JP2016054949A - Nerve stimulation device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a nerve stimulation device capable of preventing an extended continuous application of stimulation pulses to the same site.SOLUTION: A nerve stimulation device 1 indwelt in a living body for performing electric stimulation to a nerve comprises: a nerve stimulating electrode 20 having an electrode part 30 which includes stimulating electrodes for applying electric stimulation to a nerve and a lead part one end of which is connected to the stimulation electrodes; a stimulation generator 10 which has a stimulation generation unit 41 for generating a nerve stimulation signal to apply the electric stimulation, and which is connected with the other end of the lead part; a control unit 43 for controlling the stimulation generation unit; and an acceleration sensor 35 for acquiring movement information related to whether or not the electrode part is moved. The control unit provides for a search mode, in which a plurality of stimulation pulses are applied consecutively, as a mode of the nerve stimulation signal, and sets the search mode when determining that the electrode part is moved based on the movement information.SELECTED DRAWING: Figure 3

Description

  The present invention includes a nerve stimulation device, more specifically, a nerve stimulation electrode that is used in nerve stimulation treatment by being placed in a luminal tissue such as a blood vessel (blood vessel, lymphatic vessel), digestive tract, airway, urinary tract, and the like. The present invention relates to a nerve stimulation apparatus.

  Conventionally, research on treatment methods by applying electrical stimulation to nerve tissue has been performed. As one of the nerve stimulation devices, it has been proposed to insert a device including an electrode into a blood vessel and stimulate the nerve adjacent to the blood vessel through the blood vessel wall by the electrode (see, for example, Patent Document 1). .

  In the configuration described in Patent Document 1, unlike the case where the nerve is exposed by surgery and the electrode is directly attached to the nerve, the situation around the electrode cannot be seen directly. It is realistic to arrange the electrodes while confirming using the above means. In order to confirm that the electrode is disposed at a position where the nerve can be effectively stimulated, it is necessary to apply a stimulation pulse on a trial basis and observe the reaction of the living body.

Special table 2008-535624 gazette

  However, in some patients, experimental stimulation can be an excessive burden. In particular, in order to determine whether or not the position of the electrode is appropriate, it is essential for the patient to respond to the stimulus, so the intensity of the stimulus pulse may be set to a certain magnitude or more. Many. If such a stimulation pulse continues to be applied to the same location for a long time, the burden on the patient may increase.

  In view of the above circumstances, an object of the present invention is to provide a nerve stimulation device that can suppress a stimulation pulse from being continuously applied to the same location for a long time.

  The present invention is a nerve stimulation device that is placed in a living body and performs electrical stimulation on nerves, and includes an electrode unit including a stimulation electrode that applies the electrical stimulation to nerves, and one end connected to the stimulation electrode A stimulation generating device having a nerve stimulation electrode having a lead portion, a stimulation generation portion for generating a nerve stimulation signal for applying the electrical stimulation, and the other end of the lead portion being connected; and the stimulation A control unit that controls the generation unit; and a movement detection unit that acquires movement information regarding the presence or absence of movement of the electrode unit, and the control unit performs a search mode in which a plurality of stimulation pulses are continuously applied without a break. A nerve stimulation apparatus that includes the mode of the nerve stimulation signal and sets the search mode as the mode when it is determined that the electrode unit is moving based on the movement information.

  The nerve stimulation apparatus of the present invention further includes a movement amount detection unit that acquires movement amount information regarding the movement amount of the electrode unit, and the control unit has the movement amount equal to or greater than a predetermined value based on the movement amount information. And the search mode may be set as the mode when it is determined that the electrode unit is moving based on the movement information.

  The control unit is configured to be able to acquire a biological reaction of the living body in which the electrode unit is placed, and a stimulation cycle with an application time in which a plurality of stimulation pulses are continuously applied and an off time in which the stimulation pulse is not applied And determining whether or not the position of the electrode unit is appropriate based on the biological reaction after the neural stimulation signal is applied in the search mode. It may be configured to switch the mode from the search mode to the treatment mode when is appropriate.

  According to the nerve stimulation apparatus of the present invention, it is possible to suppress a stimulation pulse from being continuously applied to the same location for a long time.

It is a mimetic diagram showing the whole nerve stimulation device composition concerning a first embodiment of the present invention. It is a schematic diagram which shows the external appearance of the stimulus generator in the nerve stimulating device. It is a functional block diagram of the nerve stimulation apparatus. It is a figure which shows the aspect of the nerve stimulation signal in a treatment mode. It is a figure which shows the aspect of the nerve stimulation signal in search mode. It is a flowchart which shows the flow which a control part sets the mode of a nerve stimulation signal at the time of the indwelling procedure of the same nerve stimulation apparatus. It is a functional block diagram of the nerve stimulation apparatus which concerns on 2nd embodiment of this invention. It is a flowchart which shows the flow which a control part sets the mode of a nerve stimulation signal at the time of the indwelling procedure of the same nerve stimulation apparatus. It is a figure which shows the nerve stimulation electrode and introducer in the modification of the same nerve stimulation apparatus. It is a figure which shows the other example of the shape of an electrode part.

A first embodiment of the present invention will be described with reference to FIGS.
FIG. 1 is a schematic diagram showing an overall configuration of a nerve stimulation apparatus 1 of the present embodiment. The nerve stimulating device 1 is for electrically stimulating the vagus nerve Vn of the patient P or the like to treat tachycardia, chronic heart failure, and the like. The nerve stimulating device 10 generates a nerve stimulation signal, and the stimulus generating device 10 And a nerve stimulation electrode 20 placed in the blood vessel Bv.

The nerve stimulation electrode 20 is placed in a blood vessel of a patient or the like, applies a nerve stimulation signal generated by the stimulation generator 10 to a living tissue, and performs electrical stimulation to the nerve.
The nerve stimulation electrode 20 includes an electrode unit 30 having a pair of stimulation electrodes 30A and 30B to which a nerve stimulation signal is applied, an acceleration sensor (movement detection unit) 35 that detects the movement of the electrode unit 30, and the electrode unit 30 and the generation of stimulation. A lead portion 21 for connecting the device 10 is provided. If necessary, the electrode part 30 may further be provided with a locking member or the like for preventing displacement in the blood vessel.

  As a material of the electrode part 30, a metal material excellent in biocompatibility is preferable, and examples thereof include a noble metal material such as a platinum iridium alloy. In the present embodiment, the stimulation electrode 30A on the distal end side is a negative electrode, and the other stimulation electrode 30B is a positive electrode, and each is connected to the stimulation generator 10 by wiring (not shown) that passes through the lead portion 21. The number of stimulation electrodes is not limited to a pair, and a plurality of stimulation electrodes may be provided.

As the acceleration sensor 35, for example, a known acceleration sensor coated with a biocompatible material can be used.
The lead portion 21 has a known configuration including an insulating coating and a connector, and is configured to be long and flexible.

  FIG. 2 is a schematic diagram showing the appearance of the stimulus generator 10. The stimulus generator 10 includes a display unit 11 that displays various types of information on the outer surface, and an interface unit 12 that performs various operations of the stimulus generator 10. As the display unit 11, a known configuration such as a display using a liquid crystal screen or an LED can be appropriately selected and used. The interface unit 12 includes a setting button group 13 for performing various settings, an output button 14 for performing stimulation under the conditions set by the setting button group 13, and a stop button 16 for canceling the output of the output button 14. And.

FIG. 3 is a functional block diagram of the nerve stimulation apparatus 1. The stimulus generator 10 includes a stimulus generator 41 that generates a nerve stimulus signal, and a controller 43 that controls the entire stimulus generator 10.
The control unit 43 is connected to each button of the display unit 11 and the interface unit 12 and the acceleration sensor 35, and based on the input from the interface unit 12, various parameters (voltage value, pulse width, frequency) of the nerve stimulation signal. And the like are transmitted to the stimulus generation unit 41. The stimulation generation unit 41 generates a nerve stimulation signal based on the setting by the control unit 43 and sends it to the electrode unit 30 via the lead unit 21.

The stimulus generation device 10 has two modes of a nerve stimulation signal, a treatment mode suitable for treatment and a search mode suitable for the placement technique of the nerve stimulation electrode 20.
FIG. 4 shows an example of the mode of the nerve stimulation signal in the treatment mode. The treatment mode is based on a stimulation cycle Sc having an application time T1 including a plurality of stimulation pulses and an off time T2 that is continuous with the application time and no stimulation pulse is applied.
FIG. 5 shows an example of an aspect of the nerve stimulation signal in the search mode. In the search mode, unlike the treatment mode, there is no off time. Accordingly, in the search mode, stimulation pulses are continuously applied without a break during the stimulation cycle Sc, which is the basic unit.

  Therefore, the parameters that can be input from the interface unit 12 also differ depending on each mode. In the treatment mode, in addition to parameters for determining the mode of one stimulation pulse such as a voltage value, a pulse width, and a frequency, the length of the stimulation cycle, the length of application time, and the off time can be set. On the other hand, the off time cannot be set in the search mode. In addition, since the length of the stimulation cycle and the application time are the same, only one of them can be set.

  The control unit 43 determines the movement state of the electrode unit 30 based on the information (movement information) regarding the presence / absence of movement acquired from the acceleration sensor 35, and switches the treatment mode and the search mode based on this determination as needed. A command for generating a nerve stimulation signal is sent to the generation unit 41. Details will be described later.

  When using the nerve stimulation apparatus 1 configured as described above, a small incision is made in the blood vessel of the patient P, the nerve stimulation electrode 20 is inserted into the blood vessel Bv, and the electrode unit 30 is placed at an appropriate position in the blood vessel Bv. Detained. Thereafter, the stimulus generator 10 is fixed to the skin, the skin, or clothes. The control unit 43 causes the stimulation generation unit 41 to generate a nerve stimulation signal under the set conditions. The nerve stimulation signal is applied to the living body from the electrode unit 30, and the vagus nerve Vn is stimulated through the blood vessel wall, and a desired effect such as normalization of the heart rate is exhibited.

  In the neurostimulator 1, it is important for treatment that the electrode unit 30 is placed at an appropriate position. However, it is not easy to directly observe the inside of the blood vessel with an endoscope or the like, and the inside of the blood vessel is observed. However, the positional relationship between the vagus nerve Vn that runs parallel to the outside of the blood vessel and the electrode unit 30 cannot be immediately grasped. Therefore, it is difficult to specify an appropriate position with a single arrangement, so a test stimulation signal is applied from the arranged electrode part, and an appropriate indwelling position of the electrode part 30 is specified while confirming a biological reaction to the test stimulus signal. And detained.

That is, the electrode unit 30 is moved in the blood vessel traveling direction or around the axis of the lead unit 21 during the indwelling procedure, but basically does not move after the electrode unit 30 is indwelled at an appropriate indwelling position.
In the present invention, the basic idea is that the control unit automatically switches the mode of the nerve stimulation signal based on the difference in the mode of the electrode unit during and after the indwelling procedure described above. Details will be described below.

  FIG. 6 is a flowchart illustrating an example of a flow in which the control unit 43 sets the mode of the nerve stimulation signal. In step S <b> 10, the control unit 43 determines whether or not the electrode unit 30 has moved based on whether or not the value acquired from the acceleration sensor 35 is equal to or greater than a predetermined threshold value. When determination is No, a process progresses to step S21 and the control part 43 sets a treatment mode as a mode of a nerve stimulation signal. When determination is Yes, a process progresses to step S22 and the control part 43 sets search mode as a mode of a nerve stimulation signal. This determination flow is repeatedly performed at a predetermined frequency (for example, every 5 seconds) during the operation of the nerve stimulation apparatus 1. For example, the average acceleration in the immediately preceding 3 seconds may be calculated every 5 seconds, and the determination may be performed using the calculated average acceleration.

In the indwelling technique, the operator operates the interface unit 12 as necessary to set the various parameters described above in the search mode. When no setting is made, initial setting values are set in various parameters.
The operator makes a small incision in the blood vessel of the patient P, forms an opening, inserts a cylindrical introducer or the like into the blood vessel, and inserts the nerve stimulation electrode 20 into the blood vessel Bv via the introducer or the like. . Then, while confirming the blood vessel Bv and the electrode unit 30 with an X-ray fluoroscopic image or the like, the electrode unit 30 is temporarily placed at a position considered appropriate in the blood vessel Bv. Separately, an electrocardiograph is attached to the patient P so that the surgeon can check the electrocardiogram waveform and heart rate of the patient P.
When the surgeon presses the output button 14 of the nerve stimulation device 10, a nerve stimulation signal reflecting the parameter specified by the control unit 43 is generated by the stimulation generation unit 41 and applied from the electrode unit 30 to the living body. After applying the nerve stimulation signal, the surgeon confirms the electrocardiogram waveform and heart rate of the patient P, and determines whether the position of the electrode unit 30 is appropriate. The determination is made by confirming the presence or absence and extent of an electrocardiographic waveform and the presence or absence of an unfavorable reaction of the patient such as cough.
When the determination is No, the surgeon moves the electrode unit 30 in the axial direction of the nerve stimulation electrode 20 or around the axis, and adjusts the position of the electrode unit 30. Thereafter, the determination is performed again. If the application of the nerve stimulation signal is stopped after one stimulation cycle elapses before an appropriate position is specified, the nerve stimulation signal is applied again by pressing the output button 14. When the above determination is Yes, assuming that an appropriate position can be specified, the electrode unit 30 is fixed with the position as an indwelling position. This is the end of the detention technique.

  During the above-described indwelling technique, the electrode unit 30 is moved without being stationary for a long time until an appropriate position can be specified, and thus the control unit 43 basically continues to set the search mode as the mode of the nerve stimulation signal. Since the search mode has no off time, the surgeon can efficiently perform the above-described determination. Since the electrode unit 30 does not move after the indwelling procedure is completed, the control unit 43 does not set the search mode as the mode of the nerve stimulation signal, and it is preferable that the stimulation pulse is continuously applied to the same place for a long time. It is suppressed.

  As described above, according to the nerve stimulation apparatus 1 of the present embodiment, when the control unit 43 determines whether or not the electrode unit 30 has moved based on information from the acceleration sensor 35, and the electrode unit 30 is moving. The mode of the neural stimulation signal is set to the search mode. As a result, it is possible to prevent nerve stimulation in the search mode from being performed unintentionally during the treatment, and to improve both the efficiency of the indwelling technique and a suitable treatment.

  In the present embodiment, the position where the acceleration sensor 35 is provided is not limited to the electrode part, and may be a lead part, for example. Further, not only a mechanical acceleration sensor but also an optical or semiconductor acceleration sensor can be used. For example, there is one that measures acceleration using noise generated by friction between the electrode portion and the blood vessel wall.

  Next, a second embodiment of the present invention will be described with reference to FIGS. The difference between the present embodiment and the first embodiment is that the control unit sets the mode of the nerve stimulation signal using information on the movement amount of the electrode unit. In the following description, the same components as those already described are denoted by the same reference numerals and redundant description is omitted.

FIG. 7 is a functional block diagram of the nerve stimulation apparatus 51 of the present embodiment. The nerve stimulation electrode 20 is attached with a displacement amount sensor (movement amount detection unit) 52 for acquiring information (movement amount information) regarding the movement amount of the electrode portion. The displacement amount sensor 52 is connected to the control unit 43, and the movement amount information acquired by the displacement amount sensor 52 is sent to the control unit 43.
As the displacement sensor 52, various known systems can be selected as appropriate and coated with a biocompatible material. Even when the indwelling procedure is completed, when the displacement amount sensor is reliably provided at a position outside the body (for example, the base end side of the lead portion), the biocompatible material need not be covered.

The operation at the time of using the nerve stimulation apparatus 51 will be described.
The surgeon inputs a threshold value of the displacement sensor 52 into the stimulus generator 10 and sets it in consideration of a distance between a reference position described later and an assumed indwelling position of the electrode unit 30. For example, when the nerve stimulation electrode 20 is inserted from the opening formed in the neck and the electrode unit 30 is placed to stimulate the vagus nerve Vn, the distance from the assumed placement position is approximately when the opening is the reference position. It is about 100 mm to 180 mm. Therefore, in this case, for example, 70 mm obtained by subtracting a predetermined value (for example, 30 mm) from the minimum value of the assumed distance can be set as the threshold value.
A predetermined initial threshold value may be set in the control unit 43 according to the standard usage mode of the nerve stimulation device 51, and the device may be configured so that the initial threshold value is used when the operator does not set the threshold value. .

  The surgeon operates the interface unit 12 to reset the displacement sensor 52 when the electrode unit 30 of the nerve stimulation electrode 20 reaches the reference position. Thereafter, the nerve stimulation electrode 20 is inserted and the indwelling procedure is performed as in the first embodiment. During the indwelling procedure, the displacement sensor 52 measures and acquires the displacement amount of the electrode unit 30 from the reference position.

  FIG. 8 is a flowchart relating to mode setting of the control unit 43 in the present embodiment. The main flow is the same as the flowchart of the first embodiment, but in step S5 provided before step S10, it is controlled whether or not the value of the movement amount information acquired from the displacement amount sensor 52 is equal to or greater than a predetermined threshold value. The point which the part 43 determines differs. When the determination in step S5 is No, the control unit 43 determines that the electrode unit 30 has not yet approached the assumed indwelling position, and the process proceeds to step S21. When determination in step S5 is Yes, the control part 43 determines with the electrode part 30 having approached the indwelling position assumed, and a process progresses to step S22. Others are the same as in the first embodiment.

Similarly to the first embodiment, the nerve stimulation device 51 according to the present embodiment also prevents the unintentional search mode from being set during treatment and prevents the stimulation pulse from being continuously applied to the same location for a long time. It is possible to achieve both improvement in the efficiency of the procedure and suitable treatment.
In addition, a displacement amount sensor 52 is provided, and the mode of the nerve stimulation signal is set based on the movement amount information acquired from the displacement amount sensor 52 by the control unit 43. Therefore, the electrode unit 30 approaches the indwelling position assumed by the search mode. The search mode is not set until nerve stimulation is required. As a result, unnecessary nerve stimulation in the search mode can be suppressed not only during the treatment but also during the indwelling procedure, and the burden on the patient can be further reduced.

In the present embodiment, the movement amount detection unit is not limited to the detection of the movement amount as needed, such as the displacement amount sensor 52, and a mechanism capable of detecting that the movement is greater than a predetermined movement amount may be used. Below, such a modification is shown.
In the modification shown in FIG. 9, an optical sensor 55 is provided on the lead portion 21 of the nerve stimulation electrode 20, and an annular indicator portion 102 is provided on the inner surface of the introducer 101 through which the nerve stimulation electrode 20 is inserted in the indwelling procedure. It has been. When the nerve stimulation electrode 20 is inserted into the introducer 101 temporarily fixed to the patient, the optical sensor 55 reaches the index unit 102 when the electrode unit 30 reaches a predetermined position close to the assumed indwelling position. Alternatively, it is provided at a position that passes through the indicator 102. In this way, the optical sensor 55 can function as a movement amount detection unit. As a result, the controller 43 can determine whether or not the electrode unit 30 has approached the indwelling position by determining whether or not the index unit 102 has been detected before step S10 described above.

As a mechanism capable of detecting that the electrode portion has moved by a predetermined amount or more, various modes other than those described above can be considered. Some examples are given below.
・ It is possible to detect optically or electrically that blood has contacted the part of the lead that protrudes from the introducer into the blood vessel for the first time when the electrode reaches a predetermined position close to the assumed indwelling position. This sensor is provided as a movement amount detection unit.
By detecting changes in brightness due to entering deep inside the body, changes in wavelength characteristics related to light absorption of tissue, and the like by an optical sensor, it is detected that the electrode portion has moved by a predetermined amount or more.
By detecting changes in the ultrasonic reflection characteristics of the tissue using the ultrasonic transmission mechanism and the ultrasonic reception mechanism, it is detected that the electrode unit has moved by a predetermined amount or more.
-The amount of movement of the electrode part is detected by analyzing an X-ray fluoroscopic image of the nerve stimulation electrode during the indwelling procedure.

  In addition, a second threshold value is set for the value of the movement amount information, and when the movement amount becomes equal to or larger than the second threshold value, the control unit controls not to allow the setting of the search mode or the application of the neural stimulation signal itself. May be performed. This prevents unnecessary stimulation from being applied to the patient, for example, when the electrode part is assumed to have moved too far into the atrium, even though it is intended for vagus nerve stimulation. can do.

  The embodiments of the present invention have been described above. However, the technical scope of the present invention is not limited to the above-described embodiments, and the combinations of the components or the components may be changed without departing from the spirit of the present invention. It is possible to make various changes to or delete them.

For example, in the above-described embodiment, an example has been described in which an operator confirms a biological response to nerve stimulation by an electrocardiograph or the like attached to a patient separately. Etc. may be configured such that the control unit can acquire the biological reaction information of the patient by directly connecting them or the like or by receiving information from an electrocardiograph attached to the patient separately. In this way, by causing the control unit to execute a predetermined algorithm after nerve stimulation in the search mode, the control unit can determine whether the current position of the electrode unit is appropriate based on the acquired biological reaction. it can. As a result, when the control unit determines that the position of the electrode unit is appropriate, the nerve stimulation device can be configured such that the mode of the nerve stimulation signal is automatically switched from the search mode to the treatment mode.
Further, since it is possible to determine whether or not the electrode portion has reached a predetermined position close to the assumed indwelling position based on the shape of the electrocardiogram waveform, a mechanism for acquiring information on the electrocardiogram waveform is provided as a movement amount detection unit. It is also possible to function as.

In addition, the change mode of the stimulation pulse in the search mode may be set as appropriate.
For example, the pulse intensity may gradually increase within the stimulation cycle. Among the parts suitable for vagus nerve stimulation, there is a part where the sympathetic nerve runs nearby. Especially in the early stages of indwelling procedures, the response of the living body is virtually unpredictable, and when a nerve stimulation signal is applied to the sympathetic nerve, there is a reaction opposite to the desired response, such as an increase in heart rate. I get up. Therefore, for example, by starting application at an initial intensity lower than the set intensity in the search mode, and then gradually increasing the pulse intensity to increase the set intensity, the electrode unit was temporarily located near the sympathetic nerve Also in this case, it is possible to suppress the occurrence of an undesirable biological reaction due to excessive stimulation of the sympathetic nerve. If this aspect is combined with the above-described configuration in which the control unit can acquire the biological reaction information of the patient, the search mode is terminated when the undesirable biological reaction is confirmed, or the application of the nerve stimulation signal is stopped. It is also possible to do.

When the control unit is configured to be able to acquire the patient's biological response information, the pulse intensity is gradually increased or decreased during the stimulation cycle in the search mode, thereby obtaining the minimum necessary pulse intensity in the treatment mode (a desired therapeutic effect is obtained). It is also possible to make it possible to confirm the pulse intensity necessary for the measurement. The nerve stimulation apparatus may be configured such that the control unit automatically sets the pulse intensity in the treatment mode using the confirmed minimum necessary pulse intensity.
Note that the pulse intensity may be changed by changing any of the frequency, voltage value or current value, and pulse width.

Further, in each of the above-described embodiments, the example in which the nerve stimulation electrode is placed in the blood vessel has been described. However, the electrode is placed in another lumen tissue such as a lymphatic vessel, digestive tract, airway, urinary tract, and the like. Even when the nerve is stimulated through the cavity tissue, it is necessary to specify an appropriate placement position when placing the nerve stimulation electrode. Therefore, the present invention can be applied to these cases.
Further, the shape of the electrode portion in the nerve stimulation electrode is not limited to the illustrated linear shape, and may be other shapes such as a basket shape like the electrode portion 130 shown in FIG.

DESCRIPTION OF SYMBOLS 1, 51 Neural stimulation apparatus 10 Stimulation generating apparatus 20 Neural stimulation electrode 21 Lead part 30A, 30B Stimulation electrode 35 Acceleration sensor (movement detection part)
41 Stimulus generation unit 43 Control unit 52 Displacement amount sensor (movement amount detection unit)

Claims (3)

A nerve stimulation device that is placed in a living body and electrically stimulates nerves,
A nerve stimulation electrode having an electrode portion including a stimulation electrode for applying the electrical stimulation to the nerve, and a lead portion having one end connected to the stimulation electrode;
A stimulus generator that generates a nerve stimulus signal for applying the electrical stimulus, and the other end of the lead is connected;
A control unit for controlling the stimulus generation unit;
A movement detection unit for acquiring movement information regarding the presence or absence of movement of the electrode unit;
With
The control unit includes a search mode in which a plurality of stimulation pulses are continuously applied without a break in the mode of the nerve stimulation signal, and when it is determined that the electrode unit is moving based on the movement information, A nerve stimulation apparatus that sets the search mode as the aspect. A movement amount detection unit for obtaining movement amount information related to the movement amount of the electrode unit;
When the controller determines that the amount of movement is greater than or equal to a predetermined value based on the amount of movement information and determines that the electrode unit is moving based on the movement information, The nerve stimulation apparatus according to claim 1, wherein a search mode is set. The controller is
It is configured to be able to acquire a biological reaction of the living body in which the electrode unit is placed,
The aspect includes a treatment mode in which a stimulation cycle is configured by an application time in which a plurality of stimulation pulses are continuously applied and an off time in which the stimulation pulses are not applied,
Determining whether the position of the electrode part is appropriate based on the biological reaction after the neural stimulation signal is applied in the search mode;
Switching the mode from the search mode to the treatment mode when the position of the electrode part is appropriate,
The nerve stimulation apparatus according to claim 1 or 2.

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