JP2023030961A - Temperature stimulating device and temperature stimulating method - Google Patents

Abstract

To generate a pain sensation even at a comparatively low temperature.SOLUTION: A stimulation surface 4 located on the top surface of a stimulation part 3 of a temperature stimulating device 1 includes a first stimulation surface 31, a second stimulation surface 41, and a third stimulation surface 51. A clearance between the first stimulation surface 31 and the second stimulation surface 41 and a clearance between the second stimulation surface 41 and the third stimulation surface 51 are substantially in contact. In a case of generating a temperature difference between the second stimulation surface 41 in the center and the first and third stimulation surfaces 31 and 51 on both of the sides while a subject's skin is placed on the stimulation surface 4, the subject is capable of recognizing a pain sensation even at a comparatively low temperature and a temperature stimulation can be given safely to the subject.SELECTED DRAWING: Figure 1

Description

The present invention relates to a thermal stimulus device and a thermal stimulus method.

Chronic pain affects 13% of the population, and is a major problem in terms of annual national medical expenses of 2 trillion yen. The causes are roughly classified into organic, neuropathic and psychogenic. Among them, neuropathic pain, which accounts for 30% of the pain and is a problem, has a diagnostic method established in Europe (Non-Patent Document 1) and its introduction in Japan is being considered. The method is a method of presenting a temperature stimulus to the skin and having the patient respond to the sensation generated.

For example, after increasing the temperature from a specific temperature and repeating the measurement of the temperature at which the subject perceives warmth several times, the temperature is decreased from a specific temperature and the temperature at which the subject perceives cold is measured. is repeated a plurality of times, such as a cold sensation test (Non-Patent Document 1).

R. Rolke et al., ``Quantitative sensory testing: a comprehensive protocol for clinical trials'', European Journal of Pain, 10(2006), 77-88

At present, subjects are given thermal stimulation at a relatively high temperature of nearly 50 degrees Celsius, and there is a need to be able to perform thermal stimulation at a safe temperature. In the 84 ptable1 of Non-Patent Document 1, it can be seen that the temperature rises to nearly 50 degrees when the variation in pain sensation (HPT) is included. On the other hand, in Japan, JIST0601-1 stipulates that the maximum allowable temperature for medical devices to come into contact with the skin is 51°C or less when in contact for less than 1 minute. Although the examination of pain has been established as a threshold examination of pain stimulus, a safe stimulus method is required.

SUMMARY OF THE INVENTION An object of the present invention is to achieve a safe temperature stimulation that allows a subject to feel pain at a low temperature.

A temperature stimulation device according to the present invention comprises at least two stimulation surfaces, the adjacent stimulation surfaces being spaced apart by 2 mm or less, a temperature control element for adjusting the temperature of each of the at least two stimulation surfaces, and the at least two stimulation surfaces. It is characterized by comprising temperature control means for controlling the temperature control element so that the temperature difference between two adjacent stimulation surfaces among the two stimulation surfaces gradually increases.

The present invention also provides a temperature stimulation method suitable for a temperature stimulation device. That is, in this method, at least two adjacent stimulation surfaces are arranged with an interval of 2 mm or less, a temperature adjustment element adjusts the temperature of each of the at least two stimulation surfaces, and a temperature control means is configured to: The temperature adjustment element is controlled such that the temperature difference between two adjacent stimulation surfaces of the at least two stimulation surfaces gradually increases.

The at least two stimulation surfaces include, for example, a constant temperature stimulation surface in which the temperature of the stimulation surface is kept constant and an elevated temperature stimulation surface in which the temperature of the stimulation surface is increased. In this case, the element control means, for example, controls the temperature adjustment element so as to keep the temperature of the constant temperature stimulation surface constant and gradually increase the temperature of the temperature increase stimulation surface.

It may further include command means for giving a command from the subject to the temperature stimulation device when the subject feels pain. In this case, the element control means, for example, keeps the temperature of the constant temperature stimulus surface constant, gradually increases the temperature of the temperature increase stimulus surface, and responds to the command given by the command means. , the control of the temperature control element is repeated so as to lower the temperature of the temperature rise stimulation surface.

The element control means, for example, sets the temperature of the constant temperature stimulation surface to the initial temperature of the temperature rise stimulation surface (the initial temperature may be a predetermined temperature, or the temperature of the temperature rise stimulation surface is adjusted). It may be kept constant at a temperature lower than the temperature in the uncoiled state).

The element control means may, for example, keep the temperature of the constant temperature stimulation surface constant between the initial temperature of the temperature rise stimulation surface and a temperature 6 degrees Celsius lower than the initial temperature.

It may further include skin temperature measuring means for measuring the initial temperature of the skin in contact with the stimulation surface. In this case, the element control means, for example, keeps the temperature of the constant temperature stimulation surface constant at a temperature lower than the initial temperature of the skin measured by the skin temperature measurement means.

The element control means, for example, keeps the temperature of the constant temperature stimulation surface at a temperature between the initial skin temperature measured by the skin temperature measuring means and a temperature lower than the initial skin temperature by 6 degrees Celsius. may be kept at

When the stimulation surface is composed of at least three, for example, three stimulation surfaces in which the constant temperature stimulation surface is arranged in the center and the temperature increase stimulation surface is arranged on both sides of the constant temperature stimulation surface, Alternatively, there are three stimulation planes in which the temperature rise stimulation plane is arranged in the center and the constant temperature stimulation planes are arranged on both sides of the temperature rise stimulation plane.

The element control means, for example, controls the temperature adjustment elements so as to collectively adjust the temperature of the constant temperature stimulus surface and collectively adjust the temperature of the elevated temperature stimulation surface.

The at least two stimulation surfaces may be arranged next to each other in a substantially tangent manner.

According to this invention, since the adjacent stimulating surfaces are arranged at intervals of 2 mm or less, when a temperature difference is given to the two adjacent stimulating surfaces, a temperature stimulus is generated in the subject at a lower temperature than before. Become. A relatively safe temperature stimulus can be given to the subject.

1 is a perspective view of a thermal stimulation device; FIG. FIG. 3 is a block diagram showing the electrical configuration of the thermal stimulation device; Detail of the stimulator is shown. 1 is an example of a plan view of a stimulation surface; FIG. It is a flow chart which shows a processing procedure of a temperature stimulation device. It is a flow chart which shows a processing procedure of a temperature stimulation device. Fig. 3 shows the temperature control of the first to third stimulation surfaces; The relationship between stimulus plane spacing, mean threshold temperature and standard deviation is shown. The relationship between constant temperature, mean threshold temperature and standard deviation is shown. 1 is an example of a plan view of a stimulation surface; FIG. It is a flow chart which shows a processing procedure of a temperature stimulation device. It is a flow chart which shows a processing procedure of a temperature stimulation device. Fig. 3 shows the temperature control of the first to third stimulation surfaces;

FIG. 1 shows an embodiment of the present invention and is a perspective view of a thermal stimulation device 1. FIG.

The thermal stimulation device 1 includes a base 2 that is low on the front side and high on the back side. A stimulation section 3 is formed on the front side portion 2A of the table 2, and a display device 5 is arranged on the back side portion 2B of the table 2. - 特許庁A display screen 6 is formed on the display device 5 .

A stimulation surface 4 is exposed on the upper surface of the stimulation section 3 . The stimulation section 3 includes a first stimulation section S1, a second stimulation section S2 and a third stimulation section S3. A first stimulation surface 31, a second stimulation surface 41 and a third stimulation surface 41 constituting the stimulation surface 4 are provided on the upper surfaces of the first stimulation unit S1, the second stimulation unit S2 and the third stimulation unit S3, respectively. Surfaces 51 (three stimulation surfaces) are exposed. The stimulation surface 4 is composed of three stimulation surfaces, a first stimulation surface 31, a second stimulation surface 41 and a third stimulation surface 51, but may be composed of two or four or more stimulation surfaces. good too.

The thermal stimulation device 1 is also provided with an input device 7 in which a button 8 (command means) is formed. By pressing this button 8, a press signal is input to the CPU 10 (see FIG. 2) of the thermal stimulation device 1. FIG.

FIG. 2 is a block diagram showing the electrical configuration of the thermal stimulation device 1. As shown in FIG.

The overall operation of the thermal stimulation device 1 is controlled by a CPU 10 (element control means).

A voltage is supplied from a medical standard AC-DC power supply 19 to a DC/DC converter 18 , and the voltage value is converted in the DC/DC converter 18 . A voltage whose voltage value has been converted by the DC/DC converter 18 is supplied to each part of the temperature stimulation device 1 and is also supplied to the temperature control device 17 (element control means).

Temperature controller 17 is controlled by CPU 10 . The temperature control device 17 controls the first stimulation section S1, the second stimulation section S2 and the third stimulation section S3 that constitute the stimulation section 3, and controls the first stimulation surface 31 of the first stimulation section S1, The temperature of each of the second stimulation surface 41 of the second stimulation portion S2 and the third stimulation surface 51 of the third stimulation portion S3 is adjusted.

Below the first stimulation surface 31 is a heat flow sensor 34A for detecting heat flow between the skin of the subject placed on the first stimulation surface 31 and the first stimulation surface 31 and the first stimulation surface. A temperature sensor 34B (see FIG. 3) for detecting the temperature of 31 is provided. The signal representing the heat flow output from the heat flow sensor 34A is converted into digital data by the analog/digital conversion circuit 21A and input to the CPU 10, and the signal representing the temperature of the first stimulation surface 31 output from the temperature sensor 34B is It is converted into digital data by the analog/digital conversion circuit 21B and input to the CPU 10. FIG.

Similarly, below the second stimulation surface 41 is a heat flow sensor 44A for detecting heat flow between the second stimulation surface 41 and the subject's skin placed on the second stimulation surface 41 and a second stimulation surface 44A. A temperature sensor 44B (see FIG. 3) is provided for sensing the temperature of the stimulation surface 41 of the. The signal representing the heat flow output from the heat flow sensor 44A is converted into digital data by the analog/digital conversion circuit 22A and input to the CPU 10, and the signal representing the temperature of the second stimulation surface 41 output from the temperature sensor 44B is The analog/digital conversion circuit 22B converts it into digital data and inputs it to the CPU 10. FIG.

Also, below the third stimulation surface 51, a heat flow sensor 54A for detecting heat flow flowing between the subject's skin placed on the third stimulation surface 51 and the third stimulation surface 51 and a third A temperature sensor 54B (see FIG. 3) is provided for sensing the temperature of the stimulation surface 51 . The signal representing the heat flow output from the heat flow sensor 54A is converted into digital data by the analog/digital conversion circuit 23A and input to the CPU 10, and the signal representing the temperature of the third stimulation surface 51 output from the temperature sensor 54B is It is converted into digital data by the analog/digital conversion circuit 23B and input to the CPU 10. FIG.

Heat flow sensors 34A, 44A and 54A are provided below the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51, respectively, but the first stimulation surface 31, the second stimulation surface Heat flow sensors may be provided only below one of the stimulation surfaces 41 and 51 . When heat flow sensors 34A, 44A and 54A are provided below the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51, respectively, the heat flow sensors 34A, 44A and 54A The average skin temperature obtained may be calculated.

Based on the temperature data of the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51, the CPU 10 determines the temperature of the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51, respectively. The temperature control device 17 is controlled so that the temperature of each surface 51 reaches a desired temperature. In particular, when two or more stimulation surfaces such as the first stimulation surface 31 and the third stimulation surface 51 on both sides are controlled to have the same temperature, the stimulation surfaces 31 and 51 are separately controlled. It is preferable to control them collectively instead of controlling them.

As mentioned above, the thermal stimulation device 1 includes a display device 5 . The display device 5 is controlled by a display controller 11 controlled by the CPU 10 . A touch panel 13 is formed on the display screen 6 of the display device 5 , and a signal indicating that the touch panel 13 is touched is input to the CPU 10 via the interface 14 .

In addition, the press signal from the button 8 formed on the input device 7 is also input to the CPU 10 via the interface 15 as described above.

Further, the CPU 10 is also connected with a memory 16 for storing predetermined data.

FIG. 3 shows the details of the first stimulation section S1, the second stimulation section S2 and the third stimulation section S3 that constitute the stimulation section 3. As shown in FIG.

The first stimulation section S1 includes a cooling unit 35 (eg, air-cooled heat sink, water-cooled heat sink, etc.), on which a Peltier element 33 (temperature adjustment element) is provided. A heat transfer plate 32 (for example, a metal plate) is in contact with the upper surface of the Peltier element 33 . The upper surface of the heat transfer plate 32 is the first stimulation surface 31 mentioned above. A heat flow sensor 34A and a temperature sensor 34B are provided between the lower surface of the heat transfer plate 32 and the upper surface of the Peltier element 33. As shown in FIG.

The temperature of the heat transfer plate 32 is changed by the Peltier element 33 so that the heat flow detected by the heat flow sensor 34A becomes zero. The temperature detected by the temperature sensor 34B when the heat flow becomes 0 is the temperature of the skin placed on the first stimulation surface 31. FIG. Further, as described above, the Peltier element 33 is controlled by the temperature control device 17, and the temperature of the lower surface of the heat transfer plate 32 is detected by the temperature sensor 34B. An output signal from the temperature sensor 34B is converted into digital data by the analog/digital conversion circuit 21B and inputted to the CPU 10 as described above. The temperature of the Peltier element 33 is adjusted to raise or lower the temperature of the first stimulation surface 31 to the desired temperature. The Peltier element 33 is controlled by the temperature control device 17 . By controlling the cooling unit 35 by the temperature control device 17, the Peltier element 33 is lowered to a desired temperature.

As with the first stimulation section S1, the second stimulation section S2 also has the Peltier element 43 provided above the cooling unit 45, and the heat transfer plate 42 provided above the Peltier element 43. As shown in FIG. The top surface of the heat transfer plate 42 is the second stimulation surface 41 . Between the lower surface of the heat transfer plate 42 and the Peltier element 43, a heat flow sensor 43A and a temperature sensor 43B are provided. Peltier element 43 and cooling unit 45 are controlled by temperature controller 17 . The temperature of the heat transfer plate 42 is changed by the Peltier element 43 so that the heat flow detected by the heat flow sensor 44A becomes zero. The temperature detected by the temperature sensor 44B when the heat flow becomes 0 is the temperature of the skin placed on the second stimulation surface 41. FIG. Also, the temperature of the second stimulation surface 41 is detected by the temperature sensor 44B.

Similarly to the first stimulation section S1 and the second stimulation section S2, the third stimulation section S3 also has a Peltier element 53 above the cooling unit 55, and a heat transfer plate 52 above the Peltier element 53. is provided. The upper surface of heat transfer plate 52 is the third stimulation surface 51 . A heat flow sensor 54A and a temperature sensor 54B are also provided between the lower surface of the heat transfer plate 52 and the Peltier element 53. As shown in FIG. Peltier element 53 and cooling unit 55 are controlled by temperature controller 17 . The temperature of the heat transfer plate 52 is changed by the Peltier element 53 so that the heat flow detected by the heat flow sensor 54A becomes zero. The temperature detected by the temperature sensor 54B when the heat flow becomes 0 is the temperature of the skin placed on the third stimulation surface 51. FIG. The temperature of the skin placed on the third stimulation surface 51 is detected by the heat flow sensor 54A, and the temperature of the third stimulation surface 51 is detected by the temperature sensor 54B.

FIG. 4 is a plan view of the stimulation surface 4. FIG.

A first stimulation surface 31, a second stimulation surface 41, and a third stimulation surface 51 are arranged in a line from the back side of the thermal stimulation device 1 to the front side. The distance Δ12 between the side surface of the first stimulation surface 31 and the side surface of the second stimulation surface 41 which are adjacent to each other is 2 mm or less, and they may touch each other. The distance Δ23 between the side surface of the second stimulation surface 41 and the side surface of the third stimulation surface 51 which are adjacent to each other is also 2 mm or less. It is preferable that the gaps Δ12 and Δ23 are substantially in contact with each other (if they are 0.5 mm or less, they can be said to be substantially in contact with each other). The stimulation surface 4 shown in FIG. 4 consists of three stimulation surfaces, a first stimulation surface 31, a second stimulation surface 41 and a third stimulation surface 51. It may be configured such that the interval is 2 mm or less. For example, it is composed of a first stimulation surface that is a circular stimulation surface and an annular second stimulation surface formed around the first stimulation surface, and the first stimulation surface and the second stimulation surface may be 2 mm or less. In this case, the first stimulation surface, which is a circular stimulation surface, may be the elevated temperature stimulation surface, and the second stimulation surface, which is an annular stimulation surface, may be the constant temperature stimulation surface. The first stimulation surface may be a constant temperature stimulation surface, and the second stimulation surface, which is an annular stimulation surface, may be a temperature rising stimulation surface.

5 and 6 are flow charts showing the processing procedure of the thermal stimulation device 1, showing the first embodiment. In this embodiment, the first stimulation surface 31 and the third stimulation surface 51 (both constant temperature stimulation surfaces) are kept at a constant temperature of 30 degrees Celsius and the second stimulation surface 41 (increased temperature stimulation surface). is gradually increased.

When the power button (not shown) of the temperature stimulation device 1 is pressed to turn on the power of the temperature stimulation device 1 (step 61), the temperatures of the first stimulation surface 31 and the third stimulation surface 51 rise to degrees Celsius. At 30 degrees, the Peltier elements 33, 43 and 53 are controlled by the temperature controller 17 so that the temperature of the second stimulation surface 41 is 32 degrees Celsius (step 62).

Next, a portion of the subject's skin to be stimulated is placed on the stimulating surface 4 (step 63). The parts of the skin placed on the stimulation surface 4 are, for example, the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 41, which constitute the stimulation surface 4, such as the palm, the back of the foot, the forearm, and the upper arm. A site where the skin is continuous so as to cover almost the entire stimulation surface 51 is preferable. However, the stimulation surface 4 is arranged so that the first finger is placed on the first stimulation surface 31, the second finger is placed on the second stimulation surface 41, and the third finger is placed on the third stimulation surface 51. Parts of the skin that do not cover substantially the entire first stimulation surface 31, second stimulation surface 41, and third stimulation surface 51, which constitute the first stimulation surface 31, may be placed on the stimulation surface 4 separately.

When the part of the skin to be stimulated is put on the stimulation surface 4 so as to cover the entire stimulation surface 4, the temperature control of the first stimulation surface 31 and the third stimulation surface 51 on both sides and the temperature control of the central second stimulation surface 41 are performed. Divided into

In temperature control of the first stimulation surface 31 and the third stimulation surface 51 on both sides, the Peltier elements 33 and 53 are controlled so as to keep the temperature of 30 degrees Celsius constant (step 66).

In temperature control of the central second stimulation surface 41, first, the Peltier element 44 provided below the second stimulation surface 41 is controlled so that the temperature rises (step 71). When the temperature rises and the subject feels pain (warm sensation) and the button 8 is pressed (YES in step 72), the temperature of the central second stimulus surface 41 when the button 8 is pressed (this pain sensation A threshold temperature is defined as the temperature at which the temperature is felt) is stored in the memory 16 (step 73).

In this embodiment, the temperature of the central second stimulation surface 41 rises and falls while the temperatures of the first stimulation surface 31 and the third stimulation surface 51 on both sides are kept at a constant temperature of 30 degrees Celsius. is repeated a plurality of predetermined times to detect the threshold temperature. If the predetermined number of repetitions has not been performed (NO in step 74), the Peltier element 44 is controlled so that the temperature of the central second stimulation surface 41 is lowered (step 75). Temperature control is continued until the temperature of the second stimulation surface 41 is lowered to 34 degrees Celsius (NO at step 76, step 75). When the temperature of the second stimulation surface 41 has been lowered to 32 degrees Celsius (YES at step 76), the process from step 71 is repeated. Specifically, the temperature of the central second stimulation surface 41 is increased (step 71), the button 8 is pressed by the subject feeling pain (YES in step 72), and the threshold temperature is stored (step 73).

When the process is repeated a predetermined number of times (YES at step 74), the average temperature of the detected threshold temperatures is calculated by the CPU 10 (step 77), and the calculated average temperature is displayed on the display screen 6 (step 78).

FIG. 7 shows how the temperatures of the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51 change. In FIG. 7, the horizontal axis indicates time, and the vertical axis indicates temperature (Celsius).

The power of the thermal stimulation device 1 was turned on, and at time t12, the temperatures of the first stimulation surface 31 and the third stimulation surface 51 reached 32 degrees Celsius, and the temperature of the second stimulation surface 41 reached 30 degrees Celsius. shall be As described above, the temperature of the second stimulation surface 41 (increased temperature stimulation surface) is gradually increased and the temperature of each of the first stimulation surface 31 and the third stimulation surface 51 (constant temperature stimulation surface) is increased to The CPU 10 controls the temperature controller 17 so that the temperature of the second stimulation surface 41 is kept constant at 30 degrees Celsius, which is lower than the initial temperature of 32 degrees. The temperature of the first stimulation surface 31 and the third stimulation surface 51, which are kept constant, should be lower than the initial temperature of the second stimulation surface 41, but should be at least 6 degrees Celsius below the initial temperature. It is preferable to keep the temperature constant. If the temperature is too low, the subject will react as pain to the low temperature, so this is to prevent such a thing from occurring. For example, if the initial temperature is 32 degrees Celsius, the temperature 6 degrees below 32 degrees Celsius is 26 degrees Celsius, so Preferably, the temperature is less than 32 degrees Celsius and greater than or equal to 26 degrees Celsius. As described below, the temperature to be kept constant is preferably 30 degrees Celsius or less, so the initial temperature of the second stimulating surface 41 is preferably higher than 30 degrees Celsius.

The temperatures of the first stimulation surface 31 and the third stimulation surface 51 are kept at 30 degrees Celsius as indicated by the dashed line.

Referring to FIG. 7, the temperature of the second stimulation surface 41 is gradually increased (for example, by 0.5 degrees Celsius per second) (indicated by the solid line in FIG. 7, after time t12).

Even if the temperature of each of the first stimulation surface 31 and the third stimulation surface 51 is maintained at 30 degrees Celsius and the temperature of the second stimulation surface 41 is gradually increased (time t12 in FIG. 7). to t13), the subject does not press button 8 unless the subject feels pain. Therefore, while the temperatures of the first stimulation surface 31 and the third stimulation surface 51 are maintained at 30 degrees Celsius, the temperature of the second stimulation surface 41 continues to rise (between time t12 and t13). A temperature difference will occur between each of the first stimulation surface 31 and the third stimulation surface 51 and the second stimulation surface 41 .

At time t13, the temperature of the second stimulation surface 41 reaches C11 degrees Celsius. The respective temperatures of the first stimulation surface 31 and the third stimulation surface 51 are still kept at 30 degrees Celsius. At time t13 when the temperature of the second stimulation surface 41 reaches C11 degrees Celsius, the subject presses the button 8 when the subject feels pain. The CPU 10 then causes the memory 16 to store data representing C11 degrees Celsius, which is the temperature of the second stimulation surface 41 when the button 8 was pressed, as described above.

Even if the button 8 is pressed by the subject, the temperatures of the first stimulation surface 31 and the third stimulation surface 51 are maintained at 30 degrees Celsius (between time t13 and t14), while the temperature of the second stimulation surface 41 is gradually lowered (between times t13 and t14). The temperature of the second stimulation surface 41 is gradually lowered until the temperature of the second stimulation surface 41 reaches a temperature of 34 degrees Celsius.

When the temperature of the second stimulation surface 41 reaches 34 degrees Celsius at time t14, the temperature of the second stimulation surface 41 is gradually increased again (from time t14 to t15), and the button 8 is pressed again by the subject at time t15. Then, the temperature of the second stimulation surface 41 (C12 degrees Celsius) at the time t15 when the button 8 was pressed again is detected, and the temperature data representing the C12 degrees Celsius is stored in the memory 16. FIG.

The temperature of the second stimulation surface 41 is again lowered (time t15 to t16), and at time t16, when the temperature of the second stimulation surface 41 drops to a temperature of 34 degrees Celsius, the second stimulation surface 41 The temperature is again gradually increased (time t16 to t17). When the button 8 is pressed again by the subject at time t17, the temperature of the second stimulation surface 41 at the time t17 when the button 8 was pressed again (C13 degrees Celsius) is detected and the temperature representative of that C13 degrees Celsius is detected. Data is stored in memory 16 .

When the above process is repeated a predetermined number of times, the temperature control of the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51 is stopped.

As shown in FIG. 4, the distance Δ12 between the first stimulation surface 31 and the second stimulation surface 41 is 2 mm or less, and the distance Δ23 between the second stimulation surface 41 and the third stimulation surface 51 is also Since it is 2 mm or less, the subject feels pain even at relatively low temperatures (C11, C12, C13). Pain stimulation can be realized at a safe temperature.

FIG. 8 shows the results described above for several subjects, varying the spacing between the first stimulation surface 31 and the second stimulation surface 41 and the spacing between the second stimulation surface 41 and the third stimulation surface 51 . shows the results when a temperature stimulus is applied by the method of

The temperature of the first stimulation surface 31 and the third stimulation surface 51 on both sides is set to 28 degrees Celsius, the temperature of the second stimulation surface 41 in the center is set to 32 degrees Celsius, and the first stimulation surface 31 on both sides and the The third stimulating surface 51 was kept at a constant temperature of 28 degrees Celsius, while the central second stimulating surface 41 was gradually increased at 0.5 degrees Celsius per second. The part of the subject's skin in contact with the stimulating surface 4 was the right forearm, and the subject's eyes were closed.

The distance Δ12 between the first stimulation surface 31 and the second stimulation surface 41 and the distance Δ23 between the second stimulation surface 41 and the third stimulation surface 51 are both 0.0 mm (complete contact state) and 2.0 mm. and 5.0mm.

The average threshold temperature was 43.8 degrees Celsius with a standard deviation of 1.8 when the distances Δ12 and Δ23 were 0.0 mm. The average threshold temperature was 45.0 degrees Celsius with a standard deviation of 2.6 when the distances Δ12 and Δ23 were 2.0 mm. The average threshold temperature was 45.5 degrees Celsius with a standard deviation of 2.5 when the distances Δ12 and Δ23 were 5.0 mm.

As can be seen from the results of this experiment, the distance Δ12 between the first stimulation surface 31 and the second stimulation surface 41 and the distance Δ23 between the second stimulation surface 41 and the third stimulation surface 51 are 2.0 mm or less. It was found that the average threshold temperature was lower than when those intervals Δ12 and Δ23 were open, and a safe temperature stimulus could be given to the subject. Moreover, since the standard deviation at that time is small, it can be understood that the reliability of the experimental results is high. The time to apply the thermal stimulus is usually within one minute, and the maximum permissible temperature for contact of metal with the skin within one minute is 51 degrees according to the JIS standard for medical electrical equipment. By setting the distances Δ12 and Δ23 to 2.0 mm or less, the temperature stimulus can be applied at a temperature lower than the maximum allowable temperature. Also, by setting the distances Δ12 and Δ23 to 2.0 mm or less (preferably 0.5 mm or less when they are substantially in contact), the area of the stimulation surface 4 can be reduced, so that the temperature stimulation device 1 itself can be miniaturized.

FIG. 9 shows the results of subjecting multiple subjects to the temperature stimulus in the manner described above, with varying temperatures held constant.

The second stimulation surface 41 in the center was gradually increased at 0.5 degrees Celsius/second, and the temperatures of the first stimulation surface 31 and the third stimulation surface 51 on both sides were increased to 26 degrees Celsius, 28 degrees Celsius, and 30 degrees Celsius. and 32 degrees Celsius. The part of the subject's skin that came into contact with the stimulating surface 4 was the right forearm, and the subject's eyes were closed.

When the temperature of the first stimulation surface 31 and the third stimulation surface 51 on both sides is set to 26 degrees Celsius, the average threshold temperature is 41.1 degrees Celsius with a standard deviation of 4.3. When the temperature of the stimulation surface 51 is 28 degrees Celsius, the average threshold temperature is 43.0 degrees Celsius with a standard deviation of 2.5. The average threshold temperature is 42.1 degrees Celsius with a standard deviation of 1.8, and the average threshold temperature is 43.9 degrees Celsius with a standard deviation of was 1.6.

If the constant temperature is 26 degrees Celsius, the average threshold temperature is relatively low, but the standard deviation is 4.3, which is relatively large and the reliability is low. When the constant temperature is 30 degrees Celsius, the average threshold temperature is relatively low at 42.1 degrees Celsius, and the standard deviation is 1.8. Maintaining a constant temperature at a low temperature requires a relatively large amount of electric power, but by maintaining the temperature at about 30 degrees Celsius, the electric power can be relatively suppressed. Also, since the average threshold temperature is relatively low, a safe temperature stimulus can be given to the subject.

In the above embodiment, the temperatures of the first stimulation surface 31 and the third stimulation surface 51 on both sides are kept constant, and the temperature of the central second stimulation surface 41 is increased or decreased. The temperature of the first stimulation surface 31 and the third stimulation surface 51 may be increased or decreased, and the temperature of the central second stimulation surface 41 may be kept constant.

FIG. 10 shows a modification of the stimulation surface 4 shown in FIG. 4 and the like, and is a plan view corresponding to FIG.

The stimulation surface 4A shown in FIG. 10 is provided with a fourth stimulation surface 81 (fourth stimulation section S4) in addition to the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51. there is Thus, the stimulation surface 4 may consist of four stimulation surfaces 31 , 41 , 51 and 81 . The fourth stimulation section S4 has the same configuration as the first stimulation section S1 and the like.

10, the distance Δ12 between the first stimulation surface 31 and the second stimulation surface 41, the distance Δ23 between the second stimulation surface 41 and the third stimulation surface 51, The spacing Δ34 between the first stimulation surface 51 and the fourth stimulation surface 81 is substantially tangent.

Also, the temperatures of the first stimulation surface 31 and the third stimulation surface 51 are kept constant, and the temperatures of the second stimulation surface 41 and the fourth stimulation surface 81 rise or fall. Alternatively, the temperature of each of the first stimulation surface 31 and the third stimulation surface 51 increases or decreases, and the temperature of each of the second stimulation surface 41 and the fourth stimulation surface 81 increases or decreases. The temperature may be kept constant.

Furthermore, the temperature of each of the first stimulation surface 31 and the fourth stimulation surface 81 is kept constant, and the temperature of each of the second stimulation surface 41 and the third stimulation surface 51 rises or falls. Alternatively, the temperature of each of the first stimulation surface 31 and the fourth stimulation surface 81 may be increased or decreased, and the temperature of the second stimulation surface 41 and the third stimulation surface 51 may be increased or decreased. Each temperature may be made constant.

Furthermore, in the example shown in FIG. 4 the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51 and in the example shown in FIG. Although the sizes of the third stimulation surface 51 and the fourth stimulation surface 81 are the same, they do not necessarily have the same size as long as the adjacent stimulation surfaces are adjacent to each other with an interval of 2 mm or less. Also, even if they have the same size, they may be shifted in the row direction as long as they are adjacent to each other with an interval of 2 mm or less.

11 and 12 are flow charts showing the processing procedure of the temperature stimulation device 1, showing another embodiment. The processing procedures of FIGS. 11 and 12 correspond to the processing procedures of FIGS. 5 and 6. FIG. 12, the same processing as the processing shown in FIG. 6 is given the same reference numerals as those shown in FIG. In this embodiment, the temperature of the subject's skin is measured and used to control the temperature of the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51. FIG.

When the power button (not shown) of the thermal stimulation device 1 is pressed, the power of the thermal stimulation device 1 is turned on (step 80). Then, the temperatures of the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51 are kept at the initial temperature (step 81). Next, a portion of the subject's skin to be stimulated is placed on the stimulating surface 4 (step 82).

When the part of the skin to be stimulated is put on the stimulation surface 4 so as to cover the entire stimulation surface 4, the heat flow sensor 44A (skin temperature measurement The temperature of the subject's skin (initial temperature of the skin) is measured based on the heat flow obtained from the means) (step 83). A temperature sensor may be provided on the second stimulation surface 41, and the temperature of the subject's skin may be measured by directly contacting the subject's skin with the provided temperature sensor. In addition, the heat flow obtained from the heat flow sensors 34A, 44A and 54A provided below the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51, respectively. An average temperature may be calculated and the average temperature may be used as the skin temperature. Data representing the measured skin temperature are temporarily stored in memory 16 .

For temperature control of the first stimulation surface 31 and the third stimulation surface 51 on both sides, the Peltier element is used so that the initial temperature of the first stimulation surface 31 and the third stimulation surface 51 can be decreased (or increased). 33 and 53 are brought into control (step 84). The Peltier element 33 is maintained until the temperatures of the first stimulation surface 31 and the third stimulation surface 51 become 2 degrees Celsius lower than the measured skin temperature (skin initial temperature) (skin temperature - 2 degrees Celsius). and 53 are controlled (step 85).

When the temperatures of the first stimulation surface 31 and the third stimulation surface 51 are two degrees Celsius below the skin temperature (the initial temperature of the skin) (YES in step 85), the first stimulation surface 31 and the third stimulation surface 51 The Peltier elements 33 and 53 are controlled so that the temperature of the stimulating surface 51 is maintained at a temperature 2 degrees Celsius lower than the skin temperature (initial skin temperature) (step 86).

The temperature control of the central second stimulation surface 41 is similar to that described above, until the subject presses the button 8. The arranged Peltier element 43 is controlled (steps 71, 72). When the subject feels pain due to the temperature rise of the second stimulation surface 41 and presses the button 8 (YES in step 72), the temperature of the second stimulation surface 41 when the button 8 is pressed is detected by the temperature sensor 44B. , the detected temperature (threshold temperature) is stored in the memory 16 (step 73).

If the above-described process has not been repeated a predetermined number of times (NO in step 74), the temperature of the second stimulation surface 41 is reduced to the measured skin temperature (initial skin temperature). The Peltier element 43 provided below the second stimulation surface 41 is controlled (NO in steps 75 and 76A). When the temperature of the second stimulation surface 41 reaches the temperature of the skin (the initial temperature of the skin) (YES in step 76A), the temperature of the second stimulation surface 41 is increased until the subject presses the button 8 again ( Steps 71 and 72), the temperature (threshold temperature) at which the button 8 was pressed is stored in the memory 16 (step 73).

When the process of increasing the temperature of the second stimulating surface 41, pressing the button 8 by the subject, and storing the temperature of the second stimulating surface 41 when the button 8 is pressed in the memory 16 is repeated a predetermined number of times (step YES in 74), the average temperature of the second stimulation surface 41 when the button 8 is pressed (when the subject feels pain) is calculated (step 77), and the calculated average temperature is displayed on the display screen 6. (step 78).

FIG. 13 corresponds to FIG. 7 and shows temperature changes of the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51 temperature-controlled by the procedure shown in FIGS. showing the situation. In FIG. 13, the horizontal axis indicates time, and the vertical axis indicates temperature (Celsius).

The temperatures of the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51 at time t20 when the temperature stimulation device 1 is turned on are shown as initial temperatures. The temperature of each of the first stimulation surface 31 and the third stimulation surface 51 is kept at the initial temperature, and the second stimulation surface 41 increases (or decreases) to the palm temperature when the palm is placed thereon. (between times t20 and t21). At time t20, the temperature of the second stimulation surface 41 becomes the same as the palm skin temperature, and the temperature rise (temperature decrease) of the second stimulation surface 41 stops. temperature. The temperature of the second stimulation surface 41 is kept at the skin temperature (time t21 to t23).

At time t21, the temperature of the second stimulation surface 41 becomes the same as the skin temperature, and when the skin temperature is known, the skin temperature (initial skin temperature) is 2 degrees Celsius lower than the skin temperature (skin temperature - 2 degrees Celsius). At time t22 (skin temperature - 2 degrees Celsius), the CPU 10 controls the temperature controller 17 so that the temperature is kept constant at (skin temperature - 2 degrees Celsius) (indicated by the dashed line). . The reason why the temperature is kept at (skin temperature - 2 degrees Celsius) is to prevent the subject from reacting to the low temperature as pain if the temperature is too low.

The temperature of the second stimulation surface 41 (temperature rising stimulation surface) is gradually increased, and the temperature of the skin (initial skin temperature) measured by the heat flow sensor 44A provided below the second stimulation surface 41. is exceeded at time t23 and is further increased (indicated by the solid line).

The temperature of each of the first stimulation surface 31 and the third stimulation surface 51 is maintained at (skin temperature - 2 degrees Celsius), and the temperature of the second stimulation surface 41 is gradually increased. Even if the subject does not feel pain (time t23 to t24), the subject does not press the button 8. Therefore, the temperature of each of the first stimulation surface 31 and the third stimulation surface 51 is maintained at (skin temperature - 2 degrees Celsius), while the temperature of the second stimulation surface 41 continues to rise ( time t23 to t24).

At time t24, the temperature of the second stimulation surface 41 reaches C12 degrees Celsius. The respective temperatures of the first stimulation surface 31 and the third stimulation surface 51 are still kept at the temperature of (skin temperature - 2 degrees Celsius). At time t24 when the temperature of the second stimulation surface 41 reaches C12 degrees Celsius, the subject presses the button 8 when the subject feels pain (warm sensation). The CPU 10 then causes the memory 16 to store data representing C12 degrees Celsius, which is the temperature of the second stimulation surface 41 when the button 8 was pressed, as described above. Since the temperatures of the first stimulation surface 31 and the third stimulation surface 51 are made lower than the initial temperature of the skin, pain is produced even though the temperature of the second stimulation surface 41 is relatively low. A temperature stimulus can be safely given to a subject.

Even if the button 8 is pressed by the subject, the temperatures of the first stimulation surface 31 and the third stimulation surface 51 are kept at (skin temperature - 2 degrees Celsius) (between time t24 and t25), The temperature of the second stimulation surface 41 is gradually lowered (between times t24 and t25). The temperature of the second stimulation surface 41 is gradually lowered until the temperature of the second stimulation surface 41 reaches the temperature of the skin (initial skin temperature).

When the temperature of the second stimulation surface 41 reaches the temperature of the skin at time t25, the temperature of the second stimulation surface 41 is gradually increased again (from time t25 to t26), and the subject presses the button 8 again at time t26. Then, the temperature of the second stimulation surface 41 (C22 degrees Celsius) at the time t26 when the button 8 was pressed again is detected, and the temperature data representing the C22 degrees Celsius is stored in the memory 16. FIG.

At time t27, when the temperature of the second stimulation surface 41 drops to the temperature of the skin, the temperature of the second stimulation surface 41 is gradually increased again (time t27 to t28). When the button 8 is pressed again by the subject at time t28, the temperature of the second stimulation surface 41 (C32 degrees Celsius) at the time t28 when the button 8 was pressed again is detected and the temperature representative of that C32 degree Centigrade is detected. Data is stored in memory 16 .

When the above process is repeated a predetermined number of times, the temperature control of the first stimulation surface 31, the second stimulation surface 41 and the third stimulation surface 51 is stopped.

In the above-described embodiment, the temperature of each of the first stimulation surface 31 and the third stimulation surface 51 is kept constant at (initial skin temperature - 2 degrees Celsius), but (initial skin temperature ) and (6 degrees Celsius below the initial temperature of the skin).

1: Temperature stimulator, 2: Base, 2A: Front side of base, 2B: Back side of base, 3: Stimulator, 4-4A: Stimulation surface, 5: Display device, 6: Display screen, 7: input device, 8: button, 10: CPU, 11: display control device, 13: touch panel, 14-15: interface, 16: memory, 17: temperature control device, 18: DC-DC converter, 19: Medical standard AC-DC power supply, 21A: digital conversion circuit, 21B: digital conversion circuit, 22A: digital conversion circuit, 22B: digital conversion circuit, 23A: digital conversion circuit, 23B: digital conversion circuit, 31: first stimulation surface , 32: heat transfer plate, 33: Peltier element, 34A: heat flow sensor, 34B: temperature sensor, 35: cooling unit, 41: second stimulation surface, 42: heat transfer plate, 43: Peltier element, 43A: heat flow sensor , 43B: temperature sensor, 44: Peltier element, 44A: heat flow sensor, 44B: temperature sensor, 45: cooling unit, 51: third stimulation surface, 52: heat transfer plate, 53: Peltier element, 54A: heat flow sensor, 54B: temperature sensor, 55: cooling unit, 81: fourth stimulation surface, S1: first stimulation section, S2: second stimulation section, S3: third stimulation section, S4: fourth stimulation section Δ12 : Interval, Δ23: Interval

Claims (11)

at least two stimulation surfaces with adjacent stimulation surfaces spaced no more than 2 mm apart;
a temperature adjustment element for adjusting the temperature of each of the at least two stimulation surfaces; and controlling the temperature adjustment element so that the temperature difference between two adjacent stimulation surfaces among the at least two stimulation surfaces gradually increases. element control means for
A temperature stimulator with the at least two stimulation surfaces include a constant temperature stimulation surface that keeps the temperature of the stimulation surface constant and an elevated temperature stimulation surface that increases the temperature of the stimulation surface;
The element control means is
controlling the temperature regulating element to keep the temperature of the constant temperature stimulation surface constant and gradually increase the temperature of the temperature rising stimulation surface;
The temperature stimulation device according to claim 1. further comprising a command means for giving a command from the subject to the temperature stimulation device when the subject feels pain;
The element control means is
The temperature of the constant temperature stimulation surface is kept constant, the temperature of the temperature increase stimulation surface is gradually increased, and the temperature of the temperature increase stimulation surface is decreased in response to the command given from the command means. Repeating the control of the temperature adjustment element so as to
The temperature stimulation device according to claim 2. The element control means is
keeping the temperature of the constant temperature stimulus surface constant at a temperature lower than the initial temperature of the elevated temperature stimulus surface;
4. The temperature stimulation device according to claim 2 or 3. The element control means is
keeping the temperature of the constant temperature stimulation surface constant between the initial temperature of the elevated temperature stimulation surface and a temperature 6 degrees Celsius below the initial temperature;
5. A thermal stimulation device according to any one of claims 2-4. Further comprising skin temperature measuring means for measuring the initial temperature of the skin in contact with the stimulation surface,
The element control means is
keeping the temperature of the constant temperature stimulation surface constant at a temperature lower than the initial temperature of the skin measured by the skin temperature measuring means;
The temperature stimulation device according to claim 2. The element control means is
The temperature of the constant temperature stimulation surface is kept constant between the initial skin temperature measured by the skin temperature measuring means and a temperature 6 degrees Celsius lower than the skin temperature.
The temperature stimulation device according to claim 6. having at least three stimulating surfaces,
Three stimulation surfaces, in which the constant temperature stimulation surface is arranged in the center and the temperature increase stimulation surface is arranged on both sides of the constant temperature stimulation surface, or the temperature increase stimulation surface is arranged in the center, and comprising three stimulation surfaces on which the constant temperature stimulation surfaces are arranged on both sides of the temperature rise stimulation surface,
A thermal stimulation device according to any one of claims 1 to 7. The element control means is
controlling the temperature adjustment element so as to collectively adjust the temperature of the constant temperature stimulation surface and to collectively perform the temperature adjustment of the elevated temperature stimulation surface;
9. Thermal stimulation device according to any one of claims 1-8. the at least two stimulation surfaces are arranged substantially tangentially adjacent to each other;
11. A thermal stimulation device according to any one of claims 1-10. at least two adjacent stimulus surfaces are spaced no more than 2 mm apart, and
a temperature regulating element regulating the temperature of each of the at least two stimulation surfaces;
The temperature control means controls the temperature adjustment element so that the temperature difference between two adjacent stimulation surfaces out of the at least two stimulation surfaces gradually increases.
temperature stimulation method.

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