DE102018104515A1 - Device for transcranial magnetic stimulation - Google Patents

Abstract

Device for transcranial magnetic stimulation (TMS) of the human or animal head, in particular a device for magnetic convulsion therapy (MCT) comprising a coil arrangement (86) for generating a magnetic field and a control device (55) for driving the coil arrangement (86) with a coil current (8 ), which generates a stimulation voltage having different frequencies in at least one neuron population of the brain, wherein the coil current (8) consists of a low-frequency group of fundamental pulses (10, 10a-10e) increasing in amplitude within an envelope (11, 20, 40, 50) ) formed within a treatment time (11) with a repetition frequency in the range between 1 Hz to 50 Hz, that adjoins the treatment time (11) a pause time (12), and that the frequency of successive treatment and pause times (11, 12) follows a frequency pattern (A and / or B and / or C).

Description

The invention relates to a device for transcranial magnetic stimulation (TMS) of the human or animal head, in particular a device for magnetic convulsion therapy (MCT).

Non-invasive brain stimulation methods such as transcranial direct current or transcranial magnetic stimulation (TMS) have gained increasing importance in recent years in the diagnosis and treatment of neuropsychiatric disorders. They can be used to excite cortical neuronal associations.

TMS uses high-intensity, about 1Tesla strong pulsed magnetic fields to - in contrast to ultrashort current stimuli is possible - painlessly transfer electricity through the intact skull, thus indirectly triggering current flows in the brain tissue and thereby neural action potentials. By applying TMS repetitively (rTMS), plastic stimulation enhancements or inhibitions of circumscribed brain areas can be achieved, which can last hours beyond the stimulation time. ( Paulus, Walter: Josh. Medical Sheet Int. 2009, vol. 106 (9), p. 143-144 )

Transcranial direct current stimulation with weak currents of 1 mA ("transcranial direct current stimulation" [tDCS]) has been firmly established in human neuroplasticity research for eight years after it had been able to quantify its plasticity-producing effects in the human brain using TMS.

The physical gap between pulsed rTMS and uniform tDCS can be closed by transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNA). Both were presented for the first time at the 3rd Göttingen "International Conference on Transcranial Magnetic and Direct Current Stimulation" in October 2008 in Göttingen.

tACS allows external interference with cortical oscillations, which play a role in the temporary connection of cortical areas, especially in the so-called binding hypothesis. High-frequency tRNA produces excitatory cortical after-effects, however, in comparison to the anodal tDCS, independent of the current flow direction.

The clinical application of transcranial stimulation initially focused on the treatment of depressive patients, for which a current overview was given (Padberg, Munich). After numerous pilot studies initially yielded conflicting results on TMS, the largest multi-center study to date on 30 l patients who had not benefited from drug-based antidepressant treatment found that stimulation with 3,000 TMSs per day for 4 weeks was pulsed / day as placebo stimulant antidepressant monotherapy with about twice as high remission rates compared to placebo stimulation group was over. This led to the approval of TMS in the US in October by the "U.S. Food and Drug Administration (FDA) for the treatment of patients with depression who are not primarily on medication. However, a multi-center study funded by the German Research Foundation (DFG) on a different application, namely the primary combination of TMS and antidepressants, showed no significant difference to a placebo stimulation.

Currently, the clinical relevance of the therapeutic effects achieved is critically discussed, with comparisons with established forms of treatment (for example, antidepressants, lithium, psychotherapy) largely lacking. There are already several studies available for comparison with electroconvulsive therapy (ECT), some of which showed a greater effectiveness of ECT and no difference in efficacy. Currently, more multicentre studies on TMS are underway for depression, which should enable an evaluation of the significance of TMS in the stepwise treatment of depressive illnesses. Overall, TMS is characterized by good tolerability and is already being considered as an antidepressant form of treatment for individual patients who are inadequately responsive to medication, poorly tolerated medications, or have problematic co-morbidities for drug treatment.

Another form of TMS use in depression is so-called magnetic convulsant therapy (MKT), in which a particularly high-frequency and high-intensity TMS is used to induce - similar to the ECT - an antidepressant, generalized seizure.

The first smaller pilot studies are available for the MKT, but larger controlled studies are missing. The data available for tDCS are similar for depression, with preliminary results from several ongoing studies presented in Göttingen. More optimization options were discussed, both in terms of Stimulation site, intensity, frequency, stimulation intervals, pulse shape, current flow direction (summer, Göttingen) and grouped stimulation (so-called theta-burst technique), whose special potential became clear.

Other clinical applications of neuro-plasticity-inducing stimulation methods were investigated in individual placebo-controlled phase II studies, such as the treatment of chronic pain patients (Antal / Nitsche, Göttingen, BMBF Competence Network on Headache). In chronic pain, both rTMS and tDCS, after approximately two weeks of stimulation, are able to achieve similar, albeit transient, improvements (approximately 30 to 60% improvement on a visual analog scale), as known from invasive motorcortex stimulation. The latter has been used by neurosurgery for therapy-resistant pain for about 20 years.

In addition to many international lectures, participants used tests such as tinnitus (Langguth, Regensburg), stroke and motor rehabilitation (Hummel, Hamburg), schizophrenia (Falkai and Wobrock, Göttingen, recruiting until June 2009) and epilepsy (Rosenow, Marburg) in front. Concerning the therapy of (focal) epilepsies with rTMS and tDCS inconsistent results are available, which are most likely to suggest that focal stimulation directly above the (neocortical) epileptogenic area can lead to a temporary reduction in seizure frequency usually within a few weeks.

One session was devoted to animal experimental underpinning. Thus, the example of epilepsy showed the successful tDCS application in the rat model (Liebetanz, Göttingen). Overall, the transcranial stimulation methods are low-side-effect therapy methods. In rTMS, the main risk lies in very rare epileptic seizures; in tDCS, a few local reversible rashes have become known through insufficient contact with the electrodes.

Significant progress over the next few years is expected from current flow modeling of the combined use of transcranial stimulation techniques with associated measurement techniques such as nuclear spin spectroscopy, positron emission tomography, and the possibility now realized of being able to more accurately map activated brain areas during functional nuclear magnetic resonance imaging.

It has been found that the devices for performing a transcranial magnetic stimulation have only insufficient performance and work with untried frequencies, so that the previous treatment success was achieved insufficiently.

On the one hand, only low magnetic field strengths could be achieved and, on the other hand, pulsed alternating electromagnetic fields, as used in MKT, were used in therapeutically ineffective frequency ranges.

With the subject of DE 10 2015 114 483 A1 For example, a coil arrangement and a system for transcranial magnetic stimulation has become known, wherein a coil arrangement of annular or eight-shaped coils is present. The cited document proposes to use EEG electrodes in addition to the TMS magnetic coils.

The TMS magnetic pulses mentioned therein are generated by a control unit in response to a trigger signal, wherein a stimulus generator, in response to a drive signal, initiates a strong, time-varying current into the solenoid of the coil assembly. As a result, a magnetic field or a magnetic pulse is generated, which induces a current in the brain of the patient.

However, the coil currents used are provided with unwanted spikes and do not insure creeping induction of current in the brain due to creeping magnetic fields.

A special type of frequency distribution is not mentioned in this document, so that it must be assumed that is not treated with optimal possible frequencies of the current pulses.

With the subject of DE 10 2014 117 427 B4 Another TNS arrangement for transcranial magnetic stimulation has become known in which working with varying stimulus sequences. A control unit, which controls the stimulation unit, causes the stimulation unit to generate repetitive frequencies of stimuli, wherein the order of the stimulation channels, in which the stimuli are within one Sequence are generated, is constant for at least 20 sequentially generated sequences and then varied.

Again, there is the disadvantage that a creeping generation of magnetic pulses is not given and is not treated with an optimally possible frequency, whereby the therapeutic success could be called into question.

With the subject of DE 11 2008 004 049 T5 An arrangement with a magnetic stimulation coil for transcranial magnetic stimulation (TMS) is described. However, the strong current pulses used there with a peak of several kA leads to ohmic losses and an unwanted Joule's heating of the resistive coil. This results in an undesirable heat load and at a pulse rate of 10 Hz, this adds up to a heat output of up to 100 W.

The cited document makes use of the formation of a coil in conjunction with a cooling device made of an electrically conductive and non-magnetic material, whereby the resulting heat losses are to be dissipated.

About the nature and design of the coil currents used, the nature of the frequencies used and other parameters can be found in this document no statement. For this reason, there is the danger that with such a coil arrangement, although high currents can be introduced, but which are formed like a pulse and are not affected by an optimal frequency.

The invention is therefore based on the object to further develop a device for transcranial magnetic stimulation of the human or animal cerebral cortex that can be applied at higher magnetic fields with therapeutically effective frequencies.

A feature of the invention is that the envelope of the amplitudes of the basic impulses forms a rising (ramped) curved branch originating near zero, which rises to its maximum approximately to the middle of a treatment time and then corresponds to one of the maximum current intensity until the end of the treatment time. Constant cornering load is formed.

In the prior art, said rising, ramped curve branch reached its maximum of the current only at the end of the treatment time. This had the disadvantage that the maximum of the current was reached only at the end of the treatment time and then abruptly stopped. Thus, the treatment was not performed with the maximum possible current. The maximum current of the coil current could therefore not be effective.

With the technical teaching of the invention, however, the maximum current intensity is already reached in a range of 1/3 to 2/3 of the maximum treatment time and can then act until the end of the treatment time. Thus, the maximum coil current can act much longer. Such a treatment time may be about 4 to 10 seconds, followed by a break of e.g. 4 to 10 seconds connects.

In a preferred embodiment, this is preferred when the envelope is formed approximately as a rising straight line. However, it can also be an increasing parabolic curve, an increasing exponential curve or another rising curve, the course of which corresponds to the amplitude of the fundamental pulses used.

It is important in any case that from the beginning of the initial (starting) Grundstromimpulses a relatively low current amplitude is selected, which then increases according to the envelope, so that thus a launch pad is formed, which is about one third to two thirds of the total duration of a treatment time extends these basic pulses and then reaches a maximum of the current, which is maintained until the end of the treatment time.

The invention is not limited to extending the launch ramp in a current-time diagram for about half the treatment time. It can also be shorter or longer, and it is important only that the initial basic impulses and the magnetic fields generated from them are entered very slowly and slowly into the tissue. As a result, voltage pulses are evoked in the tissue, which according to the invention slowly prepare the neurons excited with them for larger voltage pulses due to greater magnetic field strengths in order thus to avoid pain sensations or even tissue damage.

With this type of creeping magnetic field treatment has been found that improved therapeutic success can be achieved. The maximum current and the maximum magnetic field generated with it could - unlike the prior art - be maintained for a longer time.

On the one hand, it could be shown that the therapy time (total of all treatment times) could be shortened considerably, and it was also demonstrated that the therapeutic success of the higher current intensities used here could also be increased compared to the low current levels of known devices.

In a preferred embodiment, the envelope therefore corresponds to a rectangular or e-function or sawtooth function.

The frequency of the fundamental pulses generated during a treatment time (hold time) is in the range between 1 Hz to 50 Hz.

The starting value of the first pulse of the applied fundamental pulses is in the range between 1% to 30% of the maximum amplitude. The amplitude of the fundamental pulse generated in the rising curve load corresponds to about 90-100% of the maximum amplitude, which is then maintained in the form of the maximum current in the area of the constant curve branch until the end of the treatment time .. The treatment time (holding time) is in the range between 1s to 12s and the interval between them is between 4s and 12s.

It is therefore proposed an increasing ramp curve, which is always formed from a certain initial value to a final value as a rising curve. The final value of a basic pulse preferably corresponds to a magnetic field strength of about 1.3 Tesla, and it is preferably achieved at a magnetic field strength of 0 starting with the ramp curve, a gradual increase of the basic pulses, which achieves previously unanticipated therapeutic effects.

In other applications, however, lower magnetic field strengths in the range between 0.3 to 1.3 Tesla will suffice.

Due to the novel magnetic field control, a specific ramp function (envelope of the amplitudes of the basic pulses) is always executed from the bottom until the ramp function has reached the set maximum current intensity and then continues as a constant curve branch of a maximum current strength and then terminates.

Even if a same magnetic field strength was used as in the prior art, it has been found that due to the ramped envelope of the amplitudes of the basic pulses already reached their maximum in about half of the treatment time, with a shortened treatment time improved by 20 percent treated muscle could be achieved.

In addition, the higher magnetic fields thus generated are particularly focused and have a significantly higher attack surface on the treated muscles, especially entire pelvic floor muscles, which was previously - because of the use of low magnetic field strengths - was not yet known.

In one embodiment of the invention, it is provided that the treatment blocks formed from the individual basic pulses now also follow in their amplitude of a specific "therapy lamp", which means that the amplitudes of the treatment blocks formed from the individual basic pulses follow a certain rising curve, the is called a "therapy lamp".

This therapy ramp (rising curve) can be either straight, parabolic, or exponential.

It is also preferred here that, for example, the treatment blocks have a treatment duration of, for example, 8 seconds and consist of a multiplicity of individual basic pulses which in each case induce a magnetic field pulse in the magnetic field coil.

Accordingly, these treatment blocks also follow an ascending therapy lamp, and after the passage of treatment blocks of, for example, eight times increasing in amplitude, the final maximum field strength in the magnetic field coil is then reached.

Accordingly, a double ramp function is proposed, namely once a starting ramp function in the individual treatment blocks for the basic current pulses generated there, and secondly to a therapy lamp function in the sequence of a plurality of treatment blocks consisting of individual basic pulses.

In a preferred embodiment of the invention, the current control according to the invention is made possible by the gate drive of a thyristor to which a freewheeling diode is connected in parallel opposite.

In one embodiment of the present invention, a complex therapy device is used, which has a central processor, which takes over the entire control of the therapy device and in which in particular the size of the amplitude window, the size of the ramp functions and the like are freely programmable.

In a further development of the present invention, it is further provided that now the individual basic pulses and the treatment blocks formed from the individual basic pulses follow a specific treatment frequency, which is preferably referred to as the Fibonacci frequency.

This is explained by the following Fibonacci scaling with the golden ratio cut-off and its application in diagnostics and therapy in the human cardiovascular system.

The Italian mathematician Filius Bonacci (Fibonacci, 1170 - 1250) discovered this series of numbers, which leads with its quotient limit of two consecutive numbers to the most famous scaling in the world, the "golden section". Many artists, such as Leonardo da Vinci were inspired by the "golden section". R. N. Elliot developed in the thirties of this century on this basis building on a theory, with which one could show trends and turning points in nature and technology, but also on the stock market.

The Fibonacci sequence is the infinite series of natural numbers that are (originally) twice the number 1 starts or (often, in modern spelling) additionally with a leading number 0 is provided. In each case, the sum of two consecutive numbers results in the number immediately following: $$\begin{array}{ccccccccc}0& \mathrm{1,}& \mathrm{1,}& \mathrm{2,}& \mathrm{3,}& \mathrm{5,}& \mathrm{8th,}& 13& ...\\ & & /& /& /& /& /& /& \\ & \left(\text{optional}\right)& 0+1& 1+1& 1+2& 2+3& 3+5& 5+\mathrm{8th}& \end{array}$$

The numbers contained in it are called Fibonacci numbers. The episode is named after Leonardo Fibonacci, who described in 1202 the growth of a rabbit population. The episode was already known in ancient times both the Greeks and the by.

Further investigations showed that the Fibonacci sequence also describes numerous other growth processes of the plants. It seems that it is a kind of growth pattern in nature. This finding makes use of the present invention.

• • Aufgrund der Beziehung zur vorherigen und zur folgenden Zahl scheint Wachstum in der Natur einem Additionsgesetz zu folgen.
• • Die Fibonacci-Folge steht in einem unmittelbaren Zusammenhang zum Goldenen Schnitt. Je weiter man in der Folge fortschreitet, desto mehr nähert sich der Quotient aufeinanderfolgender Zahlen dem Goldenen Schnitt (1,618033...) an (beispielsweise 13:8=1,6250; 21:13≈1,6154; 34:21≈1,6190; 55:34≈1,6176; etc).
• • Diese Annäherung ist alternierend, d. h. die Quotienten sind abwechselnd kleiner und größer als der Goldene Schnitt.

The Fibonacci numbers have some notable mathematical features:

• • Due to the relationship to the previous and following number, growth in nature seems to follow an addition law.
• • The Fibonacci sequence is directly related to the Golden Ratio. The further one progresses in the sequence, the more the quotient of successive numbers approaches the golden ratio (1.618033 ...) (for example 13: 8 = 1.6250, 21: 13≈1.6154, 34: 21≈ 1.6190; 55: 34≈1.6176; etc).
• • This approximation is alternating, ie the quotients are alternately smaller and larger than the golden ratio.

Tabelle 1: Durch Mehrfachskalierung der mittleren Aortenfläche F_Aorta = π [cm²] abgeleitete zu erwartende optimale Herz-Kreislauf-Parameter einschließlich EEG-Bereich. n optimale Frequenz Bedeutung F_n [Hz] 7 0,108 (≡ 6,5 min^-1) Blutdruckperiodik (Traube-Hering-Wellen) / untere Grenze Atmungsfrequenz (?) 6 0,175 5 0,283 (≡ 17 min^-1) Optimum Atmungsfrequenz 4 0,458 obere Grenze Atmungsfrequenz (?) 3 0,742 untere Grenze Herzfrequenz (Bradykardie) ) 2 1,2 (≡ 72 min^-1) optimale Herzfrequenz/ 1 1,942 Herzeigenfrequenz (ungedämpft) obere Grenze Herzfrequenz (Tachykardie) 0 3,142 Optimum EEG-Delta-Bereich -1 5,08 Optimum EEG-Theta-Bereich -2 8,225 Beginn EEG-Alpha-Bereich, 1. Schumann-Resonanz / -3 13,31 Ende EEG-Alpha-Bereich, Beginn Beta-Bereich (Beta _{1, 2}) 2. Schumann-Resonanz -4 21,53 EEG-Beta-Bereich (Beginn Beta ₃) , 3. Schumann-Resonanz -5 34,84 Ende EEG-Beta-Bereich In the following table, the integer values n are natural numbers as a scaling factor. $${\text{Fibonacci Scaling Principle F}}_{\text{n}}=\frac{\pi }{{\left(\mathrm{1,618}\right)}^n}$$

Table 1: Expected optimal cardiovascular parameters, including EEG, derived by multiple scaling of the mean aortic area F _aorta = π [cm ² ]. n optimal frequency meaning F _n [Hz] 7 0.108 (≡ 6.5 min ^-1 ) Blood pressure period (grape-herring waves) / lower limit respiratory rate (?) 6 0,175 5 0.283 (≡ 17 min ^-1 ) Optimum respiratory rate 4 0.458 upper limit respiratory rate (?) 3 0.742 lower limit heart rate (bradycardia)) 2 1.2 (≡ 72 min ^-1 ) optimal heart rate / 1 1,942 Heart rate (undamped) Heart rate upper limit (tachycardia) 0 3.142 Optimum EEG delta range -1 5.08 Optimum EEG theta range -2 8,225 Beginning EEG alpha range, 1. Schumann resonance / -3 13.31 End EEG alpha range, beginning beta range (Beta _{1, 2} ) 2. Schumann resonance -4 21.53 EEG beta range (start beta ₃ ), 3. Schumann resonance -5 34.84 End EEG beta range

As can be seen in Table 1, for n = 0 to -5, the optimum frequencies 3.142 are obtained; 5.08; 8.225; 13.31; 21.53 and 34.84 Hz. This shows that the numbers before the decimal point all represent Fibonacci numbers, so they were marked "bold". If you calculate the frequency at n = -6, you get 56.37 Hz. The number 56 however, is not a Fibonacci number, so this frequency is not considered relevant to the EEG area. As is known, 35 Hz are approximately the upper EEG frequency limit (end EEG beta range), as determined from experimental measurements.

Table 1 shows the "optimal values" in the cardiovascular system that occur with a 1.618 scaling of π.

• Somit wurde mit der vorstehenden Darlegung nachgewiesen, dass eine Verbesserung des Therapieeffektes durch die besondere Frequenz-Skalierung der angewendeten Magnetfelder erreicht werden kann, was bisher nicht bekannt war.

The merit of the present invention lies in recognizing that the optimal for the cardiovascular system Fibonacchi frequencies are also particularly suitable for the transcranial magnetic stimulation of the human or animal cerebral cortex and thereby achieve an unpredictable, optimal therapy success .:

• Thus, it was demonstrated with the above statement that an improvement of the therapeutic effect can be achieved by the special frequency scaling of the applied magnetic fields, which was previously unknown.

A particular advantage of the invention results from the combination of the transcranial magnetic stimulation according to the invention with a transpelvine magnetic stimulation.

A suitable device for the practice of the two methods consists of a dental chair, in the seat and / or back one or more magnetic coils are installed, which generate magnetic fields with magnetic field strengths up to 1.3 Tesla in the pelvis region of the person sitting on the dental chair person and thus carry out a Magnetkonvulsionstherapie in the body organs of the pelvis region (eg, pelvic floor, kidney, bladder).

At the treatment chair, a multiply spatially adjustable frame for holding at least one magnetic coil is preferably arranged on the upper part of the backrest, which performs the Magnetkonvulsionstherapie on the brain areas of the same person either at the same time or with a time delay.

Lower magnetic field strengths in the range between 0.3 and 1.3 Tesla are used. It is advantageous that the same control unit can be used both for the power supply of the head-side magnet coil (s) and the basin-side magnet coil (s), whereby the equipment costs for such a double therapy is decisively reduced.

When performing the two head and pelvic magnetic convulsion therapies, it is preferred to use coil currents using frequencies from the Fibonacci frequency series (see Table 1).

In this case, the head-side Magnetkonvulsionstherapie can be performed with other or even with the same Fibonacci frequencies, such as the basin-side Magnetkonvulsionstherapie.

Once it has been demonstrated above that the Fibonacci frequencies have a decisive influence on the cardiovascular system, it is preferred if a single frequency from the Fibonacci frequency series is used for the head and pelvic side magnetic convulsion therapy, because the two body regions - among others - through the common cardiovascular and nervous system related.

As stated above, it is preferred if all the pulse-like coil currents used have a gently increasing amplitude, because thereby the therapeutic effect can be increased and unwanted pain sensations are avoided.

The subject of the present invention results not only from the subject matter of the individual claims, but also from the combination of the individual claims with each other.

All information and features disclosed in the documents, including the abstract, in particular the spatial design shown in the drawings, are claimed to be essential to the invention insofar as they are novel individually or in combination with respect to the prior art.

In the following the invention will be explained in more detail with reference to drawings showing only one embodiment. Here are from the drawings and their description further features essential to the invention and advantages of the invention.

• 1: perspektivische Ansicht einer Vorrichtung zur transkraniellen Magnetstimulation in der Art eines Behandlungssessels
• 2: ein Ausschnitt aus der 1 mit Darstellung weiterer Einzelheiten
• 3: die Seitenansicht der Anordnung nach 2
• 4: Vorderansicht auf die Darstellung in 3
• 5: eine Detailansicht des oberen Teils des Grundgestells
• 6: eine vergrößerte perspektivische Ansicht gemäß 1 und 2
• 7: eine Draufsicht auf die Anordnung nach 6 mit Darstellung unterschiedlicher Einstellmöglichkeiten
• 8: eine Darstellung gemäß 7 in Seitenansicht mit weiterer Darstellung unterschiedlicher Einstellmöglichkeiten
• 9: eine perspektivische Darstellung einer zweiten Ausführungsform einer Behandlungsvorrichtung
• 10: die Ausführungsform nach 9 in anderer Darstellung
• 11: die Behandlungsvorrichtung nach 9 bis 10 mit Darstellung weiterer Einstellmöglichkeiten
• 12: eine schematisierte Darstellung der TMS-Behandlung
• 12a: die schematisierte Darstellung der Anwendung von TMS-Magnetpulsen
• 13: eine vereinfachte Darstellung einer Gehirnstruktur mit Einzeichnung der angewendeten Magnetfeldlinien
• 14: eine erste Ausführungsform von TMS-Strömen zur Betromung einer Spulenanordnung 86 nach einer der 1 bis 12
• 15: eine zweite Ausführungsform der Ausbildung der Stromimpulse nach 14
• 16: die aus den Stromimpulsen 14 oder 15 gebildeten, größeren Impulspakete, in Form von zeitlich hintereinander folgenden, voneinander beabstandeten Behandlungsblöcken
• 17: eine Abwandlung der Ausbildung nach 16, bei der die einzelnen Behandlungsblöcke noch einer ansteigenden Therapierampe folgen
• 18: das Spannungs- und Strom-Zeit-Diagramm der Ströme durch eine Stromerzeugungsanordnung
• 19: die Stromerzeugungsanordnung zur Erzeugung der Ströme nach 18
• 20: eine Tabelle über die verwendeten Spannungen, Ströme und Frequenzen
• 21: ein schematisiertes Blockschaltbild eines Steuerungsgeräte zur Erzeugung der TMS-Magnetpulse
• 22: eine gegenüber 15 abgewandelte Ausführungsform zur Verwendung von Impulspaketen
• 23: eine gegenüber 22 abgewandelte, weitere Ausführungsform
• 24: eine weitere Ausführungsform im Vergleich zur 14 mit Grundimpulsen, die einer e-Funktion folgend ansteigen
• 25: die Darstellung der Trigger-Impulse, die in den Pausenzeiten der Rundpulse nach 24 erzeugt werden
• 26: die Darstellung der aus den Grundpulsen der 24 erzeugten Form von Impulspaketen
• 27: die Darstellung der aus den Impulspaketen nach 26 gebildeten dichter gepackten weiteren Impulspaketen
• 28: die Darstellung der Frequenzverteilung der Impulspakete nach 26 und/oder 27 in Form einer Fibonacci-Frequenz
• 29: die Darstellung der Frequenzverteilung unterschiedlicher Fibonacci-Frequenzen
• 30: ein mögliches Ausführungsbeispiel für die Frequenzverteilung von Fibonacci-Frequenzen bei der Anordnung der Grundpulse und/oder der aus den Grundpulsen gebildete Impulspakete und/oder bei der Anordnung der aus den Impulspaketen gebildeten dichteren, weiteren Impulspakete

Show it:

• 1 : Perspective view of a device for transcranial magnetic stimulation in the manner of a treatment chair
• 2 : a part of the 1 with further details
• 3 : the side view of the arrangement after 2
• 4 : Front view on the illustration in 3
• 5 : a detailed view of the upper part of the base frame
• 6 an enlarged perspective view according to 1 and 2
• 7 : a plan view of the arrangement according to 6 with representation of different adjustment possibilities
• 8th : a representation according to 7 in side view with further illustration of different settings
• 9 : A perspective view of a second embodiment of a treatment device
• 10 : the embodiment according to 9 in another representation
• 11 : the treatment device after 9 to 10 with representation of further adjustment possibilities
• 12 : a schematic representation of the TMS treatment
• 12a : the schematic representation of the application of TMS magnetic pulses
• 13 : a simplified representation of a brain structure with inscription of the applied magnetic field lines
• 14 A first embodiment of TMS streams for the observation of a coil arrangement 86 after one of the 1 to 12
• 15 a second embodiment of the formation of the current pulses after 14
• 16 : those from the current pulses 14 or 15 formed, larger pulse packets, in the form of temporally successive spaced apart treatment blocks
• 17 a modification of the training 16 , in which the individual treatment blocks still follow a rising therapy light
• 18 : the voltage and current-time diagram of the currents through a power generation arrangement
• 19 : the power generating device for generating the currents 18
• 20 : a table of the voltages, currents and frequencies used
• 21 : A schematic block diagram of a control device for generating the TMS magnetic pulses
• 22 : one opposite 15 modified embodiment for the use of pulse packets
• 23 : one opposite 22 modified, further embodiment
• 24 a further embodiment compared to 14 with fundamental pulses that increase following an e-function
• 25 : the representation of the trigger pulses, which are in the pause times of the round pulses after 24 be generated
• 26 : the representation of the basic pulses of the 24 generated form of pulse packets
• 27 : the representation of the momentum packets 26 formed dense packed further pulse packets
• 28 : the representation of the frequency distribution of the pulse packets after 26 and / or 27 in the form of a Fibonacci frequency
• 29 : the representation of the frequency distribution of different Fibonacci frequencies
• 30 A possible embodiment for the frequency distribution of Fibonacci frequencies in the arrangement of the fundamental pulses and / or the pulse packets formed from the fundamental pulses and / or in the arrangement of the denser, further pulse packets formed from the pulse packets

In 1 is a treatment chair as an exemplary embodiment of a device for transcranial magnetic stimulation 71 shown on the backrest 75 a basic frame 76 is arranged, on which a coil arrangement 86 is attached, which in all three spatial directions of the X . Y- and Z- Axle is adjustable and lockable formed.

The person to be treated sits on a seat 72 the treatment chair 71 and can be on a control panel 114 choose more treatment options.

For example, the illustrated treatment chair allows 71 that, for example, in the seat 72 and / or in the backrest 75 another solenoid 73 is arranged, each one perpendicular to the seat or back surface directed magnetic field 74 produced, which penetrates the human body in the trunk area and leads to certain therapeutic effects.

As stated, accordingly, the treatment chair 71 for TMS also for the treatment of parts of the trunk of the human body with other magnetic coils 73 and associated coil currents are used, wherein the coil currents are preferably - as described above - formed in the same manner as for the coil assembly 86 to the TMS of the brain 106 be used.

After the training of the treatment device as a treatment chair 71 Alternatively, a lying surface, a chair or another suitable treatment situation may also be present, wherein in the context of the present invention it is important that the base frame 76 in a corresponding manner a furniture or device part can be fixed so that the associated adjustable coil assembly 86 in the immediate vicinity of the head to be treated 83 can be brought.

According to the embodiment shown, the base frame 76 from an upper headband 77 , which is approximately U-shaped and also from a lower headband 78 which is also U-shaped.

Both headband 77 . 78 are in a middle swivel joint 90 summarized and form there a common pivot axis 92 ,

In the middle area of the upper retaining bracket 77 is a transverse center brace 79 arranged in the middle region is a downwardly directed, multi-adjustable joint arrangement 84 located.

Similarly, in the middle region of the lower center strut 80 an edition 81 provided, which is combined with a chin rest and a headrest 82 wearing a head pad, with which the human head 83 is supported to the front.

The coil arrangement according to the invention 86 is at the free front end of an arcuately bent retaining bracket 85 adjustable attached.

Out 2 are more details of the arrangement according to 1 refer to.

The 3 shows that the headrest 82 an upper, adjustable front plate 113 has sufficient support on the forehead of the head 83 allow the user.

Furthermore, it is shown that the bent headband 85 by a clamping device 94 passes through, so that according to the setting of the clamping device 94 the entire coil arrangement 86 in the direction of the arrows 95 slidable and lockable on the headband 85 is attached.

In the embodiment shown, the coil arrangement consists 86 from two parallel coils 87 . 88 , the overall an 8-shaped coil arrangement 86 form.

The invention is based on the illustrated coil arrangement 86 not limited. It can also be single coils 87 or 88 used or otherwise shaped coils.

Each of the coils 87 . 88 has a central recess 89 ,

According to 3 is the joint arrangement 84 in the swivel axis 91 adjustable and lockable besiege and consists of a downwardly directed holding tube 98 , on which the joint arrangement designed as a universal joint 84 (please refer 5 ) is arranged.

This joint arrangement is accordingly according to 5 also in the direction of the arrow 100 around the pivot axis 93 pivoted and the headband 85 can in the clamping device 94 in the direction of the arrows 95 be stored adjustable and lockable.

According to 6 can thus both coils 87 . 88 in any way to the head to be treated 83 be applied, not only on the temporal sides, but also on the front sides of the head to be treated 83 or at its top.

The 7 shows more adjustment options over the 1 to 5 modified embodiment, where it can be seen that in the region of a pivot joint 105 , which this time is not gimbal trained, now a headband 85 is arranged, on which the coil arrangement 86 with the help of the clamping device 94 in the direction of the arrows 95 is displaceable up and down.

Likewise, thus, the holding tube in the pivoting direction 96 be formed pivotable and lockable.

Due to the design of the swivel joint 105 is thus the entire headband 95 also in the direction of the arrows 100 swiveling up and down as it is in 8th is shown. Likewise, of course, the coils 87 . 88 the coil arrangement 86 in any direction three-dimensional in the arrow directions 102 be pivoted because the clamping device 94 is designed accordingly and also a pivot axis 101 formed.

The 9 shows the application of the inventive device for the treatment of the human brain from above, as it then again in 12 and 12a is shown.

The same reference numbers apply to the same parts. Instead of a universal joint is a double Schwenkarmanordnung of individual pivot arms 103 . 104 present in a joint joint arrangement 84 are held pivotable and lockable.

The 10 and 11 show the different adjustment possibilities of the two swivel arms 103 . 104 formed pivoting arrangement, wherein from 11 the individual settings of the coil arrangement 86 indicated by arrow directions.

The 12 and 12a now show the action of one of the coil assembly 86 generated magnetic field 109 , which with magnetic field lines 112 from above into the human brain 106 penetrates and only in the area of a very thin penetrating layer 107 is effective. This is off 12a refer to.

The 13 schematically shows that in the coil assembly 86 generated magnetic field lines 112 now ring in the brain 106 form at a mutual distance and in this case a number of neurons 110 activated while outside the magnetic field lines 112 lying neurons 111 remain passive.

The stimulated brain region 108 can therefore be strongly focused and limited to narrow spatial areas.

The 14 to 30 Now show that with a certain frequency distribution of the set nerve stimuli, the connection with the generation of the coil currents and their frequency optimized therapy successes can be achieved.

From the 14 is recognizable that from the individual basic impulses 10 within the treatment time 11 now a variety of basic impulses 10 be formed, the total of a treatment block 14 that form within the treatment time 11 expires. In such a treatment block 14 is then, for example, a number of 40 to 60 basic pulses 10 contain.

The basic pulses used preferably have the following properties: Envelope pulse shape (rectangle, e-function or sawtooth) repetition (1Hz - 50Hz) Start value first pulse (1% - 100%) Final value last pulse (1% - 100%) hold time (1s-12s) pause time (4s - 12s)

The invention provides in a first embodiment according to 14 and / or 15 before that the individual basic impulses 10 now as ramping basic pulses 10a . 10b . 10c . 10d and 10e within one treatment time 11 a certain envelope 17 follow, which is formed in the embodiment shown as a parabolic curve. The amplitudes of these consecutive basic pulses 10a-e follow a parabolic curve.

In another embodiment, it may be provided that, instead of a parabolic curve, the amplitudes of a straight line follow or an exponential curve, as shown in FIG 20 and 21 will be shown later.

1. 1. Die Frequenz der Grundimpulse, die während einer Behandlungszeit (Haltezeit) erzeugt werden liegt im Bereich zwischen 1 Hz bis 50 Hz.
2. 2. Der Startwert des Erstimpulses der angewendeten Grundimpulse beträgt liegt im Bereich zwischen 1% bis 30 % der maximalen Amplitude.
3. 3. Die Amplitude des in der Behandlungszeit erzeugten Grundimpulses ist etwa 90-100% der maximalen Amplitude.
4. 4. Die Behandlungszeit (Haltezeit) ist im Bereich zwischen 1s bis 12s und die dazwischen liegende Pausenzeit liegt im Bereich zwischen 4s bis 12s.

Importantly, starting from a seed 16 , which is relatively low and close to zero, now the current and also the magnetic field slowly according to the envelope used 17 increase, up to a higher final value 15 ,

1. 1. The frequency of the basic pulses, which are generated during a treatment time (holding time) is in the range between 1 Hz to 50 Hz.
2. 2. The starting value of the first pulse of the applied fundamental pulses is in the range between 1% to 30% of the maximum amplitude.
3. 3. The amplitude of the fundamental pulse generated in the treatment time is about 90-100% of the maximum amplitude.
4. 4. The treatment time (holding time) is in the range between 1s to 12s and the interval between them is in the range between 4s to 12s.

The 15 shows a second preferred embodiment, in which it can be seen that the envelope 17a only for a part of the treatment time 11 as rising curve branch 57 extends, for example, only up to half of the treatment time 11 , And that from the exceeding of the half treatment time t1 now in the form of the constant Kurvenastes 58 the maximum coil current until the end of the treatment time 11 is produced.

This is just an increasing launch pad 18 in the form of the rising curve branch 57 used in the course of which the envelope 17 is used, which - according to the previous description - can be configured either as a parabolic curve, as a straight line or as an E-function.

Advantage of this measure is that from the time t1 to the time t2 - in the range of the constant curve load 58 - The full coil current and thus the maximum magnetic field are available, while in the period from 0 to t1 a rising start ramp 18 is used so as to achieve a slow creep of the magnetic field into the tissue. This no longer leads to unpleasant tissue reactions and no longer to annoying interference impulses, which severely impaired treatment success.

The 16 now shows that the multiplicity of basic impulses 10 with their respective envelopes according to the curve branches 57 . 58 , a treatment block 14 form and a variety of treatment blocks 14 in 14 or 15 forms a packet and these packets in the embodiment 16 expire one after the other with the same amplitude. Alone 16 illustrated basic pulses 10 thus form pulse packets 44 with constant amplitude, in which, however, the fundamental pulses 10 with increasing amplitude either after 14 or 15 are included.

Between those as treatment blocks 14 trained impulse packages 44 Therefore, the break times form 12 ' , which can be in the range of 8 seconds, for example. The impulse packages 44 can for a treatment time 11 ' last for.

The variety of treatment blocks 14 , each of a variety of basic impulses 10 exist are therefore according to form 26 the pulse packets 44 , The time interval 13 between the individual basic impulses 10 has shrunk and as a multiplicity of temporally successive impulse packages 44 in 16 and 17 shown. It can with the in 21 illustrated control unit 55 both the break time 12 ' be set as well as the treatment time 11 ' , In the application example shown, the treatment time extends 11 ' with the impulse packages 44 over a period of 8 seconds and after that there is a break 12 ' for example 4 seconds.

In the embodiment according to 14 is the envelope of the current amplitudes formed as a square wave. But after every impulse package 44 a plurality of ramp-shaped basic pulses 10 . 10a . 10b ... 10e is included, it comes to a good therapeutic success.

However, the therapeutic success can be increased if, instead of a rectangular envelope according to 14 now a ramping rising envelope 20 to 15 is used.

This envelope 20 consists of a rising branch 57 whose rise begins near zero and spreads over several treatment and break times 11 . 12 extends until time t ₁ . The rising curve branch 57 is also called a "therapy lamp". From the time t ₁ then extends a horizontal Kurvenast 58 until time t ₂ .

There are also two different, selectable amplitude levels (level 1 and level 2 ).

The from the basic impulses 10 in 14 formed pulse packets 44 follow in 16 a rectangular (amplitude) envelope with the treatment blocks contained therein 14 ,

In 17 is as a modification to the 16 still shown that the individual amplitudes of successively running treatment packages 14 . 44 each one of increasing amplitude in the envelope 17a so that also the individual successive treatment blocks 14a - 14e follow a specific amplitude function, namely a therapy light 19 that by a rising envelope 20 is formed.

Also this envelope 20 can be either as a rising line according to 17 be formed or as a parabola or as an e-function.

It is a slow crawl of the individual, from basic impulses 10 existing treatment blocks 14a to 14e achieved, wherein in each treatment block 14 again a variety of fundamental currents 10 are included, each of which is according to the envelope function 14 or 15 equivalent.

The 18 and 19 show the technical design for the current control after the aforementioned 14 to 17 ,

Out 19 it turns out that a thyristor 23 at its gate with a gate signal 21 is driven, and an oppositely polarized freewheeling diode 22 is connected in parallel. The current and voltage values contained in Table 20 are achieved with such a circuit.

According to 18 thus results from the time 0 starting from a positive peak current of, for example, 1500 amperes, which reaches the zero crossing at a certain time, and then a compensating current takes place as a current through the freewheeling diode as a negative current -1500 amperes.

Likewise, the voltage curves are drawn on the coil and the preferred time intervals that act there.

In the 20 (Table), the various parameters of the circuit according to the invention are listed in detail by numerical values.

It is emphasized that the numerical values represent only a preferred embodiment and the invention is not limited thereby.

In 21 is the functional structure of such a control unit 55 shown, wherein a signal generator 32 a digital central processor 24 controls with which the amplitude window and the envelopes 17 . 20 be generated.

In the central processor 24 is an input for a program selector 31 switched, with the light effect on the applicator 35 can be generated. This in turn is from an operator keypad 25 driven.

The control keypad 25 also controls a program selector 26 with which the various magnetic therapy programs can be activated.

In addition to a basic program, there is a Relax program, a vital program and a Fibonacci program, in which a certain frequency distribution of the magnetic pulses according to the invention is applied.

The control keypad 25 also controls an intensity selector 27 on, with which the intensity of the magnetic pulses can be controlled. There are different programs.

The control keypad 25 also controls a time setting 28 on, and at the output of the central processor 24 becomes a power output stage 33 for the light therapy on the applicator 35 controlled, and also a power output stage 34 for the magnetic therapy, which finally the applicator 36 is fed, in the embodiment shown as a treatment device 1 with his coils 5 . 5a . 5b can be trained.

It is still a power supply 30 available and an advertisement 29 for the display of the various functional states.

The 22 shows in a modification to the ramp function of the invention compared to 15 that also has a different ramp function for the treatment blocks 14 can be achieved.

There the amplitudes of the treatment blocks increase 14a . 14b . 14c . 14d in the manner of an exponentially rising curve branch 41 up to a medium treatment time and fall in the middle of the treatment period 11 again as another curve branch 42 exponentially until time t3 is reached. Then the break time closes 12 on.

Instead of a launch pad 18 with a slowly rising envelope 17 . 17a Therefore, an E-function can be used, which consists of a rising curve branch 41 and a sloping curve branch 42 consists.

In a modification of the embodiment according to 22 show the 23 that instead of a rising and a falling curve branch 41 . 42 also only an ascending curve branch may be present, and the envelope formed therefrom 50 corresponds to an exponential function.

The 24 to 29 show now that all basic impulses 10 (10a-10e) and the treatment blocks formed therefrom 14 follow a particular frequency pattern called the Fibonacci frequency distribution.

There are a variety of embodiments, which are described only approximately below in one embodiment.

1. 1 Anwendung einer oder mehrerer Fibonacchi-Frequenzen für die Ausbildung der Grundimpulse 10, 37 während der gesamten Anwendungszeit oder für einen Teil der Anwendungszeit.
2. 2 Anwendung einer oder mehrerer Fibonacchi-Frequenzen für die Ausbildung der aus den Grundimpulsen 10, 37 gebildeten Impulspakete 44 während der gesamten Anwendungszeit oder für einen Teil der Anwendungszeit.
3. 3 Anwendung einer oder mehrerer Fibonacchi-Frequenzen für die Ausbildung der aus den kürzeren Impulspaketen 44 zusammen gesetzten längeren Impulspakete 45, 49 während der gesamten Anwendungszeit oder für einen Teil der Anwendungszeit.
4. 4 Anwendung einer oder mehrerer Fibonacchi-Frequenzen für die Ausbildung der Frequenz der aufeinander folgenden Pausenzeiten 39, 43, 46, 47 während der gesamten Anwendungszeit oder für einen Teil der Anwendungszeit.
5. 5 Anwendung einer oder mehrerer Fibonacchi-Frequenzen für die Ausbildung der Frequenz der aufeinander folgenden Behandlungszeiten 10, 11, 44, 45, 49 während der gesamten Anwendungszeit oder für einen Teil der Anwendungszeit.

The use of frequencies from the Fibonacchi series allows the following embodiments, wherein each embodiment can be combined with each other embodiment or with several embodiments with each other:

1. 1 Application of one or more Fibonacchi frequencies for the formation of the basic impulses 10 . 37 during the entire application time or for part of the application time.
2. 2 Application of one or more Fibonacchi frequencies for the formation of the fundamental impulses 10 . 37 formed pulse packets 44 during the entire application time or for part of the application time.
3. 3 Application of one or more Fibonacchi frequencies for the training of the shorter pulse packets 44 put together longer pulse packets 45 . 49 during the entire application time or for part of the application time.
4. 4 Use of one or more Fibonacchi frequencies for training the frequency of the consecutive pause times 39 . 43 . 46 . 47 during the entire application time or for part of the application time.
5. 5 Use of one or more Fibonacchi frequencies for training the frequency of successive treatment times 10 . 11 . 44 . 45 . 49 during the entire application time or for part of the application time.

This shows the 24 as an example the ramping rising single pulses 37 that then after 25 are interrupted by intervening trigger pulses. The individual impulses 37 correspond to the basic pulses shown before 10 ,

The duration of the individual pulses 37 in conjunction with the pause time of the first break between 4.5-5 in seconds (packet distance 46 ) and the pause times 9.5-10 seconds of the second pause thus form a certain frequency series, which corresponds to a Fibonacchi frequency.

In 26 is shown that from the single pulses 37 and break times 24 now formed impulse packages 38 in conjunction with the intermediate pause times are formed with a certain successive frequency, namely a frequency from the Fibonacchi series, and the pulse packets 38 a break interval 39 and repeat periodically at a certain frequency from the Fibonacchi series.

From the in 26 shown pulse packets 38 are therefore - on a time scale denser - pulse packets 44 formed, which also other intermediate break times (package intervals 46 . 47 ) contain, and from this form the even larger momentum packages 44 , which with intervening break times the even larger pulse packets 45 form.

These form certain frequency patterns, as with the time intervals in 27 is shown. The drawn package distance 46 corresponds to a certain break time. The 28 shows the frequency distribution of in 27 shown larger pulse packets 45 in an even denser time scale, in the form of time-compressed pulse packets 49 ,

This will result in the larger pulse packets 49 formed, which in turn follow one another at a certain frequency spacing corresponding to at least one frequency of the Fibonacchi series.

In the 24 Break times shown 4.5 - 5 and 9.5 -10 seconds of single pulses 10 . 37 can be pauses according to a Fibonacci distribution.

In the 27 Break times shown 0 - 136 , 5; 333.5 to XX can again be the pause times of a Fibonacci distribution.

The 29 now shows that the frequencies of the fundamental pulses 10 . 37 can take certain values, namely at the time from 0 to t1 a frequency of 8.225 hertz, at the time t2 to t3 a frequency of 13.31 Hertz and at the time of t4 to t5 a frequency of 21.53 Hertz, etc. That can do everything Be frequencies of the Fibonacci series.

The 30 shows the nesting of the different pulse packets 38 to larger pulse packets 44 , and from these in turn even larger pulse packets 49 which are formed in a particular Fibonacci frequency pattern.

The sequence of these frequency patterns is given in the general description.

• Die Grundimpulse 10, 37 können einer ersten FB-Verteilung A entsprechen.
• Die aus den Grundimpulsen 10, 37 gebildeten Impulspakete 44 können einer zweiten FB-Verteilung B entsprechen.
• Die aus den Impulspaketen gebildeten Impulspakete 49 können einer dritten FB-Verteilung entsprechen.

The 30 discloses several different embodiments in the application of frequency distribution to Fibonacci (FB) of the frequencies used:

• The basic impulses 10 . 37 may correspond to a first FB distribution A.
• The from the basic impulses 10 . 37 formed pulse packets 44 may correspond to a second FB distribution B.
• The pulse packets formed from the pulse packets 49 can correspond to a third FB distribution.

• FB (A) und/oder FB (B) und/oder FB (C).
  1. (1) Das bedeutet, dass nur die Frequenz der Grundimpulse 10, 37 einer FB-Verteilung entsprechen kann, dass aber die Frequenz der Impulspakte 44 und 49 gleichbleibend ist.
  2. (2) Das bedeutet, dass die Frequenz der Grundimpulse 10, 37 einer FB-Verteilung entsprechen kann, dass die Frequenz der Impulspakte 44 ebenfalls einer FB-Verteilung entspricht, die Frequenz der Impulspakete 49 aber gleichbleibend ist.
  3. (3) Das bedeutet, dass die Frequenz der Grundimpulse 10, 37 einer FB-Verteilung entsprechen kann, dass aber die Frequenz der Impulspakte 44 und 49 ebenfalls einer FB-Verteilung entspricht.
  4. (4) Weitere Ausführungen ergeben sich durch die weiteren Mutationen der vorgenannten Auswahlmöglichkeiten A und/oder B und/oder C

For these embodiments, the different possible frequency distributions and their combination with one another apply to FB:

• FB (A) and / or FB (B) and / or FB (C).
  1. (1) This means that only the frequency of the fundamental pulses 10 . 37 can correspond to a FB distribution, but that the frequency of the pulse packets 44 and 49 is consistent.
  2. (2) This means that the frequency of the fundamental pulses 10 . 37 an FB distribution can match that the frequency of the pulse packets 44 also corresponds to a FB distribution, the frequency of the pulse packets 49 but is consistent.
  3. (3) This means that the frequency of the fundamental pulses 10 . 37 can correspond to a FB distribution, but that the frequency of the pulse packets 44 and 49 also corresponds to a FB distribution.
  4. (4) Further explanations result from the further mutations of the aforementioned choices A and / or B and / or C.

The frequency distribution (A) may be equal to or different from the frequency distribution (B) equal to or different from the frequency distribution (C).

It thus becomes clear that the specific frequency distribution of the fundamental pulses over the course of time follows the Fibonacci frequency distribution, and thus the treatment success with magnetic fields 6 in the treatment device 1 can be significantly increased.

The term Fibonacci frequency distribution mentioned above generally refers to the frequencies given in Table 1. Each of these frequencies can be used alone for the frequency distribution (A) and / or (B) and / or (C). This means that each of the Fibonacci frequencies listed in Table 1 is the frequency for the fundamental pulses 10 . 37 (Distribution A)) and / or for the frequency of the basic pulses 10 . 37 formed pulse packets 44 and / or for those from the impulse packages 44 formed impulse packages 49 can be used.

Of course it is possible for the basic pulses 10 . 37 a first Fibonacci frequency (A), for the pulse packets 44 a second Fibonacci frequency (B) and for the pulse packets 49 to use a third Fibonacci frequency (C).

The term "frequency distribution" therefore means that any frequency (A and / or B and / or C) from the Fibonacci frequency series in any distribution (size) for the fundamental pulses 10 . 37 and / or the pulse packets 44 and / or the pulse packets formed therefrom 49 can be used.

These frequencies may also correspond to the Fibonacci frequency scaling: 8.225 13.31 21.53 Hz.

It is beneficial if all the pulses used here 10 . 37 ; and the pulse packets formed from this 44 and 49 have a ramp-like rise, as shown in the 15 to 17 is shown. Reference is made to the description there.

Thus, the advantage is achieved that the physiologically for the neural tissue particularly compatible and particularly effective Fibonacci pulses (these are the pulses 10 . 37 and the pulse packages 44 and 49 with the respectively selected Fibonacci frequency A, B, C) provide an improved therapeutic effect with a shorter treatment time.

In the general description it has already been stated - in connection with Table 1 - that the distribution of the intensity of the magnetic fields according to the Fibonacci frequency scaling has particular influences on the heart rate.

According to the invention, it has been found that the FB frequencies used here (in any combination of the frequency distributions specified above) have a therapeutically particularly valuable influence on the brain waves (EEG).

Thus, with the application of the Fibonacci frequency scaling, both the heart rate, the blood flow, the filling volume of the pericardium and other physiological parameters of the blood circulation can be positively influenced, as well as the influence of currents in the other body organs. In addition, the brain waves could be positively influenced. For example, the brain waves corresponding to the resting phases and the sleep phases could be reached and maintained for longer periods of time.

LIST OF REFERENCE NUMBERS

1

treatment device

2

backrest

3

seat

4

footboard

5

treatment coil

5a

treatment coil

5b

treatment coil

6

magnetic field

7

Coil current (stage 2 )

8th

Coil current (stage 1 )

9

period

10

basic pulse

10a

basic pulse

10b

basic pulse

11

treatment time

12

break time

13

Time interval (from 10 )

14

treatment block

15

full scale

16

start value

17

Envelope (parabola)

17a

envelope

17b

envelope

18

launch pad

19

therapy ramp

20

Envelope (large)

21

Gate signal

22

Freewheeling diode

23

thyristor

24

central processor

25

keyboard

26

program selector

27

intensity selector

28

time setting

29

display

30

power supply

31

program selector

32

signal generator

33

power output stage

34

power output stage

35

applicator

36

applicator

37

Single pulse

38

Impulse package (small)

39

distance

40

Envelope (large)

41

Curve branch rising

42

Curve branch sloping

43

pulse interval

44

Impulse package (large)

45

Impulse package (large)

46

Package distance (large)

47

Package distance (small)

48

frequency sequence

49

burst

50

Envelope (large)

51

52

53

54

55

control unit

57

Curve branch (rising) 13

58

Curve branch (constant) 13

67

Curve branch (rising) 15

68

Curve branch (constant) 15

71

treatment chairs

72

seat

73

solenoid

74

magnetic field

75

backrest

76

base frame

77

Upper headband

78

lower headband

79

Center strut above

80

Center strut down

81

edition

82

headrest

83

Head (user)

84

joint arrangement

85

headband

86

coil assembly

87

Kitchen sink

88

Kitchen sink

89

central recess

90

pivot

91

swivel axis

92

swivel axis

93

swivel axis

94

clamping device

95

arrow

96

pan direction

97

arrow

98

Support tube

99

clamping device

100

arrow

101

swivel axis

102

arrow

103

swivel arm

104

swivel arm

105

pivot

106

brain

107

penetrant

108

stimulated brain region

109

magnetic field

110

activated neurons

111

passive neurons

112

magnetic field lines

113

faceplate

114

Control panel

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• DE 102015114483 A1 [0017]
• DE 102014117427 B4 [0021]
• DE 112008004049 T5 [0023]

Cited non-patent literature

• Paulus, Walter: Josh. Medical Sheet Int. 2009, vol. 106 (9), p. 143-144 [0003]

Claims (11)

Device for transcranial magnetic stimulation (TMS) of the human or animal head, in particular a device for magnetic convulsion therapy (MCT) comprising a coil arrangement (86) for generating a magnetic field and a control device (55) for controlling the coil arrangement (86) with a coil current (8 ), which generates a stimulation voltage having different frequencies in at least one neuron population of the brain, characterized in that the coil current (8) consists of a low-frequency group of basic pulses (10, 10, 50) which increase in amplitude within an envelope (11, 20, 40, 50). 10a-10e), which can be generated within a treatment time (11) with a repetition frequency in the range between 1 Hz to 50 Hz, that a break time (12) follows the treatment time (11), and that the frequency of the successive treatment - and pauses (11, 12) a frequency pattern (A and / or B and / or C) follows. Device after Claim 1 , characterized in that the frequency of the basic pulses (10, 10a-10e) corresponds to a first Fibonacci frequency (A). Device after Claim 1 or 2 , characterized in that the frequency of the pulse packets (44) formed from the groups of basic pulses (10, 10a-10e) corresponds to a second Fibonacci frequency (B). Device according to one of Claims 1 to 3 , characterized in that the frequency of the further pulse packets (45) formed from the pulse packets (44) corresponds to a third Fibonacci frequency (C). Device according to one of Claims 1 to 4 , characterized in that the envelope curve (11), which describes the basic pulses (10, 10a-10e) rising during the treatment time (11), is a rectangular or e-function or a sawtooth curve. Device according to one of Claims 1 to 4 , characterized in that the envelope curve (20), which describes the basic pulses (10, 10a-10e) rising during the treatment time (11), consists of a rising curved branch (57). Launching ramp - passes, which during the treatment time (t ₁ ) in a horizontal curved branch (58), ( 15 ). Device according to one of Claims 1 to 6 , characterized in that the envelope curve (20) which describes the pulse packets (14, 44) formed from the basic pulses (10, 10a-10e) consists of a rising curved branch (17a) -. Launching ramp - consists of, during several consecutive treatment times (t ₁ ) and pause times in a horizontal curve branch (58), ( 17 ). Device according to one of Claims 1 to 7 , characterized in that the Fibinacci frequencies (A and / or B and / or C) of a selection from the values 3.142; 5.08; 8.225; 13.31; 21.53 and 34.84 Hz. Device according to one of Claims 1 to 8th , characterized in that the device for transcranial magnetic stimulation (TMS) forms a combination with a device for transpelvine magnetic stimulation. Device after Claim 9 , characterized in that the device for transcranial magnetic stimulation (TMS) is arranged on the arrangement for transpelvine magnetic stimulation. Device after Claim 9 or 10 , characterized in that the device for transcranial magnetic stimulation (TMS) and the device for transpelvine magnetic stimulation with one or more of the Fibonacci frequencies (A and / or B and / or C) work.

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