FR3062306A1 - DEVICE FOR TREATING AT LEAST ONE PATIENT WITH PSYCHIATRIC AND / OR NEUROLOGICAL AFFECTION - Google Patents

Abstract

The invention relates to a treatment device (1) for at least one patient suffering from certain psychiatric and / or neurological disorders, the device comprising at least one confined space (2) defined by a wall, a seat (3) disposed in the confined space (2) for receiving the patient, an interactive audiovisual device for immersing the patient in a virtual environment and stimulating it sensory and cognitively, a transcranial magnetic stimulation device (9) comprising a suitable magnetic field source (9a) to be placed on or near the skull of the patient, and a control device (5) of the treatment device (1) for controlling the magnetic, cognitive and sensory stimulations delivered to the patient.

Description

Holder (s):

HAROUNIAN HERVE.

O Extension request (s):

(® Agent (s): IP TRUST.

(54) DEVICE FOR TREATING AT LEAST ONE PATIENT WITH A PSYCHIATRIC AND / OR NEUROLOGICAL CONDITION.

FR 3 062 306 - A1

The invention relates to a treatment device (1) for at least one patient suffering from certain psychiatric and / or neurological conditions, the device comprising at least one confined space (2) defined by a wall, a seat (3) arranged in the confined space (2) for receiving the patient, an interactive audiovisual device for immersing the patient in a virtual environment and for sensory and cognitive stimulation, a transcranial magnetic stimulation device (9) comprising a suitable magnetic field source (9a) to be placed on or near the patient's skull, and a control device (5) of the treatment device (1) to control the magnetic, cognitive and sensory stimuli delivered to the patient.

DEVICE FOR TREATING AT LEAST ONE PATIENT WITH A PSYCHIATRIC AND / OR NEUROLOGICAL CONDITION

FIELD OF THE INVENTION

The present invention relates to a device for the treatment, magnetic and cognitive stimulation of at least one patient suffering from certain psychiatric and / or neurological conditions. It aims in particular to provide stimulation devices and methods making it possible to delay the loss of cognitive faculties, or even to stabilize or even improve these faculties, for patients suffering from such affections. It can be Alzheimer's disease or Parkinson's disease.

TECHNOLOGICAL BACKGROUND OF THE INVENTION

There is little treatment available to treat certain psychiatric or neurological conditions. Drug-based treatments are only temporarily and partially effective. In order to limit the intellectual decline of patients, it is sometimes recommended that these patients practice cognitive stimulation exercises. The exercises can consist of series of questions and answers, forming neuropsychological tests, aiming to solicit the different cognitive functions of the patient (perception, language, memory, reasoning, decision) in a question-and-answer session group or individually. a staff

repeated. These conduits in dealing, or

can also be run on a computer.

More recently, it has been proposed to combine cognitive stimulation sessions with transcranial magnetic stimulation. According to such an approach, a pulsed magnetic field is directed towards selected areas of the brain in order to electrically excite them.

Such experiences are for example described in the document "Benefit of repetitive transcranial magnetic stimulation combined with cognitive training for the treatment of Alzheimer's disease: a proof of concept study", J. Bentwich et al,

J. Neural

Transm (2011), 118463-471.

Although the reported experiences seem to indicate a favorable evolution of the cognitive faculties of the patients, there is currently no treatment device allowing to take full advantage of this new approach. The known devices rather form laboratory equipment which does not predispose the patient to fully receive all the benefits of the treatment. The present invention aims to remedy this situation.

BRIEF DESCRIPTION OF THE INVENTION

With a view to achieving one of these aims, the object of the invention provides a treatment device for at least one patient suffering from certain psychiatric and / or neurological conditions, the device comprising:

- at least one confined space defined by a wall;

- a seat arranged in the confined space to receive the patient;

- an interactive audiovisual device to immerse the patient in a virtual environment and stimulate them sensory and cognitively;

- a transcranial stimulation device comprising a source of magnetic field adapted to be placed on or near the patient's skull;

- a device for controlling the treatment device to control the magnetic, cognitive and sensory stimulations delivered to the patient.

The device according to the invention makes it possible to immerse each patient in a virtual environment which isolates him from the outside world while placing him in a favorable psychological state to conduct cognitive tests, under magnetic stimulation.

According to other advantageous and non-limiting characteristics of the invention, taken alone or in any technically feasible combination:

• The treatment device comprises a plurality of confined spaces for simultaneously treating a plurality of patients;

• the seat is articulated or placed on a movable platform;

• the magnetic field source is placed on an articulated arm;

• the wall has a transparent portion whose degree of transparency can be controlled;

• the treatment device also includes an odor, smoke and / or mist diffuser to stimulate the patient's sense of smell and / or touch;

• the interactive audiovisual device comprises a plurality of loudspeakers;

• the audiovisual device comprises a display device comprising a screen to form a virtual visual environment;

• the interactive multimedia device comprises a device for recognizing movements and / or the position of the patient's hands;

• the recognition device comprises a plurality of infrared image sensors.

BRIEF DESCRIPTION OF THE DRAWINGS

Other characteristics and advantages of the invention will emerge from the detailed description of the invention which will follow with reference to the appended figures in which:

- Figure la shows a perspective view of a processing device according to the invention;

- Figure lb shows schematically an overview of a processing device according to the invention;

- The figure shows schematically a confined space of the processing device.

DETAILED DESCRIPTION OF THE INVENTION

The present invention is based on the conviction that a greater benefit from the sessions of cognitive and magnetic transcranial stimulation can be obtained if the patient is fully sensed at the same time. The invention therefore provides a device making it possible to arrange the patient in favorable conditions to receive the treatment.

Figures la, lb and the represent a processing device 1 according to the invention. It comprises a plurality of confined spaces 2, each confined space 2 (more simply called space in the rest of this description) being defined by a wall. Each space also contains a seat 3 to accommodate a patient. During the treatment, the patients are therefore in a sitting or lying position in the seats 3 placed in the confined spaces 2.

The isolation of the patient in space 2 contributes to putting him in a favorable psychological state to receive the treatment. For this purpose, the size of space 2 is chosen to be large enough not to oppress the patient during treatment, and small enough to create this favorable psychological state. For example, the space can consist of a volume of between 3 and 10 cubic meters. The wall can define an essentially spherical space as shown in FIG. La, but the invention is in no way limited to this shape.

In order to help limit the patient's stress, it may be desirable for the wall defining the space 2 to have at least one transparent portion. Advantageously, the degree of transparency of this portion can be controlled, for example by providing the surface of the wall or by integrating into the thickness of the wall an electro-chromium film. The film is in this case connected to a control device 5 of the treatment device 1, so as to be able to control the degree of transparency of the transparent portion of the wall. We can thus choose to go from a fully transparent state, limiting the possible oppression that a patient might feel, to an opaque or almost opaque state, favoring the immersion of the patient in the virtual environment that will be created in space. 2. The transition from one state to another can be done gradually during the treatment and under the control of the control device 5, in order to make this change imperceptible to the patient.

Each seat 3 can be mounted orientable and movable on a rail 4, so that each patient can sit in his seat 3 outside the space 2, and place it without particular effort in the treatment position in the space

2. In addition, each seat 3 can be articulated and motorized so as to be able to place a patient in a comfortable position, sitting or lying down, during the treatment. This mechanism can also be used to physically solicit the patient during treatment, for example by coordinating the movement of the seat with an audiovisual scene to which it is exposed. A similar function can be obtained by placing the spaces 2 on a plate 6 made movable by controlled jacks. To allow this coordination, the mechanism for moving the seat 3 and / or the plate 6 (jack, motor) is also in communication with the control device 5.

Continuing the description of Figures la to the, the treatment device also includes an interactive audiovisual device making it possible to immerse the patient in a virtual environment and interact with this patient.

The interactive audiovisual device also makes it possible to subject the patient to neuropsychological tests. As a reminder, neuropsychological tests include a battery of questions, instructions or procedures to follow, which have been specifically designed to assess psychological functions associated with particular structures of the brain. These tests can aim to stimulate or evaluate a range of cognitive functions of a patient, such as memory, intelligence, language, visiospatial or executive functions, gnosis ... they can be specifically designed to evaluate, stimulate or screen for patients who may have certain psychiatric or neurological conditions, such as the Lawton test or the Folstein test.

Many means can be deployed to provide the immersion and interaction functionalities of the interactive audiovisual device.

In a particular embodiment, the interactive audiovisual device comprises a display device for exposing the patient to a film or to an image. The device may include a screen 7a, for example placed against the wall of the confined space 2, opposite the seat 3. To promote the immersion of the patient in the virtual visual environment created in the confined space 2, the screen may be able to form a three-dimensional image and / or have a curved shape and / or have a minimum definition of 4000 pixels across its width. The screen 7a has a sufficient dimension, for example a diagonal greater than 50 cm, to immerse the patient in a virtual visual environment created by the images or the film displayed on the screen 7a. This immersion effect can be reinforced when the wall of the space 2 in which the patient is located is opaque or has been made opaque.

The display device can also include, in addition to the screen 7a, other display means such as a device for projecting an image or a complementary film on the wall of the space 2. This image or this additional film may correspond to questions or instructions constituting the neuropsychological test, for example in the form of a text message, and aiming to stimulate the patient cognitively. Alternatively, the text message can also be embedded in the 3D image forming on the screen and appear, for the patient, located at a particular point inside the space 2.

The visual virtual environment can be supplemented by a virtual sound environment caused by at least one loudspeaker 7b placed in the space 2. Advantageously, the virtual sound environment implements a plurality of loudspeakers judiciously arranged in space 2 in order to spatialize the sound produced for the patient. In certain cases also, the interactive audiovisual device can implement an ambisonic technique for the creation of the virtual sound environment making it possible to ensure the realism of this environment.

The interactive audiovisual device can be supplemented by other means making it possible to solicit the patient's senses and cognitive functions, arranged in or outside of space 2. It can be, for example, a perfume diffuser, '' a fogger, a smoke diffuser placed in space 2.

All of the stressing means which have just been described, including those consisting in deploying or moving the seat 3 in the space 2, are connected to a control device 5 which will be described in detail below. This control device can activate all of the means described in a scripted and coordinated manner, so as to make the virtual environment created in the confined space 2 as realistic as possible. It notably makes it possible to archive or synthesize the images, movies and sounds that are processed during processing.

In order to detect the responses, action or reactions of the patient, and to interact with the latter, the interactive audiovisual device of the invention also comprises at least one detection device.

It can recognize the example being a patient device. This type of technology generally, different image sensors a space of the present image sensors 8 at an infrared length, and movement possibly comprising at least one source for example based on light emitting diode, sensors by a module by movement or position of a hand of known device can implement active imaging or device includes scanning of reactive work. From this a plurality of viewing angles corresponding, in the case of the confined space 2. The ones chosen under the invention, can be of determined wave, the device to be sensitive for example in recognition of the light, in the same wavelengths of captured image images, which may be those of the processed ones correspond to matérielο hardware or software of the control device 5 of the processing device 1.

The motion recognition device is capable of detecting simple or more patient gestures, such as pointing the finger at space or that of an area of

Screen 7a.

The audiovisual interactive device for sophisticated detection of a point of also can voice recognition.

of the device include a This can voice message of the sound analysis device include a patient microphone 7c, the microphone being used to translate be more easily operated, can be dedicated means hardware and / or integrated software 5.

to collect a connected means the message in a form that can

The means of sound analysis or correspond to a module to the control devices

According to a particularly advantageous embodiment of the invention, the detection device comprises an oculometric device making it possible to determine an area of attention of the patient, when the latter is positioned on his seat and watches the film or the image of the device display. This attention zone corresponds for example to an area of the screen 7a towards which his eyes are oriented.

Conventionally, an eye tracking device implements active imaging technology, according to which an infrared source exposes the patient's eyes to infrared radiation, and in particular his pupils. An image sensor captures infrared radiation reflected from the cornea to form a complete image of the eye. The light intensity emitted back by the eye depends on the position of the eye in its orbit. Processing of the acquired image, possibly

completed with a step calibration, allows of determine the attention zone, that is to say the zoned of Screen 7a towards which are ori entered the patient's eyes. In this mode particular of stake in work of

the invention, the control device 5, or a particular element thereof such as the calculating station 5b, in communication with the eye tracking device, receives from this device the coordinates of the attention zone. The control device 5 is configured to control the progress of the neuropsychological test to which the patient is subjected according to the area of attention determined by the oculometric device.

By way of example, the control device 5 can generate the display of a question or an instruction to the patient after it has been determined that this patient has focused his visual attention on a particular area of the screen. . The patient can answer the question or the instruction by an action which can consist in a movement of the hand or in a spoken message.

According to another example, the answer to a question and the passage to a next question or instruction can be triggered by the patient when he focuses his attention on a determined object displayed on a determined zone of the screen 7a. In this case, the question can be displayed using the display device or spoken acoustically by the speakers in confined space 2.

In all cases, the neuropsychological test can be conducted and proceed without breaking the immersion of the patient in his virtual environment as is the case when the response or more generally the reaction of the patient requires handling an object such as a keyboard or mouse.

A treatment device 1 according to the invention also comprises a transcranial magnetic stimulation device 9. This comprises a source of magnetic field 9a, placed on or near the patient's skull so as to activate the neuronal structures of his brain .

The transcranial magnetic stimulation device 9 can for example have the shape or be placed in a helmet, integral with the seat, and placed overhanging the patient.

The magnetic field source 9a, for example an electromagnetic coil, is crossed by a current of high intensity, leading to generate a pulsed magnetic field. The generator, including the geometry of the coil, can be configured to stimulate a surface area of the brain or deeper areas. In general, it is important that the magnetic field is sufficiently localized to properly treat the chosen area of the patient's brain. The chosen area can correspond or be included in the frontal lobe, the occipital lobe, the parietal lobe, or in the temporal lobe which are each associated with particular cognitive functions.

The magnetic field source 9a is controlled by a control member 5c which can be an electronic card or a microprocessor whose function is to supervise the emission of magnetic chips.

In known magnetic stimulation devices, the magnetic field source is fixedly positioned on the patient's skull so as to expose a selected area of the brain to the magnetic field. This implementation of the treatment is particularly uncomfortable for the patient, which can hamper him during cognitive stimulation exercises generally carried out simultaneously with magnetic stimulation.

To give more comfort to the patient, and in a particular embodiment of the invention, the magnetic stimulation device 9 provides controllable means for positioning the source 9a. For example, the source 9a and the positioning means of this source can be placed overhanging the seat 3 so as to be close to the patient's head when the latter is positioned on this seat 3. The positioning means can correspond an articulated arm allowing the source to be moved to a chosen position with respect to the patient's skull. The positioning means are controlled by the control member 5c to expose the chosen area to the pulsed magnetic field. Since the patient is likely to move during the treatment, it is not sufficient to place the magnetic field source in a suitable location at the start of treatment to expose the chosen area of the patient's brain to the magnetic field for the duration of the treatment. . In this embodiment of the invention, the magnetic stimulation device 9 therefore comprises a detector of the position of the patient's skull. This detector can use active or reactive imaging technology. In the first case, it may be two image sensors directed at different angles of view towards the patient's skull so that, by stereo vision, it is possible to determine the precise location of the skull in space. In the second case, the detector can comprise an image sensor and a light source, for example both active in the near infrared domain, making it possible, as is known, to achieve the same results of precise localization of the skull of the patient. The skull position detector can use the same means (image sensor 8 and light source) as those used to form the motion or position detector for the patient's hands.

The control member 5c is connected to the positioning means and to the skull position detector. It is configured to control the adjustment of the position of the source in order to expose the chosen area to the magnetic field, by controlling the positioning means. This compensates the movement of the patient, by regularly repeating the detection and positioning steps during the treatment.

The control member 5 of the magnetic stimulation device is connected to the control device of the treatment device, in order to coordinate the application of the field to the cognitive and sensory stimulation of the patient. And preferably, it is a separate device from the control device.

The main function of the control device 5 of the treatment device 1 is to control and coordinate the operation of all of the elements which have just been described. It also has the function of controlling or sequencing the development of the sensory stimulation and cognitive stimulation phases. It also collects actions / reactions or responses from the patient, in particular during the execution and development of neuropsychological tests, with a view to qualifying them and establishing a patient measurement. This establishment of reliable status qualification the correctness of or progress of the can include responses provided, that is to say the comparison between the detected action of the patient and the expected action. It can also include the measurement of its response time, that is to say the time separating the statement or display of a question or instruction, and the detected action of the patient.

To carry out all of these functions, the control device 5 may include a plurality of calculation stations 5b, each calculation station 5b being associated with a confined space 2 for implementing and sequencing the tasks that must take place in this space. It can be a question of storing and / or synthesizing the images or the films which will be displayed on the display device of each space 2. More generally, it can also be a matter of controlling and coordinating the device interactive multimedia and the control member 5c of the magnetic stimulation device 9.

The control device 5 can also include a central station 5a, reserved for the operator or the nurse in charge of the patients, making it possible to supervise the good progress of the treatment, to collect data from each calculation station 5a to qualify and provide a diagnosis or a progress report for each patient as described above.

The computing stations 5c, the central station 5a and the control members 5b are preferably interconnected via a communication bus such as an Ethernet network or a wireless link.

The invention therefore provides a device making it possible to treat several patients simultaneously, while carrying out individualized neuropsychological tests. It allows each patient to be immersed in a virtual environment which isolates him from the outside world while placing him in a favorable psychological state to conduct cognitive tests. He can participate in these tests by responding with speech or movement, and he does not have to manipulate objects (keyboard, mouse) foreign to his virtual environment. In certain modes of implementation, he can receive the magnetic stimulation treatment without being hindered by uncomfortable equipment attached to his skull. The patient or patients are thus placed in favorable conditions allowing to derive all the benefits from the treatment or to provide a faithful diagnosis of their condition.

Of course, the invention is not limited to the modes of implementation described and it is possible to add variants without departing from the scope of the invention as defined by the claims.

Claims (7)

1. Treatment device (1) for at least one patient suffering from certain psychiatric and / or neurological conditions, the device comprising: - at least one confined space (2) defined by a wall; - a seat (3) arranged in the confined space (2) to receive the patient; - an interactive audiovisual device to immerse the patient in a virtual environment and stimulate them sensory and cognitively; - a transcranial stimulation device (9) comprising a source of magnetic field to be placed on or to a magnetic treatment device, patient. (1) for cognitive proximity to the command (5) to control the patient's skull (9a); stimulation device 3. and sensory delivered to Main device (2) for patients. of treatment comprising a treatment (1) according to the plurality simultaneously claim of confined spaces plurality of of treatment (1) according to Device for preceding claims in which the articulated or placed on a movable plate. 1 of the is Treatment device (1) according to the preceding claims in which the magnetic field (9a) is placed on an arm 1 of the articulated source. of 5. Treatment device (1) according to one of the preceding claims wherein the wall has a transparent portion whose degree of transparency can be controlled. 6. Treatment device (1) according to one of the preceding claims also comprising an odor, smoke and / or mist diffuser to stimulate the patient's sense of smell and / or touch. 7. Processing device (1) according to one of the preceding claims wherein the interactive audiovisual device comprises a plurality of speakers (7b). 8. Processing device (1) according to one of the preceding claims wherein the audiovisual device comprises a display device comprising a screen (7a) to form a virtual visual environment. 9. Treatment device (1) according to one of the preceding claims wherein the interactive multimedia device comprises a device for recognizing movements and / or the position of the patient's hands. 10. Processing device (1) according to the preceding claim wherein the recognition device comprises a plurality of infrared image sensors.