WO2016159139A1 - 経頭蓋磁気刺激装置用コイル装置 - Google Patents
経頭蓋磁気刺激装置用コイル装置 Download PDFInfo
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- WO2016159139A1 WO2016159139A1 PCT/JP2016/060492 JP2016060492W WO2016159139A1 WO 2016159139 A1 WO2016159139 A1 WO 2016159139A1 JP 2016060492 W JP2016060492 W JP 2016060492W WO 2016159139 A1 WO2016159139 A1 WO 2016159139A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N2/00—Magnetotherapy
- A61N2/02—Magnetotherapy using magnetic fields produced by coils, including single turn loops or electromagnets
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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
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6802—Sensor mounted on worn items
- A61B5/6803—Head-worn items, e.g. helmets, masks, headphones or goggles
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/40—Applying electric fields by inductive or capacitive coupling ; Applying radio-frequency signals
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N2/00—Magnetotherapy
- A61N2/004—Magnetotherapy specially adapted for a specific therapy
- A61N2/006—Magnetotherapy specially adapted for a specific therapy for magnetic stimulation of nerve tissue
Definitions
- the present invention relates to a coil device for a transcranial magnetic stimulation device, a method for manufacturing the same, a transcranial magnetic stimulation device including the coil device for a transcranial magnetic stimulation device, and a method for manufacturing the same.
- Transcranial magnetic stimulation is a treatment method that painlessly and non-invasively stimulates neurons in the brain.
- FIG. 1 is a perspective view showing a configuration example of a typical transcranial magnetic stimulation system according to the prior art.
- a stimulation coil is brought into contact with an appropriate position on the surface of the head as shown in FIG. 1, and a magnetic field is instantaneously generated, so that nerve cells in the brain immediately below the coil are induced by an electric field. Stimulate by.
- the magnetic field generated from the coil induces an electric field in the living body by electromagnetic induction and causes depolarization in nerves located in the cerebrum.
- the transcranial magnetic stimulation method has been mainly used for mapping brain functions of the motor cortex as a means of stimulating cranial nerves in a non-invasive and painless manner. Furthermore, in recent years, clinical research with a clear therapeutic aim has been advanced for neurological diseases such as pain, Parkinson's disease, and depression, or for evaluation of spinal cord and peripheral neuropathy. In these neurological diseases, there are clinical cases in which it is difficult to obtain an effect by treatment with a drug, and it is attracting attention as a patient-friendly treatment method replacing an electrical stimulation treatment method involving craniotomy. As an example, it has been reported that in intractable neuropathic pain, there was an analgesic effect for about one day by magnetically stimulating the primary motor cortex of the cerebrum.
- a transcranial magnetic stimulation system 1 (hereinafter “magnetic stimulation system”, “transcranial magnetic stimulation device”, “transcranial magnetic stimulation treatment system”, “transcranial”
- the magnetic stimulation system ”) is generally configured to include a stimulation coil 2 (magnetic field generating means) and a magnetic stimulation control device 6 electrically connected to the stimulation coil 2 via a cable 4 for treatment. Treatment and / or alleviation of symptoms is performed by applying a magnetic stimulation of a predetermined intensity to nerves in the brain by the stimulation coil 2 placed on the scalp surface of the patient M seated on the chair 8 for use.
- a coil holder 10 having a coil 2 is fixed to the tip of a holder fixture 11 (posture holding means).
- the holder fixture 11 includes a column 11a and a base 11b, and a part of the column 11a (near the tip of the holder fixture 11) is formed of a metal flexible tube 11c. Therefore, the coil 2 can be fixed at the optimum coil position simply by moving the coil holder 10 to a predetermined position on the scalp surface of the patient M.
- the transcranial magnetic stimulation system is not limited to the configuration shown in FIG. 1, and other modes are possible.
- the stimulation coil 2 generates a dynamic magnetic field for applying magnetic stimulation to at least a specific part of the brain of the patient M.
- the stimulation coil 2 various types of known magnetic coils can be used.
- the stimulation coil 2 is a so-called eight-shaped spiral coil in which two spiral coils are arranged in the shape of the numeral “8” on the same plane. .
- the maximum induced current density can be obtained immediately below the portion where these coils overlap by causing current to flow through the two coils in the same direction (for example, the direction indicated by the arrow).
- This form of stimulation coil (magnetic coil) 2 is suitable for providing stimulation with a limited area on the brain skin to be stimulated.
- the magnetic stimulation control device 6 controls the supply of current pulses to the stimulation coil 2.
- various conventionally known forms can be used.
- the on / off operation of the magnetic stimulation control device 6 is performed by an operator.
- the operator can also set the intensity of the current pulse and the pulse waveform that determine the intensity and cycle of the magnetic stimulation.
- a higher pain reduction effect can be obtained by accurately applying a local stimulus to the intracerebral nerve directly from the coil placed on the scalp surface of the patient. For this reason, in a medical institution, the optimal coil position and posture of the coil 2 which can reduce a patient's neuropathic pain most are determined using the positioning device for exclusive use at the time of a patient's initial medical examination.
- the conventional magnetic stimulation device weighs about 70 kg and requires electrical work for installation, so it can only be used in a well-equipped medical institution.
- the stimulation position is determined with reference to the patient's MRI (Magnetic Resonance Imaging) data, and thus treatment by a skilled medical staff is necessary.
- transcranial magnetic stimulation therapy there are various types of stimulation coils for magnetic stimulation, such as circular coils, 8-shaped coils, four-leaf coils, Hesed coils, and many small circular coils arranged on the head surface.
- a shape has been proposed, and currently an 8-shaped coil is mainly used.
- An 8-shaped coil is a series of two circular coils connected in series, for example, partially overlapped at their circular ends, and by passing a current in the opposite direction to these circular coils, It is possible to stimulate locally by concentrating eddy currents.
- a navigation system for determining the stimulation position by the hands of non-medical workers In developing magnetic stimulation used for home treatment, the development of a navigation system for determining the stimulation position by the hands of non-medical workers is also underway.
- a navigation system for determining a magnetic stimulation position a plurality of magnetic sensors installed in eyeglasses are used to reverse the position and orientation of a magnetic stimulation coil as a magnetic field source in a three-dimensional space.
- the positioning operation using the magnetic stimulation therapy coil navigation system that teaches the coil moving operation so that the irradiation position / orientation of the magnetic stimulation coil, which is a prescription value predetermined by the doctor, is detected by an analysis technique will be described. .
- the patient first wears glasses equipped with a plurality of magnetic sensors in the hospital.
- the doctor moves the magnetic stimulation coil to the vicinity of the irradiation position of the patient's brain skin and tries the magnetic stimulation to determine the optimal stimulation position (prescription position).
- the data of the position and orientation of the magnetic stimulation coil tracked by the stereo camera at the position of, and the data detected by the magnetic sensor of the glasses for the magnitude of the magnetic field generated by the permanent magnet incorporated in the coil Record as a table.
- the current magnetic sensor detection value is compared with the magnetic sensor value in the data table collected in advance, so that the current coil 3
- the dimension position and orientation are specified. Since the brain MRI image and the magnetic stimulation coil image are superimposed and displayed on the monitor screen next to the patient, the patient can observe the monitor screen and the magnetic stimulation coil becomes the target prescription. It is possible to visually and intuitively know where the current position is relative to the position, and it is possible to easily move the magnetic stimulation coil to the prescription position and position the coil. Note that navigation systems other than the configuration described above are also possible.
- the guidance error is, for example, 5 mm at the maximum from the optimum stimulation position, while in the 8-shaped coil described above, the irradiation site (optimum stimulation position) is within, for example, 5 mm. It is assumed that the target site can be stimulated therapeutically and effectively. In this case, when using a treatment device that performs magnetic stimulation with an 8-shaped coil at a stimulation position induced using a navigation system, the site to be irradiated (optimum stimulation position) may not fall within the stimulation effective range of the treatment coil. Because there is, it is difficult to accurately stimulate the treatment part.
- a winding coil is placed on or near the surface of the head, and a current is generated by an induced electric field in a magnetic stimulation target region in the brain by electromagnetic induction.
- a coil device for a stimulating transcranial magnetic stimulator The winding coil includes a near head surface conductor portion disposed on or near the head surface, and a far head surface conductor disposed away from the near head surface conductor portion from the head surface. With The distance between the near-surface surface conductor and the far-surface surface conductor is changed and set so that the induction electric field strength increases compared to the peripheral region of the magnetic stimulation target region.
- the electric field strength on the head surface can be further increased as compared with the prior art.
- a transcranial stimulation system 1 In order to generate an electric field for magnetic stimulation treatment by applying an electric current to a magnetic stimulation coil (hereinafter also referred to as “treatment coil”, “stimulation coil”, or simply “coil”), a transcranial stimulation system 1 Includes a magnetic stimulation control device 6 connected to the stimulation coil 2, and the magnetic stimulation control device 6 includes a coil drive circuit therein.
- FIG. 2A is a circuit diagram showing a configuration example of a stimulation coil drive circuit of a transcranial magnetic stimulation device according to one embodiment of the present invention
- FIG. 2B is a waveform showing a coil voltage waveform of the transcranial magnetic stimulation device of FIG. 2A
- FIG. 2C is a waveform diagram showing a coil current waveform of the transcranial magnetic stimulation apparatus of FIG. 2A.
- the coil drive circuit 20 includes a power supply device 21, a capacitor 22, a semiconductor switch 23, a stimulation coil 2, and a control circuit 26.
- the power supply device 21 includes an AC power supply 21a, a power supply circuit 21b, and a booster circuit 21c.
- the semiconductor switch 23 is configured by connecting a thyristor 23 a and a diode 23 b in the reverse direction in parallel, and the thyristor 23 a is turned on or off based on a control signal from the control circuit 26.
- a capacitor 22 having a capacitance value C, a semiconductor switch 23, an inductance component 24 of the stimulation coil 2 having an inductance Lc, and a resistance component 25 of the stimulation coil 2 having a resistance value Rc are connected in series. .
- the capacitor 22 and the inductance component 24 of the stimulation coil 2 resonate by turning on (conducting) the thyristor 23a.
- the current i flowing through the inductance component 24 during resonance is expressed by the following differential equation when the resistance component 25 is ignored.
- the current i is expressed by the following equation using the boosted voltage V 0 .
- the coil voltage (both ends of the inductance component 24 of the stimulation coil 2 is turned off) by turning off (cutting off) the thyristor 23a when the time corresponding to one resonance period has elapsed. 2B) and the current waveform flowing through the stimulation coil 2 are as shown in FIGS. 2B and 2C.
- the horizontal axis represents time
- the vertical axis represents voltage
- the horizontal axis in FIG. 2C represents time
- the vertical axis represents current.
- the voltage applied to the stimulation coil 2 is 0.4 to 3 kV, and the current flowing through the stimulation coil 2 is 4 to 20 kA.
- the pulse width suitable for transcranial magnetic stimulation treatment is 200 ⁇ s to 300 ⁇ s, and the induced electric field strength generated in the brain is said to be about 200 V / m when the gray matter conductivity is 0.1 S / m.
- the stimulus intensity and the reaction effect obtained thereby vary from subject to subject, and there are many empirical parts.
- FIG. 3 is a schematic external view of an 8-shaped coil and a dome-shaped coil used in this embodiment.
- a patent application was filed for the dome-shaped coil in order to perform a wider range of stimulation than the conventional 8-shaped coil (see, for example, Patent Document 3).
- the dome-shaped coil first has the number of turns N, the height L, and the conductor interval d as independent parameters. Further, as parameters that depend on these independent parameters, the overall coil width W and the upper sphere radius R are set. Have. Hereinafter, these parameters are also collectively referred to as “variable parameters”.
- the radius of the bottom surface contact portion (see FIG. 3) when the coil is viewed from above is defined as x.
- the radius R is uniquely determined by the values of the radius x and the height L when designing based on the bottom surface contact portion.
- the dome coil according to the present embodiment can be defined as follows. That is, the near head surface conducting wire part arranged near the head surface and the far head surface conducting part arranged away from the head surface are electrically connected to form a single turn coil.
- a plurality of turn coils configured such that the shape of the head surface conductor portion and / or the far head surface conductor portion is the same for each turn connected or gradually different for each turn connected, This is a coil device arranged in the direction in which the centers are connected.
- each turn of the winding coil is placed on or near the head surface so that the central axis of each turn of the winding coil is substantially parallel to the head surface, and a current is generated in the brain by electromagnetic induction to stimulate neurons.
- It is a coil apparatus used for cranial magnetic stimulation treatment.
- the coil height L is the maximum value of the distance between the near-surface surface conductor portion and the far-surface surface conductor portion in each turn coil constituting the dome-shaped coil.
- the dome-shaped coil is considered.
- the present invention is not limited to this, and the eight-character configuration includes a coil of the near-head surface conductor portion and a coil of the far-head surface conductor portion. It may be a mold coil.
- the 8-shaped coil is placed on or near the head surface so that the central axis of each turn of the winding coil is substantially perpendicular to the head surface, and generates an electric current in the brain by electromagnetic induction.
- This is a coil device for a transcranial magnetic stimulation device that stimulates neurons.
- the stimulation range is set to a design target of 1.5 times the horizontal and vertical dimensions of the conventional 8-shaped coil.
- the stimulation efficiency is reduced, it is necessary to apply more current to the coil, and as a result, continuous stimulation becomes difficult due to heating of the coil, so that the stimulation efficiency may not be reduced. It was important.
- the design of the dome-shaped coil is changed to a method of fixing and proceeding with the examination based on the “head contact area of the coil bottom surface”, and as a result, the induction electric field given as a result is changed. It was clarified that “spread” and “strength” depended on “head contact area” and “coil height and turn number density”, respectively. As a result, the design of the dome-shaped coil can be changed in strength while keeping the spread of the generated induction electric field constant, so that it is easy to find the optimum value. The result of examination by the present inventor based on such a policy will be specifically described below.
- SPFD method Scalar-Potential Finite Difference method
- an object that generates an induced electric field by a dynamic magnetic field is divided into small rectangular parallelepipeds, and an induced electric field generated in each minute volume can be obtained as a solution of a differential equation of a magnetic vector potential.
- the electric field E generated by the coil is expressed as follows using the magnetic vector potential A 0 and the scalar potential ⁇ .
- FIG. 4 is a perspective view showing the structure of a minute hexahedron for explaining the principle of the scalar potential finite difference method used in this embodiment.
- Sn is the conductance of each line
- ln is the length of each line
- ⁇ n is a scalar potential at node Pn
- a 0 n is a directional component connecting node P0 and node Pn.
- the induction electric field E (vector) can be obtained by solving this equation for the entire voxel.
- FIG. 5 is a table showing each example when the height L of the dome-shaped coil is used as a parameter in the transcranial magnetic stimulation apparatus of FIG. 2A.
- a plurality of coil models fixed to the base value were prepared, and the change of the induced electric field in the hemispherical conductor imitating the head was analyzed.
- the dome-shaped coil is configured by connecting elements of a plurality of turns, for example, in series, and the width between the elements of two adjacent turns is defined as an element width d.
- the upper conductor radius (R in FIG. 3) of the dome-shaped coil is changed from 60.2 mm to 56 mm in accordance with the height L because the height L is changed while the head contact area is constant.
- the following three types of coil models were prepared.
- the model M1 is a model group M1
- the model M2 is a model group M2
- the model M3 is a model group M3.
- a current of 5.3 kA and 4 kHz was applied to the stimulation coil. Then, changes in the induced electric field strength and the spread with respect to the change in the coil height L were calculated and compared based on the scalar potential finite difference method as described below.
- FIG. 6 is a graph showing the electric field strength generated by the coil when the height L of the dome-shaped coil is changed in the transcranial magnetic stimulation apparatus of FIG. 2A.
- the induction electric field strength increased as the coil height increased to ⁇ 87 V / m.
- the “in-sphere average value of the induction electric field” is a value obtained by calculating the electric field strength at each point inside the sphere for the sphere within a predetermined radius from the center point, and calculating the average value.
- the in-sphere average of the induction electric field is 73 V / m to 118 V / m, and only the strength is increased as compared with the model group M2.
- the spread of the induction electric field did not change.
- the spread of the induction electric field is a value defined on the basis of the point of attenuation to 50% of the maximum value of the generated induction electric field.
- the half width of the model group M1 is 8.7 cm ⁇ 4.2 cm, the model group M2 and The full width at half maximum of M3 was 9.7 cm ⁇ 5.3 cm.
- the strength can be increased without increasing or decreasing the spread of the generated induction electric field. It turns out that it can be maximized. This is an important finding when aiming at a coil design in which the induction electric field does not spread more than necessary and can be stimulated efficiently.
- the pulse width T of the current generated by the general drive circuit described above is determined as follows using the self-inductance Lc of the coil and the capacitance C of the circuit.
- the coil strength as an extrapolated value calculated from the approximate straight line obtained from the result was 107 V / m, and the result obtained by analyzing the induction electric field from the above equations under the same experimental conditions was 103 V / m. .
- the minimum value of the inductance is 5.63 ⁇ H, and the inductance is preferably 5 ⁇ H or more.
- FIG. 7A is a perspective view showing an outline of the appearance of an 8-shaped coil used in the present embodiment
- FIG. 7B is a perspective view showing an outline of the appearance of a dome-shaped coil used in the present embodiment.
- the 8-shaped coil was formed by stacking two circular coils having an outer radius of 51 mm, an inner radius of 11 mm, and 10 turns.
- the hemisphere model was the same as in the above study, and the current flowing through the coil was 5.3 kA and 3.4 kHz.
- the spread range in which the stimulation intensity of the dome-shaped coil is halved is 9.8 cm ⁇ 5.4 cm, and the 8-shaped coil is 6.0 cm ⁇ 3.4 cm.
- the average value of the induction electric field generated in a sphere having a radius of 10 mm centered on the top of the hemisphere was 83 V / m for the dome-shaped coil and 169 V / m for the 8-shaped coil.
- FIG. 8A is a simulation result of the 8-shaped coil according to the present embodiment, and is an image showing the intensity of the induction electric field generated on the surface of the hemisphere model.
- FIG. 8B is a simulation result of the dome-shaped coil according to the present embodiment, and is an image showing the induction electric field strength generated on the surface of the hemisphere model.
- FIG. 9A is a simulation result of the 8-shaped coil according to the present embodiment, and is an image showing the induction electric field strength generated in the cross section of the hemisphere model.
- FIG. 9B is a simulation result of the dome-shaped coil according to the present embodiment, and is an image showing the induction electric field strength generated in the cross section of the hemisphere model. That is, the state of the model surface of the induction electric field generated in the hemisphere model is shown in FIGS. 8A and 8B, and the state of the cross section is shown in FIGS. 9A and 9B.
- the dome-shaped coil is inferior to the 8-shaped coil in stimulation intensity, but the stimulation range for the hemisphere model is wider. It can also be seen that the distance to the position where the stimulation depth attenuates to 50% of the maximum induction electric field is 9.8 mm for the 8-shaped coil and 15 mm for the dome-shaped coil. It is generally said that the allowable displacement of the stimulation position due to the 8-shaped coil is about 5 mm. From this result, it can be predicted that the displacement of the stimulation position due to the dome-shaped coil will increase to about 8 mm, which is about 1.5 times. It can be seen that a coil resistant to misalignment has been realized.
- the present inventor conducted a study on a brain shape model created from an MRI image of a hemispherical subject's head based on a simulation of a displacement of a stimulus position at a 3 mm grid, 5 points ⁇ 5 points centered on a motor cortex. It was.
- the brain shape model was extracted from the MRI image by dividing into three elements of brain white matter, gray matter, and cerebrospinal fluid by using the statistical image analysis package SPM operating on MATLAB.
- the conductivities of white matter, gray matter, and cerebrospinal fluid were 0.07 S / m, 0.11 S / m, and 1.79 S / m, respectively.
- the induction electric field at the stimulation planned point at the time of displacement was compared between an 8-shaped coil and a dome-shaped coil having the same design as in Example 2.
- FIG. 10A is a photographic image showing the measurement position of the electric field strength in the MRI image of the subject's head in the simulation of the 8-shaped coil and the dome-shaped coil according to this embodiment.
- FIG. 10B is a table showing the simulation result of the 8-shaped coil according to the present embodiment and showing the relative value of the electric field strength at the measurement position in FIG. 10A.
- FIG. 10C is a table showing a simulation result of the dome-shaped coil according to the present embodiment and showing a relative value of the electric field intensity at the measurement position in FIG. 10A.
- the measurement position in FIG. 10A is a coordinate determined by the coordinates of the Xa axis and the Ya axis orthogonal to each other.
- FIG. 10A shows the brain shape obtained by MRI and the state of the stimulation points of the primary motor area corresponding thereto.
- the intensity of the induced electric field was 264 V / m for the 8-shaped coil and 101 V / m for the dome-shaped coil, taking an average in a sphere with a radius of 10 mm at the stimulation center point.
- FIG. 10B there was a stimulation point that attenuated by 10.8% at the maximum in the 8-shaped coil. This is consistent with a report that a therapeutic effect may not be obtained due to a positional deviation of a coil of 5 mm or more.
- the maximum attenuation with the dome-shaped coil was 1.1%. From this, it can be said that the dome-shaped coil is designed to be resistant to misalignment in stimulating the actually complex brain. Further, the result agrees with the consideration that the allowable displacement of the stimulation position in the hemisphere model is about 8 mm.
- the distance between the near head surface lead wire portion and the far head surface lead wire portion is compared with the peripheral region of the magnetic stimulation target region (region to be magnetically stimulated) in the brain,
- the induction electric field intensity can be greatly increased as compared with the prior art.
- the inductance Lc is set to be in an inductance range in which the inductance Lc is preferably 5 ⁇ H or more and 13 ⁇ H or less and the induction electric field is within a predetermined spread on the head surface.
- the pulse width is set within a predetermined pulse width range, and the distance between the near head surface conducting wire portion and the far head surface conducting wire portion is determined by the induced electric field strength. It is preferable to set it so as to increase as compared with the peripheral region of the magnetic stimulation target region.
- an 8-shaped coil composed of two circular coils has been described.
- the present invention is not limited to this, and the center axis of the two circular coils is eccentric to the central portion of the coil device.
- An eccentric 8-character coil may be used.
- the manufacturing method of the coil apparatus has mainly described the dome-shaped coil, the present invention is not limited to this, and can be applied to an 8-shaped coil and an eccentric 8-shaped coil.
- a winding coil is placed on or near the head surface, and an electromagnetic induction generates a current due to an induction electric field in a magnetic stimulation target region in the brain.
- a coil device for a transcranial magnetic stimulator for stimulating neurons The winding coil includes a near head surface conductor portion disposed on or near the head surface, and a far head surface conductor disposed away from the near head surface conductor portion from the head surface. With The distance between the near-surface surface conductor and the far-surface surface conductor is changed and set so that the induction electric field strength increases compared to the peripheral region of the magnetic stimulation target region.
- a coil device for a transcranial magnetic stimulation device is the coil device for a transcranial magnetic stimulation device according to the first aspect, wherein the coiling device for the transcranial magnetic stimulation device is between the near-surface surface conductor portion and the far-field surface conductor portion.
- the distance is set so that the inductance of the coil device is within a predetermined inductance range and the induction electric field is within a predetermined spread on the head surface.
- a coil device for a transcranial magnetic stimulation device is the coil device for a transcranial magnetic stimulation device according to the second aspect, wherein the inductance range is 5 ⁇ H or more and 13 ⁇ H or less. .
- a coil device for a transcranial magnetic stimulation device is the coil device for a transcranial magnetic stimulation device according to any one of the first to third aspects, wherein the coil device is a dome shape. It is a coil, an 8-shaped coil, or an eccentric 8-shaped coil.
- the transcranial magnetic stimulation apparatus is A coil device for a transcranial magnetic stimulation device according to any one of the first to fourth aspects;
- a transcranial magnetic stimulation device comprising: a driving circuit that outputs a current pulse having a predetermined pulse width to the coil device;
- the pulse width is set within a predetermined pulse width range, and the distance between the near head surface conducting wire portion and the far head surface conducting wire portion is set so that the induced electric field strength is in the peripheral region of the magnetic stimulation target region. It is characterized by being set so as to increase in comparison.
- the transcranial magnetic stimulation apparatus is the fifth transcranial magnetic stimulation apparatus, wherein the pulse width range is 200 ⁇ s or more and 300 ⁇ s or less.
- a method of manufacturing a coil device for a transcranial magnetic stimulation device A method of manufacturing a coil device for a transcranial magnetic stimulation device that generates and stimulates neurons,
- the winding coil includes a near head surface conductor portion disposed on or near the head surface, and a far head surface conductor disposed away from the near head surface conductor portion from the head surface.
- a method for manufacturing a coil device for a transcranial magnetic stimulation device is the method for manufacturing a coil device for a transcranial magnetic stimulation device according to the seventh aspect, wherein the near-surface surface lead wire portion and the far head Changing the distance to the surface conductor portion by changing the inductance of the coil device so that the inductance of the coil device is within a predetermined inductance range and the induction electric field is within a predetermined spread on the head surface. It is characterized by.
- a method of manufacturing a transcranial magnetic stimulation device includes: A coil device for a transcranial magnetic stimulation device according to any one of the first to fourth aspects; A method of manufacturing a transcranial magnetic stimulation device comprising a drive circuit that outputs a current pulse having a predetermined pulse width to the coil device, The pulse width is set within a predetermined pulse width range, and the distance between the near head surface conducting wire portion and the far head surface conducting wire portion is set so that the induced electric field strength is in the peripheral region of the magnetic stimulation target region.
- the method includes a step of changing and setting so as to increase in comparison.
- the electric field strength of the head surface can be further increased, and the present invention can be used to manufacture a coil device for a transcranial magnetic stimulation device and a coil device for a transcranial magnetic stimulation device.
- the present invention can be widely applied to a method, a transcranial magnetic stimulation device using the coil device, and a manufacturing method of the transcranial magnetic stimulation device.
- Transcranial magnetic stimulation system 2 ... Stimulation coil, 4 ... Cable 6 ... Magnetic stimulation control device, 20 ... Coil drive circuit, 21 ... Power supply, 21a ... AC power supply, 21b ... power supply circuit, 21c ... Booster circuit, 22: Capacitor, 23. Semiconductor switch, 23a ... Thyristor, 23b ... a diode, 24: Inductance component of the stimulation coil, 25. Resistance component of the stimulation coil, 26 ... control circuit, M ... Patient.
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Abstract
Description
上記巻線コイルは、上記頭部表面上又はその近傍に配置された近頭部表面導線部と、上記頭部表面から上記近頭部表面導線部よりも離れて配置された遠頭部表面導線部とを備え、
上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記誘導電場強度が上記磁気刺激対象領域の周辺領域に比較して増大するように変化させて設定したことを特徴とする。
磁気刺激用コイル(以下、「治療コイル」、「刺激用コイル」、あるいは単に「コイル」ともいう)に電流を印加して磁気刺激治療のための電場を生成するために、経頭蓋刺激システム1は刺激用コイル2と接続された磁気刺激制御装置6を備えており、磁気刺激制御装置6は内部にコイル駆動回路を備えている。
上記に説明した各パラメータを有するドーム型コイルを前提とし、本発明者は次のような方針と知見に基づいて、本実施形態にかかるコイル装置に至る検討を行った。
本実施形態に至る、経頭蓋磁気刺激における誘導電場の計算をその過程に含んだ各検討では、本発明者はすべて、スカラーポテンシャル有限差分法(SPFD法:Scalar-Potential Finite Difference method)を用いた。SPFD法では、動磁場により誘導電場を発生させる対象物を微小直方体に分割し、各微小体積に発生する誘導電場を磁気ベクトルポテンシャルの差分方程式の解として得ることができる。まず、コイルにより発生する電場Eを磁気ベクトルポテンシャルA0及びスカラーポテンシャル∇φを用いて表すと以下となる。
図5は図2Aの経頭蓋磁気刺激装置においてドーム型コイルの高さL等をパラメータとしたときの各実施例を示す表である。本発明者は、まず、各パラメータに対する刺激効果の変化を解析するため、図5のように、コイルの高さLを21mm及び39mmとして、頭部接触面の面積をx=56mmという設計値に基づく値に固定した複数のコイルモデルを用意し、頭部を模した半球の導電体における誘導電場の変化を解析した。なお、ドーム型コイルは複数のターンの各エレメントが例えば直列に接続されて構成され、互いに隣接する二つのターンのエレメント間の幅をエレメント幅dとする。
(モデルM1)ターン数N=20、エレメント幅d=1mm、コイル全体幅W=59mm;
(モデルM2)ターン数N=20、エレメント幅d=2mm、コイル全体幅W=78mm;
(モデルM3)ターン数N=26、エレメント幅d=1mm、コイル全体幅W=78mm。
次に、ドーム型コイルの位置ロバスト性を評価するため、半球モデルに対する8字型コイルとドーム型コイルによる誘導電場の広がり及び強度をそれぞれ比較する検討を行った。
本発明者は、半球被験者頭部のMRI画像から作られた脳形状モデルに対し、運動野刺激点を中心とした3mm格子、5点×5点での刺激位置ずれのシミュレーションに基づく検討を行った。
第1の態様にかかる経頭蓋磁気刺激装置用コイル装置は、巻線コイルが頭部表面上又はその近傍に置かれ、電磁誘導によって脳内の磁気刺激対象領域に誘導電場による電流を発生させてニューロンを刺激する経頭蓋磁気刺激装置のためのコイル装置であって、
上記巻線コイルは、上記頭部表面上又はその近傍に配置された近頭部表面導線部と、上記頭部表面から上記近頭部表面導線部よりも離れて配置された遠頭部表面導線部とを備え、
上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記誘導電場強度が上記磁気刺激対象領域の周辺領域に比較して増大するように変化させて設定したことを特徴とする。
第1~第4の態様のうちのいずれか1つに記載の経頭蓋磁気刺激装置用コイル装置と、
上記コイル装置に所定のパルス幅を有する電流パルスを出力する駆動回路とを備えた経頭蓋磁気刺激装置であって、
上記パルス幅を所定のパルス幅範囲内に設定し、上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記誘導電場強度が上記磁気刺激対象領域の周辺領域に比較して増大するように変化させて設定したことを特徴とする。
上記巻線コイルは、上記頭部表面上又はその近傍に配置された近頭部表面導線部と、上記頭部表面から上記近頭部表面導線部よりも離れて配置された遠頭部表面導線部とを備え、
上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記誘導電場強度が上記磁気刺激対象領域の周辺領域に比較して増大するように変化させて設定するステップを含むことを特徴とする。
第1~第4の態様のうちのいずれか1つに記載の経頭蓋磁気刺激装置用コイル装置と、
上記コイル装置に所定のパルス幅を有する電流パルスを出力する駆動回路とを備えた経頭蓋磁気刺激装置の製造方法であって、
上記パルス幅を所定のパルス幅範囲内に設定し、上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記誘導電場強度が上記磁気刺激対象領域の周辺領域に比較して増大するように変化させて設定するステップを含むことを特徴とする。
2…刺激用コイル、
4…ケーブル、
6…磁気刺激制御装置、
20…コイル駆動回路、
21…電源装置、
21a…交流電源、
21b…電源回路、
21c…昇圧回路、
22…コンデンサ、
23…半導体スイッチ、
23a…サイリスタ、
23b…ダイオード、
24…刺激用コイルのインダクタンス成分、
25…刺激用コイルの抵抗成分、
26…制御回路、
M…患者。
Claims (9)
- 巻線コイルが頭部表面上又はその近傍に置かれ、電磁誘導によって脳内の磁気刺激対象領域に誘導電場による電流を発生させてニューロンを刺激する経頭蓋磁気刺激装置のためのコイル装置であって、
上記巻線コイルは、上記頭部表面上又はその近傍に配置された近頭部表面導線部と、上記頭部表面から上記近頭部表面導線部よりも離れて配置された遠頭部表面導線部とを備え、
上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記誘導電場強度が上記磁気刺激対象領域の周辺領域に比較して増大するように変化させて設定したことを特徴とする、経頭蓋磁気刺激装置用コイル装置。 - 上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記コイル装置のインダクタンスが所定のインダクタンス範囲に入り、かつ上記誘導電場が頭部表面上の所定の広がり内に入るように変化させて設定したことを特徴とする、請求項1記載の経頭蓋磁気刺激装置用コイル装置。
- 上記インダクタンス範囲は、5μH以上でかつ13μH以下であることを特徴とする、請求項2記載の経頭蓋磁気刺激装置用コイル装置。
- 上記コイル装置は、ドーム型コイル、8字型コイル、又は偏心8字型コイルであることを特徴とする、請求項1~3のうちのいずれか1つに記載の経頭蓋磁気刺激装置用コイル装置。
- 請求項1~4のうちのいずれか1つに記載の経頭蓋磁気刺激装置用コイル装置と、
上記コイル装置に所定のパルス幅を有する電流パルスを出力する駆動回路とを備えた経頭蓋磁気刺激装置であって、
上記パルス幅を所定のパルス幅範囲内に設定し、上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記誘導電場強度が上記磁気刺激対象領域の周辺領域に比較して増大するように変化させて設定したことを特徴とする、経頭蓋磁気刺激装置。 - 上記パルス幅範囲は、200μs以上でかつ300μs以下であることを特徴とする、請求項5記載の経頭蓋磁気刺激装置。
- 巻線コイルが頭部表面上又はその近傍に置かれ、電磁誘導によって脳内の磁気刺激対象領域に誘導電場による電流を発生させてニューロンを刺激する経頭蓋磁気刺激装置のためのコイル装置の製造方法であって、
上記巻線コイルは、上記頭部表面上又はその近傍に配置された近頭部表面導線部と、上記頭部表面から上記近頭部表面導線部よりも離れて配置された遠頭部表面導線部とを備え、
上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記誘導電場強度が上記磁気刺激対象領域の周辺領域に比較して増大するように変化させて設定するステップを含むことを特徴とする、経頭蓋磁気刺激装置用コイル装置の製造方法。 - 上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記コイル装置のインダクタンスが所定のインダクタンス範囲に入り、かつ上記誘導電場が頭部表面上の所定の広がり内に入るように変化させて設定するステップを含むことを特徴とする、請求項7記載の経頭蓋磁気刺激装置用コイル装置の製造方法。
- 請求項1~4のうちのいずれか1つに記載の経頭蓋磁気刺激装置用コイル装置と、
上記コイル装置に所定のパルス幅を有する電流パルスを出力する駆動回路とを備えた経頭蓋磁気刺激装置の製造方法であって、
上記パルス幅を所定のパルス幅範囲内に設定し、上記近頭部表面導線部と上記遠頭部表面導線部との間の距離を、上記誘導電場強度が上記磁気刺激対象領域の周辺領域に比較して増大するように変化させて設定するステップを含むことを特徴とする、経頭蓋磁気刺激装置の製造方法。
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CA2981420A CA2981420C (en) | 2015-04-02 | 2016-03-30 | Coil apparatus for use in transcranial magnetic stimulation apparatus |
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JP2017510138A JP6583699B2 (ja) | 2015-04-02 | 2016-03-30 | コイル設計装置及びコイル設計方法 |
KR1020177029768A KR102556124B1 (ko) | 2015-04-02 | 2016-03-30 | 경두개 자기 자극 장치용 코일 장치 |
CN201680020711.2A CN107708611B (zh) | 2015-04-02 | 2016-03-30 | 经颅磁刺激装置用线圈装置及其制造方法 |
AU2016240919A AU2016240919B2 (en) | 2015-04-02 | 2016-03-30 | Coil apparatus for use in transcranial magnetic stimulation apparatus |
US15/563,044 US20180369601A1 (en) | 2015-04-02 | 2016-03-30 | Coil apparatus for use in transcranial magnetic stimulation apparatus provided with wound-wire coil disposed on or near head surface |
EP16773020.9A EP3278764B1 (en) | 2015-04-02 | 2016-03-30 | Coil device for use in transcranial magnetic stimulation device |
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US16/842,124 Division US11491343B2 (en) | 2015-04-02 | 2020-04-07 | Coil apparatus for use in transcranial magnetic stimulation apparatus provided with wound-wire coil disposed on or near head surface |
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- 2016-03-30 JP JP2017510138A patent/JP6583699B2/ja active Active
- 2016-03-30 EP EP16773020.9A patent/EP3278764B1/en active Active
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- 2016-03-30 WO PCT/JP2016/060492 patent/WO2016159139A1/ja active Application Filing
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Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPWO2018066171A1 (ja) * | 2016-10-06 | 2019-07-18 | 新東工業株式会社 | 表面特性検査方法及び表面特性検査装置 |
KR101953615B1 (ko) * | 2017-10-16 | 2019-03-04 | 서울대학교산학협력단 | 금속판과 숏스텁을 이용한 뇌 자극용 어플리케이터 |
JP2022548193A (ja) * | 2019-07-11 | 2022-11-17 | ユナイテッド ステイツ ガバメント アズ リプレゼンテッド バイ ザ デパートメント オブ ベテランズ アフェアーズ | 経頭蓋磁気刺激コイルの位置合わせ装置 |
JP7397963B2 (ja) | 2019-07-11 | 2023-12-13 | ユナイテッド ステイツ ガバメント アズ リプレゼンテッド バイ ザ デパートメント オブ ベテランズ アフェアーズ | 経頭蓋磁気刺激コイルの位置合わせ装置 |
Also Published As
Publication number | Publication date |
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EP3278764A4 (en) | 2019-01-09 |
US11491343B2 (en) | 2022-11-08 |
CN107708611A (zh) | 2018-02-16 |
ES2940892T3 (es) | 2023-05-12 |
CA2981420A1 (en) | 2016-10-06 |
JP6583699B2 (ja) | 2019-10-02 |
JPWO2016159139A1 (ja) | 2018-02-08 |
KR20170134495A (ko) | 2017-12-06 |
AU2016240919B2 (en) | 2020-05-14 |
CA2981420C (en) | 2023-07-11 |
CN107708611B (zh) | 2020-12-22 |
US20180369601A1 (en) | 2018-12-27 |
EP3278764B1 (en) | 2023-03-08 |
KR102556124B1 (ko) | 2023-07-14 |
EP3278764A1 (en) | 2018-02-07 |
AU2016240919A1 (en) | 2017-10-19 |
US20200230431A1 (en) | 2020-07-23 |
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