JP2020511276A - 電気生理学的誘発電位における変化を検出する医用システム及び方法 - Google Patents
電気生理学的誘発電位における変化を検出する医用システム及び方法 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
- A61B5/7217—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise originating from a therapeutic or surgical apparatus, e.g. from a pacemaker
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/74—Details of notification to user or communication with user or patient ; user input means
- A61B5/746—Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2505/00—Evaluating, monitoring or diagnosing in the context of a particular type of medical care
- A61B2505/05—Surgical care
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4821—Determining level or depth of anaesthesia
-
- 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
- A61N1/0404—Electrodes for external use
- A61N1/0408—Use-related aspects
- A61N1/0456—Specially adapted for transcutaneous electrical nerve stimulation [TENS]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36014—External stimulators, e.g. with patch electrodes
Abstract
Description
本願は、2017年3月22日付米国暫定特許出願第62/475097号に基づき優先権を主張する出願であるので、この参照を以てその全容を本願に繰り入れることにする。
本発明は、大略、誘発電位(EP)における変化を改質及び自動検出する医用システム、器具、装置及び方法に関し、より具体的には、信号から交絡ノイズを除去することで誘発電位(EP)における変化を自動検出する医用システム及び医用方法に関する。
Claims (19)
- 患者の生理系から受け取った信号を自動改質する医用方法であって、
患者の神経経路に対する刺激信号を、その神経系路上に配置された電極を介し電気パルスで以て送給することで、複数通りの電気生理学的応答(ER)に基づき複数通りの帰結電気波形(EP)を生成するステップと、
上記複数通りの帰結EPを記録するステップと、
アンサンブル平均波形(EA)を生成するステップであり、その生成に際し上記複数通りのERの部分集合が平均されるステップと、
上記EAをデノイズするステップであり、そのデノイズに際し当該EAにウェーブレット変換が適用されるステップと、
を有する方法。 - 請求項1の方法であって、上記デノイズステップが、更に、
上記変換を経たEAを分解することでその変換済EAのうちノイズ成分を減衰させるステップと、
上記変換済EAに逆変換を適用してデノイズドEAを生成するステップと、
を含む方法。 - 請求項1の方法であって、更に、上記デノイズドEAを閾EAと比較するステップを有する方法。
- 請求項3の方法であって、上記閾EAに旧デノイズドEAが含まれうる方法。
- 請求項3の方法であって、更に、上記デノイズドEA・上記閾EA間の変化を判別するステップを有する方法。
- 請求項5の方法であって、更に、上記デノイズドEA・上記閾EA間に変化が生じたとの警報を通知するステップを有する方法。
- 請求項1の方法であって、更に、
旧デノイズドEAに対する上記デノイズドEAの変化を計算するステップと、
計算された変化に基づき警報を提供するステップと、
を有する方法。 - 請求項1の方法であって、更に、手術環境内の他装置に情報を送信することでそれら装置が上記デノイズドEA・旧デノイズドEA間の変化を手動又は自動識別しうるようにするステップを有する方法。
- 請求項1の方法であって、更に、
麻酔器又は血圧計から情報を取得するステップと、
いつのEP変化が麻酔又は血圧変化によるものなのかを判別するステップと、
を有する方法。 - 請求項1の方法であって、更に、上記デノイズドEAを監視装置上に表示させるステップを有する方法。
- 患者の生理系に生じた変化を秀逸に監視、検出及び識別する誘発電位自動分析システムであって、
患者の神経経路に対する刺激の印加後にその患者の生理系から電位データを取得する入力装置と、
少なくとも1個のプロセッサと、
命令を格納する少なくとも1個のメモリと、
を備え、上記少なくとも1個のデータプロセッサによりそれら命令を実行することでもたらされる諸動作に、
患者の神経経路に対する刺激を、その神経系路上に配置された電極を介し電気パルスで以て引き起こして、複数通りの電気生理学的応答(ER)に基づき複数通りの帰結電気波形(EP)を生成する動作と、
上記複数通りの帰結EPを記録する動作と、
アンサンブル平均波形(EA)を生成する動作であり、その生成に際し上記複数通りのERの部分集合が平均される動作と、
上記EAをデノイズする動作であり、そのデノイズに際し当該EAにウェーブレット変換が適用される動作と、
が含まれるシステム。 - 請求項11のシステムであって、上記デノイズ動作が、更に、
上記変換を経たEAを分解することでその変換済EAのうちノイズ成分を減衰させる動作と、
上記変換済EAに逆変換を適用してデノイズドEAを生成する動作と、
を含むシステム。 - 請求項11のシステムであって、上記諸動作が、更に、上記デノイズドEAを閾EAと比較する動作を含むシステム。
- 請求項13のシステムであって、上記閾EAに旧デノイズドEAが含まれうるシステム。
- 請求項14のシステムであって、上記諸動作が、更に、上記デノイズドEA・上記閾EA間の変化を判別する動作を含むシステム。
- 請求項13のシステムであって、上記諸動作が、更に、上記デノイズドEA・上記閾EA間に変化が生じたとの警報を通知する動作を含むシステム。
- 請求項11のシステムであって、上記諸動作が、更に、
旧デノイズドEAに対する上記デノイズドEAの変化を計算する動作と、
計算された変化に基づき警報を提供する動作と、
を含むシステム。 - 請求項11のシステムであって、上記諸動作が、更に、手術環境内の他装置に情報を送信することでそれら装置が上記デノイズドEA・旧デノイズドEA間の変化を手動又は自動識別しうるようにする動作を含むシステム。
- 請求項11のシステムであって、上記諸動作が、更に、
麻酔器又は血圧計から情報を取得する動作と、
いつのEP変化が麻酔又は血圧変化によるものなのかを判別する動作と、
を含むシステム。
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PCT/US2018/023643 WO2018175646A1 (en) | 2017-03-22 | 2018-03-21 | Medical systems and methods for detecting changes in electrophysiological evoked potentials |
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EP3600024A4 (en) | 2017-03-22 | 2021-01-06 | SafeOp Surgical, Inc. | MEDICAL SYSTEMS AND METHODS FOR DETECTION OF CHANGES IN ELECTROPHYSIOLOGICALLY AVOID POTENTIALS |
EP3638361B1 (en) | 2017-06-16 | 2020-09-30 | Alphatec Spine, Inc. | Systems for detecting the threshold of nerve-muscle response using variable frequency stimulation |
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