JP2006239447A - 幻肢痛を治療し義肢から被切断者に感覚フィードバックを与える電気刺激システム - Google Patents
幻肢痛を治療し義肢から被切断者に感覚フィードバックを与える電気刺激システム Download PDFInfo
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Abstract
【解決手段】該システムは埋め込み可能な多チャネルの多室性インターフェース構造、即ち神経カフ30を使用する。この埋め込まれた神経カフは、電極14を備える。電極14は信号発生器12から発生した信号を神経20に送信し、感覚信号を大脳皮質に送信するよう特定のニューロンの反応を増大させ、切断手術を受けた者に感覚を示す。このような信号は、正常に神経支配されている四肢の皮質に認識される信号の列に近似して直接信号発生器から発せられるか、或いは義肢のセンサ(50a〜c)から発せられる。
【選択図】図1
Description
(従来技術の説明)
幻肢痛の治療の為に様々な薬理学的な解決方法が提唱されてきた。鎮痛薬は一般にこのような痛みに不利には作用しない。抗うつ病の投薬は痛みの感覚を減少する可能性を持ちはするが、深刻な副作用があり適用範囲が制限されている。望まれない副作用を伴わずに幻肢痛を安全かつ効果的に治療すると認められている認可薬は現時点では存在しない。別の解決方法は断端への交感神経の供給の遮断または除去であり、これは幻肢痛の一時的な減少をもたらす可能性はあるが、効果は切断後どれだけ早く手順を踏むかに依存し、持続性がない場合がある(Livingston KE (1945) Phantom Limb Syndrome. A Discussion of the Role of Major Peripheral Nerve Neuromas. J. Neurosurgery 2:251−5)。
径が太い感覚神経線維に沿って中枢を流れる活性は、径が細い線維が伝える痛みの情報の中枢知覚を助けて抑制させる可能性があり、当然の結果として、通常径が太い感覚神経線維、例えば末梢感覚器官との連絡が切断された触覚の受容体の求心性神経に発生する活性が無い場合、痛覚が意識される機会はより大きい。被切断者に痛覚がある場合、この状態は例えば、このように線維内の感覚の交通量を回復する為に太い感覚神経線維を選択的に電気刺激することにより逆になる場合があり、従って、径が太い線維と径が細い線維の活性のより正常なバランスが回復され、中枢的な経路における痛みの情報の過剰な流量を再度平衡させる。
1)義肢のパラメータ、例えば触覚、圧力、力、すべり、関節の位置、温度情報などに関する感覚フィードバックの提供、または
2)幻肢痛を治療する効果的な方法の提供、の少なくともどちらか一方を達成する。
代替的に、1つ以上のカテーテルが痛みの治療の為に選択的に薬物を神経の断端に送達し得る。
請求項3に記載の発明は、前記信号発生器およびマイクロプロセッサが義肢の内部への配置用に適合されている請求項1に記載のシステムを提供する。
請求項5に記載の発明は、前記遠隔送信手段が、前記信号発生器に結合された送信アンテナと、前記電極に結合された受信アンテナとを含む請求項4に記載のシステムを提供する。
請求項7に記載の発明は、前記電気刺激信号が、10〜1000μsの持続時間を有するインパルスである請求項1に記載のシステムを提供する。
請求項9に記載の発明は、前記電気刺激信号が二相である請求項1に記載のシステムを提供する。
請求項12に記載の発明は、前記信号発生器は電気刺激信号の周波数を調整可能である請求項1に記載のシステムを提供する。
図1に示すように、手に断端10を持つ被切断者の幻肢痛を軽減する本システムは、手の断端10に埋め込まれた複数の電極14(図2と図3により詳細に示す)を備えている。電極14は、切断された手の断端10において、切断された手を神経支配している「感覚」神経20に近接している。
Claims (16)
- 手足に断端を有する患者の幻肢痛を軽減するシステムであって、
切断された手足の神経の1つ以上の選択された感覚神経繊維を刺激するための電気刺激信号を生成する信号発生器であって、該電気刺激信号は、切断される前の、正常に神経支配されている手足から受け取られる感覚のパターンに近似することと、
幻肢痛を軽減するために、前記信号発生器に前記電気刺激信号を発生させ、該電気刺激信号を前記1つ以上の選択された感覚神経繊維に送るようにプログラムされたマイクロプロセッサであって、前記電気刺激信号の選択が患者からのフィードバックに基づくものであることと、
前記電気刺激信号を、前記選択された感覚神経繊維に送信する手段とを備え、
前記電気刺激信号を、前記選択された感覚神経繊維に送信する手段は、切断された手足の神経の近傍に埋め込まれるように適合された複数の電極から成り、該電極の各々は前記切断された手足の神経の異なる感覚神経繊維の近傍に配置されるシステム。 - 前記信号発生器およびマイクロプロセッサが身体の外部への配置用に適合されている請求項1に記載のシステム。
- 前記信号発生器およびマイクロプロセッサが義肢の内部への配置用に適合されている請求項1に記載のシステム。
- 前記電気刺激信号を送信する手段が遠隔送信手段である請求項1に記載のシステム。
- 前記遠隔送信手段が、前記信号発生器に結合された送信アンテナと、前記電極に結合された受信アンテナとを含む請求項4に記載のシステム。
- 前記電気刺激信号を送信する手段が、前記1つ以上の電極と前記信号発生器との間に延びるケーブルを有する請求項1に記載のシステム。
- 前記電気刺激信号が、10〜1000μsの持続時間を有するインパルスである請求項1に記載のシステム。
- 前記電気刺激信号が単相である請求項1に記載のシステム。
- 前記電気刺激信号が二相である請求項1に記載のシステム。
- 前記電気刺激信号は、痛覚神経刺激の反応増大を起こさずに径が太い感覚神経繊維の反応増大を起こすために必要な閾値電流の1〜10倍になるように選択された電流の振幅を有する請求項1に記載のシステム。
- 前記信号発生器は電気刺激信号の振幅を調整可能である請求項1に記載のシステム。
- 前記信号発生器は電気刺激信号の周波数を調整可能である請求項1に記載のシステム。
- 前記電極は、埋め込まれた時に切断された手足の神経の周囲を取り囲む絶縁神経カフ内に組み込まれ、該神経カフ内の各電極は、切断された手足の神経の異なる感覚神経繊維の近傍に位置する請求項1に記載のシステム。
- 前記神経カフが多室性であり、電極間の絶縁を提供する並列した複数のリッジを有する管状の神経カフである請求項13に記載のシステム。
- 埋め込まれた時に切断された手足の神経の周囲を取り囲む神経カフを更に備え、該神経カフは、複数の分離された室と、前記切断された手足の神経の感覚神経繊維に薬物を選択的に送るために該室の各々に関連するカテーテルとを有し、前記電気刺激信号を選択された感覚神経繊維に送信する手段は、薬物を1つ以上のカテーテルに送る請求項1に記載のシステム。
- 前記電気刺激信号を手足の断端の感覚神経繊維に送信する手段は、光学送信リンクからなる請求項1に記載のシステム。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US14298399P | 1999-07-06 | 1999-07-06 |
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JP2006129003A Expired - Fee Related JP4313805B2 (ja) | 1999-07-06 | 2006-05-08 | 幻肢痛を治療し義肢から被切断者に感覚フィードバックを与える電気刺激システム |
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CA (1) | CA2376169C (ja) |
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Cited By (5)
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EP1955679A1 (en) | 2007-02-09 | 2008-08-13 | Semiconductor Energy Laboratory Co., Ltd. | Assist device |
JP2012520714A (ja) * | 2009-03-16 | 2012-09-10 | クリニカ メジカ サント アントニオ デ ジョアネ エリデーアー | 咀嚼及び下顎咬合のための生体デバイス |
US8676334B2 (en) | 2012-03-20 | 2014-03-18 | Korea Institute Of Science And Technology | Peripheral nerve interface system and method for prosthetic hand control |
JP2020124609A (ja) * | 2012-12-14 | 2020-08-20 | ケース ウェスタン リザーブ ユニバーシティCase Western Reserve University | 神経刺激用のパターン化された刺激強度 |
JP2021183196A (ja) * | 2015-09-28 | 2021-12-02 | バイオス ヘルス リミテッド | モジュラー装置及びインタフェース設計 |
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US9480582B2 (en) | 2005-03-23 | 2016-11-01 | Ossur Hf | System and method for conscious sensory feedback |
US8244360B2 (en) | 2005-06-09 | 2012-08-14 | Medtronic, Inc. | Regional therapies for treatment of pain |
WO2008019483A1 (en) * | 2006-08-14 | 2008-02-21 | Med-El Elektro-Medizinische Geräte Gesellschaft M.B.H. | Implantable medical cuff with electrode array |
DE102014009811A1 (de) | 2014-07-03 | 2016-01-07 | Alfred Meier-Koll | System zur Anregung von Phantomempfindungen |
DE102015009828A1 (de) | 2015-08-03 | 2017-02-09 | CortXsensorics GmbH | System zur Anregung von Phantomempfindungen |
KR101988645B1 (ko) * | 2017-09-19 | 2019-06-12 | 중원대학교 산학협력단 | 온열감각 전달 기능을 가지는 의지 |
CN113456484A (zh) * | 2021-07-06 | 2021-10-01 | 国家康复辅具研究中心 | 基于多生理信号融合实时监测的针灸刺激评估方法及系统 |
CN114177472A (zh) * | 2021-11-30 | 2022-03-15 | 中国人民解放军总医院第四医学中心 | 一种应用于下肢假肢的植入式电刺激感知反馈系统 |
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US4232679A (en) * | 1977-01-26 | 1980-11-11 | Pacesetter Systems, Inc. | Programmable human tissue stimulator |
US5851223A (en) * | 1991-05-21 | 1998-12-22 | Medi Consultants, Inc. | Combination non-intrusive analgesic neuroaugmentive system and method triple-modulated gigatens with optional bipolar spike |
US5413611A (en) * | 1992-07-21 | 1995-05-09 | Mcp Services, Inc. | Computerized electronic prosthesis apparatus and method |
US6500210B1 (en) * | 1992-09-08 | 2002-12-31 | Seattle Systems, Inc. | System and method for providing a sense of feel in a prosthetic or sensory impaired limb |
DE4404842A1 (de) * | 1994-02-16 | 1995-08-17 | Pierre Nicolas Dr Med Foss | Gerät zur antipruriginösen Elektrotherapie (APET) |
US5487756A (en) | 1994-12-23 | 1996-01-30 | Simon Fraser University | Implantable cuff having improved closure |
US5824027A (en) | 1997-08-14 | 1998-10-20 | Simon Fraser University | Nerve cuff having one or more isolated chambers |
-
2000
- 2000-07-05 DE DE60044956T patent/DE60044956D1/de not_active Expired - Lifetime
- 2000-07-05 EP EP06075827A patent/EP1709992B1/en not_active Expired - Lifetime
- 2000-07-05 DE DE60028773T patent/DE60028773T2/de not_active Expired - Lifetime
- 2000-07-05 JP JP2001507542A patent/JP3822823B2/ja not_active Expired - Fee Related
- 2000-07-05 EP EP00941857A patent/EP1196217B1/en not_active Expired - Lifetime
- 2000-07-05 AU AU56692/00A patent/AU5669200A/en not_active Abandoned
- 2000-07-05 CA CA2376169A patent/CA2376169C/en not_active Expired - Fee Related
- 2000-07-05 WO PCT/CA2000/000789 patent/WO2001002054A2/en active IP Right Grant
- 2000-07-05 AT AT00941857T patent/ATE329651T1/de not_active IP Right Cessation
- 2000-07-05 AT AT06075827T patent/ATE480297T1/de not_active IP Right Cessation
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US8585775B2 (en) | 2007-02-09 | 2013-11-19 | Semiconductor Energy Laboratory Co., Ltd. | Assist device |
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US8676334B2 (en) | 2012-03-20 | 2014-03-18 | Korea Institute Of Science And Technology | Peripheral nerve interface system and method for prosthetic hand control |
JP2020124609A (ja) * | 2012-12-14 | 2020-08-20 | ケース ウェスタン リザーブ ユニバーシティCase Western Reserve University | 神経刺激用のパターン化された刺激強度 |
JP2022107627A (ja) * | 2012-12-14 | 2022-07-22 | ケース ウェスタン リザーブ ユニバーシティ | 神経刺激用のパターン化された刺激強度 |
US11446483B2 (en) | 2012-12-14 | 2022-09-20 | Case Western Reserve University | Patterned stimulation intensity for neural stimulation |
US11612741B2 (en) | 2012-12-14 | 2023-03-28 | Case Western Reserve University | Patterned stimulation intensity for neural stimulation |
US11672971B2 (en) | 2012-12-14 | 2023-06-13 | Case Western Reserve University | Patterned stimulation intensity for neural stimulation |
JP2021183196A (ja) * | 2015-09-28 | 2021-12-02 | バイオス ヘルス リミテッド | モジュラー装置及びインタフェース設計 |
Also Published As
Publication number | Publication date |
---|---|
DE60028773D1 (de) | 2006-07-27 |
WO2001002054A3 (en) | 2001-08-02 |
DE60028773T2 (de) | 2007-06-14 |
JP2003503166A (ja) | 2003-01-28 |
EP1709992A2 (en) | 2006-10-11 |
JP4313805B2 (ja) | 2009-08-12 |
AU5669200A (en) | 2001-01-22 |
WO2001002054A2 (en) | 2001-01-11 |
CA2376169A1 (en) | 2001-01-11 |
EP1709992B1 (en) | 2010-09-08 |
CA2376169C (en) | 2012-01-31 |
ATE480297T1 (de) | 2010-09-15 |
ATE329651T1 (de) | 2006-07-15 |
EP1196217A2 (en) | 2002-04-17 |
EP1709992A3 (en) | 2007-01-03 |
DE60044956D1 (de) | 2010-10-21 |
EP1196217B1 (en) | 2006-06-14 |
JP3822823B2 (ja) | 2006-09-20 |
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