DE10205734A1 - Device for improving frequency discrimination in patients suffering from tinnitus has a microprocessor controlled signal generator that is used with patient answers in response to differentiation of different frequency signals - Google Patents

Device for improving frequency discrimination in patients suffering from tinnitus has a microprocessor controlled signal generator that is used with patient answers in response to differentiation of different frequency signals

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Publication number
DE10205734A1
DE10205734A1 DE10205734A DE10205734A DE10205734A1 DE 10205734 A1 DE10205734 A1 DE 10205734A1 DE 10205734 A DE10205734 A DE 10205734A DE 10205734 A DE10205734 A DE 10205734A DE 10205734 A1 DE10205734 A1 DE 10205734A1
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Germany
Prior art keywords
frequency
tinnitus
patient
microprocessor
pair
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
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DE10205734A
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German (de)
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
ELBERT THOMAS
MUEHLNICKEL WERNER
WIENBRUCH CHRISTIAN
Original Assignee
ELBERT THOMAS
MUEHLNICKEL WERNER
WIENBRUCH CHRISTIAN
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Application filed by ELBERT THOMAS, MUEHLNICKEL WERNER, WIENBRUCH CHRISTIAN filed Critical ELBERT THOMAS
Priority to DE10205734A priority Critical patent/DE10205734A1/en
Publication of DE10205734A1 publication Critical patent/DE10205734A1/en
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/12—Audiometering
    • A61B5/128—Audiometering evaluating tinnitus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/12—Audiometering
    • A61B5/121—Audiometering evaluating hearing capacity
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/20—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for electronic clinical trials or questionnaires
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records

Abstract

The microprocessor and its loaded algorithm select a tone pair with a randomized frequency difference from a frequency range matched to a particular patient. The microchip signal generator produced the tone in real time and transmits it into the headphones. The patient pushes yes-no buttons to indicate if he can differentiate between a tone pair. The microprocessor receives the feedback answer and selects the next tone pair frequency difference based on the answer. The invention also relates to a corresponding method.

Description

Tinnitus ist eine abnorme Geräuschempfindung, ohne dass ein physikalisches Schallereignis vorliegt. Für die Betroffenen ist, neben den oft unerträglichen Ohrgeräuschen, die Unkontrollierbarkeit des Tinnitus besonders schwerwiegend. Bisherige Apparate versuchen passiv den Tinnitus der Patienten zu unterdrücken oder zu maskieren (Patente WO 01/08617 A1, WO 94/09606). Dies geschieht häufig durch eine ständige Beschallung des Patienten mit Geräuschen, die mit modernen digitalen Hörgeräten (Gebrauchsmusterschrift DE 299 16 891 U1) erzeugt werden. Ein bekanntes Problem dieser Tinnitusmasker ist ihre temporäre Wirkung. Werden die Masker ausgeschaltet, stellt sich der Tinnitus der Patienten nach kurzer Zeit wieder ein. Tinnitus is an abnormal sensation of noise without being physical Sound event is present. For those affected, besides the often unbearable Ringing in the ears, the uncontrollability of tinnitus is particularly serious. Previous devices try to passively suppress the patient's tinnitus or to mask (patents WO 01/08617 A1, WO 94/09606). This happens frequently due to the patient's constant sound reinforcement with sounds similar to modern ones digital hearing aids (utility model DE 299 16 891 U1) are generated. A known problem with these tinnitus maskers is their temporary effects. Become If the maskers are switched off, the patient's tinnitus will turn up after a short time again.

Studien zur Verarbeitung akustischer Signale im Gehirn von Affen zeigen eine Veränderte neuronale Repräsentation der Schallfrequenzen im Gehirn der Versuchstiere. Allerdings nur wenn die Versuchstiere aktiv auf die Signale reagieren mussten. Eine ausschließlich passive Beschallung zeigte keine Veränderung in der Repräsentation der Signale im Gehirn (G. H. Recanzone et al., 1993, Journal of Neuroscience, Vol. 13, Seite 87-103). Studies on the processing of acoustic signals in the monkey brain show one Altered neural representation of the sound frequencies in the brain of the Experimental animals. However, only if the test animals actively react to the signals had. An exclusively passive sound system showed no change in the Representation of signals in the brain (G.H. Recanzone et al., 1993, Journal of Neuroscience, vol. 13, pages 87-103).

Im Gegensatz zu den vorherigen Geräten basiert das Gerät zur Verbesserung der Frequenzdiskrimination bei Tinnitus auf der aktiven Beteiligung der Patienten an der Darbietung der Töne nach Anspruch 1 (Zeichnung 1). Die aktive Rückkopplung durch die Patienten, zusammen mit der Wahl und der Verringerung der Frequenzbereiche (Anspruch 2 und 3), führt zu einer langfristigen Unterdrückung des Tinnitus. Die Erfindung nach Anspruch 1 kann realisiert werden durch handelsübliche tragbare Kleinstcomputer (sogenannte Handhelds). Sie integrieren bereits den benötigten Mikroprozessor, die Signalerzeugungseinheit und den Handschalter. Unlike the previous devices, the device is based on improving Frequency discrimination in tinnitus based on active patient participation the presentation of the tones according to claim 1 (drawing 1). The active feedback through the patient, along with the choice and reduction of Frequency ranges (claims 2 and 3) leads to long-term suppression of the Tinnitus. The invention according to claim 1 can be implemented by commercially available portable microcomputers (so-called handhelds). You integrate already the required microprocessor, the signal generating unit and the Manual switch.

Die Rückkopplung durch den Patienten besteht aus der Frequenzdiskrimination des dargebotenen Tonpaares und der anschließenden ja/nein-Antwort. Dabei muss beantwortet werden, ob die Frequenzen der Töne gleich oder ungleich waren. Die Beantwortung erfolgt dabei durch Tastendruck auf einen Handschalter. Nach Anspruch 1 bewertet der Mikroprozessor die Antworten folgendermaßen: Richtige Antworten verringern die mögliche Frequenzdifferenz des nächsten Tonpaares (die Unterscheidung wird schwieriger). Falsche Antworten vergrößern die Frequenzdifferenz des nachfolgenden Tonpaares (die Unterscheidung wird leichter). Nach Anspruch 3 führt eine Reihe richtiger Antworten zusätzlich zu einer Verkleinerung der gesamten Frequenzbereiche aus dem die Tonpaare ausgewählt werden derart, dass die Frequenzbereiche zur Tinnitusfrequenz hin eingeschränkt werden (Zeichnung 2). The feedback from the patient consists of the frequency discrimination of the presented pair of tones and the subsequent yes / no answer. It must be answered whether the frequencies of the tones were the same or not. The The answer is given by pressing a hand switch. To Claim 1, the microprocessor evaluates the answers as follows: correct Answers reduce the possible frequency difference of the next pair of tones (the Differentiation becomes more difficult). Incorrect answers increase the Frequency difference of the following pair of tones (the distinction becomes easier). According to claim 3, a series of correct answers additionally leads to one Reduction of the total frequency ranges from which the tone pairs are selected are such that the frequency ranges are restricted to the tinnitus frequency be (drawing 2).

Dieses Verhalten des Algorithmus nach Anspruch 1 und die Wahl der Frequenzbereiche nach Anspruch 2 ergeben sich ebenfalls aus der Studie von Recanzone et al. Denn die von ihm beobachtete neuronale Veränderung bestand aus einer Vergrößerung der neuronalen Gruppe, die den Ton verarbeitete, auf den die Tiere reagieren mussten. Übertragen auf den Tinnitus bedeutet das, dass die dem Tinnitusfrequenzbereich benachbarten neuronalen Frequenzareale unterstützt werden. Der Tinnitusfrequenzbereich wird also verkleinert und der Tinnitus verschwindet. This behavior of the algorithm according to claim 1 and the choice of Frequency ranges according to claim 2 also result from the study of Recanzone et al. Because the neuronal change he observed consisted of an enlargement of the neural group that processed the sound to which the Animals had to react. Transferred to tinnitus, it means that the Supported tinnitus frequency range adjacent neural frequency areas become. The tinnitus frequency range is thus reduced and the tinnitus disappears.

Die Parameter der vorgespielten Töne und der Frequenzbereiche betragen typischerweise:
Tondauer eines Tons: 500 ms
Verzögerung zwischen einem Tonnpaar: 500 ms
Lautstärke eines Tons: 40 dB über der individuellen Hörschwelle
mag. Antwortzeit des Patienten: 2500 ms
Startbedingung der Frequenzbereiche: 500-1000 Hz*
Dauer eines Übungsdurchgangs: mindestens 0,5 h
Gesamtdauer der Übung 4 Wochen/1 h täglich
* Die Größe der Frequenzbereiche hängt ab von der individuellen Frequenzdiskriminationsfähigkeit der Patienten zu Beginn der Übungen. Sie verbessert sich im Verlauf der Übungen. Zitierte Nichtpatentliteratur 1. G. H. Recanzone et al., (1993): Plasticity in the Frequency Representation of Primary Auditory Cortex following Diserimination Training in Adult Owl Monkeys., The Journal of Neuroscience, Vol. 13, Seite 87-103 The parameters of the sounds played and the frequency ranges are typically:
Tone duration of a tone: 500 ms
Delay between a pair of tones: 500 ms
Volume of a tone: 40 dB above the individual hearing threshold
like. Patient response time: 2500 ms
Start condition of the frequency ranges: 500-1000 Hz *
Duration of a training session: at least 0.5 h
Total duration of the exercise 4 weeks / 1 hour a day
* The size of the frequency ranges depends on the individual frequency discrimination ability of the patients at the beginning of the exercises. It improves over the course of the exercises. Non-patent literature cited 1.GH Recanzone et al., (1993): Plasticity in the Frequency Representation of Primary Auditory Cortex following Diserimination Training in Adult Owl Monkeys., The Journal of Neuroscience, Vol. 13, pp. 87-103

Claims (3)

1. Das Gerät zur Verbesserung der Frequenzdiskrimination bei Tinnitus besteht aus einem Mikroprozessor und einer nachgeschalteten Signalerzeugungseinheit. Der Mikroprozessor und der darauf aufsetzende Algorithmus wählen ein Tonpaar mit einer randomisierten Frequenzdifferenz aus einem individuell an den Patienten angepassten Frequenzbereich aus. Die Signalerzeugungseinheit (Mikrochip) erzeugt die Töne in Echtzeit und überträgt sie an einen Kopfhörer. Durch Tastendruck auf einen Handschalter bestätigt der Patient, ob das Tonpaar unterscheidbar (ja/nein) war. Der Mikroprozessor erhält rückgekoppelt die Antwort und wählt abhängig von der Antwort des Patienten die Frequenzdifferenz für das nächste Tonpaar. 1. The device for improving frequency discrimination in tinnitus consists of a microprocessor and a downstream signal generation unit. The The microprocessor and the algorithm based on it select a pair of tones a randomized frequency difference from an individual to the patient adjusted frequency range. The signal generation unit (microchip) generates the sounds in real time and transmits them to headphones. By Pressing a button on a hand switch confirms the patient whether the pair of tones was distinguishable (yes / no). The microprocessor receives the response in feedback and selects the frequency difference for that depending on the patient’s response next tone pair. 2. Das Verfahren zur Bestimmung der Ausgangsdaten für den Mikroprozessor nach Anspruch 1 besteht in der Festlegung der Frequenzbereiche aus denen die Tonpaare randomisiert ausgewählt werden. Dabei ist ein Tonpaar dadurch gekennzeichnet, dass es aus einem Frequenzbereich ausgewählt wird. Die Frequenzbereiche werden in einem Tinnitusmatching so auf den einzelnen Patienten angepasst, dass ein Frequenzbereich unterhalb der Tinnitusfrequenz (bzw. des Tinnitusfrequenzbereichs) des Patienten liegt und der zweite Frequenzbereich oberhalb der Tinnitusfrequenz. Die Grenzen der Frequenzbereiche die dem Tinnitus am nächsten liegen, werden so gewählt, dass sie vom Patienten als gerade eben nicht zum Tinnitus gehörig klassifiziert werden. 2. The procedure for determining the output data for the microprocessor after Claim 1 consists in the definition of the frequency ranges from which the Tone pairs can be selected randomly. A pair of tones is thereby characterized that it is selected from a frequency range. The frequency ranges are so in a tinnitus matching to the individual Patients adjusted that a frequency range below the tinnitus frequency (or the tinnitus frequency range) of the patient and the second Frequency range above the tinnitus frequency. The limits of the frequency ranges The closest to the tinnitus are chosen so that they are from the patient be classified as just not belonging to tinnitus. 3. Die Veränderung der Frequenzbereiche nach Anspruch 1 und 2 verringern sich mit fortschreitender Anwendung in folgender Weise:
Die dem Tinnituston direkt benachbarten Grenzen des oberen und unteren Frequenzbereichs bleiben fest. Die entfernt liegenden Grenzen der beiden Frequenzbereiche verschieben sich mit zunehmendem Erfolg der Anwendung in Richtung der Tinnitusfrequenz. Die Frequenzbereiche werden kleiner. 3. The change in the frequency ranges according to claim 1 and 2 decrease with increasing use in the following way:
The upper and lower frequency range limits directly adjacent to the tinnit tone remain fixed. The distant limits of the two frequency ranges shift towards the tinnitus frequency with increasing success of the application. The frequency ranges are getting smaller.
DE10205734A 2002-02-12 2002-02-12 Device for improving frequency discrimination in patients suffering from tinnitus has a microprocessor controlled signal generator that is used with patient answers in response to differentiation of different frequency signals Withdrawn DE10205734A1 (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102813520A (en) * 2012-08-27 2012-12-12 清华大学 Pure tone audiometric and psychophysical tuning curve detecting system
RU2535405C1 (en) * 2013-05-17 2014-12-10 Общество с ограниченной ответственностью "Национальная Инновационная Компания" Apparatus for diagnosing and treating sensorineural hearing loss

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102813520A (en) * 2012-08-27 2012-12-12 清华大学 Pure tone audiometric and psychophysical tuning curve detecting system
CN102813520B (en) * 2012-08-27 2014-11-26 清华大学 Pure tone audiometric and psychophysical tuning curve detecting system
RU2535405C1 (en) * 2013-05-17 2014-12-10 Общество с ограниченной ответственностью "Национальная Инновационная Компания" Apparatus for diagnosing and treating sensorineural hearing loss

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