CN104622468A - Deep brain stimulation system with predication function - Google Patents
Deep brain stimulation system with predication function Download PDFInfo
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- CN104622468A CN104622468A CN201310567405.9A CN201310567405A CN104622468A CN 104622468 A CN104622468 A CN 104622468A CN 201310567405 A CN201310567405 A CN 201310567405A CN 104622468 A CN104622468 A CN 104622468A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/369—Electroencephalography [EEG]
- A61B5/377—Electroencephalography [EEG] using evoked responses
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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
- A61N1/372—Arrangements in connection with the implantation of stimulators
Abstract
The invention discloses a deep brain stimulation system with the predication function. The deep brain stimulation system comprises an inner stimulation treatment device and an external detection control device. The deep brain stimulation system can predict epilepsy accurately in advance, a patient is informed through an alarm unit so as to adopt precautionary measures in advance, and the epilepsy can be treated through deep brain stimulation. According to the deep brain stimulation system, the detection control device is placed in vitro, so that the inner epilepsy stimulation treatment device works only when the epilepsy attack is about to happen; the inner implanted device power consumption is greatly reduced, so that the inner power supply unit using time is greatly prolonged. Meanwhile, due to the fact that a battery is easy to replace outside, a prediction algorithm is selected based on the prediction accuracy, scalp electroencephalogram signals are adopted to replace intracranial electroencephalogram signals, and the phenomenon that an electrode is implanted in the cranium to obtain electroencephalogram signals is avoided, so that the installation operation is easy, and injuries are small.
Description
Technical field
The invention belongs to medical instruments field, relate to nervous system disease device, particularly relate to a kind of deep brain stimulation system of external forecast function, for prediction and treatment epileptic condition.
Background technology
Epilepsy is one of neural common disease.According to World Health Organization's conservative estimation, about have 5,000 ten thousand people to suffer the torment of epilepsy by the end of the whole world in 2005, wherein the patient of 80% lives in developing country.In China, large-scale survey report shows that domestic prevalence is about 8 ‰, this means domestic nearly more than 1,000 ten thousand epileptics.The primary treatments adopted clinically at present has Drug therapy and surgical operation therapy.But long term combined use can cause curative effect to go down, and develops into intractable epilepsy, and occurs serious side effect; Often there is much serious post-operative complication in the method for surgical resection nervous tissue treatment, and this treatment is irreversible.
Deep brain stimulation system is commonly called as brain pacemaker, and English name is Deep Brain Stimulator, is called for short DBS.One of DBS important operation method having become functional neurosurgery surgical field, it is to parkinson disease, myodystonia, the dyskinesia such as essential tremor, the effectiveness of disease treatment and long-time stability have obtained universally acknowledged, and in the treatment of the diseases such as epilepsy, pain, mental disorder, also demonstrate good application prospect.DBS has the advantages such as Wicresoft, scalable, reversible and untoward reaction are few.
The research of DBS originates in the sixties in last century, and neurosurgeon and neurosurgical doctor bring into use electricity irritation to locate and to distinguish the privileged sites in brain, finds that in Stimulation of The Brain, certain part-structure can produce the result suppressing sacred disease symptom.The eighties, Medtronic company and the internal medicine researcher that some are outstanding develop a set of brain stimulation technology.In August, 1992, Europe multicenter clinical research of trembling included 100 multidigit patients in test for the first time.February nineteen ninety-five, Medtronic thalamus irritation therapy was in Europe, and Canada and Australia are passed through, in order to treat essential tremor and parkinsonian tremor.1997, U.S. FDA approval entered American market.Domesticly started the operation of existing 20 hospital brain pacemakers from 1999.
The DBS used clinically is at present open cycle system.
The disadvantage of existing product is: 1. existing deep brain stimulation system is open cycle system, namely stimulus modelity is that circulation stimulates, just brain tissue's a period of time is stimulated every a few minutes after implanting, this Therapeutic mode not only therapeutic effect is not good, and more electricity can be consumed, and the supplying cell of the DBS system implanted can only single use, its life-span is approximately 3-5 years, battery is once exhaust, patient can only undergo surgery replacing battery again, so both add misery and the operation risk of patient, increase the weight of again its financial burden.Although 2. by can obviously reduce epilepsy number of times after deep brain stimulation system treatment, but still epilepsy can not be stopped completely; Because it can not predict epilepsy, the irregular outbreak of epilepsy can make patient there is potential danger, by movable for some greatly restriction in patient's daily life.
Summary of the invention
The object of the invention is to for above-mentioned the deficiencies in the prior art, a kind of deep brain stimulation system of external forecast function is provided.This system not only can look-ahead epilepsy more accurately, and can inform patient by alarm unit, so that patient carries out preventive measure in advance, and can treat epilepsy by deep brain stimulation.
Because epileptic prediction part carries out computing and analysis to the EEG signals obtained, amount of calculation is larger, power dissipation ratio is higher, this part is placed on external by the present invention, inner epilepsy stimulation treatment system only just can be worked when epilepsy is about to outbreak, internal therapentics device is in the past compared, and inner implanting device power consumption significantly reduces and makes internal electric source unit have improvement by a relatively large margin service time; Simultaneously owing to easily changing battery in outside, prediction algorithm just can be chosen based on the accuracy of prediction, and EEG signals adopts scalp brain electricity to replace intracranial brain electricity, avoids intracranial and implants the electrode obtaining EEG signals, makes that installation is performed the operation simply, wound is little.
In order to achieve the above object, present invention employs following technical scheme:
A kind of deep brain stimulation system of external forecast function, comprise internal stimulus therapy equipment and external detection control device, described internal stimulus therapy equipment mainly comprises with the stimulation therapy unit 11 of housing, lead-in wire 12, probe 13 and brain depth electrode 14, and described brain depth electrode 14 is electrically connected with stimulation therapy unit by probe 13 and lead-in wire 12; Described stimulation therapy unit comprises first microprocessor 101, memory element 102, communication unit 103, treatment unit 104, power subsystem 105 and clock unit 106; Described communication unit 103, microprocessor 101 are connected successively with treatment unit 104, and described microprocessor 101 is also connected with memory element 102;
Described external detection control device mainly comprises hook 22, lead-in wire 23, electrod-array 24 and detection control unit, and described electrod-array 24 is electrically connected with detection control unit by lead-in wire 23; Described detection control unit comprises the second microprocessor 201, memory element 202, communication unit 203, detecting unit 204, display unit 205, keyboard unit 206, alarm unit 207, power subsystem 208 and clock unit 209, described detecting unit (204), microprocessor 201, keyboard unit 206 are bi-directionally connected successively, and described microprocessor 201 is also connected respectively with memory element 202, communication unit 203, display unit 205 and alarm unit 207 simultaneously;
The communication unit 103 of described internal stimulus therapy equipment is connected with the communication unit 203 of external detection control device.
First microprocessor 101 of the present invention, for there being the low-power consumption microcontroller of certain operational capability, is in holding state for controlling communication unit; When receiving the signal that external detection system sends, control power subsystem and power to treatment unit; When receiving the signal that external detection system sends, control the pulse signal that treatment unit produces certain amplitude, frequency and dutycycle, reached the object for the treatment of epilepsy by the electrode stimulating brain deep of implanting brain deep;
Described communication unit 103 adopts the wireless communication technology of low-power consumption;
Described treatment unit 104 produces chip composition primarily of the PWM ripple of low-power consumption;
Described brain depth electrode 14 is implanted to deep-brain, is made up of the material with biological compatibility.
Second microprocessor 201 of the present invention, for there being the low-power consumption microcontroller of certain operational capability, carries out filtering, amplification and digital-to-analogue conversion for controlling detecting unit to data; Obtain the data after detecting unit process, and store; The epileptic Seizure Prediction Method Based implanting inside is used to carry out calculation process to gathering the data got, and whether epilepsy is made a policy by outbreak, when predicting epilepsy, controls to open alarm unit, point out patient's epilepsy to be about to outbreak in advance, allow patient carry out prevention in advance and prepare; When predicting epilepsy, control communication unit and inform that its epilepsy is about to outbreak to interior arrangement epilepsy stimulating system signal;
Described communication unit 203 adopts the wireless communication technology of low-power consumption;
Described detecting unit 204 is made up of electrode interface 2041, elementary filter circuit 2042, stimulation filter circuit 2043, amplifying circuit 2044, analog to digital conversion circuit 2045, data-interface 2046, for under control of the microprocessor, filtering, amplification and digital-to-analogue conversion are carried out to the scalp brain electricity that electrode obtains;
Described display unit 205 is the liquid crystal display that power consumption is lower, for showing boost pulse parameter, electricity and some other parameter;
Described keyboard unit 206 comprises at least three buttons, for controlling the open and close of external detection system, and controls the adjustment of stimulus parameter;
Described alarm unit 207 is speaker or buzzer, for giving the alarm;
Described electrod-array 24 is for obtaining scalp brain electricity.
Filter circuit of the present invention is second-order filter circuit; Described amplifying circuit adopts and repeatedly amplifies; The wave filter of described filter circuit is that high pass filter, 50Hz notch filter and cut-off frequency in 1Hz is for form higher than 100Hz low pass filter by cut-off frequency.
The algorithm implanted in second microprocessor of the present invention is at least one in pattern recognition, linear, non-linear or chaology.
Electrod-array 24 of the present invention is plate-like metal electrode, and utilizes collodion to be fixed on netted medicated cap, and described netted medicated cap is worked out by fine rule.
The power subsystem 208 of external detection control device of the present invention is made up of button cell.
The first microprocessor of external detection control device of the present invention, communication unit, detecting unit, alarm unit, power subsystem and clock unit are integrated into in a shell; Second microprocessor of described internal stimulus therapy equipment, communication unit, treatment unit, power subsystem and clock unit are integrated into in a shell.
Shell of the present invention is the bumper housings being wrapped in biocompatibility material.
External detection system mainly gathers scalp brain electricity by the electrod-array of outer acquisition scalp brain electricity, then detecting unit carries out preliminary treatment to the signal collected, and carry out prediction in early stage and signal storage in the microprocessor, and predicting in the imminent situation of epilepsy, on the one hand, warning system gives the alarm and notifies that patient is ready in advance, and on the other hand, Microprocessor S3C44B0X communication unit is by this information notification internal stimulus therapy system.In addition, keyboard unit is for the adjustment of the switch and stimulus parameter that control external detection system, and display unit is for showing boost pulse parameter and electricity.
Internal stimulus therapy system is not when accepting external detection system and being about to the signal of outbreak, other unit is in closed condition, when receiving outside external detection system and being about to the signal of outbreak, internal microprocessor controls to open treatment unit and starts working, electrode to Stimulation of The Brain deep tissue provides the pulse signal of certain amplitude, frequency and dutycycle, Stimulation of The Brain deep tissue, and then treat epilepsy.
Compared with prior art, the present invention has following effective effect:
(1) outbreak of the look-ahead epilepsy of external detection system energy precise and high efficiency of the present invention, reminds patient in time, reduces the probability that peril occurs;
(2), in the present invention, just open internal stimulus therapy equipment when epilepsy arrives, compared with stimulating with the circulation of prior art, therapeutic effect significantly improves;
(3) the present invention wears, the battery altering of external detection system is very convenient, is conducive to patient oneself and independently carries out;
(4) mode of operation of external detection control system of the present invention and internal stimulus therapy system makes this system normally can work in long time, substantially reduce the frequency changing internal stimulus therapy system power subsystem, and then decrease misery and the surgical risks of patient, alleviate the financial burden of patient.
Accompanying drawing explanation
Fig. 1 is that the deep brain stimulation system of external forecast function of the present invention is at patient's brain implantation site schematic diagram.
Fig. 2 is the logic diagram of internal stimulus therapy equipment of the present invention.
Fig. 3 is the logic diagram of external detection control device of the present invention.
Fig. 4 is the logic diagram of the detecting unit of external detection control device of the present invention.
Detailed description of the invention
Below in conjunction with detailed description of the invention, the deep brain stimulation system with external forecast function of the present invention is elaborated, but the scope of protection of present invention is not limited thereto.
As shown in Figure 1, the patient's brain suffering from epilepsy implants the deep brain stimulation system of external forecast function of the present invention.This system comprises the netted medicated cap by the internal stimulus therapy equipment between Operation scalp and skull and the external detection control device hung on ear and fixed electrode array.
External detection control device carries out work by the therapy equipment of Control on Communication intra-prediction, netted medicated cap can make the electrod-array of external detection control device very easily chosen position be fixed.
The housing of internal stimulus therapy equipment is made by biocompatible materials, be placed between head and scalp, there is certain radian, during placement, on skull, usually get out a groove, the size shape of groove and being consistent of housing, can make it well fix like this.Brain depth electrode assembly is multi-contact electrode, be implanted to position, brain deep, for epilepsy therapy, be generally be implanted in thalamus district (nucleus anterior thalami, subthalamic nuclei, median thalamic nuclei) or hippocampus, Ye Shiding district is by being directly inserted into position, brain deep after boring.
The detection control unit of external detection control apparatus hangs on ear by hook, and electrod-array is fixed on scalp, and electrod-array is connected by going between in external detection control unit.Be hollow-core construction in the middle of hook, pass lead-in wire.Electrod-array is placed in prefrontal area, top district, occipital region, and for the collection of scalp brain electricity, it is fixed on netted medicated cap.Generally patient only needs to coat a small amount of conductive paste on an array when using this device, and under using have gentle hands flicking after then putting on netted medicated cap, electrode just can contact well with scalp, and then can obtain scalp EEG signals.
As shown in Figure 2, the stimulation therapy unit of internal stimulus therapy equipment comprises microprocessor 101, memory element 102, communication unit 103, treatment unit 104, power subsystem 105 and clock unit 106.Communication unit do not receive external detection control device about epilepsy be about to outbreak signal time, other unit is in holding state, treatment unit 103 do not have stimulation pulse signal to produce, when communication unit receive external detection control device about epilepsy be about to outbreak signal time, first microprocessor 101 in internal stimulus therapy equipment controls treatment unit 104, certain amplitude is provided to the brain depth electrode array 14 be used for the treatment of, the pulse signal of frequency and dutycycle, this amplitude, frequency and dutycycle are arranged according to the coincident with severity degree of condition of patient, need to set according to the practical situation of patient according to experienced doctor, generally patient's amplitude within a period of time, frequency, changeless with dutycycle, after treatment after a while, the state of an illness of patient carries out the amendment of parameter again by external detection control device after making moderate progress, pulse signal frequency adjustable extent is 100 ~ 150 hertz, the adjustable extent of voltage magnitude is 0 ~ 10, the adjustable extent of pulse width is 80 ~ 120 microseconds, by the brain depth electrode 14 Stimulation of The Brain deep tissue of the pulse signal set by being used for the treatment of, and then treat epilepsy.Memory element 102 selects the memorizer of certain memory space, such as flash memorizer, DDR or SDRAM etc., is mainly used in the stimulus parameter and the program that store present stage.In addition, communication unit is mainly made up of the chip of low-power consumption, such as zigbee chip.
As shown in Figure 3, the detection control unit of external detection control device comprises microprocessor 201, memory element 202, communication unit 203, detecting unit 204, display unit 205, keyboard unit 206, alarm unit 207, power subsystem 208 and clock unit 209.Electrod-array 24 is transferred to detecting unit 204 after collecting signal, detecting unit 204 carries out pretreatment to the signal collected, and such as, this pretreatment comprises filtering, multistage amplification several times and A/D conversion, pretreated signal is sent in microprocessor 201 and is carried out prediction in early stage.Second microprocessor 201 is by performing implantation algorithm realization wherein to the feature extraction of EEG signals, generally extract the feature of an EEG signals every 5 seconds, here the feature selected is single variable linear feature (energy of different frequency bands) and bivariate linear character (maximum cross-correlation value of two passages), such as, if eeg signal acquisition is six passages (symmetrical), each side select a passage as reference passage for single variable linear feature, the energy value that wavelet transformation extracts different frequency range is carried out after the signal amplitude that two passages are left on both sides in addition deducts the signal amplitude of corresponding reference channel, for bivariate linear character, the reference channel in single variable linear feature is selected to ask computing cross-correlation with two other passage corresponding respectively equally, and ask its maximum, finally these two features are merged into an one-dimensional vector, and then compare with the default correction data being stored in memory element 202, classification, second microprocessor 201 identifies the state residing for patient 3, here identify with adopting arbitrary mode identification method, such as, support vector machine method wherein can be adopted to identify.Predicting in the imminent situation of epilepsy, the second microprocessor 201 generates alarm signal, and riches all the way delivers to alarm unit 206 for this alarm signal, and notify that to give the alarm patient is ready in advance, such as, alarm unit can be buzzer or speaker.In concrete enforcement, as long as when high level can be had to arrive according to circuit design, it just can be driven to send sound, under predicting the imminent situation of epilepsy, provide the high level signal of a period of time just can send sound.Memory element 202 is also select the memorizer of certain memory space, such as flash memorizer, DDR or SDRAM etc., is mainly used in storing EEG signals, the stimulus parameter of present stage and corresponding program; The low-power chip the same with intra-prediction therapy equipment that communication unit 203 is selected, is mainly used for carrying out radio communication with intra-prediction therapy equipment; Display unit 205 selects LCD display or LED display, is mainly used in the stimulus parameter showing present stage, the electricity of battery, and alarm signal etc.; Keyboard unit 206 controls the switch of external prediction control device, the switch of internal stimulus therapy system, and the setting of the selection of stimulus parameter and parameter size; Alarm unit 207 is mainly made up of buzzer or speaker, can send sound when there being high level signal to input, for notifying that patient's epilepsy is about to outbreak; Power subsystem 208 is common button cells, can be changed by the lid opened inside external detection control apparatus 21.
As shown in Figure 4, the detecting unit 204 that patient implants is made up of electrode interface 2041, elementary filter circuit 2042, stimulation filter circuit 2043, amplifying circuit 2044, A/D change-over circuit 2045, data-interface 2046.Electrod-array 24 by the EEG signals collected by carrying out elementary filter circuit after electrode interface, elementary filter circuit is made up of second order high-pass filtering circuit and second-order low-pass filter circuit, the filtering of second order high-pass filtering circuit lower than the EEG signals of 0.5Hz, the filtering of second-order low-pass filter circuit higher than the signal of 128Hz; EEG signals after elementary filter circuit is through secondary filter circuit, and filtering is lower than the Hz noise of 50Hz.EEG signals is amplified through amplifying circuit more subsequently, here amplifying circuit is through repeatedly multistage amplifier circuit and amplifies about 10000 times to EEG signals, the amplification of primary amplifying circuit is at about 10 times, instrument amplifier (as: AD620) selected by amplifying circuit for the first time, carry out second time to it more subsequently to amplify, words in need are carried out third time and are amplified, and second time and third time amplification select operational amplifier to realize.Again signal is changed through A/D change-over circuit, the signal after conversion is transferred to microprocessor by data-interface.
In the above-described embodiments, external detection control device is suspended from ear, and according to the needs of patient, in the embodiment had, what have can be positioned in medicated cap, or is positioned in pocket by the lead-in wire lengthening the electrod-array obtaining scalp brain electricity.
Claims (9)
1. a deep brain stimulation system for external forecast function, comprises internal stimulus therapy equipment and external detection control device, it is characterized in that:
Described internal stimulus therapy equipment mainly comprises with the stimulation therapy unit (11) of housing, lead-in wire (12), probe (13) and brain depth electrode (14), and described brain depth electrode (14) is electrically connected with stimulation therapy unit by probe (13) and go between (12); Described stimulation therapy unit comprises first microprocessor (101), memory element (102), communication unit (103), treatment unit (104), power subsystem (105) and clock unit (106); Described communication unit (103), microprocessor (101) are connected successively with treatment unit (104), and described microprocessor (101) is also connected with memory element (102);
Described external detection control device mainly comprises hook (22), lead-in wire (23), electrod-array (24) and detection control unit, and described electrod-array (24) is electrically connected with detection control unit by lead-in wire (23); Described detection control unit comprises the second microprocessor (201), memory element (202), communication unit (203), detecting unit (204), display unit (205), keyboard unit (206), alarm unit (207), power subsystem (208) and clock unit (209), described detecting unit (204), microprocessor (201), keyboard unit (206) are bi-directionally connected successively, and described microprocessor (201) is also connected respectively with memory element (202), communication unit (203), display unit (205) and alarm unit (207) simultaneously;
The communication unit (103) of described internal stimulus therapy equipment is connected with the communication unit (203) of external detection control device.
2. deep brain stimulation system according to claim 1, is characterized in that, described first microprocessor (101), for there being the low-power consumption microcontroller of certain operational capability, is in holding state for controlling communication unit; When receiving the signal that external detection system sends, control power subsystem and power to treatment unit; When receiving the signal that external detection system sends, control the pulse signal that treatment unit produces certain amplitude, frequency and dutycycle, reached the object for the treatment of epilepsy by the electrode stimulating brain deep of implanting brain deep;
Described communication unit (103) adopts the wireless communication technology of low-power consumption;
Described treatment unit (104) produces chip composition primarily of the PWM ripple of low-power consumption;
Described brain depth electrode (14) is implanted to deep-brain, is made up of the material with biological compatibility.
3. deep brain stimulation system according to claim 1, is characterized in that, described second microprocessor (201), for there being the low-power consumption microcontroller of certain operational capability, carries out filtering, amplification and digital-to-analogue conversion for controlling detecting unit to data; Obtain the data after detecting unit process, and store; The epileptic Seizure Prediction Method Based implanting inside is used to carry out calculation process to gathering the data got, and whether epilepsy is made a policy by outbreak, when predicting epilepsy, controls to open alarm unit, point out patient's epilepsy to be about to outbreak in advance, allow patient carry out prevention in advance and prepare; When predicting epilepsy, control communication unit and inform that its epilepsy is about to outbreak to interior arrangement epilepsy stimulating system signal;
Described communication unit (203) adopts the wireless communication technology of low-power consumption;
Described detecting unit (204) is made up of electrode interface (2041), elementary filter circuit (2042), stimulation filter circuit (2043), amplifying circuit (2044), analog to digital conversion circuit (2045), data-interface (2046), for under control of the microprocessor, filtering, amplification and digital-to-analogue conversion are carried out to the scalp brain electricity that electrode obtains;
Described display unit (205) is the lower liquid crystal display of power consumption, for showing boost pulse parameter, electricity and some other parameter;
Described keyboard unit (206) comprises at least three buttons, for controlling the open and close of external detection system, and controls the adjustment of stimulus parameter;
Described alarm unit (207) is speaker or buzzer, for giving the alarm;
Described electrod-array (24) is for obtaining scalp brain electricity.
4. deep brain stimulation system according to claim 3, is characterized in that, described filter circuit is second-order filter circuit; Described amplifying circuit adopts and repeatedly amplifies; The wave filter of described filter circuit is that high pass filter, 50Hz notch filter and cut-off frequency in 1Hz is for form higher than 100Hz low pass filter by cut-off frequency.
5. deep brain stimulation system according to claim 4, is characterized in that, the algorithm implanted in described second microprocessor is at least one in pattern recognition, linear, non-linear or chaology.
6. deep brain stimulation system according to claim 5, is characterized in that, described electrod-array (24) is plate-like metal electrode, and utilizes collodion to be fixed on netted medicated cap, and described netted medicated cap is worked out by fine rule.
7. deep brain stimulation system according to claim 6, is characterized in that, the power subsystem (208) of described external detection control device is made up of button cell.
8. according to the deep brain stimulation system one of claim 1 ~ 7 Suo Shu, it is characterized in that, the first microprocessor of described external detection control device, communication unit, detecting unit, alarm unit, power subsystem and clock unit are integrated into in a shell; Second microprocessor of described internal stimulus therapy equipment, communication unit, treatment unit, power subsystem and clock unit are integrated into in a shell.
9. deep brain stimulation system according to claim 8, is characterized in that, described shell is the bumper housings being wrapped in biocompatibility material.
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