mm above the brain model, and the spacing is according to the thickness of the scalp and skull.
- the alternating current applied to the coil has a frequency of 3.4 kHz and a current value of 5.3 kA, which is a typical alternating pulse width of a TMS device using a wavelength range of 200 to 300 ⁇ s.
- the coil width A when the coil width A is increased, the maximum intensity of the induced electric field and the inductance of the coil are reduced, while the range in which the induced electric field is distributed is expanded. From this, it can be seen that the coil width A may be reduced in order to increase the electric field strength. However, if the coil inductance is not made smaller than 12.6 ⁇ H, the width of the excitation pulse will increase, so the electric field strength needs to be made smaller than 121 ⁇ V / m. Under that condition, the range in which the induced electric field is distributed is narrowed to 86 mm ⁇ 50 mm.
- the inductance of the coil is increased.
- the distribution range of the induced electric field is slightly widened and the strength of the induced electric field is also slightly increased. If an attempt is made to increase the induced electric field strength by this method, the electric field strength is 70 V / m, and the electric field distribution range is 105 ⁇ 76 mm.
- the limit here is determined not by the coil inductance conditions but by the upper conductor radius (external curvature) C. That is, the upper conductor radius C is 56 mm, and the coil height B must be geometrically smaller than 56 mm.
- FIG. 30 and Table 4 collectively show how the coil characteristics are improved when the design parameters are changed.
- the best way to increase the induction field strength and the induction field range is to increase the upper conductor radius C.
- increasing the upper conductor radius C increases the size of the coil itself.
- the electrical resistance of the coil if the coil size is increased, the resistance value of the entire coil is also increased, so that the heating of the coil is also increased. For this reason, if the number of excitation pulses increases in rTMS (repetitive TMS), the heat generation will exceed the limit. Therefore, it is necessary to limit the number of excitation pulses to a certain limit or less, so the coil size is increased.
- FIG. 30D shows the induced electric field intensity distribution of the model obtained as a result.
- the maximum value of the induced electric field strength is 93 V / m
- the distribution of the induced electric field is 106 ⁇ 68 mm
- the coil inductance is 11 ⁇ H.
- the optimized design model described above improves the induced electric field strength without the distribution of the induced electric field spreading.
- the optimized design model obtained this time with a coil width of 78 mm, a coil height of 39 mm, and a coil upper conductor radius of 66 mm exhibits the same effects as described above by selecting the design values.
- the design value can be selected from different values as appropriate within a range. Specifically, it is a model in which at least any one or all of a coil width of 78 mm, a coil height of 39 mm, and an upper conductor radius of 66 mm are increased or decreased within a range of 10%.
- the inventor further made his own computer program based on the SPFD method (the scalar potential finite-difference method) for the dome-shaped coils of the start data model and the optimization model shown above.
- the numerical brain model realistic brain model (realistic brain model) (T. Nagaoka, S. Watanabe, K. Sakurai, E. Kunieda, ana S. Watanabe, M. Taki, and Y. , 1 (2004)).
- the result is shown in FIG.
- the 99.9 percentile value of all voxels is 55 V / m for the coil of the start data model (Fig. 31 (a)) and 83 V / m for the coil of the optimized model (Fig. 31 (b)).
- Transcranial magnetic stimulation system 2 Patient 3: Magnetic stimulation device 4: Coil unit (coil device) 5: Coil 6: Cable 7: Drive unit 8: Drive circuit 10: Patient head 11: Power supply 12: Power supply circuit 13: Booster circuit 14: Capacitor 15: Resistor 16: Semiconductor switch 21: Reel 22: Bottom wall 22a: The outer surface portion 23 of the bottom wall: the ceiling wall 23a: the outer surface portion 24 of the ceiling wall: the neutral shaft 25: the cylindrical surface 26: the flange 27, 28: the virtual line 31: the conducting wire 32: 41: bottom coil portion 42: bottom housing portion 43: ceiling coil portion 44: ceiling housing portion A: Coil width B: Coil height C: Upper conductor radius of the coil
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Abstract
Description
そこで,手術を要さない非侵襲的な磁気刺激を反復して行う反復経頭蓋磁気刺激が治療法として研究されている。例えば難治性神経障害性疼痛において,大脳の一次運動野に磁気刺激を行った後1日間ほど除痛効果をえられたことが報告されている。
8字コイルは,2つの円形コイルを部分的に重ねて配置したもので,それらの円形コイルに逆向きに電流を流すことで,コイル交差部直下に渦電流を集中させて局所への刺激が可能である。
一方,治療の対象や,患者個人の症状によっては,局所的な刺激とは逆に,より広い範囲で刺激することが有効な場合がある。
また,局所に刺激が集中するコイルでは,対象の部位へ正確に位置を決めることが求められ,この場合,ナビゲーションシステム等による正確な位置決めを実施する必要があった。
る磁気刺激が可能なコイルとして,図6に示すドーム型コイルを提案する。このドーム型
コイルでは,断面積に変化を持たせることによってインダクタンスを小さくしながら,渦
電流密度の大きさを保ち,渦電流密度が大きく流れる範囲を広くすることができると考え
られる。このドーム型コイルの評価をするために,図7に示す簡易モデルを用いた。
巻数は渦電流の広がりに対しては影響をほとんど与えないが,巻数が多くなるにしたがって渦電流密度が大きくなることが分かった。また,同条件で従来の8字コイルに関して解析した結果は,渦電流密度は24.32 A/m2,渦電流の広がりは4.29 cm×7.55 cm,インダクタンスは9.71 μHであった。
横断面中の重心を連結した中立軸と前記中立軸を囲む筒状面とを有する巻枠と,
前記中立軸の周りで前記筒状面に巻かれた導線からなるコイルを備えており,
前記筒状面は,使用時に前記頭表面の近くに配置される内面部分と,前記中立軸と平行な第1の方向と前記第1の方向と直交する第2の方向に関して前記筒状面の外側に向かって突出した凸状の曲面を描く外面部分を有し,
前記中立軸が前記内面部分から前記外面部分に向かって突出した凸状の曲線を描くことを特徴とするものである。
それとともに,治療の対象や,患者個人の症状によっては,局所的な刺激とは逆に,より広い範囲で刺激することが有効な場合があるので,そのような治療に適合する治療コイルを実現できる。
が好ましい。その他の構成は上述の実施形態1と同じである。
以下の検討では、次の設計パラメータ等は固定して検討をおこなっている。
すなわち、コイルは6×2mmの長方形断面を有する導線を巻回して形成されており、コイルの巻数は20ターンである。また、導線は半径100mmの頭皮に接する形状となるよう巻かれている。
上記の各実施形態に示した通り、ドーム型コイルの最適設計値を得るために検討を行う対象の設計パラメータは、A:コイル幅、B:コイル高さ、C:コイルの上側導線半径(外側曲率)の3つ(図29(a))とすることが適切であり、これら3つのパラメータは互いに独立である。また、決められたコイルの幅Aから、頭皮に接する側の各導線間の間隔が決まることになる。
尚、今回得られた最適化設計モデルであるコイル幅78mm、コイル高さ39mm、コイルの上側導線半径66mmというモデルは、設計値の選択により上記に示した各効果が実質的に同様に奏される範囲内で適宜、異なる値から設計値を選択することができる。具体的には、コイル幅78mm、コイル高さ39mm、上側導線半径66mmの少なくともいずれか又は全てを10%の範囲内で増大させた、または減少させたモデルである。
2:患者
3:磁気刺激装置
4:コイルユニット(コイル装置)
5:コイル
6:ケーブル
7:駆動ユニット
8:駆動回路
10:患者頭部
11:電源
12:電源回路
13:昇圧回路
14:コンデンサ
15:抵抗
16:半導体スイッチ
21:巻枠
22:底壁
22a:底壁の外面部分
23:天井壁
23a:天井壁の外面部分
24:中立軸
25:筒状面
26:鍔
27,28:仮想線
31:導線
32:
41:底部コイル部分
42:底部ハウジング部分
43:天井部コイル部分
44:天井部ハウジング部分
A:コイル幅
B:コイル高さ
C:コイルの上側導線半径
Claims (13)
- 頭表面上あるいはその近傍に置かれ,電磁誘導によって脳内に電流を発生させてニューロンを刺激する,経頭蓋磁気刺激治療に使用するコイル装置(4)であって,
横断面中の重心を連結した中立軸(24)と前記中立軸を囲む筒状面(25)とを有する巻枠(21)と,
前記中立軸の周りで前記筒状面に巻かれた導線(31)からなるコイル(5)を備えており,
前記筒状面(25)は,使用時に前記頭表面の近くに配置される内面部分(22a)と
前記中立軸と平行な第1の方向と前記第1の方向と直交する第2の方向に関して前記筒状面の外側に向かって突出した凸状の曲面を描く外面部分(23a)を有し,
前記中立軸が前記内面部分から前記外面部分に向かって突出した凸状の曲線を描くことを特徴とする,コイル装置。 - 前記内面部分が前記筒状面の内側に向かって凹状に窪んだ曲面であることを特徴とする,請求項1のコイル装置。
- 前記内面部分が平坦な面であることを特徴とする,請求項1のコイル装置。
- 前記外面部分の上に位置するコイル部分を覆う外側ハウジング部分を有する請求項1~3のいずれかのコイル装置。
- 前記内面部分の上に位置するコイル部分を覆う内側ハウジング部分を有する請求項1~4のいずれかのコイル装置。
- 前記内側ハウジング部分の外面が前記筒状面の内側に向かって凹状に窪んだ曲面であることを特徴とする請求項5のコイル装置。
- 前記筒状面は,前記中立軸の一端側と他端側の端部横断面が,前記一端側と他端側の中央に位置する中央部横断面よりも小さいことを特徴とする請求項1~6のいずれかのコイル装置。
- 前記筒状面の横断面は,前記中央部横断面から前記端部横断面に向かって漸次小さくなるように構成されていることを特徴とする請求項7のコイル装置。
- 前記中立軸は,前記筒状面の横断面の図心又は重心を通る軸であること特徴とする請求項1~8のいずれかのコイル装置。
- 前記巻枠は,前記中立軸に沿って伸びる中空の部材によって構成されている請求項1~9のいずれかのコイル装置。
- 前記巻枠は中実の部材によって構成されている請求項1~9のいずれかのコイル装置。
- 頭表面上あるいはその近傍に置かれ,電磁誘導によって脳内に電流を発生させてニューロンを刺激する,経頭蓋磁気刺激治療に使用するコイル装置(304)であって,
横断面中の重心を連結した中立軸(324)と前記中立軸を囲む筒状面(325)とを有する巻枠(321)と,
前記中立軸の周りで前記筒状面に巻かれた導線(331)からなるコイル(305)を備えており,
前記筒状面(325)は,使用時に前記頭表面の近くに配置される内面部分(322a)と使用時に前記頭表面から遠くに配置される外面部分(323a)を有し,前記内面部分と前記外面部分が共に外側に向かって突出した凸状の曲面を描いていることを特徴とする,コイル装置。 - 請求項1~12のいずれかのコイル装置を備えた経頭蓋磁気刺激システム。
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