JP2015146912A - magnetic stimulation device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To appropriately stimulate a target position of a cerebral base.SOLUTION: A magnetic stimulation device includes a magnetic flux generating coil 10 disposed in an oral cavity for generating a magnetic flux toward a cerebral base, a power source part 20 which is drive means for controlling a current fed to the magnetic flux generating coil and generating a pulse magnetic flux, and a magnetic material 40 disposed on a tongue side of the magnetic flux generating coil disposed in the oral cavity. The magnetic material 40 that converges the magnetic flux generated by the magnetic flux generating coil 10 is arranged in the deep part of a nasal cavity. The magnetic flux generated by the magnetic flux generating coil 10 can be set so as to be directed to the cerebral base.

Description

  The present invention relates to a magnetic stimulation apparatus for a brain or the like.

  According to an announcement by the Ministry of Health, Labor and Welfare in Japan, the total number of elderly people aged 65 and over is 30.79 million as of 2012, of which about 4.62 million are elderly with dementia. The number of elderly people is expected to increase further in the future, and improvement of treatment for dementia is an urgent issue for elderly people. Alzheimer-type dementia, a typical dementia, is a disease in which the hippocampus at the bottom of the brain is mainly impaired, but there is no definitive treatment at present. Currently, treatment with drugs is mainly performed. However, there is a possibility that the effect of surpassing drug treatment may be obtained by activating the hippocampus by electrical stimulation.

  In addition, it is necessary to grasp the pathological condition in detail for the treatment of intractable diseases such as Alzheimer type dementia. However, the current situation is that the methodology for understanding brain function is scarce. In order to understand brain function in this situation, Transcranial Magnetic Stimulation (TMS), which not only enhances functions non-invasively but also suppresses functions, is important in the fields of neuroscience and brain medicine. Technology.

  Transcranial magnetic stimulation with a pulsed magnetic field is an excellent technique for non-invasive stimulation of the brain. Magnetic stimulators developed so far are based on the principle that a pulsed magnetic field is generated from a coil placed on the scalp and the brain is stimulated by eddy currents induced in the brain. Since eddy currents in the brain decrease with depth, the area that can be stimulated effectively is limited to the cortical area on the surface of the cerebrum.

  Typical coils for magnetic stimulation include a circular coil that has been used since the inception of TMS in 1985, and an eight-shaped coil in which circular coils are arranged on the left and right sides and current flows in the opposite direction. Since the 8-shaped coil generates a strong eddy current locally in the brain immediately below the portion where the left and right coil loops intersect, it is possible to perform targeted stimulation. In addition, various coils such as an eccentric 8-character coil, a helmet-type array coil, an H coil, and a slinky coil have been devised. All of these are intended to stimulate the cerebral cortex located on the upper or lateral surface of the brain.

  By the way, various functional centers that control vital functions are located at the bottom of the brain. Effective stimulation of the thalamic and hypothalamic nuclei and the limbic system such as the hippocampus and tonsils can adjust the function of the autonomic nerves, and may also reduce memory loss due to hippocampal disorders. is there. However, since these brain bottom regions are located deep from the surface of the head where a conventional stimulation coil can be placed, sufficient stimulation intensity cannot be obtained.

  For this reason, diagnosis and treatment related to voluntary movements and sensations related to the upper limbs involving the cerebral cortex have progressed, while diagnosis and treatment related to involuntary movements related to the brain base, memory, and emotions are almost unexplored. Alzheimer's disease, which is a typical disease of dementia, is thought to be caused by a decrease in the function of the brain floor, particularly in the hippocampus. Therefore, similarly to the application to rehabilitation treatment, if the hippocampus with reduced function can be magnetically stimulated with TMS, it is expected that it will be possible to prevent the hippocampal function from being increased or decreased.

  In contrast to the above, systems are known that provide brain stimulation with magnetic stimulation to diagnose and treat various brain related conditions. This system is configured so that energy is directed to areas such as the amygdala and hippocampus. Therefore, the structure which arrange | positions the source of irritation | stimulation in opening, such as a mouth and a nose is employ | adopted (refer patent document 1).

Special table 2011-511762 gazette

  However, in the above stimulation system, although it is said that “the energy is directed to areas such as the amygdala region and hippocampus”, the stimulation source itself is arranged in the mouth, nose, and other openings, There was a possibility that the target position could not be stimulated accurately. Further, when magnetic stimulation is performed by arranging a coil in the opening of a living body, the skin is stimulated by eddy current. In particular, when a coil is installed in the oral cavity, symptoms such as numbness of the tongue appear, and there is a possibility that stimulation cannot be given appropriately.

  The present invention has been made to solve the problems of the conventional stimulation system as described above, and an object of the present invention is to provide a magnetic stimulation device capable of accurately and appropriately stimulating the target position of the brain bottom. That is.

  A magnetic stimulation device according to the present invention is disposed in the oral cavity, generates a magnetic flux toward the brain bottom, a magnetic flux generating coil, a driving unit that generates a pulsed magnetic flux by controlling a current flowing through the magnetic flux generating coil, an oral cavity It is characterized by comprising a magnetic body or a diamagnetic body provided on the tongue side of a magnetic flux generating coil disposed inside.

  The magnetic stimulation apparatus according to claim 1, wherein the magnetic substance or the diamagnetic substance has a sheet shape.

  In the magnetic stimulation apparatus according to the present invention, the diamagnetic material is a superconductor.

  The magnetic stimulation apparatus according to the present invention further includes temporary fixing means for temporarily fixing the magnetic flux generating coil in the oral cavity.

  In the magnetic stimulation apparatus according to the present invention, the temporary fixing means is a mouthpiece having a groove portion along the dentition and sandwiching the dentition and / or gum by the wall portion of the groove.

  The magnetic stimulation apparatus according to the present invention includes a magnetic body that is disposed deep in the nasal cavity and converges the magnetic flux generated by the magnetic flux generating coil.

  According to the present invention, a magnetic flux generating coil that generates a magnetic flux toward the brain base is disposed in the oral cavity, and a magnetic body or a diamagnetic body is further provided on the lingual side of the magnetic flux generating coil disposed in the oral cavity. Therefore, it is possible to accurately and appropriately stimulate the target position of the brain base.

The block diagram of the magnetic stimulation apparatus which concerns on embodiment of this invention. Sectional drawing of the oral cavity and nasal cavity part which arrange | positions the magnetic stimulation apparatus which concerns on embodiment of this invention. The perspective view which shows an example of the temporary adhering means with which the magnetic stimulation apparatus which concerns on embodiment of this invention is provided. Sectional drawing which shows the magnetic flux of the oral cavity and the nasal cavity part of the state which has arrange | positioned the principal part structure of the magnetic stimulation apparatus which concerns on embodiment of this invention.

  Embodiments of a magnetic stimulation apparatus according to the present invention will be described below with reference to the accompanying drawings. The magnetic stimulation apparatus according to the embodiment includes a magnetic flux generating coil 10 as shown in FIG. The magnetic flux generating coil 10 can be configured by, for example, winding a covered conductive wire 11 in which one or a plurality of conductive wires are insulated and spirally wound. The magnetic flux generating coil 10 may be a laminated coil. The size of the coil portion, the number of turns, and the like are appropriately selected according to the purpose of stimulation. A power supply unit 20 is connected to the coated conducting wire 11 of the magnetic flux generating coil 10. The power supply unit 20 functions as a driving unit that causes a current to flow intermittently through the covered conductive wire 11 of the magnetic flux generating coil 10 to generate a pulse magnetic flux in the magnetic flux generating coil 10.

  The direction of the magnetic flux generated by the magnetic flux generating coil 10 by the current is the upward direction of FIG. As shown in FIG. 2, the magnetic flux generating coil 10 is disposed in the oral cavity 31. In this state, the magnetic flux generated by the magnetic flux generating coil 10 can be set so as to go to the brain bottom 32.

  Furthermore, in this embodiment, as shown in FIG. 2, the magnetic body 40 that converges the magnetic flux generated by the magnetic flux generating coil 10 is disposed in the deep nasal cavity 33. The nasal cavity 34 is a cavity that extends from the nostril 35 to the pharynx 39. On the outer wall side of the nasal cavity 34, there are protrusions such as a bowl-shaped upper turbinate 36 </ b> A, middle turbinate 36 </ b> B, and lower nasal turbinate 36 </ b> C in three steps from top to bottom. 37 refers to the frontal sinus and 38 refers to the sphenoid sinus. The magnetic body 40 can be disposed between the superior nasal concha 36A and the sphenoid sinus 38. In order to perform semi-fixed installation on the deep nasal cavity 33 of the magnetic body 40, the magnetic body 40 may be covered with an elastic member such as cotton or nonwoven fabric.

  Next, the fixing method of the magnetic body 40 inserted from the nasal cavity 34 will be described more specifically. First, the magnetic body 40 can be placed by invasively opening the sphenoid sinus 38 under general anesthesia by a surgical technique such as endoscopic surgery. In this case, the magnetic body 40 having a diameter of 10 mm or more can be placed. Furthermore, it is possible to place it directly under the bottom of the Turkish basin. When the hippocampus is selected as a target for directing the magnetic flux, it is possible to place two magnetic bodies 40 in total on both sides of the nasal cavity 34.

  The fixing method can be as follows. The shape of the magnetic body 40 can be arbitrary (because the insertion port is widened by surgery, the magnetic body 40 having various shapes can be placed if the diameter is within 10 mm). According to the target such as the hippocampus, a shape that maximizes the eddy current may be adopted as the optimum shape by simulation.

  A pattern made of a non-magnetic material such as plastic connected to the magnetic material 40 can be used. In this case, a face guard (made of mesh-like resin) that matches the patient's face by 3DCT is prepared in advance, and the end of the pattern protruding from the nasal cavity 34 is fixed to the face guard. Can be fixed in close contact with the face (with a surface adhesive tape or the like). The face guard may be a ready-made one.

  In the above, from the experience of pituitary surgery, if the nasal cavity 34 is tightly packed and fixed, the magnetic body 40 and the handle connected to the magnetic body 40 can be configured not to move.

  The magnetic substance can be placed in the nasal cavity by inserting it as much as possible without surgery. In this case, the nostril is expanded with a nasal mirror, and epinephrine is applied or injected into the nasal mucosa to suppress bleeding from the mucosa. After the epinephrine treatment, the nasal mucosa is sufficiently anesthetized with a local anesthetic spray or local anesthetic injection, and then the magnetic body 40 (possibly connected with a thread by a sphere) is inserted into the pharynx 39. The magnetic body 40 is bonded to the end of a tube such as silicon having a hollow lumen, and the thread is passed through the lumen of the tube and taken out from the opposite end, and the thread and the tube are held in the nasal cavity 34. Can be inserted. After the magnetic stimulation, the magnetic body 40 can be pulled out by pulling the thread from the nostril 35.

  In the above method, since the magnetic body 40 is inserted into the nasal cavity without surgery, the size of the magnetic body 40 is preferably about 5 mm to 10 mm, and can be inserted from the nostril 38 to the upper pharynx. It can be inserted into both nasal passages 34. In this case, the patient will breathe in the mouth. Insertion may be difficult for people who are born with a narrow nasal cavity 34 or who have nasal septal gulfosis (even if the wider nasal cavity 34 is selected in this case). This method limits the insertion range of the magnetic body 40, but is very simple and attractive because it can be inserted without surgery.

  In addition, when the magnetic flux generating coil 10 is installed in the oral cavity 31, symptoms such as numbness of the tongue due to eddy current may appear. Therefore, in the present embodiment, a magnetic body or a diamagnetic body can be provided on the tongue side of the magnetic flux generating coil 10 disposed in the oral cavity 31. The diamagnetic material can be a superconductor. In the example of FIG. 1, a disk-shaped magnetic material sheet 15 having an area substantially the same as the planar area of the magnetic flux generating coil 10 is provided. The magnetic sheet 15 and the magnetic flux generating coil 10 can be bonded or combined. The magnetic sheet 15 and the magnetic flux generating coil 10 bonded or bonded are installed in the oral cavity 31.

  The magnetic stimulation apparatus can further include temporary fixing means for temporarily fixing the magnetic flux generating coil in the oral cavity. Temporary fixation means that it is detachable. In FIG. 3, the temporary fixing means is a mouthpiece 50 having a groove portion 51 along the tooth row and sandwiching the tooth row by a wall portion 52 of the groove portion 51.

  The mouthpiece 50 is entirely composed of a resin such as silicon rubber, a non-woven fabric, or the like, and the dentition and / or gums can be sandwiched between the grooves 51 by the elasticity of the wall 52. This structure can correspond to, for example, the dentition of the upper gum, but a similar configuration can be provided on the lower side in a plane symmetry and can also correspond to the dentition of the lower gum.

  A sheet portion 53 on which the magnetic sheet 15 and the magnetic flux generating coil 10 are arranged is provided from the lower end portion of the wall portion 52 that is curved as a whole to the center portion side. The magnetic sheet 15 and the magnetic flux generating coil 10 are provided in a fixed or semi-fixed state, for example, at the center of the sheet portion 53. All or part of the magnetic material sheet 15 and the magnetic flux generating coil 10 may be embedded in the sheet portion 53. In a state where the mouthpiece 50 is attached, the magnetic flux generating coil 10 (or the magnetic sheet 15 and the magnetic flux generating coil 10) is moved in a predetermined direction so that the magnetic flux generated from the magnetic flux generating coil 10 is directed to the target position at the bottom of the brain. It can be provided to be inclined. In addition, the covered conducting wire 11 extending from the magnetic flux generating coil 10 to the power supply unit 20 is drawn from an appropriate position of the mouthpiece 50.

  The magnetic stimulation apparatus configured as described above is used when performing stimulation. That is, the magnetic sheet 15 and the magnetic flux generating coil 10 are arranged in the oral cavity at a position where the magnetic flux is generated toward the brain base 32 by the mouthpiece 50 or without using the mouthpiece 50. Further, the magnetic body 40 is disposed in the deep nasal cavity 33 that converges the magnetic flux generated by the magnetic flux generating coil 10. As a result, the magnetic flux generated by the magnetic flux generating coil 10 is converged by the magnetic body 40 and reaches the position of the target brain bottom 32 as shown by the arrow φ in FIG. As a result, an eddy current is generated at the target brain bottom position, and appropriate stimulation can be performed.

  As described above, according to the present invention, it becomes possible to magnetically stimulate the nucleus and limbic system of the brain base, and various new applications in the medical field can be expected. For example, application to Alzheimer type dementia can be expected. For Alzheimer-type dementia, medication is currently being used, but it is symptomatic and does not provide fundamental treatment. Therefore, the present invention is expected to provide a new option for the treatment of Alzheimer's dementia.

  As for depression, the hypothesis is that there is a hypothesis of nerve damage in the hippocampal region. Therefore, it is possible to stimulate the hippocampus with the magnetic stimulation device according to the present invention, and it can be expected that the therapeutic effect will be greatly improved. In Parkinson's disease, DBS (deep brain stimulation) in which an electrode is inserted into the hypothalamus is used, but it is highly invasive. The magnetic stimulation apparatus according to the present invention is expected to provide a noninvasive treatment method that replaces the DBS.

  Thalamic pain is also an intractable stubborn pain seen after thalamic hemorrhage. About this thalamic pain, the analgesic effect by the magnetic stimulation apparatus according to the present invention is expected. Furthermore, it is anticipated that the magnetic stimulation apparatus according to the present invention can stimulate not only the nucleus at the bottom of the brain but also the motor cortex of the lower limb depending on the cerebral fissure. Therefore, it is expected that the magnetic stimulation apparatus according to the present invention can contribute to rehabilitation treatment of patients with movement paralysis of the lower limbs.

DESCRIPTION OF SYMBOLS 10 Magnetic flux generation coil 11 Coated conducting wire 15 Magnetic material sheet 20 Power supply part 31 Oral cavity 32 Brain bottom part 33 Deep nasal cavity 34 Nasal cavity 35 Nostril 36A Upper turbinate 36B Middle turbinate 36C Lower turbinate 38 Sphenoid sinus 39 Pharynx 40 Magnetic body 50 Mouse Piece 51 Groove 52 Wall 53 Sheet

Claims (6)

A magnetic flux generating coil that is arranged in the oral cavity and generates a magnetic flux toward the brain bottom;
Driving means for controlling the current flowing through the magnetic flux generating coil to generate a pulsed magnetic flux;
A magnetic stimulation apparatus comprising: a magnetic body or a diamagnetic body provided on the tongue side of a magnetic flux generating coil disposed in the oral cavity.   The magnetic stimulation apparatus according to claim 1, wherein the magnetic body or the diamagnetic body has a sheet shape.   3. The magnetic stimulation apparatus according to claim 1, wherein the diamagnetic material is a superconductor.   The magnetic stimulation apparatus according to claim 1, further comprising temporary fixing means for temporarily fixing the magnetic flux generating coil in the oral cavity.   5. The magnetic stimulation apparatus according to claim 4, wherein the temporary fixing means is a mouthpiece having a groove portion along the dentition and sandwiching the dentition and / or gums by the wall portion of the groove portion.   The magnetic stimulation apparatus according to claim 1, further comprising a magnetic body that is disposed in a deep portion of the nasal cavity and converges the magnetic flux generated by the magnetic flux generation coil.

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