EP3157624A2 - Procédé et dispositif de neurostimulation magnétique silencieuse - Google Patents

Procédé et dispositif de neurostimulation magnétique silencieuse

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Publication number
EP3157624A2
EP3157624A2 EP15760381.2A EP15760381A EP3157624A2 EP 3157624 A2 EP3157624 A2 EP 3157624A2 EP 15760381 A EP15760381 A EP 15760381A EP 3157624 A2 EP3157624 A2 EP 3157624A2
Authority
EP
European Patent Office
Prior art keywords
coil
mechanically
electrical
pulse
rigid
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Withdrawn
Application number
EP15760381.2A
Other languages
German (de)
English (en)
Inventor
Stefan M. Goetz
David L. K. MURPHY
Angel V. Peterchev
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.)
Individual
Original Assignee
Individual
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Priority claimed from DE201420004930 external-priority patent/DE202014004930U1/de
Priority claimed from DE202014004932.7U external-priority patent/DE202014004932U1/de
Priority claimed from DE102014008820.0A external-priority patent/DE102014008820A1/de
Application filed by Individual filed Critical Individual
Publication of EP3157624A2 publication Critical patent/EP3157624A2/fr
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N2/00—Magnetotherapy
    • A61N2/02—Magnetotherapy using magnetic fields produced by coils, including single turn loops or electromagnets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/06—Electrodes for high-frequency therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/40—Applying electric fields by inductive or capacitive coupling ; Applying radio-frequency signals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N2/00—Magnetotherapy
    • A61N2/004—Magnetotherapy specially adapted for a specific therapy
    • A61N2/006—Magnetotherapy specially adapted for a specific therapy for magnetic stimulation of nerve tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N2/00—Magnetotherapy
    • A61N2/12—Magnetotherapy using variable magnetic fields obtained by mechanical movement
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01F—MAGNETS; INDUCTANCES; TRANSFORMERS; SELECTION OF MATERIALS FOR THEIR MAGNETIC PROPERTIES
    • H01F27/00—Details of transformers or inductances, in general
    • H01F27/28—Coils; Windings; Conductive connections
    • H01F27/32—Insulating of coils, windings, or parts thereof
    • H01F27/327—Encapsulating or impregnating
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01F—MAGNETS; INDUCTANCES; TRANSFORMERS; SELECTION OF MATERIALS FOR THEIR MAGNETIC PROPERTIES
    • H01F27/00—Details of transformers or inductances, in general
    • H01F27/33—Arrangements for noise damping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N2/00—Magnetotherapy
    • A61N2/004—Magnetotherapy specially adapted for a specific therapy

Definitions

  • the present invention relates to a device and a method for the stimulation of nerve and muscle cells according to the principle of magnetic stimulation, the invention having the same stimulus strength a significantly reduced acoustic emission compared to the prior art.
  • the acoustic emission in the form of click noise which on the one hand causes an important safety risk on the other hand undesired uncontrollable sensory-auditory brain irritation, is increased by increasing the frequency of a substantial portion of the spectrum of the pulse, preferably to or beyond the human hearing range, decreased.
  • the present invention relates to a quieter coil technology that reduces the conversion of electrical energy into mechanical-acoustic vibrations, prevents their transmission to the surface by elastic decoupling and instead converts the mechanical-acoustic energy into heat via viscoelastic material deformation.
  • Transcranial magnetic stimulation is a method of noninvasive brain stimulation with short strong magnetic pulses that induce an electric field in the brain. This technology is widely used in neuroscience as a method for testing certain brain functions. It is also approved by the US Food and Drug Administration (FDA) for the clinical treatment of depression and is being investigated for a variety of other psychiatric and neurological disorders and syndromes. In addition, TMS has demonstrated that individual cognitive functions of healthy subjects can be temporarily increased.
  • FDA US Food and Drug Administration
  • a TMS device contains a pulse source or pulse generator and a stimulation coil placed on the head of a subject.
  • Typical TMS devices generate current pulses in the coil which are sinusoidal with a dominant fundamental frequency (here also the fundamental frequency) of about 1-5 kHz at current amplitudes up to 8 kA and magnetic field strengths at the coil surface of around 2.5T.
  • the high pulse amplitudes lead to electromagnetically induced mechanical forces in the pulse source, the coil and the cable, which connects the two, which in turn cause loud noises.
  • the noise of the coil dominates because of the strong magnetic fields in the coil.
  • the sound of the coil is most difficult to suppress because the coil is placed on the subject's head, from where the sound is transmitted through the air and the cranial bone.
  • the loud clicking sound may cause hearing damage in the TMS subject, the TMS operator, and other persons or animals near the system
  • TMS is either an approved (depression) or researched form of therapy.
  • tension-type headache is the most prevalent side effect of rTMS and occurs in about 23% -58% of subjects or patients and in 16% -55% of control groups [Loo CK, McFarcluhar TF, and Mitchell PB (2008).
  • a US FDA-approved rTMS depression treatment uses 10-Hz pulse trains. This is consistent with the repetition rate for strongest auditory cortex sensitivity (10-14 Hz) and is very close to the 13 Hz at which auditory-induced LTP has been detected in humans [Clapp WC, Hamm JP, Kirk IJ, and Teyler TJ (2012 ). Translating Long-Term Potentiation from Animals to Humans: ANovel Method for Noninvasive Assessment of Cortical Plasticity. Biological Psychiatry, 71 (6): 496-502.].
  • TMS equipment The loud clicking sound of TMS equipment is a challenge in the environment where TMS equipment is deployed and operated. Because the noise of TMS equipment can penetrate the building's adjacent rooms, researchers and physicians using TMS equipment are exposed to problems with residents, colleagues, and / or the building operator. Furthermore, in many countries, the noise emission / noise immission is regulated by law. Since many medical practices are not located in designated industrial areas, noise levels of 55 dB (A) outdoors and 35 dB (A) in adjacent units in the building may apply [TAL (1998), German Technical Instruction on Noise Protection According to the Federal Control of Pollution Act BImSchG / Technical instructions for protection against noise issued on the basis of the Federal Immission Control Act. GMBI no. 26/1998, p. 503.]. Without enhanced soundproofing in the building, the use of TMS for medical applications may be limited.
  • This approach attempts to reduce the acoustic emissions by removing all media in the vicinity of the coil winding that could carry the sound.
  • this approach has some shortcomings: (1) The airtight evacuated vessel around the coil typically increases the distance between the coil turn and the stimulation target, thereby degrading the electromagnetic coupling to the target as well as the electrical efficiency of the system. (2) Alternative sound paths still exist from the locations where the coil conductor is evacuated Vessel enters, starting from the coil cable and starting from the pulse source. (3) An evacuated vessel is large, inflexible, impractical, likely to break and expensive.
  • the present invention incorporates a concept of quiet TMS technology that significantly reduces the sound radiation from TMS.
  • Figure 2 shows the amplitude spectrum of the coil current of a conventional biphasic Magstim figure-8 pulse (201, black) and a biphasic pulse with 30 kHz (202, gray) at the stimulation threshold.
  • FIG. 3 shows two embodiments of acoustically more advantageous pulse current waveforms (301, 302), spga, spgb, in the sense of the invention.
  • Both pulses are normalized to their individual threshold for a human motor neuron.
  • the fundamental frequency or carrier frequency of the electromagnetic oscillation is considerably higher to push a significant portion of the energy above the audible range.
  • the oscillations are not abruptly switched on or off at certain times, for example at zero crossings of the current with a sinusoidal course and an otherwise approximately constant amplitude, but rather modulated by a pulse enveloping the pulse start (attack) and the end of the pulse (decay) Smooth the waveform.
  • the resulting waveforms are bandwidth limited and have no strong sidebands in the spectrum, as shown in FIG.
  • FIG. 4 shows the amplitude spectrum of waveforms spga (404) and spgb (405) of FIG. 3 and compares them to simpler waveforms
  • "30 kHz x 2" (402) polyphase waveform with two periods at a fundamental frequency of 30 kHz;
  • “30 kHz x 3" (403) polyphase waveform with three periods at a fundamental frequency of All individual curves are normalized for comparability with respect to their individual stimulus threshold.
  • the strong sidebands of the biphasic and polyphasic pulses which extend far into the audible range, are suppressed for the spga and spgb waveforms, hence the spectral power of the electromagnetic oscillation at low lower frequencies, which in turn excite the
  • Figure 5 shows a cross section of a coil according to the first embodiment of the mechanical part of the invention.
  • the individual turns of the conductor (501) are electrically isolated and mechanically fixed to each other.
  • This fixed connection (503) is made with high rigidity (characterized by a high modulus of elasticity).
  • the connection between the outermost turn and the cable or a second coil ring, for example in a so-called figure-of-eight or butterfly coil can be used to form a mechanically stabilizing beam, as indicated in the figure.
  • All of the columns may also be filled with rigid materials, as indicated in the figure by reference numeral 502 (also called "stiff core”) .
  • the entire rigid block which is composed of the individual conductors, will depend on the housing and the environment a layer of viscoelastic material (504) (high 77 value, in addition a high ii value is advantageous) and an additional layer of a highly elastic material (505) (low ii modulus and shore hardness)
  • This layer sequence can be repeated.
  • the sequence may also begin and end with a viscoelastic layer, ie, as the innermost and outermost layers
  • a housing (506) preferably rigid and / or massive, terminates the coil outwardly and forms the interface with the environment (if desired).
  • Conductor (501) preferably of high density, preferably stiff, preferably not too thin (avoiding bending modes in the transverse direction), preferably no inhomogeneous mass or bulk density (similar thickness to avoid tuning fork effect); rigid core (502); preferably rigid compound (503): for example, epoxy-Kapton-epoxy composite, fiber composite, glass wool, aramid-epoxy composite (in the case of Kapton or polyimides with surface treatment as a primer), rigid epoxy or cyanoacrylate epoxide; highly viscoelastic layer (504): preferably high Young's modulus, preferably high viscosity, for stiffening and generating mechanical energy losses; highly elastic layer (505): for decoupling; Housing (506): preferably rigid and massive, optionally struts for stiffening and softer inserts for controlled generation of mechanical modes.
  • rigid core preferably rigid compound (503): for example, epoxy-Kapton-epoxy composite, fiber composite, glass wool, aramid-epoxy composite (in the
  • FIG. 6 shows a particular embodiment in which the conductors of the embodiment from FIG. 5 are formed by a copper-coated steel conductor (601) (so-called copper-clad steel).
  • the conductor is designed as a flat band conductor with a steel core covered on both sides by copper.
  • Other conductor shapes and cross sections can also be used.
  • Figure 7 shows a modification of the coil cross-section of Figure 5 in which the effect of the viscoelastic layer is enhanced by an additional rigid layer (708).
  • the viscoelastic layer (704) comes to lie between two rigid layers (702, 708).
  • This structure forces vibrations to always drive the viscous material properties of this layer, causing shear stress, bending and compression; otherwise, vibrations could only shift the entire viscoelastic layer, which is relatively stiff, without (lossy) shape change of the material or exciting modes with relatively little viscous energy loss.
  • An alternative to an additional rigid layer may also be rigid grains or bars in the viscoelastic layer which force deformation or flexing of the viscoelastic material.
  • Figure 8 shows a cross section of a coil according to the second embodiment of the mechanical part of the invention.
  • the individual turns (801) are individually treated as well as the larger block formed in the first embodiment (e.g., Figure 5) of some or all of the conductors or turns of the same conductor (801).
  • the individual turns are surrounded by associated viscoelastic layers (803) and associated elastic layers (802).
  • the viscoelastic layers and / or the elastic layers of individual for example adjacent, conductors or turns can touch one another and form a single coherent layer. Should there be sufficient space, as shown here, the remaining gaps and spaces in the coil can be filled with a viscoelastic material (804).
  • the gaps and spaces may be filled with the material of the closest layer.
  • the housing encloses the coil and forms the surface to the environment (possibly wrapped in insulating foam or other materials).
  • the conductors may have a round or oval cross section for a good surface to volume ratio.
  • the conductor may be a copper-coated conductor, for example with a steel core.
  • Figure 9 shows the surface of a coil, which is further reinforced in part with known measures, for example with beams, to increase the rigidity and / or mass in general or for certain (mechanical) modes.
  • Figure 10 shows a simplified equivalent circuit of the acoustic ratios of the second part of the invention and simplifies equivalences with electronic elements.
  • a pressure source (1001), ie a mechanical equivalent of an electrical voltage source, on the left represents the conversion of electromagnetic energy into the acoustic domain.
  • the high stiffness (E st and E s i) (1002) and the high mass (m s ) (1003) of the conductor, as preferred by the invention, increases the input impedance and minimizes the amount of energy that is converted.
  • Damping and decoupling units Each formed of a viscoelastic layer (with viscosities and ⁇ ⁇ and an elastic layer (with E moduli E e ⁇ and E e ) convert the energy into heat and decouple their left side from their right Page in the circuit diagram These units can be repeated
  • the housing with mass m c and moduli E c ⁇ and E ct forms the interface with the environment to which it emits sound through air and body conduction
  • the equivalent electrical elements are as far as possible An approximation, because almost all known materials have a strong frequency dependence of their parameters and significant nonlinearities Furthermore, a description in the form of a one-dimensional circuit can only approximate the complicated three-dimensional geometric relationships.
  • the elements are characterized by pressure source (1001), high rigidity (1002), high mass (1003), high viscosity / viscoelasticity (1004), high elasticity and low rigidity (1005).
  • the blocks are the source with high source impedance (1006), attenuation and / or decoupling (1007) and a package (1008).
  • FIG. 11 shows equivalences between electrical and mechanical / acoustic parameters.
  • Figure 12 illustrates the forces that cause the vibrations in a coil.
  • Representation 1201 illustrates the dominant direction of forces between the conductor turns (1204, 1205, 1206) in a coil compressing the material between two conductors or conductor turns (1204, 1205, 1206).
  • Illustration 1202 shows the conversion of bending vibrations in the conductor core under heavy load in the viscoelastic layer.
  • Representation 1203 shows longitudinal oscillations (hence contraction or translation of the materials), which is more important for TMS coils, depending on the specific material properties for high-frequency frequency components, predominantly above the audible limit.
  • FIG. 13 shows measured waveforms of a TMS pulse with a period of 300 ⁇ 8 (1301, 1303) and a shorter pulse with 45 ⁇ 8 (1302, 1304) duration. Both pulses were generated with a controllable-pulse-parameter TMS device (cTMS) and a round coil. The electric field generated by each pulse was measured with a single turn dl / dt probe. The peak neuronal depolarization induced by each pulse was replicated by passing the signal from the probe through a first order low pass filter with a time constant of 150 ⁇ 8. The intensity of each pulse was chosen so that each pulse depolarized (measured from peak to peak) of 1000 mV.
  • cTMS controllable-pulse-parameter TMS device
  • the acoustic signal 280 generated by the round coil was recorded with an AKG C214 microphone. Both the microphone and the coil were placed in an acoustically isolated space to reduce background noise and to isolate the coil sound from the noise generated by the device during the pulse. A second tuned AKG C214 microphone recorded noise in the room so that the acoustic isolation could be checked.
  • QTMS (1303, 1304) refers to recordings with a coil in the sense of the present invention "Magstim" (1301, 1302) on a commercial 90 mm round coil.
  • FIG. 14 shows sound recordings associated with the electrical pulses (waveforms) from FIG. 13.
  • FIG. 15 shows power density spectra associated with the electrical pulses (waveforms) of FIG. 13 and the corresponding sound recordings of FIG. 14.
  • FIG. 16 compares the sound levels (equivalent average sound pressure level after A weighting) associated with the electrical pulses from FIG. 13.
  • FIG. 17 shows a circuit topology that can generate ultrashort TMS pulses according to the invention.
  • the circuit represents a biphasic topology in which common thyristor as switch (1702) is replaced by an IGBT.
  • IGBT common thyristor as switch
  • the latter allows significantly higher current dynamics, which are needed for ultrashort pulses. Future thyristor generations could also possibly enable their use for ultra-short pulses.
  • An important disadvantage of this topology is the fixed pulse shape given by the circuit with predetermined pulse duration and thus also spectral characteristics.
  • Figure 18 shows how two or more semiconductor switches in accordance with one embodiment of the invention can be connected in series to increase the common withstand voltage (specified peak switchable circuit).
  • the additional passive circuit elements form a compensation circuit which ensures that the total voltage is divided into a plurality of stable, preferably equal parts.
  • the resistors (R a and Rb) divide the voltage va for static voltages, for example in the state of open switches;
  • the capacitors (C a and C b ) stabilize the voltage divider during transient processes, for example during switching or during a sinusoidal pulse progression.
  • Other known methods for voltage division of series connected switches such as antiparallel zener diodes and transient voltage suppressor elements, may also be used.
  • Figure 19 shows a cTMS technology with a half bridge of two electronic switches (1903, 1904). This technology allows control of the pulse duration and can accordingly change the frequency spectrum of a pulse in the coil L (1907).
  • Figure 20 shows a cTMS technology with two half-bridges of two electronic switches each (2003, 2004) and (2005, 2006) for enhanced flexibility.
  • Figure 21 shows a modular stimulator for generating high voltage pulses through the use of smaller voltage steps.
  • the figure shows the structure of the overall circuit with N modules, a coil L and a controller and lines for power supply.
  • the individual modules can be implemented as small H-bridge circuits (see FIG. 22).
  • the entire pulse voltage is divided into smaller units, each about 1 / Nth of the total pulse voltage.
  • the module structure keeps the circuit in balance so that none of the circuit components in the modules, both semiconductors and passive elements such as capacitors, are exposed to more than one pulse-voltage. This approach allows the use of cost-effective
  • Circuit elements with low voltage design can quickly switch between voltage levels and synthesize pulses very flexibly and freely.
  • FIG. 22 shows a module circuit for the N modules from FIG. 21
  • Figure 23 shows a staircase pulse which can be generated and modified from pulse to pulse by the high flexibility due to the dynamic switching between the circuit levels of the modules of the circuit of Figures 21 and 22.
  • Figure 24 shows a random walk pulse illustrating the high flexibility of the circuit of Figures 21 and 22.
  • the invention of quiet TMS (quiet TMS) consists of two parts, which can be combined but also used separately, separately.
  • the first part consists in shifting a considerable part of the spectrum of the TMS pulse sound to higher frequencies, so that the spectral component falling within the range of the highest sensitivity of the human ear between 500 Hz and 8 kHz, is minimal; particularly preferred is a shift of a substantial portion of the spectrum to frequencies above the human auditory limit of about 18 kHz - 20 kHz.
  • This approach is based on three reasons. First, the human perception of sounds above the auditory limit is negligible. Second, from a technical standpoint, mechanical vibrations are much easier to suppress than those in the conventional TMS spectrum.
  • Magnetic nerve stimulation the effect of waveform on efficiency, determination of neural membrane time constants and the measurement of stimulator output. Electroencephalography and clinical neurophysiology. Supplement 43: 227-237; Goetz SM, Truong CN, Gerhofer MG, Peterchev AV, Duke HG, Weyh T. (2013). Analysis and Optimization of Pulse Dynamics for Magnetic Stimulation. PLOS One, 8 (3): e55771.].
  • the use of these pulses makes use of the fact that the neurons can be stimulated with pulses of different shape and duration when the amplitude is appropriately scaled. For example, pulses that consist of shorter electrical current phases are associated with higher acoustic frequencies.
  • a pulse phase is part of the electrical pulse; usually, a phase or pulse phase refers to a portion of the pulse during which the current does not change polarity and is limited by either the beginning of a pulse and / or the end of a pulse and / or a polarity change of the current.
  • the second part consists in designing the components (coil, coil cable and pulse source) so that, despite the very high electromagnetic energy of a pulse (a), only a small part of the electromagnetic energy is converted into mechanical / acoustic energy (b ) the portion of the mechanical / acoustic energy delivered to the environment is minimized and (c) the portion of the mechanical / acoustic energy that is not dissipated is rapidly converted into heat within the apparatus.
  • this invention proposes several measures, including targeted impedance mismatching, frequency-selective decoupling with phase-shifting materials, and frictional mechanical power delivery elements. According to the state of the art, these measures have hitherto not been deliberately used for improved TMS noise suppression.
  • the first part of the invention shifts a significant portion of the spectrum of acoustic emissions from the listening area, particularly to the ultrasonic range (> 18-20 kHz).
  • a central factor influencing the acoustic emission is the waveform of the current pulse, which stimulates both the stimulation Onesf Anlagen as well, due to the conversion of electromagnetic forces into acoustic shrinkage, the sound emission causes.
  • the first part is supported by the second part described below, in that all elements have to be executed in such a way that they convert only a small part of the energy content of the high-frequency vibrations back into the listening area, for example by mechanical effects (for example energy exchange between modes or non-linear effects). , and that they therefore keep the frequencies in the mechanical range in high ranges.
  • the very short electric pulse waveform does not directly determine the time course and the spectrum of the acoustic emission.
  • conventional pulses use largely sinusoidal current waveforms which have pronounced spectral components with sidebands around the sinusoidal frequency (see FIG. 2)
  • the associated sound recordings show a wide, almost flat distribution of the emission along the entire audible range (see FIG. 15).
  • the exact relationship between these two phenomena has not been well studied. Part of the big difference comes from non-linear mechanical effects, which depend on the physical properties of the materials used.
  • the spectrum of common TMS pulse waveforms (usually called biphasic pulses) is not monomodal but very broad because of their brevity and their sharp onset / fading.
  • TMS devices and related technologies which generally allow control over pulse shape and pulse duration, were not available until they were developed by the inventors [Peterchev AV, Jalinous R., and Lisanby SH (2008).
  • the goal of reducing the audible noise from TMS can be achieved by shortening the magnetic pulse, which in turn is generated directly by the current pulse, so that the fundamental frequency and dominant frequency are above 18-20 kHz (see Figure 2). Because of the well-known strength-duration curve of the neuronal response response, this has the consequence that the pulse amplitude must be increased in order to achieve an equally strong neurostimulation. This in turn implies that the peak voltage and / or the current in the TMS coil must be increased, as shown in FIG.
  • the magnitude spectrum in FIG. 2 compares the coil current of a conventional biphasic pulse (201, black) with the coil current of a balanced pulse with a fundamental frequency of 30 kHz (202). Both stimuli were computer-assisted to have approximately the same neurostimulation strength. Although the spectral peak power is similar for both pulses the spectral component in the hearing range for the 30 kHz pulse is significantly reduced in comparison to the conventional pulse, which has its peak in the spectrum in the range of maximum auditory sensitivity between 0.5 kHz and 2 kHz.
  • a particular embodiment of the invention has several refinements. Instead of a sinusoidal biphasic pulse with increased fundamental frequency - which basically corresponds to a sinusoidal oscillation, which is stopped after a period - the number of wave trains can be increased.
  • multiphasic or polyphasic pulses reduce the neural triggering threshold [Emrich D., Fischer A., Altenhöfer C, Weyh T., Helling F., Brielmeier M., and Matiasek K. (2012). Muscle force development after low-frequency magnetic burst stimulation in dogs.
  • a further preferred embodiment of the invention uses an amplitude-modulated waveform which softly fades in and fades out, for example, with a Gauss-shaped or Secans hyperbolic-shaped envelope, which are known, for example, from bandwidth-limited ultrashort laser pulses in optics (see FIGS. 3 and 4).
  • these pulses generally cause less non-linear effects since they have a less abrupt onset and also a lower peak amplitude of the magnetic field and thus forces with the same stimulation effect compared to the classical sinusoidal biphasic waveform.
  • Such nonlinear mechanical effects in the individual parts of the stimulation system, particularly in the coil are the major mechanism that transfers the inaudible portions of a TMS waveform spectrum into the auditory range.
  • Classic TMS pulse source technologies can not generate such bandwidth limited pulses due to limitations associated with the circuit topology and implementation.
  • FIG. 1 shows the required voltage level for sinusoidal, biphasic pulses as a function of the fundamental frequency for two coils (9 and 18 turns).
  • a prior art nonlinear neuron model estimates a necessary peak voltage of about 10 kV to achieve an equivalent amplitude range, such as the typical current commercial stimulator, such as the Magstim Rapid device.
  • the biphasic topology ( Figure 17), is the commonly used thyristor switch for shorter, higher voltage pulses.
  • the ultrashort current pulses of the invention are generated with an oscillator circuit including a pulse capacitor, an electrical switch and a stimulation coil, wherein the switch contains at least one IGBT and the product of coil inductance L and capacitance of the pulse capacitor C is less than 150 microhenrys microfarad ,
  • the pulse from FIG. 12 can be used with the so-called cTMS technology from FIG. 13 [Peterchev AV (2010). US 2012/0108883, EP2432547].
  • the cTMS topology in Figure 19 consists of a half-bridge with capacitors C a and C b , which have a center tap. This topology can actively switch from one pulse phase to the next by switching the coil L between the capacitors C a and Cb using the switches and Qi commutes.
  • the pulse duration and the dominant frequency and / or the fundamental frequency of the pulse by the control software which controls the switching instants of the switches Q x and Q 2 can be changed.
  • capacitors C a and C b should have similar voltage limits.
  • the cTMS concept is expanded in FIG.
  • the two half-bridge circuits (Q1-Q2 and Q3-Q4) allow the waveform to be piecewise generated with the
  • Atran- scranial magnetic stimulator inducing near-rectangular pulses with controllable pulse width (cTMS). IEEE Transactions on Biomedical Engineering, 55 (1): 257-266; Peterchev AV, Murphy DL, and 520 Lisanby SH (2011). Repetitive transcranial magnetic stimulator with controllable pulse parameters.
  • an output transformer can be used for all the mentioned topologies.
  • the coil inductance may be maintained in the typical range of about 8 ⁇ to 25 ⁇ in order to reduce the losses due to the otherwise (at lower inductance) higher current in the cable and an otherwise lower ratio of coil inductance and parasitic inductances in series with the coil.
  • FIG. 22 An alternative approach to overcoming the high voltages and currents needed for ultrashort TMS pulses is to implement the pulse source with a modular circuit topology as depicted in FIG. As shown in Figure 21, the total pulse voltage is equal to the accumulated output voltage of the many individual modules.
  • the individual modules can be implemented, for example, as an H-bridge (see FIG. 22).
  • This technology divides the entire high pulse voltage into smaller units [Goetz S.M., Pfaeffi M., Huber J., Singer M., Marquardt R., and Weyh T. (2012). Circuit topology and control principle for a first magnetic stimulator with fully controllable waveform. Proceedings of the IEEE Engineering in Medicine and Biology Society (EMBC), 4700-4703, doi: 10.1109 EMBC.2012.6347016.]. With these smaller units, the system can generate a waveform using smaller voltage levels as in the footage in
  • FIGS. 23, 24 For a system with N modules ( Figure 21), the total pulse voltage for each module is divided by N and dynamically balanced so that the system can use inexpensive low-voltage components for the switches and capacitors.
  • This topology can be considered as a high performance digital-to-analog converter, producing virtually any waveform.
  • this technology can produce acoustically advantageous pulses such as the bandwidth-limited polyphasic pulse with Gaussian, hyperbolic, or similar smooth temporal envelope as in FIG.
  • All deployable envelopes have in common that they have a maximum level from which the envelope drops monotonically to either side, with the absolute value of the derivative not exceeding a predefined limit. A reasonable value for this limit is the amplitude of the envelope divided by the period duration of the polyphasic pulse.
  • part 1 of the invention includes how the acoustic emission can be reduced by using appropriate pulse shapes
  • part 2 relates to the mechanical structure of the system. This includes the conversion of electromagnetic energy into the mechanical range, propagation (also as propagation or transmission), conversion into heat and emission as air Sound and structure-borne noise, that is, the clicking, usually associated with TMS pulses.
  • the mechanics must fulfill two conditions. First, the conversion and acoustic emission should be minimal. Second, should this be combined with part 1 of the invention, the sound spectrum of the click should be kept above the listening range. This includes minimizing nonlinear mechanical effects that produce new frequency components through waveform distortion. Furthermore, the frequency-dependent acoustic impedance is to be formed so that all acoustic vibrations in the listening area within the TMS device (including the coil) are held so that they can be converted there into heat.
  • the complete path of the acoustic waves and vibrations is divided into several sections which are treated by different means.
  • the acoustic path extends from the source (all parts that directly conduct the pulse current) to the surface of the device, where the sound is mechanically coupled as structure-borne sound to the subject or patient and / or released as airborne sound into the environment.
  • the most important parts of the device with regard to emissions are the coil and the coil cable due to the strict space and weight restrictions.
  • the pulse source can be easily damped with known, traditional soundproofing measures.
  • the coil structure of the invention systematically divides the acoustic path into three parts.
  • the acoustic source in a coil is the electrical conductor that vibrates due to the magnetic forces generated by the high pulse currents.
  • the central process here is a conversion of a part of the electric pulse energy into mechanical energy, whereby this conversion is to be minimized.
  • the invention reduces the total sound output by adjusting the mechanical impedances by means of impedance offset, phase-shifting elements (materials with high elasticity and mass density) and (phase-neutral) friction-impairing material properties (visco-elasticity).
  • the system can be considered as an energy converter coupling two domains: the electromagnetic and the acoustic / mechanical.
  • TMS devices can incorporate the conversion process into problem solving.
  • the sound sources in magnetic stimulation systems are the conductors that conduct the high stimulation pulse current. Because of the electromagnetic forces inside and between conductors, a part of the electrical energy in acoustical see transformed energy. In order to reduce this conversion, so that further attenuation measures have to cope with only a minimum of acoustic energy, the acoustic impedances are intentionally mismatched / offset from each other (also referred to as impedance matching).
  • the sound source ie, the electromechanical transducer
  • the sound source is a pressure-excited source (equivalent to a synchronous motor below the overturning moment, which is thus in the force-excited region).
  • a pressure-excited source equivalent to a synchronous motor below the overturning moment, which is thus in the force-excited region.
  • the mechanical pressure amplitude at the conductors is nearly constant, while the resulting deflection depends on both the pressure and the mechanical impedance.
  • a high input mechanical impedance is presented to minimize the conversion rate.
  • this step can be used in particular to suppress low-frequency modes in the audible spectrum.
  • the non-linear conversion of high-frequency excitation into audible components can be further reduced.
  • a central aspect of the first section of the acoustic path is the reduction of electrical energy conversion to acoustic shrinkage. First, this step minimizes the amount of energy that must subsequently be damped. Secondly, the now unconverted fraction of energy remains on the electrical side of the electromechanical transducer and is no longer part of the losses, thereby also increasing the efficiency of the TMS device.
  • the conversion efficiency is essentially a mechanical impedance problem.
  • the conversion of electrical energy into mechanical vibrations takes place at the power conductors in the coil, the pulse source and the cables therebetween, which vibrate because of the alternating magnetic forces.
  • the electrical side is formed by a high voltage, high current oscillator with little mechanical energy loss.
  • Future TMS technologies that do not implement oscillator circuitry will most likely continue to have low impedance and low mechanical energy loss. Accordingly, the conductors behave from a mechanical point of view as a pressure source. Consequently, the electrical source can be considered inexhaustible from a mechanical point of view, and any attenuation measures that traditionally work to convert vibrations to heat must be avoided to obtain a low conversion rate.
  • the sound pressure would only be reduced slightly, while the sound velocity - as the acoustic equivalent of the electric current - and thus the acoustic energy that would be converted into the mechanical domain, would rise sharply. Only very strong attenuation could deplete the energy source so that the acoustic emission sink again. However, this would typically mean nearly complete conversion of the TMS system's pulse electric energy into the mechanical domain. For this reason, in accordance with the present invention, the conversion is purposefully reduced by increasing the mechanical impedances by one or both of the following ways:
  • Measures to increase the rigidity of the conductor include, for example, the use of bimetallic structures of copper (or other electrically conductive materials) and a more rigid metal, a strained conductor embedded in a stiffer material, stiffening elements such as beams or struts, and / or by connection different conductors or parts of conductors by rigid structural adhesives.
  • a suitable stiffening material is steel, which has about four times the Young modulus (E modulus) than copper [Moser M., Kropp W. (2010). Structure-borne sound. Springer, Berlin / New York.].
  • Thin flat conductors such as those used in commercially available coils are suboptimal without rigid stabilization.
  • the frequency transfer function follows approximately 6 dB ld () / ld (£) with the stiffness E frequency and the two logarithm id. Furthermore, most real materials exhibit frequency-dependent stiffness, which typically increases with frequency [Moser M., Kropp W. (2010). Structure-borne sound. Springer, Berlin / New York.].
  • the mass of the ladder composite is increased to increase the inertia. While stiffness mainly prevents the conversion of lower frequencies and shifts the frequency transfer function as well as possible resonances towards higher frequencies, the mass limits the spectrum in the high-frequency range by eliminating fast deflections and thus the speed of sound. If the electromagnetic spectrum of the TMS pulse is selected predominantly in the high-frequency range, the influence of the mass is significantly increased.
  • the frequency characteristic of the impedance approximates exponential growth with a growth rate of 6 dB / [ld (m) ld ()] with mass m and frequency
  • a second aspect in the design of the acoustic path is to reduce the propagation of the acoustic vibrations from the conductors to the surface, from where they are delivered to the air as sound and / or to the subjects as structure-borne sound.
  • TMS coil materials For the frequency domain, spatial extent, and characteristic wave velocities of TMS coil materials, the dominant mechanical modes are predominantly represented by bending modes. On the other hand, transverse shear waves and longitudinal pressure waves occur above all at the lower and upper end of the relevant frequency range, where they can be effectively reduced by known methods.
  • the wavelength range and the propagation mechanisms of the acoustic radiation must be taken into consideration. These depend on the geometrical expansions, the material properties (in particular the wave velocity for the specific oscillation type) and the excitation frequency, which is determined by the electromagnetic waveform. For the typical ratios in TMS, the dominant parts are usually given by bending vibrations. In addition, higher frequency components can emit surface waves. Only in the lower frequency range of the vibrations and especially for smaller coils, the coil can act as a point source. In this case, instead of bending, the entire body undergoes almost uniform oscillations in the form of translation or contraction / expansion and becomes similar to a loudspeaker.
  • phase-shifting, capacitive nature of an elastic path to the surface decouples the coil winding block (core) and suppresses with a low-pass characteristic the transmission of the acoustic energy to the surface of the coil. Dissipation of trapped mechanical energy in Heat is achieved in a stiff viscoelastic layer that can cover the acoustic source (the conductor core) as a parallel energy-dissipating resistor path.
  • the TMS coil conductor can be encased by an electrical high-voltage insulation.
  • the acoustic materials can also be used for electrical insulation.
  • a thicker layer of insulation material between the coil and the head of a subject can improve the acoustic properties of the coil.
  • the viscoelastic and elastic layers on the subject side should only have thicknesses of the order of one millimeter per layer.
  • traditional coil types such as figure-eight coils (also figure-of-eight coil or butterfly coil) and round coils can provide thicker insulation (acoustic and electrical).
  • coil insulation has two aspects.
  • the insulation between the individual coil turns is not safety-relevant and can therefore be designed as a simple standard insulation according to IEC 60601.
  • insulation materials are further selected to be arc resistant (eg, Stage 4 to VDE 0303) to avoid side effects of potential breakdowns.
  • potting compounds with insulation thicknesses of more than 20 kV / mm are available; including 25 kV elastic silicone, 33 kV / mm highly rigid epoxy composites, 35 kV / mm polyurethane (PU), 90 kV / mm polyethylene terephthalate (PET), 70 kV acrylonitrile butadiene styrene (ABS) / mm. Therefore, adjacent windings exposed to only a fraction of the total voltage (typically less than 1 kV) can be sufficiently isolated by the core potting. In places where windings with higher stress differences meet, insulation distances of up to 1 mm must be considered.
  • insulation between the conductor and the surface is considered safety-relevant and should therefore be reinforced in accordance with IEC 60601.
  • insulation strengths greater than 25 kV (AC) with a total thickness of more than 2.5 mm are proposed.
  • two layers a viscoelastic and an elastic layer, reduce and direct the acoustic emission of the preferably rigid and heavy conductor core.
  • the viscoelastic layer covers the core while the elastic layer surrounds the viscoelastic layer.
  • a layer or material layer is usually a volume filled with at least one material of any known state of matter (for example, a low-pressure gas or low-pressure gas mixture), wherein the volume has at least one well-defined surface which is in mechanical contact with at least one other material and the interface formed by the contact has a finite surface area, preferably greater than one square centimeter, particularly preferably greater than five square centimeters.
  • the interface between two materials should prevent a mixing of the materials. For example, two liquids or gases which are soluble in one another can not form an interface in the sense of the invention.
  • two solid materials can form layers with a well-defined interface, even if slow material degradation, material diffusion, or the like from a layer of material into the material each other instead of a step-like material transition to a gradual material transition, provided that the process of mixing at the interface takes place slowly in operation compared to typical operating times, preferably less than 1% mass diffusion into the other material per hour.
  • the minimum volume of a material layer is preferably 100 cubic millimeters.
  • a layer or material layer does not necessarily have to be contiguous, but may also consist of a certain number of individual parts or individual spots, which are arranged side by side, for example, with gaps.
  • a layer or layer of material may include a plurality of different materials that provide the desired overall property (eg, stiffness, viscoelasticity, or elasticity) in concert, or any of which material generally has the desired property, but in each case to varying degrees or different strength.
  • desired overall property eg, stiffness, viscoelasticity, or elasticity
  • the viscoelastic layer is characterized by a high viscosity ⁇ . Ideally, the latter is accompanied by a high stiffness due to a high modulus.
  • the product E ⁇ allows both inhibition of bending modes and a conversion to heat, which leads to an attenuation of the sound waves / sound vibrations that enter the layer.
  • the viscoelastic layer has a mechanically strong bond with the adjacent adjacent layer, which is closer to the source. In this case, flexural vibrations and flexural waves of the core can be relieved by shear stress losses, which is the most effective mode for most viscoelastic materials.
  • the effect of the viscoelastic layer can be significantly increased if it is completed by a stiff and possibly (but not necessarily) massive layer designed to limit the viscoelastic layer on both sides.
  • the rigid winding conductors or any other rigid layer adjacent to the viscoelastic layer from the inside and the additional rigid layer on the outside together can advantageously together significantly increase the energy losses due to shear stress.
  • the interface of the viscoelastic layer to adjacent layers behaves as a high source impedance source that can be quite depleted. That is their energy content can be practically used up. For this reason, a decoupling by a highly elastic layer is possible.
  • the elastic layer does not inhibit the shrinkage, but acts like the mechanical equivalent of a (phase shifting) capacitor in the electrical domain and produces a mechanical low pass filter.
  • the impedance offset effect can be significantly increased by a high density / mass of the viscoelastic layer.
  • a low density / mass is generally advantageous for the elastic layer.
  • an elastic layer should be surrounded by a massive and / or stiff layer. This may be either the housing of the coil or a repetitive series of viscoelastic and / or elastic layers followed by a housing.
  • fiber reinforcement plastic shells (eg thermosets), acrylamide polymer composites, ceramics or composites consisting of a polymer with inorganic fillers may be used.
  • the above-described coil arrangement (which can also be applied to the pulse source and cable) can be represented by a much simplified equivalent circuit diagram as in FIG.
  • the equivalent circuit consists of a pressure source p, a wanted high source impedance 8io represented by the mass m s and the high rigidity E s , a damping block consisting of a highly elastic (ie less rising) element E t and the viscoelastic component r i (both can be repeated) and the housing with the mass m c and the stiffness E c .
  • the two main embodiments of the above-described concept for a quiet mechanical structure differ in the design of the individual elements, in particular the head of the turns. Differences in performance also depend on the frequency range and the dominant type of acoustic modes.
  • some or all of the turns of the conductor or conductors are combined in a single rigid block and mechanically fixed. 820
  • the individual turns are closely connected, for example embedded in an epoxy matrix. Further, because the compressive forces are directed toward a conductor toward the neighbors, it is possible to establish close mechanical contact between the windings and / or to provide increased rigidity and rigidity through mechanically strained conductors.
  • the rigid winding block suppresses mechanical movement and increases the input impedance from the perspective of the electrical pulse source and the pressure source as the secondary side of the electromechanical energy converter.
  • the entire winding block is then damped and decoupled by a combination of viscoelastic and elastic layers, the sequence of which can be repeated, as described above.
  • the housing can follow either an elastic or a viscoelastic layer.
  • the advantage of this embodiment is that the conductor block, acting as the 830 acoustic source, can easily be combined with various types of known measures, such as wise beams / struts or composite fibers (eg, glass fiber or polyamides), and suitable conductor shapes can be reinforced and stiffened to push possible acoustic modes or frequency windows toward higher frequencies.
  • the entire conductor block can be relatively compact and requires little space. However, the small pitch of the individual windings requires suitable electrical insulation, which in some circumstances may affect the rigidity.
  • each turn is separately decoupled. Accordingly, each turn is surrounded by at least one viscoelastic and one (optional) elastic layer.
  • this embodiment requires more space, but is less critical in terms of electrical insulation between turns and a possibly insufficiently stiff mechanical connection between individual turns. The isolation requirements may be important for ultra-short, high-frequency pulses whose electromagnetic pulse spectrum is significantly above the listening range and which require comparatively high voltages of several kilovolts, as previously explained.
  • each individual turn has at least one separate elastic and / or viscoelastic layer as in the second embodiment.
  • two or more or all windings divide the remaining layers as in the first embodiment.
  • the mechanical source impedances can be further increased.
  • the source impedance can be increased by increasing the stiffness (described by the ii-modulus) and / or the mass m. Since the high electrical conductivity of copper in the conductor is advantageous, additional materials can be used to alter the mechanical conductor properties. While this can also be achieved by alloy, possibly with spatially heterogeneous materials, this embodiment prefers bimetals and copper-coated metals.
  • Such conductor connections are formed by two or more metals - of which at least copper or a similar good conductive material (such as silver or gold) with certain purity - which are mechanically fixed together. This close and mechanically strong connection can be produced by known methods, for example various welding techniques or chemical methods such as galvanic deposition.
  • Such copper-coated conductors are used to conserve copper in a number of power engineering applications.
  • a particularly preferred embodiment uses copper-coated steel conductors. These conductors and the interface between the individual, usually metallic, portions may be in any geometric shape to get voted.
  • the copper content is advantageously selected to reflect the uneven localized current distribution in the conductor cross-sections due to skin and proximity effects as well as other current displacement phenomena such that the highly conductive copper is placed at the high current density locations is.
  • the effective conductivity of the entire conductor is only slightly lower than a pure copper conductor, despite significant advantageous acoustic properties due to the increased mechanical stiffness.
  • the conductor of another particularly preferred embodiment may be further divided into smaller subregions or filaments known from high frequency power so that the entire conductor cross-section is divided into smaller units which are either electrically isolated from each other or poorly conductive.
  • the stranded principle of this particularly preferred embodiment reduces the frequency-dependent increase in the line resistance and can be achieved in this application by structuring the conductivity of the conductor in subdivisions of the cross-section with different conductivity.
  • the two or more portions of the composite conductor such as copper and steel, may be patterned such that the highly electrically conductive material forms a plurality of independent current paths along the conductor or conductor axis that is similar to a strand in the less electrically conductive but mechanically stiffer material many filaments are mechanically firmly embedded.
  • another preferred embodiment uses a high frequency strand.
  • the above concept of a stiff coil winding as an acoustic source recommends that the strand is made as stiff as possible. This can be achieved, for example, by embedding the strand in a rigid material such as a ceramic or a polymer.
  • the individual filaments of the strand itself may be composite conductors, for example copper-coated steel. In the latter, the individual filaments receive a high rigidity due to the material properties.
  • Another embodiment refers to a method for stimulating nerve and / or muscle cells, in which magnetic pulses are generated by current pulses, which cause electrical stimulation currents in the body tissue according to the principle of electromagnetic induction, which trigger an action potential of the nerve and / or muscle cells.
  • the magnetic field pulses are generated by a coil that is positioned so close to the body tissue to be stimulated that the magnetic field generated by the coil passes through the body tissue, and wherein the magnetic field pulses have a time course, the time course of an electric current through the coil corresponds; and wherein the time course of current during a strong current pulse in the coil is selected so that less than a quarter of the energy of the current pulse in the spectral range of 500 Hz to 18 kHz.
  • a further embodiment of the invention generates short strong current pulses with a total duration of less than one millisecond in at least one coil, so that the at least one coil generates magnetic field pulses with a magnetic flux density of 0.1 to 10 Tesla, which according to the principle of electromagnetic induction inducing in electrical tissue electrical currents that trigger an action potential of nerve and / or muscle cells by stimulation, the at least one coil being adapted to be positioned close to the body tissue to be stimulated so that a magnetic field generated by it passes through the body tissue; wherein the device comprises at least one capacitor for storing energy required for the magnetic field pulses, wherein the electrical stimulation currents caused by the magnetic field of the coil are at least one tenth and at most ten times the stimulation currents required for stimulating the cells.
  • This embodiment is characterized in that it is designed to reduce the due to the current pulse from the coil and / or at least one electrical supply cable to the at least one coil emitted acoustic sound such that at least one electrical conductor of the at least one coil and / or at least an electrical supply cable by embedding in a mechanically rigid polymer and / or a mechanically rigid plastic and / or a mechanically rigid composite material and / or a mechanically rigid ceramic and / or a mechanically rigid glass forms a rigid unit.
  • the at least one coil and / or the at least one electrical supply cable of the aforementioned embodiments further includes at least one viscoelastic material accumulation and / or at least one elastic material accumulation.
  • At least one conductor of the at least one coil and / or the at least one electrical supply cable of one of the aforementioned embodiments at least two different metals, which may each be different alloys, wherein the at least two metals have at least one interface at which the at least two metals are mechanically firmly connected to each other, wherein at least one of the at least two metals has at least twice as high electrical conductivity and at the same time a maximum half as large elastic modulus as at least one other of the at least two metals.
  • the at least two metals in the cross section of the at least one conductor of the aforementioned embodiment are arranged such that the metal of the at least two metals, which has the highest electrical conductivity, is preferably arranged in regions of high current intensity and due to skin effects and other current displacement phenomena does not flow uniformly over the cross section of the at least one conductor distributed electrical pulse current to a maximum of one third in that of at least two metals, which has the lowest electrical conductivity.
  • the modulus of elasticity of the at least one elastic material accumulation in one of the aforementioned embodiments is less than one-eighth of the elasticity mode of the mechanically stiff polymer and / or the mechanically rigid plastic and / or the mechanically stiff composite material and / or the mechanically stiff ceramic and / or or the mechanically stiff glass.
  • the product of viscosity and modulus of elasticity of the at least one viscoelastic material accumulation of one of the aforementioned embodiments exceeds 10 billion pascal square seconds.
  • the loss factor of the viscoelastic material according to ISO 6721 measured with a 2 mm material coating of the viscoelastic material on a 1 mm thick steel sheet, exceeds 0.75.
  • At least one viscoelastic material pool covers at least one third of the surface area of the rigid unit of any of the aforementioned embodiments, wherein the riser unit through the at least one into a mechanically rigid polymer and / or a mechanically rigid plastic and / or a mechanically stiff composite material and / or a mechanically rigid ceramic and / or a mechanically rigid glass embedded conductor is formed.
  • the viscoelastic material is also mechanically bonded to this surface, and the viscoelastic material collection may be surrounded by other other material collections.
  • At least one elastic accumulation of material covers at least one third of the surface of the rigid unit of one of the aforementioned embodiments and / or at least one viscoelastic material accumulation partially covering said rigid unit of one of the aforesaid embodiments, said rigid unit being defined by said at least one a mechanically rigid polymer and / or a mechanically rigid plastic and / or a mechanically stiff composite material and / or a mechanically rigid ceramic 80 and / or mechanically rigid glass embedded conductor is formed.
  • an elastic aggregate of material that can form a layer covers at least a portion of that surface of the coil that is in mechanical contact with the body tissue.
  • the at least one elastic material accumulation of one of the aforementioned embodiments consists of a material that is attributed to the class of soft matter;
  • the at least one elastic material accumulation may comprise a spring mechanism made of a solid in a gas and / or a vacuum.
  • the material of the at least one elastically loosely assembled material from the abovementioned embodiment is an elastomer and / or a polymer melt and / or a gel and / or a colloidal suspension.
  • less than a quarter of the energy of the electrical current pulse of one of the aforementioned embodiments is in the frequency range from 500 Hz to 8000 Hz.
  • the fundamental frequency and / or the dominant frequency of the electrical current pulse of one of the aforementioned embodiments is higher than the human hearing limit of 18 kHz.
  • less than one third of the energy of the electrical current pulse of one of the aforementioned embodiments lies in the frequency range below 18 kHz.
  • the electrical current pulse of one of the aforementioned embodiments contains exactly one zero crossing, in which the current changes from one polarity to the other, and the total duration of the current pulse does not exceed 75 microseconds.
  • the electrical current pulse of one of the aforementioned embodiments comprises a sinusoidal oscillation, which may have a finite or an infinite duration and whose amplitude envelope increases from less than one fifth of the maximum within less than 500 microseconds to a maximum and then within less than 500 microseconds falls to less than one fifth of the maximum, wherein the frequency of the sinusoidal oscillation may vary continuously during the current pulse.
  • the electrical current pulse of one of the abovementioned embodiments is generated by an electrical pulse source which contains at least three capacitors and by dynamic electrical combination (for example in electrically conductive series and / or in parallel) of the at least three capacitors Generates current pulse, wherein the electric pulse source can generate current pulses having different amplitude and shape, wherein the amplitude and the shape can be changed independently between the generation of two successive current pulses.
  • the electrical current pulse of one of the aforementioned embodiments is generated by an electrical pulse source comprising at least one capacitor (1701, 1901, 1902, 2001, 2002) and at least one turn-off electronic switch (1702, 1903, 1904) (eg an IGBT ) includes.
  • an electrical pulse source comprising at least one capacitor (1701, 1901, 1902, 2001, 2002) and at least one turn-off electronic switch (1702, 1903, 1904) (eg an IGBT ) includes.
  • the electrical current pulse of one of the abovementioned embodiments is generated by an electrical pulse source which has at least one capacitor (1901,

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Abstract

L'invention concerne un dispositif et un procédé d'excitation de cellules nerveuses et musculaires selon le principe de la stimulation magnétique, ladite invention présentant, à intensité d'excitation égale, une émission sonore nettement réduite comparativement à l'état de la technique. L'émission sonore sous la forme d'un bruit de clic, qui induit dans la stimulation magnétique d'une part un risque majeur en termes de sécurité et d'autre part une stimulation cérébrale indésirable et incontrôlable au niveau sensoriel-auditif, est réduite dans la présente invention, par augmentation de la fréquence qu'une part importante du spectre de l'impulsion, de préférence jusqu'à la gamme audible humaine ou au-delà. L'invention concerne par ailleurs la technologie des bobines, plus silencieuse, qui réduit la conversion d'énergie électrique en oscillations mécaniques acoustiques, empêche leur propagation à la surface par découplage élastique et convertit à la place l'énergie mécanique acoustique en chaleur par déformation de matière viscoélastique.
EP15760381.2A 2014-06-20 2015-06-20 Procédé et dispositif de neurostimulation magnétique silencieuse Withdrawn EP3157624A2 (fr)

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DE201420004930 DE202014004930U1 (de) 2014-06-20 2014-06-20 Magnetstimulationssystem zur Verringerung akustischer Emissionen durch Vermeidung des menschlichen Hörbereiches und Ausnutzung psychoakustischer Phänomene
DE202014004932.7U DE202014004932U1 (de) 2014-06-20 2014-06-20 Mechanische Anordnung einer Magnetspule und zugehörige elektronische Schaltung zur Unterbindung unerwünschter mechanischer Schwingungen
DE102014008820.0A DE102014008820A1 (de) 2014-06-20 2014-06-20 Vorrichtung und Verfahren zur geräuscharmen magnetischen Neurostimulation
PCT/EP2015/063889 WO2015193505A2 (fr) 2014-06-20 2015-06-20 Procédé et dispositif de neurostimulation magnétique silencieuse

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CN108865881B (zh) * 2018-07-10 2022-04-12 深圳大学 基于声磁耦合电刺激原理的细胞功能调控系统及调控方法
AU2020267399A1 (en) 2019-05-06 2021-12-02 Kamran Ansari Therapeutic arrays of planar coils configured to generate pulsed electromagnetic fields and integrated into clothing
WO2021222185A1 (fr) * 2020-04-28 2021-11-04 The Regents Of The University Of California Perturbation magnétique transcrânienne en kilohertz avec interférence temporelle

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US4940453A (en) * 1987-01-28 1990-07-10 Cadwell Industries, Inc. Method and apparatus for magnetically stimulating neurons
FI103384B1 (fi) 1997-11-28 1999-06-30 Risto Ilmoniemi Stimulointikärki ja menetelmä stimulaattorikelan äänen vaimentamiseksi
JP2001293098A (ja) * 2000-04-14 2001-10-23 Nippon Koden Corp コイル装置およびコイル駆動装置
US6701185B2 (en) * 2002-02-19 2004-03-02 Daniel Burnett Method and apparatus for electromagnetic stimulation of nerve, muscle, and body tissues
US20030158585A1 (en) * 2002-02-19 2003-08-21 Burnett Daniel R. Method and apparatus for electromagnetic stimulation of nerve, muscle, and body tissues
US20110125203A1 (en) * 2009-03-20 2011-05-26 ElectroCore, LLC. Magnetic Stimulation Devices and Methods of Therapy
US20100222629A1 (en) * 2006-10-02 2010-09-02 Emkinetics, Inc. Method and apparatus for magnetic induction therapy
KR101022244B1 (ko) * 2008-08-29 2011-03-16 (주) 엠큐브테크놀로지 방열특성이 우수한 저소음 자기장 발생 장치
EP2432547B1 (fr) 2009-05-19 2014-11-12 The Trustees of Columbia University in the City of New York Systèmes d'induction d'impulsion de champ électrique dans un organe de corps
US8460167B2 (en) * 2009-09-14 2013-06-11 Minnesota Medical Physics Llc Thermally assisted pulsed electro-magnetic field stimulation device and method for treatment of osteoarthritis
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