Classifications

• • 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
  • A61N1/0492—Patch electrodes
• • 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
  • A61N1/36021—External stimulators, e.g. with patch electrodes for treatment of pain
• • 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
  • 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
  • A61N1/36034—Control systems specified by the stimulation parameters

Definitions

• the invention pertains to the technical field of devices and methods for the abortive or preventive treatment of headaches via transcutaneous electrical nerve stimulation (TENS), in particular via external trigeminal nerve stimulation (e-TNS).
• TTENS transcutaneous electrical nerve stimulation
• e-TNS external trigeminal nerve stimulation
• NSAIDs non-steroidal anti-inflammatory drugs
• Neurostimulation has been shown to be a good alternative to pharmacologic approaches, and is suitable for both acute treatment and prevention treatment.
• WO 2016/155 773 A1 and US 2018/0 056 065 A1 disclose a device for the transcutaneous electrical stimulation of the trigeminal nerve, and in particular the supratrochlear and supraorbital nerves of the ophthalmic branch of the trigeminal nerve.
• the device is configured for generating rectangular biphasic pulses with a width between 2 and 500 ps, a frequency between 1 and 250 Hz, and an intensity between 1 and 25 mA.
• e-TNS Through its action on the nerve, e-TNS generates paresthesia on the forehead and/or the skull that can be felt as unpleasant by some patients. In addition, a portion of migraine patients suffer from forehead cutaneous allodynia. In combination with the forehead cutaneous allodynia, the paresthesia induced by e- TNS are very painful, which renders e-TNS treatment impossible for these patients.
• hed2501012.x discloses TENS via monophasic pulses with amperages of max. 4 mA, frequencies of 12 kHz to 20 kHz, and widths of approximately 30 ps. The document remains silent about trigeminal nerve stimulation.
• US 2010/0 030299 A1 discloses a battery-operated TENS unit to treat headache in an abortive and/or preventive manner.
• the document discloses comb-like electrodes to be placed at the back of the head.
• the document discloses, amongst other combinations, monophasic pulses of frequency/width: 3 kHz/50 ps and 10 kHz/40 ps.
• the document further discloses, amongst other examples, spaced rectangular biphasic pulse streams with frequency 1 kHz and a biphasic pulse width of 275 or 475 ps.
• the output current may be limited via a series resistance to a maximum of, amongst other values, 10 mA or 5 mA.
• the device according to the document is not suited for trigeminal nerve stimulation.
• the present invention aims to resolve at least some of the problems mentioned above.
• the present invention provides for a device for the abortive or preventive treatment of a headache via external trigeminal nerve stimulation (e- TNS), according to claim 1.
• e- TNS external trigeminal nerve stimulation
• the present invention provides for consecutive electrical pulses for use in the abortive or preventive electrotherapeutic treatment of a headache via transcutaneous non-invasive electrical trigeminal nerve stimulation, according to claim 16.
• the present invention provides for consecutive electrical pulses for use in the electrotherapeutic treatment of a neurological disorder via transcutaneous non-invasive electrical trigeminal nerve stimulation, according to claim 17.
• the present invention provides for a method for the abortive or preventive treatment of a headache via e-TNS, according to claim 18.
• the present invention provides for use of a device according to the first aspect for the electrotherapeutic treatment of a neurological disorder, according to claim 20.
• the frequency according to the present invention lies in between 0.5 kilohertz and 50 kilohertz (i.e. 500 hertz to 50000 hertz), i.e. significantly higher than the frequencies disclosed in WO 2016/155773, US 2018/0056065 A1 and Riederer (2015).
• the particular treatment parameters have the advantageous technical effect of mitigating or avoiding paresthesia during external trigeminal nerve stimulation.
• the membrane pumps modify the ions (Na+ and K+ ) permeability through the nerve membrane to re-establish the rest potential that is needed to make the nerve cell excitable again.
• the repetition frequency of the impulses is high enough, the impulse is fired during the refractory period after the action potential and cannot generate a new action potential, but is enough to keep the cell depolarized and prevent the reestablishment of the rest polarization, making the nerve cell not able to trigger the action potential and paresthesia.
• Figures 1 to 5 show several embodiments of consecutive pulses.
• Figures 6A and 6B show an embodiment of a powering apparatus of a device according to the present invention.
• Figure 7 shows an embodiment of an electrode piece of a device according to the present invention applied to a person’s forehead in the supraorbital region.
• Figure 8 shows a self-supporting device attached to a person’s forehead, according to the embodiments of Figures 6A, 6B and 7.
• the present invention concerns a device and a method for the abortive or preventive treatment of headaches via external trigeminal nerve stimulation (e- TNS), as well as use of the device for the electrotherapeutic treatment of a neurological disorder.
• e- TNS external trigeminal nerve stimulation
• a compartment refers to one or more than one compartment.
• the value to which the modifier“about” refers is itself also specifically disclosed.
• “Comprise”, “comprising”, and“comprises” and“comprised of” as used herein are synonymous with “include”, “including”, “includes” or “contain”, “containing”, “contains” and are inclusive or open-ended terms that specify the presence of what follows e.g. component and do not exclude or preclude the presence of additional, non-recited components, features, elements, members, steps, known in the art or disclosed therein.
• the invention provides a device for the abortive or preventive treatment of a headache via e-TNS.
• the device is configured for non-invasive transcutaneous electrical nerve stimulation (TENS) of the trigeminal nerve via consecutive pulses.
• the consecutive pulses comprise:
• the present invention provides consecutive electrical pulses for use in the abortive or preventive electrotherapeutic treatment of a headache via transcutaneous non-invasive electrical trigeminal nerve stimulation.
• the consecutive pulses comprise:
• the present invention provides consecutive electrical pulses for use in the electrotherapeutic treatment of a neurological disorder via transcutaneous non-invasive electrical trigeminal nerve stimulation.
• the consecutive pulses comprise:
• the present invention provides a method for the abortive or preventive treatment of a headache via e-TNS.
• the method comprises the step of non-invasive TENS of the trigeminal nerve via consecutive pulses.
• the consecutive pulses comprise:
• the device according to the first aspect may be used in the preventive or abortive electrotherapeutic treatm ent of headaches.
• the invention m ay therefore also pertain to a device according to the first aspect for use in the preventive or abortive electrotherapeutic treatm ent of a headache.
• the device according to the first aspect may be used in the electrotherapeutic treatm ent of a neurological disorder.
• the invention may therefore also pertain to a device according to the first aspect for use in the electrotherapeutic treatm ent of a neurological disorder.
• the invention m ay also pertain to use of a device according to the first aspect for the electrotherapeutic treatm ent of a neurological disorder.
• said neurological disorder is selected from the group consisting of m igraine, tension headaches, cluster headaches, hem icrania continua, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) , chronic paroxysmal hem icrania, trigem inal neuralgia, facial nerve disturbances, fibromyalgia, chronic pain , depression , cyclothym ia, post-traumatic stress syndrom e, post-concussion syndrome, coma, anxiety, tremor, aphasia, obsessive compulsive disorder, insom nia, sleep disorders, sleep apnea syndrom e, hypersom nia, epilepsy, drop attacks, attention deficit hyperactivity disorder, Parkinson's disease, Alzheim er's disease, m ultiple sclerosis, stroke and Cerebellar syndrom e.
• SUNCT conjunctival injection and tearing
• e-TNS has previously been shown to be very effective for treatm ent of headaches, and in particular m igraine.
• the treatm ent can be effected via non-invasive TENS, which , as opposed to percutaneous m ethods requiring electrode insertion , can be effected entirely non-invasive, i.e. without surgery.
• the applicant has surprisingly discovered that the particular treatm ent param eters of the present invention avoid or m itigate paresthesia during the treatm ent. Without being bound by theory, the applicant deems this may be attributed to the following explanation.
• the m embrane pum ps modify the ions ( Na+ and K+ ) perm eability through the nerve m embrane to re-establish the rest potential that is needed to make the nerve cell excitable again .
• the im pulse is fired during the refractory period after the action potential and cannot generate a new action potential, but is enough to keep the cell depolarized and prevent the reestablishm ent of the rest polarization, making the nerve cell not able to trigger the action potential and paresthesia.
• a device ay be configured for delivering the consecutive pulses according to the second and/or third aspect.
• a device according to the first aspect may be configured for carrying out a m ethod according to the fourth aspect and that a m ethod according to the fourth aspect may be performed with a device according to the first aspect.
• the different aspects of the present invention are hence interrelated. Therefore, each feature described above and below may relate to each of the aspects of the present invention, even if it has been described in conjunction with a particular aspect.
• the “treatm ent parameters”, as used herein com prise properties of the consecutive pulses, such as pulse repetition frequency f and/or pulse repetition period T p , pulse amplitude, pulse width T w , and treatm ent tim e Tt.
• pulse amplitude is the maxim um absolute amplitude.
• the pulse repetition frequency is the inverse of the average pulse repetition period of the consecutive pulses.
• the device, the consecutive pulses and/or the m ethod are configured for transcutaneous electrical nerve stim ulation (TENS) of the supraorbital and supratrochlear nerves of the ophthalm ic branch of the trigem inal nerve via the consecutive pulses.
• TENS transcutaneous electrical nerve stim ulation
• the device, the consecutive pulses and/or the m ethod are configured for non-invasive TENS of the afferent paths of the supratrochlear and supraorbital nerves of the ophthalm ic branch of the trigem inal nerve via the consecutive pulses.
• these nerves can be easily stim ulated via non-invasive TENS through a skin portion, typically a person’s forehead, and more specifically the supraorbital region, which is typically hairless or com prises a low amount of hair, allowing for easy application and removal of an electrode.
• the pulses are rectangular pulses.
• a rectangular biphasic pulse comprises said two consecutive pulses, which are both rectangular and monophasic.
• the first pulse comprises an in essence constant first amplitude Ai during a first pulse width T
• the second pulse in time later than the first pulse, comprises an in essence constant second amplitude A ⁇ during a second pulse width T ⁇ .
• the second amplitude comprises an opposite sign with respect to the constant first amplitude, i.e. A1.A2 ⁇ 0.
• An in essence zero net charge transfer is realized when A1.T1 + A2.T2 « 0.
• the biphasic pulse is a symmetric rectangular biphasic pulse.
• the first pulse width is in essence equal to the second pulse width, i.e. T1 « T2
• the constant first amplitude is in essence the opposite of the constant second amplitude, i.e. A1 + A2 « 0.
• the rectangular biphasic pulse may be gapped or may be non-gapped, i.e. the first pulse and the second pulse may or may not comprise a time gap in between. In the latter case, the second pulse is in essence immediately subsequent to the first pulse.
• Figure 1 shows several consecutive pulses on a two-dimensional graph comprising an amplitude axis (101) and a time axis (100).
• Amplitude (112) denotes that no current is transferred, i.e. an amplitude of 0.0 milliampere.
• a pulse (102) comprises a pulse width T w (121) and a pulse repetition period T P (123), both of which are time parameters.
• the pulse furthermore comprises a pulse amplitude A (111).
• a pulse may be rectangular, thereby comprising an in essence constant amplitude A during the pulse width T w , as is the case in Figure 1.
• the applied current signal may be continuous.
• a pulse may thereby be triangular or sinusoidal, for example.
• Figure 2 shows several consecutive pulses on a two-dimensional graph comprising an amplitude axis (101) and a time axis (100).
• Amplitude (312) denotes that no current is transferred, i.e. an amplitude of 0.0 milliampere.
• Two consecutive pulses (302, 303) comprise a net charge transfer of in essence 0.0 picocoulomb.
• a rectangular gapped biphasic pulse comprises a first monophasic rectangular pulse (302) and a second monophasic rectangular pulse (303).
• the first pulse (302) comprises a pulse width h, w (321), an amplitude Ai (311), and a time gap Ti, g (322) to the second pulse.
• the second pulse (303) comprises a pulse width T2,w (324), and an amplitude A ⁇ (313), whereby Ai and A ⁇ comprise opposite phase, i.e. A1.A2 ⁇ 0.
• the second pulse comprises a time gap T2, g (325) to the following pulse.
• the pulse repetition period T p (330) is the repetition period of the biphasic pulse, i.e. the time span in between the beginning of two consecutive rectangular biphasic pulses.
• the two consecutive pulses (302, 303) comprises an in essence zero net charge transfer, i.e. Ai.Ti, w + A2.T ⁇ ,w ⁇ 0.
• the biphasic pulse may be symmetric, in which case Ai + A ⁇ ⁇ 0, but may alternatively be non-symmetric, in which case ⁇ Aij 1 IA21
• Figure 3 shows several consecutive pulses on a two-dimensional graph comprising an amplitude axis (101) and a time axis (100).
• Amplitude (512) denotes that no current is transferred, i.e. an amplitude of 0.0 milliampere.
• Two consecutive triangular pulses (502, 503) comprise a net charge transfer of in essence 0.0 picocoulomb.
• a symmetric triangular gapped biphasic pulse comprises a first monophasic triangular pulse (502) and a second monophasic triangular pulse (503).
• the first pulse (502) comprises a pulse width h, w (521), an amplitude Ai
• the second pulse (503) comprises a pulse width T2,w (524), and an amplitude A ⁇ (513), whereby Ai and A ⁇ comprise opposite phase, i.e. A1.A2 ⁇ 0.
• the second pulse comprises a time gap T2, g (525) to the following pulse.
• the pulse repetition period T P (530) is the repetition period of the biphasic pulse, i.e. the time span in between the beginning of two consecutive biphasic pulses.
• the time gaps of the first pulse and the second pulse may or may not be equal.
• the pulse widths of the first pulse and the second pulse are equal, as the biphasic pulse is symmetric.
• the pulse amplitudes, i.e. the absolute values of the amplitudes, of the first pulse and the second pulse are equal, as the biphasic pulse is symmetric.
• Figure 4 shows several consecutive pulses on a two-dimensional graph comprising an amplitude axis (101) and a time axis (100).
• Amplitude (712) denotes that no current is transferred, i.e. an amplitude of 0.0 milliampere.
• Two consecutive sinusoidal pulses (702, 703) comprise a net charge transfer of in essence 0.0 picocoulomb.
• a symmetric sinusoidal gapped biphasic pulse comprises a first monophasic sinusoidal pulse (702) and a second monophasic sinusoidal pulse (703).
• the first pulse (702) comprises a pulse width h, w (721), an amplitude Ai (711), and a time gap Ti, g (722) to the second pulse.
• the second pulse (703) comprises a pulse width T 2,w (724), and an amplitude A 2 (713), whereby Ai and A 2 comprise opposite phase, i.e. A1.A2 ⁇ 0.
• the second pulse comprises a time gap T 2,g (725) to the following pulse.
• the pulse repetition period T P (730) is the repetition period of the biphasic pulse, i.e. the time span in between the beginning of two consecutive biphasic pulses.
• the time gaps of the first pulse and the second pulse may or may not be equal.
• the pulse widths of the first pulse and the second pulse are equal, as the biphasic pulse is symmetric.
• the pulse amplitudes, i.e. the absolute values of the amplitudes, of the first pulse and the second pulse are equal, as the biphasic pulse is symmetric.
• the pulse repetition frequency is between 2 kilohertz and 40 kilohertz.
• the pulse repetition frequency is preferably at least 4 kilohertz, more preferably at least 6 kilohertz, even more preferably at least 7 kilohertz, yet even more preferably at least 8 kilohertz, and most preferably at least 9 kilohertz.
• the pulse repetition frequency is preferably is preferably at most 30 kilohertz, more preferably at most 24 kilohertz, even more preferably at most 20 kilohertz, yet even more preferably at most 16 kilohertz, with greater preference at most 14 kilohertz, with an even greater preference at most 12 kilohertz, and with greatest preference at most 11 kilohertz.
• the pulse repetition frequency is about 10 kilohertz.
• the pulse width is between 4 microseconds and 240 microseconds, preferably between 8 microseconds and 120 microseconds, more preferably between 12 microseconds and 60 microseconds, even more preferably between 16 microseconds and 50 microseconds, yet even more preferably between 20 microseconds and 40 microseconds, and most preferably between 25 microseconds and 35 microseconds. In a particularly preferred embodiment, the pulse width is about 30 microseconds.
• the pulse amplitude is between 1 milliampere and 128 milliampere, preferably between 2 milliampere and 64 milliampere, more preferably between 4 milliampere and 32 milliampere, even more preferably between 5 milliampere and 16 milliampere, most preferably between 6 milliampere and 12 milliampere. In a particularly preferred embodiment, the pulse amplitude is about 8 milliampere.
• the treatment time is at least 5 minutes, preferably at least 10 minutes, more preferably at least 15 minutes, even more preferably at least 20 minutes, yet even more preferably at least 25 minutes, with greater preference at least 30 minutes, with even greater preference at least 40 minutes, with yet even greater preference at least 45 minutes, and with greatest preference at least 60 minutes.
• the device according to first aspect and the method according to the fourth aspect may be configured for non-invasive TENS of the afferent paths of the supratrochlear and supraorbital nerves of the ophthalmic branch of the trigeminal nerve via rectangular pulses comprising:
• the device is configured for increasing, preferably linearly increasing, the pulse amplitude at a rate of at most 480 microampere/second prior to the treatment.
• the method comprises the step of increasing, preferably linearly increasing, the pulse amplitude at a rate of at most 480 microampere/second prior to the treatment step.
• the rate is preferably at most 240 microampere/second, more preferably at most 120 microampere/second, even more preferably at most 60 microampere/second, yet even more preferably at most 30 microampere/second, and most preferably at most 15 microampere/ second. In a particularly preferred embodiment, the rate is about 9.5 microampere/second.
• the increasing is performed during a start-up time span of at least 4 minutes, preferably at least 6 minutes, more preferably at least 8 minutes, even more preferably at least 10 minutes, and most preferably at least 12 minutes.
• the pulse amplitude remains in essence constant during the treatment time. This is advantageous, as it allows a person to become gradually accustomed to the amplitude of the treatment during a start-up phase prior to the treatment.
• Figure 5 illustrates several aspects of the start up, and is not intended to, nor should it be interpreted to, limit the scope of the invention.
• Figure 5 shows several consecutive sym m etric biphasic rectangular pulses during the start-up on a two-dim ensional graph comprising an amplitude axis ( 1 01 ) and a time axis ( 1 00) .
• Am plitude (912) denotes that no current is transferred, i.e. an amplitude of 0.0 m illiam pere.
• Each biphasic pulse com prises a first pulse (902, 902’, 902”, 902’”) and a second pulse (903, 903’, 903”, 903”’) , which comprise successively larger pulse amplitudes (91 1 , 91 1’, 91 1”, 91 1”’) over the subsequent biphasic pulses.
• the increase of the pulse am plitude is in the present case linear.
• the first pulse (902) comprises a pulse width h ,w (921 ) , and a tim e gap Ti ,g (922) to the second pulse.
• the second pulse (903) comprises a pulse width T 2,w (924) , and a tim e gap T ⁇ ,g (925) to the following pulse.
• the pulse widths of the first pulse and the second pulse are equal, as the biphasic pulses are sym m etric.
• the pulse repetition period T p (930) is the repetition period of the biphasic pulse, i.e. the time span in between the beginning of two consecutive rectangular biphasic pulses.
• the device is portable and configured for self-support on a person’s forehead.
• the portable device m ay comprise an electrode piece and a powering apparatus.
• the powering apparatus m ay be configured for m tract attachment to and m tract detachment from the electrode piece.
• the electrode piece may comprise a pair of spaced self-adhesive conductive gel zones for application to a person’s forehead.
• the powering apparatus is configured for m tract attachm ent to and manual detachm ent from the electrode piece via at least two engaging pairs of metallic contacts.
• the engaging pairs of metallic contacts are thereby further configured for establishing electrical connection between the powering apparatus and the pair of spaced self-adhesive conductive gel zones.
• an engaging pair of m etallic contacts comprises a snap button or a m agnet.
• the electrode piece is configured for application on the person’s forehead in the supraorbital region , thereby covering the afferent paths of the supratrochlear and supraorbital nerves of the ophthalm ic branch of the trigem inal nerve.
• the device com prises a powering apparatus configured for determ ining an im pedance for electrical current transfer, whereby the powering apparatus is further configured for aborting treatm ent upon determ ining an im pedance above a predefined threshold.
• the device comprises at least one physiological sensor. The device is configured for aborting treatment and/or adapting one or more treatment parameters based at least in part on a signal obtained from said at least one physiological sensor.
• the device comprises a powering apparatus configured for retaining a battery.
• the powering apparatus may retain a battery.
• the battery may be rechargeable.
• the powering apparatus may comprise a USB port for recharging the battery.
• the USB port may also allow for transferring treatment parameters to the powering apparatus and/or receiving information about a treatment session from the powering apparatus.
• the powering apparatus may comprise a contactless recharging module for inductively or capacitively recharging the battery.
• Figures 6A and 6B show an embodiment of a powering apparatus of a device according to the present invention.
• Figure 7 shows an embodiment of an electrode piece (30) of a device according to the present invention, applied to a person’s forehead in the supraorbital region (20).
• Figure 8 shows a self-supporting device attached to a person’s forehead, comprising a powering apparatus according to Figures 6A and 6B and an electrode piece according to Figure 7.
• the powering apparatus comprises an upper part (2) and a lower part (3) which may be relatively fixed.
• the lower part (3) comprises a control opening (5) through which at least one control means (5’), such as a button for example, may protrude.
• the lower part (3) furthermore comprises two magnet openings (6), through each of which a magnet (6’) may protrude.
• the lower part (3) furthermore also comprises a micro-USB opening (7) through which a micro-USB port (7’) may protrude.
• the electrode piece (30) comprises a front side and a back side. At the back side (not shown), the electrode piece (30) comprises a pair of spaced self-adhesive conductive gel zones for application to a person’s forehead. At the front side, the electrode piece (30) comprises a pair of metallic contacts, preferably magnetic metallic contacts, comprising a relative distance corresponding to the magnet openings (6) of the powering apparatus. Each metallic contact is electrically connected to a self-adhesive conductive gel zone. The device is via the magnets and metallic contacts configured for removable attachment of the powering apparatus to the electrode piece.
• the upper and lower parts (2, 3) provide for an internal space for housing a printed circuit board (PCB) (10) and a battery (11).
• Mechanical movement of the control means (5’) may be transferred via an intermediary component (5”) to the PCB (10), where said mechanical movement may be converted to suitable impedance (resistance, capacitance, inductance), voltage and/or current changes.
• the battery (11) may be connected via at least two wires (12) to the PCB (10).
• the PCB comprises two contact blades (6”) configured for retaining the battery against the PCB and further each configured for contact with a magnet (6’).
• the PCB further comprises a microcontroller unit (15) and a tangible non- transitory computer-readable storage medium.
• the micro-USB port allows for recharging the battery and for transferring treatment parameters and/or other information to and/or from the powering device.
• the PCB is configured for:
• a predefined region of interest e.g. a resistance above a predefined threshold

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• 2018
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