WO2018182825A1 - Système de stimulation transcrânienne par courant et réalité virtuelle pour le traitement d'espt ou de peurs - Google Patents

Système de stimulation transcrânienne par courant et réalité virtuelle pour le traitement d'espt ou de peurs Download PDF

Info

Publication number
WO2018182825A1
WO2018182825A1 PCT/US2018/014294 US2018014294W WO2018182825A1 WO 2018182825 A1 WO2018182825 A1 WO 2018182825A1 US 2018014294 W US2018014294 W US 2018014294W WO 2018182825 A1 WO2018182825 A1 WO 2018182825A1
Authority
WO
WIPO (PCT)
Prior art keywords
traumatic
tdcs
pattern
set forth
subject
Prior art date
Application number
PCT/US2018/014294
Other languages
English (en)
Inventor
Michael D. Howard
Praveen K. PILLY
Original Assignee
Hrl Laboratories, Llc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Hrl Laboratories, Llc filed Critical Hrl Laboratories, Llc
Priority to EP18775894.1A priority Critical patent/EP3600532A4/fr
Priority to CN201880013919.0A priority patent/CN110325242B/zh
Publication of WO2018182825A1 publication Critical patent/WO2018182825A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/36025—External stimulators, e.g. with patch electrodes for treating a mental or cerebral condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/369—Electroencephalography [EEG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M21/00—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis
    • A61M21/02—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis for inducing sleep or relaxation, e.g. by direct nerve stimulation, hypnosis, analgesia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/3603—Control systems
    • A61N1/36031—Control systems using physiological parameters for adjustment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M21/00—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis
    • A61M2021/0005—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis by the use of a particular sense, or stimulus
    • A61M2021/0027—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis by the use of a particular sense, or stimulus by the hearing sense
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M21/00—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis
    • A61M2021/0005—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis by the use of a particular sense, or stimulus
    • A61M2021/0044—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis by the use of a particular sense, or stimulus by the sight sense
    • A61M2021/005—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis by the use of a particular sense, or stimulus by the sight sense images, e.g. video
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M21/00—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis
    • A61M2021/0005—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis by the use of a particular sense, or stimulus
    • A61M2021/0072—Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis by the use of a particular sense, or stimulus with application of electrical currents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502—User interfaces, e.g. screens or keyboards
    • A61M2205/507—Head Mounted Displays [HMD]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/52—General characteristics of the apparatus with microprocessors or computers with memories providing a history of measured variating parameters of apparatus or patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/08—Other bio-electrical signals
    • A61M2230/10—Electroencephalographic signals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/0404—Electrodes for external use
    • A61N1/0408—Use-related aspects
    • A61N1/0456—Specially adapted for transcutaneous electrical nerve stimulation [TENS]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/0404—Electrodes for external use
    • A61N1/0472—Structure-related aspects
    • A61N1/0476—Array electrodes (including any electrode arrangement with more than one electrode for at least one of the polarities)

Definitions

  • the present invention relates to a system for treatment of traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic
  • memories and, more particularly, to a system for treatment of traumatic memories using a combination of transcranial current stimulation and virtual reality.
  • the reconsolidation hypothesis states that when a consolidated memory is recalled, it becomes unstable and susceptible to modification for a discrete period of time, gradually becoming stable again.
  • the most common method for treatment of post-traumatic stress disorder (PTSD) is aversion therapy under the guidance of a psychologist or psychiatrist, in order to associate more benign, safe feelings with the stressful memory.
  • PTSD post-traumatic stress disorder
  • this process is inefficient; it can take years of therapy to overcome the painful memory, since the intense emotion of the initial experience causes it to be strongly encoded.
  • Prior art methods to impair existing declarative memories in humans by disrupting reconsolidation either use a behavioral re-conditioning paradigm during waking (see Literature Reference No. 4 of the List of Incorporated Literature References) or employ drugs that inhibit protein synthesis during or following the experience of a traumatic memory (see Literature Reference No. 5).
  • the present invention relates to a system for treatment of traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic traumatic
  • the system comprises one or more processors and a non-transitory computer-readable medium having executable instructions encoded thereon such that when executed, the one or more processors perform multiple operations.
  • the system causing a virtual environment to be displayed via a virtual reality system in a benign setting.
  • a traumatic episode is displayed in the virtual environment via the virtual reality system, wherein the traumatic episode is created to include painful aspects of a traumatic memory.
  • tCS transcranial current stimulation
  • tDCS transcranial direct current stimulation
  • tCS transcranial alternating current stimulation
  • the virtual environment is gradually altered to be similar to an environment in which the subject experienced the traumatic memory.
  • the pattern of tDCS is a Spatial-Temporal Amplitude Modulated Pattern (STAMP).
  • STAMP Spatial-Temporal Amplitude Modulated Pattern
  • the duration of the tDCS application is varied based on the traumatic memory.
  • the period of slow-wave sleep comprises a slow-wave oscillation
  • the system using the tCS controller, applies the pattern of tDCS for at least a portion of the slow-wave oscillation.
  • the slow-wave oscillation comprises a plurality of UP phases
  • the system using the tCS controller, applies the pattern of tDCS to a percentage of the plurality of UP phases.
  • the virtual environment is altered in a series of sessions to gradually increase the level of discomfort of a subject.
  • a duration of no stimulation occurs, wherein the duration of no stimulation is shorter than the duration of application of the tACS, and wherein following the duration of no stimulation, the system causes the tCS controller to apply the pattern of tDCS to the subject to weaken the traumatic memory.
  • the present invention also includes a computer program product and a computer implemented method.
  • the computer program product includes computer-readable instructions stored on a non-transitory computer-readable medium that are executable by a computer having one or more processors, such that upon execution of the instructions, the one or more processors perform the operations listed herein.
  • the computer implemented method includes an act of causing a computer to execute such instructions and perform the resulting operations.
  • FIG. 1 is a block diagram depicting the components of a system for
  • FIG. 2 is an illustration of a computer program product according to some embodiments of the present disclosure
  • FIG. 3A is an illustration of a wake stage of the method for treatment of traumatic memories according to some embodiments of the present disclosure
  • FIG. 3B is an illustration of a sleep stage of the method for treatment of traumatic memories according to some embodiments of the present disclosure
  • FIG. 4 is a flow diagram illustrating day operation of the system for
  • FIG. 5 is a flow diagram illustrating sleep operation of the system for
  • the present invention relates to a system for treatment of traumatic
  • any element in a claim that does not explicitly state "means for” performing a specified function, or “step for” performing a specific function, is not to be interpreted as a "means” or “step” clause as specified in 35 U.S.C. Section 112, Paragraph 6.
  • the use of "step of 1 or “act of in the claims herein is not intended to invoke the provisions of 35 U.S.C. 1 12, Paragraph 6.
  • the first is a system for treatment of traumatic memories.
  • the system is typically in the form of a computer system operating software or in the form of a "hard-coded" instruction set. This system may be incorporated into a wide variety of devices that provide different functionalities.
  • the second principal aspect is a method, typically in the form of software, operated using a data processing system (computer).
  • the third principal aspect is a computer program product.
  • the computer program product generally represents computer-readable instructions stored on a non-transitory computer-readable medium such as an optical storage device, e.g., a compact disc (CD) or digital versatile disc (DVD), or a magnetic storage device such as a floppy disk or magnetic tape.
  • a non-transitory computer-readable medium such as an optical storage device, e.g., a compact disc (CD) or digital versatile disc (DVD), or a magnetic storage device such as a floppy disk or magnetic tape.
  • Other, non- limiting examples of computer-readable media include hard disks,
  • FIG. 1 A block diagram depicting an example of a system (i.e., computer system
  • the computer system 100 is configured to perform calculations, processes, operations, and/or functions associated with a program or algorithm. In one aspect, certain processes and steps discussed herein are realized as a series of instructions (e.g., software program) that reside within computer readable memory units and are executed by one or more processors of the computer system 100. When executed, the instructions cause the computer system 100 to perform specific actions and exhibit specific behavior, such as described herein.
  • the computer system 100 may include an address/data bus 102 that is configured to communicate information. Additionally, one or more data processing units, such as a processor 104 (or processors), are coupled with the address/data bus 102.
  • the processor 104 is configured to process information and instructions. In an aspect, the processor 104 is a microprocessor.
  • the processor 104 may be a different type of processor such as a parallel processor, application-specific integrated circuit (ASIC), programmable logic array (PLA), complex programmable logic device (CPLD), or a field programmable gate array (FPGA).
  • ASIC application-specific integrated circuit
  • PLA programmable logic array
  • CPLD complex programmable logic device
  • FPGA field programmable gate array
  • the computer system 100 is configured to utilize one or more data storage units.
  • the computer system 100 may include a volatile memory unit 106 (e.g., random access memory (“RAM”), static RAM, dynamic RAM, etc.) coupled with the address/data bus 102, wherein a volatile memory unit 106 is configured to store information and instructions for the processor 104.
  • RAM random access memory
  • static RAM static RAM
  • dynamic RAM dynamic RAM
  • the computer system 100 further may include a non-volatile memory unit 108 (e.g., read-only memory (“ROM”), programmable ROM (“PROM”), erasable programmable ROM (“EPROM”), electrically erasable programmable ROM “EEPROM”), flash memory, etc.) coupled with the address/data bus 102, wherein the nonvolatile memory unit 108 is configured to store static information and instructions for the processor 104.
  • the computer system 100 may execute instructions retrieved from an online data storage unit such as in "Cloud” computing.
  • the computer system 100 also may include one or more interfaces, such as an interface 1 10, coupled with the address/data bus 102.
  • the one or more interfaces are configured to enable the computer system 100 to interface with other electronic devices and computer systems.
  • the communication interfaces implemented by the one or more interfaces may include wireline (e.g., serial cables, modems, network adaptors, etc.) and/or wireless (e.g., wireless modems, wireless network adaptors, etc.) communication technology.
  • the computer system 100 may include an input device 112 coupled with the address/data bus 102, wherein the input device 1 12 is configured to communicate information and command selections to the processor 100.
  • the input device 112 is an alphanumeric input device, such as a keyboard, that may include alphanumeric and/or function keys.
  • the input device 1 12 may be an input device other than an alphanumeric input device.
  • the computer system 100 may include a cursor control device 1 14 coupled with the address/data bus 102, wherein the cursor control device 1 14 is configured to communicate user input information and/or command selections to the processor 100.
  • the cursor control device 1 14 is implemented using a device such as a mouse, a track-ball, a track-pad, an optical tracking device, or a touch screen.
  • the cursor control device 1 14 is directed and/or activated via input from the input device 1 12, such as in response to the use of special keys and key sequence commands associated with the input device 1 12.
  • the cursor control device 1 14 is configured to be directed or guided by voice commands.
  • the computer system 100 further may include one or more
  • a storage device 1 16 coupled with the address/data bus 102.
  • the storage device 1 16 is configured to store information and/or computer executable instructions.
  • the storage device 1 16 is a storage device such as a magnetic or optical disk drive (e.g., hard disk drive (“HDD”), floppy diskette, compact disk read only memory (“CD-ROM”), digital versatile disk (“DVD”)).
  • a display device 118 is coupled with the address/data bus 102, wherein the display device 118 is configured to display video and/or graphics.
  • the display device 1 18 may include a cathode ray tube (“CRT”), liquid crystal display (“LCD”), field emission display (“FED”), plasma display, or any other display device suitable for displaying video and/or graphic images and alphanumeric characters recognizable to a user.
  • CTR cathode ray tube
  • LCD liquid crystal display
  • FED field emission display
  • plasma display or any other display device suitable for displaying video and/or graphic images and alphanumeric characters recognizable to a user.
  • the computer system 100 presented herein is an example computing
  • the non-limiting example of the computer system 100 is not strictly limited to being a computer system.
  • an aspect provides that the computer system 100 represents a type of data processing analysis that may be used in accordance with various aspects described herein.
  • other computing systems may also be
  • one or more operations of various aspects of the present technology are controlled or implemented using computer-executable instructions, such as program modules, being executed by a computer.
  • program modules include routines, programs, objects, components and/or data structures that are configured to perform particular tasks or implement particular abstract data types.
  • an aspect provides that one or more aspects of the present technology are implemented by utilizing one or more distributed computing environments, such as where tasks are performed by remote processing devices that are linked through a communications network, or such as where various program modules are located in both local and remote computer-storage media including memory-storage devices.
  • FIG. 2 An illustrative diagram of a computer program product (i.e., storage device) embodying the present invention is depicted in FIG. 2.
  • the computer program product is depicted as floppy disk 200 or an optical disk 202 such as a CD or DVD.
  • the computer program product generally represents computer-readable instructions stored on any compatible non-transitory computer-readable medium.
  • the term "instructions” as used with respect to this invention generally indicates a set of operations to be performed on a computer, and may represent pieces of a whole program or individual, separable, software modules.
  • Non-limiting examples of "instruction” include computer program code (source or object code) and "hard-coded" electronics (i.e. computer operations coded into a computer chip).
  • the "instruction" is stored on any non-transitory computer-readable medium, such as in the memory of a computer or on a floppy disk, a CD-ROM, and a flash drive. In either event, the instructions are encoded on a non-transitory computer-readable medium.
  • the reconsolidation hypothesis states that when a consolidated memory is recalled, it becomes unstable and susceptible to modification for a discrete period of time, gradually becoming stable again.
  • the most common method for treatment of PTSD is aversion therapy under the guidance of a psychologist or psychiatrist, in order to associate more benign (i.e., gentle, not harmful), safe feelings with the stressful memory.
  • this process is inefficient; it can take years of therapy to overcome the painful memory, since the intense emotion of the initial experience causes it to be strongly encoded.
  • the system consists of two stages.
  • the first stage is to employ virtual reality to evoke the painful memory, including painful aspects of the memory, under safe and controlled conditions (e.g., a benign setting). Safe and controlled conditions may simply involve being in a home or office.
  • safe and controlled conditions may simply involve being in a home or office.
  • the benign setting is key, because the subject can experience the traumatic memory with less fear and stress. This is the basis of aversion therapy. This, in itself, is not new, but it increases the efficacy of the second stage.
  • the second stage of the system is to apply a weak, unique pattern of electrical stimulation to the scalp during one or more of these aversion therapy sessions, and then use this same pattern as a cue during sleep to promote reactivation of the new benign association during sleep, consolidating it much faster than normal.
  • FIGs. 3A and 3B depict the two stages of the invention described herein.
  • FIG. 3A illustrates the wake stage, wherein the subject 300 relives the traumatic episode in the virtual world (created by three-dimensional (3D) images in a VR (virtual reality) head-mounted display 302 (e.g., a virtual reality system)_and spatialized audio 304 over headphones 306).
  • a unique spatial pattern of high definition (HD) transcranial stimulation is applied (i.e.
  • the pattern is a set of currents, one for each stimulation electrode on the scalp, and this spatial pattern must be different from any other pattern associated with any other experience applied to this subject.
  • the computer 310 detects slow-wave oscillations in the HD-EEG data 312, the same pattern of stimulation is applied (i.e. HD-tCS control signals 308), thereby cueing a recall of the therapy session.
  • the subject 300 wears a high-density array of electrical stimulators 314 HD-tCS (high-definition transcranial current stimulation) on his or her head. Additionally, the subject 300 wears a virtual reality head-mounted display 302 on the eyes ("VR HMD"), and spatialized audio 304 over headphones.
  • VR HMD virtual reality head-mounted display 302 on the eyes
  • a computer 308 projects a compelling virtual environment on the display 302, and the subject 300 should feel immersed and comfortable in the environment, as it is changed gradually to become very similar to the environment in which the subject experienced the traumatic episode.
  • a therapist or a loved one can make the subject 300 feel comfortable and safe, for example, by holding a hand or putting a hand on a shoulder.
  • the virtual reality simulator (see FIG. 4, element 400) notifies the HD-tCS controller (FIG. 4, element 310) the precise time when the painful memory is being simulated. From the time the memory is evoked, during the extent of the experience, a unique Spatial-Temporal Amplitude Modulated Pattern (STAMP) of weak current is applied to the scalp of the subject 300. The best result will be if the experience can be evoked suddenly and strongly, and for a short time span on the order of seconds or a minute, so that a strong mental impression can be associated with the STAMP.
  • STAMP Spatial-Temporal Amplitude Modulated Pattern
  • the strength of the experience may be determined by biometrics measurements from a sensor such as galvanic skin response relative to baseline readings from the subject taken before the session, or by subjective indications the subject can be asked to give, such as indicating a level of stress from 1 to 10 by holding up fingers.
  • FIG. 4 is a flow diagram depicting the day (or wake) operation stage of the present invention.
  • a virtual world is created by a virtual reality simulator 400 and displayed via a virtual reality head-mounted display (VR HMD) 302.
  • the virtual reality simulator 400 is a computer configured to render a 3D image of some environment that may be real or computer- generated, and display it on a stereoscopic display (such as a VR HMD), where the point-of-view of the display is controlled by location/direction/gyroscope sensors on the head and other parts of the body.
  • the painful episode 402 (having a start and an end) is evoked by creating the situation in the virtual environment.
  • the virtual environment may include images from photographs of that location.
  • the virtual environment may be a representation of that location created from software based on descriptions or images of the environment.
  • Particular cues associated with the traumatic memory such as an item, people wearing camouflage, particular types of vehicles, implements, may be included in the virtual environment.
  • the situation created by the virtual environment may be new rather than based on a person's prior specific experiences.
  • the environment may include getting in various types of aircraft, or being on an elevated platform such as a balcony, porch, or cliff. Additional examples are provided below with respect to types of therapy sessions.
  • the virtual reality simulator 400 notifies the HD-tCS controller the precise time when the painful memory is being simulated.
  • the computer 310 causes the tCS controller to apply a transcranial direct current stimulation (tDCS) stamp for the duration of the painful episode 402.
  • tDCS is a form of neurostimulation that uses constant, low current delivered to electrodes arranged on the scalp. Thus, stimulation currents are held constant.
  • FIG. 5 is a flow diagram illustrating a sleep operation (or stage), which is described in detail in U.S. Provisional Application No. 62/516,350, which is hereby incorporated by reference as though fully set forth herein.
  • the technique employs a rolling mean of EEG channels and fits a 1 Hertz (Hz) oscillation to the previous second or so, and that fitted oscillation is the prediction for the next positive phase of the slow wave oscillation. Note that the actual phase of SWO constantly varies around 1 Hz so one has to constantly update prediction of the next UP phase.
  • the subject 300 again wears the same high-density array of stimulators 314 on the head (FIG. 3B), this time including sensors, such as EEG (electro-encephalogram).
  • the computer 308 monitors the EEG recording. When a period of slow-wave sleep is detected
  • tACS transcranial alternating current stimulation
  • PFC prefrontal cortex
  • the system causes the HD-tCS array to stimulate the STAMP montage for the duration of the positive half-cycle of the SWO (approximately 500 milliseconds (ms), called the UP-phase (element 508).
  • the architecture of the slow-wave oscillation is well-known in the art, such as described in
  • This two-stage process (FIGs. 3A-3B, 4, and 5) may be repeated to get the desired improvement in the subject's condition.
  • a desired improvement would be a subjective judgement (e.g., a survey or questionnaire) of the PTSD sufferer who would report frequency and intensity of experiences of PTSD during the days and nights of treatment. When the subject feels that PTSD is no longer a debilitating condition, the subject's treatment could be stopped. All memories are consolidated during the SWO periods.
  • the "time for stim?" box 502 in FIG. 5 becomes true when an UP-phase prediction is available and there is enough time to ramp up the stimulation (100ms, depending on the tCS controller).
  • transcranial direct current electrical stimulation tDCS
  • tACS transcranial direct current electrical stimulation
  • tACS transcranial direct current electrical stimulation
  • tACS transcranial direct current electrical stimulation
  • tACS transcranial direct current electrical stimulation
  • tACS transcranial magnetic stimulation
  • targeted memory targeted memory
  • TMR reactivation
  • exposure therapy in a session with a therapist talking though the traumatic experience may be used to replace the display of the virtual reality to the subject.
  • this disclosure describes a system to weaken a traumatic event
  • the memory by using a unique, weak pattern of transcranially-applied electrical stimulation to tag a reactivation of the memory in a benign setting during a therapy session and, subsequently, to cue the benign association during sleep, thereby consolidating the benign association.
  • the traumatic episode is recreated, and the STAMP pattern is applied while the stressful episode is being simulated.
  • a period of tACS is applied, interleaved with the STAMP.
  • the STAMP acts as a cue to reactivate the benign association.
  • Some SWO cycles should be un-STAMPed to allow time for other memories to consolidate.
  • the intensity of the traumatic episode can be increased from waking session to waking session, until the subject is relieved of the painful associations.
  • the therapy can be staged to present short, mild experiences during the first treatment periods, and gradually increase their intensity and duration.
  • the first experience might be on a porch in a virtual environment, with no railing, only a meter or so off the ground. After enough sessions that the subject is comfortable, the porch can be raised by a meter or two at a time to present more challenging experiences.
  • the first experiences might be just walking into an airplane and buckling the seat belt. Later, a takeoff can be added, and finally turbulence. It is easy to create very compelling experiences in such a virtual world.
  • fear may be addressed using this system, including fear of objects, animals, insects, sounds, sensations, experiences, smells, etc.
  • the fear may be addressed by presenting the fear through virtual reality while making the experience more benign through the use of a controlled environment and/or the assistance of other persons.
  • Fear of sensations and experiences may be simulated with props or controlled presentation of the feared experience.
  • fear of heat or cold may be addressed with gradually increasing application of the feared experience in small amounts to a subject while they are presented with the virtual environment and while transcranial direct current stimulation is applied to the subject.
  • the targeted transcranial neurostimulation system will cure people of post-traumatic stress and irrational fears and rid them of disturbing memories without physical risk to the patient. It is reasonable and useful to fear traumatic events, but when such fears become crippling and debilitating, it is a problem.
  • the invention described herein has goals similar to trauma-focused cognitive behavioral therapy techniques (e.g., Literature Reference No. 1 ) common in psychological treatment. The approach is to relive the trauma in a safe setting, guided by a skilled therapist, and leam a new association. However, unlike such techniques that require appointments with trained therapists for months or years of sessions, the system and method according to embodiment of this disclosure can accelerate treatment.
  • the approach described herein has low physical risk and no pharmacological side effects, and will be more effective than behavioral therapies. Additionally, the approach will allow, for the first time, a targeted personalized closed-loop system for weakening the specific memories that are bothering the patient.
  • Several commercial companies market high-definition transcranial stimulation products to which the invention described herein can be applied.
  • the advantages of the system and method according to embodiments of the present disclosure include the following.
  • the therapeutic procedure is safe; it does not require drugs.
  • the therapy can be added to standard psychological therapy techniques to greatly improve their effectiveness.
  • the therapy is targeted; it is applied only during certain periods of sleep with the only side- effects being a more restful night's sleep (due to the AC protocol applied to lengthen the slow wave sleep stage), compared with a drug treatment whose effects can have unintended systemic chemical side-effects.
  • the patient may sleep during the day and be awake during the night, so any reference to a "night's sleep" or '"night operation" can be considered to be applicable to whenever the patient sleeps, day or night.
  • the system can significantly decrease the number of such sessions required.
  • the desired end-result is subjective.
  • the patient wants relief from debilitating PTSD experiences that may occur daily and can destroy a person's ability to hold down a job and/or to take care of their children.
  • the resulting depression can lead to drinking or drugs to try to numb the emotions.
  • assessment measures used to diagnose PTSD and to measure the effectiveness of therapy There are a number of structured interviews and self-report
  • PTSD Scale The Clinician- Administered PTSD Scale (CAPS) was created by the National Center for PTSD, and is one of the most widely used PTSD interviews (see Literature Reference No. 8).
  • the first stage of transition would be a clinical system, for lab use where the disturbing memory needs to be artificially evoked.
  • a second stage would be a home system that can be either self-initiated or works automatically.
  • a final stage would be a portable personal therapy system that also can be operated by a naive user with minimal supervision.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Psychology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Anesthesiology (AREA)
  • Psychiatry (AREA)
  • Physics & Mathematics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Physiology (AREA)
  • Hematology (AREA)
  • Acoustics & Sound (AREA)
  • Child & Adolescent Psychology (AREA)
  • Developmental Disabilities (AREA)
  • Hospice & Palliative Care (AREA)
  • Neurology (AREA)
  • Pain & Pain Management (AREA)
  • Social Psychology (AREA)
  • Pathology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Magnetic Treatment Devices (AREA)
  • Electrotherapy Devices (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)

Abstract

L'invention concerne un système de traitement de souvenirs traumatiques. Pendant une étape de réveil, un environnement virtuel est présenté à un sujet. Un épisode traumatique qui peut être similaire à un souvenir traumatique du sujet est présenté à l'utilisateur dans l'environnement virtuel dans un contexte bénin. Un dispositif de commande de stimulation transcrânienne par courant (ICS) applique un modèle de stimulation transcrânienne par courant continu (tDCS) au sujet pendant l'épisode traumatique, de telle sorte que le souvenir traumatique dans un contexte bénin est associé au modèle de tDCS. Pendant une phase de sommeil, si le sommeil lent chez le sujet est détecté par l'intermédiaire d'enregistrements d'électroencéphalogramme (EEG), alors dans une première période de temps, le dispositif de commande de tCS peut appliquer une stimulation transcrânienne par courant alternatif (tACS) au sujet suivi d'une deuxième période de temps sans stimulation, dans une troisième période de temps, le dispositif de commande de tCS peut appliquer le modèle de tDCS au sujet. L'étape de sommeil peut être répétée jusqu'à ce qu'un affaiblissement souhaité du souvenir traumatique soit atteint.
PCT/US2018/014294 2017-03-29 2018-01-18 Système de stimulation transcrânienne par courant et réalité virtuelle pour le traitement d'espt ou de peurs WO2018182825A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP18775894.1A EP3600532A4 (fr) 2017-03-29 2018-01-18 Système de stimulation transcrânienne par courant et réalité virtuelle pour le traitement d'espt ou de peurs
CN201880013919.0A CN110325242B (zh) 2017-03-29 2018-01-18 用于治疗ptsd或恐惧的经颅电流刺激系统和虚拟现实

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US201762478538P 2017-03-29 2017-03-29
US62/478,538 2017-03-29
US201762516350P 2017-06-07 2017-06-07
US62/516,350 2017-06-07

Publications (1)

Publication Number Publication Date
WO2018182825A1 true WO2018182825A1 (fr) 2018-10-04

Family

ID=63677973

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2018/014294 WO2018182825A1 (fr) 2017-03-29 2018-01-18 Système de stimulation transcrânienne par courant et réalité virtuelle pour le traitement d'espt ou de peurs

Country Status (3)

Country Link
EP (1) EP3600532A4 (fr)
CN (1) CN110325242B (fr)
WO (1) WO2018182825A1 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112007255B (zh) * 2020-09-02 2021-04-13 龙马智芯（珠海横琴）科技有限公司 基于混合现实的心理治疗方法、装置、系统及服务器
CN112365956A (zh) * 2020-12-13 2021-02-12 龙马智芯（珠海横琴）科技有限公司 基于虚拟现实的心理治疗方法、装置、服务器及存储介质

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6012926A (en) * 1996-03-27 2000-01-11 Emory University Virtual reality system for treating patients with anxiety disorders
US9089703B2 (en) * 2008-07-02 2015-07-28 Microtransponder, Inc. Methods for enhancing exposure therapy using vagus nerve stimulation
WO2016102602A1 (fr) * 2014-12-22 2016-06-30 Icm (Institut Du Cerveau Et De La Moelle Épinière) Procédé et dispositif pour améliorer la consolidation de la mémoire

Family Cites Families (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU2007300014B2 (en) * 2006-09-28 2011-08-04 Wisconsin Alumni Research Foundation Method and apparatus for promoting restorative sleep
US20080319505A1 (en) * 2007-05-09 2008-12-25 Massachusetts Institute Of Technology Integrated Transcranial Current Stimulation and Electroencephalography Device
US8938301B2 (en) * 2010-01-06 2015-01-20 Evoke Neuroscience, Inc. Headgear with displaceable sensors for electrophysiology measurement and training
US8838247B2 (en) * 2010-01-06 2014-09-16 Evoke Neuroscience, Inc. Transcranial stimulation device and method based on electrophysiological testing
CN202096603U (zh) * 2011-05-26 2012-01-04 沈阳助邦科技有限公司 多功能抑郁焦虑治疗仪
WO2014170781A1 (fr) * 2013-04-17 2014-10-23 Koninklijke Philips N.V. Ajustement de l'intensité de stimulation sensorielle pour augmenter l'activité d'onde lente du sommeil
CA2857555A1 (fr) * 2014-04-01 2015-10-01 William F. Stubbeman Methode et systeme de stimulation cerebrale therapeutique a l'aide d'impulsions electromagnetiques
CN106413810B (zh) * 2015-03-20 2020-08-14 L·林 用于脑的非侵入式神经刺激治疗的系统和装置
CN106139359A (zh) * 2015-04-23 2016-11-23 普乐普医疗系统股份有限公司 一种心理创伤治疗仪
WO2016182947A1 (fr) * 2015-05-08 2016-11-17 Hrl Laboratories, Llc Conception de montage pour la détection à boucle fermée et la neurostimulation du cortex préfrontal latéral dorsal et/ou cortex moteur
GB2541947A (en) * 2015-09-07 2017-03-08 Cerestim Ltd Electrode apparatus
CN106175690A (zh) * 2016-08-24 2016-12-07 中国科学院深圳先进技术研究院 慢波睡眠增强系统及慢波睡眠监测方法

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6012926A (en) * 1996-03-27 2000-01-11 Emory University Virtual reality system for treating patients with anxiety disorders
US9089703B2 (en) * 2008-07-02 2015-07-28 Microtransponder, Inc. Methods for enhancing exposure therapy using vagus nerve stimulation
WO2016102602A1 (fr) * 2014-12-22 2016-06-30 Icm (Institut Du Cerveau Et De La Moelle Épinière) Procédé et dispositif pour améliorer la consolidation de la mémoire

Non-Patent Citations (4)

* Cited by examiner, † Cited by third party
Title
ANONYMOUS: "HRL receives DARPA award to ''STAMP'' learnin into the brain", 12 May 2016 (2016-05-12), pages 1 - 2, XP055617883, Retrieved from the Internet <URL:http://www.hr1.com/news/ 2016/05/12 /hr1-receives-darpa-award-to-stamp-learning -into-the-brain> *
MARIN, M.-F. ET AL.: "Neuromodulation approaches for the treatment of post-traumatic stress disorder: stimulating the brain following exposure-based therapy", CURRENT BEHAVIORAL NEUROSCIENCE REPORTS, vol. 2, no. 2, 2015, pages 67 - 71, XP055553151 *
NOVAKOVIC, V. ET AL.: "Brain stimulation in posttraumatic stess disorder", EUROPEAN JOUNAL OF PSYCHOTRAUMATOLOGY, vol. 2, 2011, pages 1 - 12, XP055553146 *
See also references of EP3600532A4 *

Also Published As

Publication number Publication date
EP3600532A1 (fr) 2020-02-05
CN110325242B (zh) 2023-06-27
EP3600532A4 (fr) 2021-01-06
CN110325242A (zh) 2019-10-11

Similar Documents

Publication Publication Date Title
US10744321B2 (en) Transcranial current stimulation system and virtual reality for treatment of PTSD or fears
Xia et al. Effects of 10 Hz repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex in disorders of consciousness
Lew et al. Single trial prediction of self-paced reaching directions from EEG signals
Grecco et al. Cerebellar transcranial direct current stimulation in children with ataxic cerebral palsy: A sham-controlled, crossover, pilot study
Oberman et al. Safety of theta burst transcranial magnetic stimulation: a systematic review of the literature
Jones et al. Dose-dependent effects of closed-loop tACS delivered during slow-wave oscillations on memory consolidation
Fu et al. Long-term effects of continuous theta-burst stimulation in visuospatial neglect
Pellegrino et al. Transcranial direct current stimulation over the sensory‐motor regions inhibits gamma synchrony
Thomson Wave therapy
Mariano et al. Transcranial direct current stimulation (tDCS) targeting left dorsolateral prefrontal cortex modulates task-induced acute pain in healthy volunteers
Ziegler et al. Do words stink? Neural reuse as a principle for understanding emotions in reading
Voarino et al. tDCS for memory enhancement: analysis of the speculative aspects of ethical issues
US10596372B2 (en) Targeted steerable transcranial intervention to accelerate memory consolidation
Gerge What neuroscience and neurofeedback can teach psychotherapists in the fieid of complex trauma: Interoception, neuroception and the embodiment of unspeakable events in treatment of complex PTSD, dissociative disorders and childhood traumatization
US10918862B1 (en) Method for automated closed-loop neurostimulation for improving sleep quality
US11052252B1 (en) Transcranial intervention to weaken an undesirable memory
US10046162B1 (en) Transcranial intervention to weaken traumatic memories
Antal et al. The impact of electrical stimulation techniques on behavior
CN110325242B (zh) 用于治疗ptsd或恐惧的经颅电流刺激系统和虚拟现实
Mishra et al. Neurophysiological correlates of cognition as revealed by virtual reality: Delving the brain with a synergistic approach
Zhang et al. Technology for chronic pain
Bob The brain and conscious unity: Freud's omega
Mancini et al. tDCS modulation of visually induced analgesia
Edelstein Neuroscience and architecture
US10357654B1 (en) Mapping transcranial signals to transcranial stimulation required to reproduce a brain state

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 18775894

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

ENP Entry into the national phase

Ref document number: 2018775894

Country of ref document: EP

Effective date: 20191029