WO2020223942A1 - 一种用于大脑功能检测与治疗的一体化tms线圈拍 - Google Patents

一种用于大脑功能检测与治疗的一体化tms线圈拍 Download PDF

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WO2020223942A1
WO2020223942A1 PCT/CN2019/086108 CN2019086108W WO2020223942A1 WO 2020223942 A1 WO2020223942 A1 WO 2020223942A1 CN 2019086108 W CN2019086108 W CN 2019086108W WO 2020223942 A1 WO2020223942 A1 WO 2020223942A1
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Prior art keywords
coil
optical fiber
brain function
mounting holes
fiber probe
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PCT/CN2019/086108
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English (en)
French (fr)
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孙聪
王波
蔡胜安
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武汉资联虹康科技股份有限公司
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Priority to EP19928235.1A priority Critical patent/EP3906840A4/en
Priority to US17/284,156 priority patent/US20210330987A1/en
Priority to CN201980001075.2A priority patent/CN110392594B/zh
Priority to PCT/CN2019/086108 priority patent/WO2020223942A1/zh
Publication of WO2020223942A1 publication Critical patent/WO2020223942A1/zh

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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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
    • A61B5/004—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for image acquisition of a particular organ or body part
    • A61B5/0042—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for image acquisition of a particular organ or body part for the brain
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0075—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy
    • 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
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B6/00—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings
    • G02B6/24—Coupling light guides
    • G02B6/36—Mechanical coupling means
    • G02B6/3616—Holders, macro size fixtures for mechanically holding or positioning fibres, e.g. on an optical bench
    • H—ELECTRICITY
    • H05—ELECTRIC TECHNIQUES NOT OTHERWISE PROVIDED FOR
    • H05K—PRINTED CIRCUITS; CASINGS OR CONSTRUCTIONAL DETAILS OF ELECTRIC APPARATUS; MANUFACTURE OF ASSEMBLAGES OF ELECTRICAL COMPONENTS
    • H05K7/00—Constructional details common to different types of electric apparatus
    • H05K7/20—Modifications to facilitate cooling, ventilating, or heating
    • H05K7/20218—Modifications to facilitate cooling, ventilating, or heating using a liquid coolant without phase change in electronic enclosures
    • H—ELECTRICITY
    • H05—ELECTRIC TECHNIQUES NOT OTHERWISE PROVIDED FOR
    • H05K—PRINTED CIRCUITS; CASINGS OR CONSTRUCTIONAL DETAILS OF ELECTRIC APPARATUS; MANUFACTURE OF ASSEMBLAGES OF ELECTRICAL COMPONENTS
    • H05K7/00—Constructional details common to different types of electric apparatus
    • H05K7/20—Modifications to facilitate cooling, ventilating, or heating
    • H05K7/20218—Modifications to facilitate cooling, ventilating, or heating using a liquid coolant without phase change in electronic enclosures
    • H05K7/20272—Accessories for moving fluid, for expanding fluid, for connecting fluid conduits, for distributing fluid, for removing gas or for preventing leakage, e.g. pumps, tanks or manifolds

Definitions

  • the invention belongs to the technical field of brain function detection and transcranial magnetic stimulation diagnosis and treatment equipment, and in particular is an integrated TMS coil beat for brain function detection and treatment.
  • Transcranial magnetic stimulation diagnosis and treatment technology is a new technology for non-invasive cerebral cortex stimulation and modulation that appeared after 1985. It has been widely used in brain science research and clinical diagnosis and treatment; TMS uses impulse transient magnetic fields to pass through without hindrance and pain In the skull, induced currents are generated in the skull to stimulate the cerebral cortical nerves to produce a series of physiological and biochemical reactions. TMS affects all levels of molecules, synapses, cells, networks, functional areas, system structures, and decision-making behaviors in neuroscience; in recent years, it has received increasing attention in the fields of rehabilitation medicine, psychiatry, and neuroscience. And scientific research has been gradually promoted.
  • TMS modulating nerve function is to use different stimulation modes and stimulation parameters to act on local nerves and networks, to regulate the strength of synaptic connections of nerves in both directions, that is, to modulate the long-term enhancement or long-term inhibition of nerve function, and to adjust the excitability of nerves in both directions. , Regulate local cerebral blood flow and metabolism, and use this to regulate nerve function and treat neurological dysfunction diseases.
  • TMS is often used to stimulate the motor area of the cerebral cortex, which can make the target muscle controlled by the motor nerve contract and shake.
  • the amplitude of the motor evoked potential on the target muscle is often used to detect the stimulation effect, to determine the stimulation parameters, and to artificially interfere with the nerve function according to the predetermined target.
  • the effect of conventional high-frequency stimulation is affected by many factors. These uncertain factors require the correct choice of stimulation mode and parameters.
  • the stimulation position cannot be determined. Changes in oxygen consumption make it difficult to determine the effect of TMS on the stimulation site, and it is difficult to determine the therapeutic effect of TMS, which hinders the application, development and promotion of TMS.
  • the Chinese patent with publication number CN103007432B discloses an integrated device for brain function modulation and detection on July 1, 2015.
  • a silicone sleeve is placed on the surface of the transcranial magnetic stimulation coil, and the inner and outer rings of the silicone sleeve The ring has several holes at different distances to facilitate the insertion of the near-infrared transmitting and receiving probes.
  • the near-infrared brain function detection device uses a microprocessor to set the frequency of the near-infrared emission and reception of the two wavelengths of 690nm and 830nm, and uses the time-division multiplexing mode to sequentially light up several LD/LEDs distributed in the center of the stimulation coil The light source is emitted, and the signals detected by the surrounding probes are processed and displayed on the LCD screen to display the changes in oxygenated hemoglobin and blood flow, reflecting the strength, range and depth of the functional activities of the brain regions corresponding to each detection channel during transcranial magnetic stimulation.
  • the coil shot in the prior art still has many problems to be solved urgently. For example, how to arrange the probe to perfectly integrate the detection area of the optical fiber probe and the treatment area of the TMS coil, so as to achieve the best treatment effect and detection effect. Ensure that the fiber optic probe and the TMS coil structure do not interfere with each other; how to enhance the comfort of the patient in the process of receiving treatment and testing; and the TMS coil generates a lot of heat when working, how to arrange the heat dissipation system to ensure good heat dissipation effect, and at the same time Does not affect the internal structure of the TMS coil beat.
  • the purpose of the present invention is to solve the problems existing in the prior art and provide an integrated TMS coil shot for brain function detection and treatment.
  • the optical fiber probe is installed on the TMS coil shot, and the near-infrared brain function imager is used to detect and treat in real time. According to the treatment effect, the stimulation parameters of the TMS coil are adjusted to achieve the optimal treatment effect.
  • An integrated TMS coil pat used for brain function detection and treatment comprising a coil housing in which a "8"-shaped coil is arranged, and two waist-shaped bosses are arranged on the coil housing, The two waist-shaped bosses are embedded in the two inner circles of the coil to limit the position of the coil; the two waist-shaped bosses are respectively provided with two mounting holes, and the outer ring of the coil is , The lower side is provided with two mounting holes; each of the mounting holes is provided with an optical fiber seat for installing the optical fiber probe; the inside of the coil housing is provided with a silicone skin, and the silicone skin is provided with 8 through holes , The positions of the eight through holes correspond to the positions of the eight mounting holes on the coil housing, and the through holes on the silicone rubber cover the inside of the optical fiber holder to limit the movement of the optical fiber holder; The wire passes through the bottom of the coil housing and is connected to the transcranial magnetic stimulator; the signal end of the optical fiber probe is connected to the near-infrared brain functional imager, and the detection
  • the positions of the eight mounting holes on the coil housing are defined as: taking the center point of the coil as the origin, the horizontal direction as the X axis, and the vertical direction as the Y axis to establish a plane rectangular coordinate system;
  • the coordinates of the mounting holes on the waist-shaped bosses from left to right are: (-45, 0), (-15, 0), (15, 0) and (45, 0); on the outer ring of the coil
  • the coordinates of the two mounting holes on the side from left to right are: (-15, 30) and (15, 30);
  • the coordinates of the two mounting holes on the lower side of the coil outer ring from left to right are: ( -15, -30) and (15, -30);
  • the two mounting holes on the waist-shaped boss are arranged close to the edge of the inner ring of the coil, and the 4 mounting holes on the upper and lower sides of the outer ring of the coil housing It is arranged close to the edge of the outer ring of the coil; through this arrangement, the treatment area of
  • the optical fiber probe includes 4 transmitting optical fiber probes and 4 receiving optical fiber probes; the 8 mounting holes are used to install 4 transmitting optical fiber probes and 4 receiving optical fiber probes respectively; The two mounting holes are respectively used to install a transmitting optical fiber probe and a receiving optical fiber probe; the two mounting holes on the upper/lower side of the coil outer ring are respectively used to install a transmitting optical fiber probe and a receiving optical fiber probe.
  • the coil is wound by a hollow copper tube, and the inside of the hollow copper tube is used to circulate cooling liquid;
  • the part where the coil is connected to the transcranial magnetic stimulator is provided with a water inlet and a water outlet, and the inlet The water port and the water outlet are respectively connected to the two ports of the hollow copper tube;
  • the transcranial magnetic stimulator is provided with a transcranial magnetic stimulation main body, a water pump, a water tank and a radiator;
  • the water pump is respectively connected with the water tank and the water inlet, so
  • the radiator is respectively connected with the water outlet and the water tank;
  • the cooling liquid circulates in the water tank, the hollow copper tube, and the radiator to dissipate the heat of the coil; by passing the cooling liquid into the hollow copper tube, the hollow copper tube also serves as the TMS coil Used with the cooling water pipe, it saves the space inside the TMS coil and improves the heat dissipation effect.
  • the optical fiber holder includes a ring-shaped boss and a nut, the nut and the ring-shaped boss are connected by threads; the inner diameter of the ring-shaped boss is slightly smaller than the outer diameter of the optical fiber probe, and is used to cover the optical fiber;
  • the outer diameter of the upper part of the ring boss is larger than the diameter of the through hole on the silicone rubber, and the through hole on the silicone rubber is sleeved on the upper part of the ring boss; the optical fiber seat can be elastic in the silicone rubber along the perforation direction of the mounting hole.
  • the silicone rubber can fix the fiber holder while allowing the fiber holder to have a certain movement space; it is convenient for the fiber probe to fit the patient's scalp more closely to prevent the fiber probe from falling off and affecting the test results At the same time, it will not cause damage to the patient's scalp due to excessive compression.
  • the end of the optical fiber probe in contact with the patient's scalp is provided with a buffer silicone head, which is used to buffer the damage of the optical fiber probe to the patient's scalp and improve the comfort of the patient.
  • the optical fiber holder is made of non-metallic material, and its purpose is to avoid interference with the magnetic field generated by the TMS coil, thereby affecting the therapeutic effect.
  • a number of cable tie holes are provided on the side of the coil housing, the function of which is to fix the TMS coil rack with the patient's head through the cable tie or ribbon passing through the cable tie hole, and prevent the TMS coil rack from sticking to the patient's head. Not close together.
  • the front of the coil housing is a concave curved surface, and the radius of the concave curved surface is 100 mm; the front of the coil housing is set as a concave curved surface to make the TMS coil beat more closely fit the human head.
  • the coil housing is made of insulating and heat-insulating material.
  • the present invention Compared with the prior art, the present invention has the following beneficial effects: (1) The present invention installs the optical fiber probe by setting a mounting hole on the coil housing, and the signal end of the optical fiber probe is connected with the near-infrared brain function imager, thereby achieving In the process of magnetic stimulation treatment with TMS coil, the treatment effect is detected in real time by the near-infrared brain function imager, and the parameters of the TMS coil are adjusted according to the treatment effect, thereby greatly improving the treatment effect of the TMS coil; (2) the coil shell of the present invention The installation arrangement of the optical fiber probe on the body and the TMS coil do not bother each other, work independently and at the same time, make full use of the internal space of the coil beat, and greatly reduce the volume of the TMS coil beat; and the optical fiber probes are all close to the inside of the TMS coil.
  • the edge arrangement of the ring/outer ring makes the detection area of the optical fiber probe overlap with the treatment area of the TMS coil to the greatest extent, real-time feedback of detection and treatment, mutual confirmation, thereby improving the accuracy of detection and the effectiveness of treatment;
  • the invented optical fiber probe is embedded in the through hole of the silicone rubber through the fiber holder, so that the optical fiber probe can only make linear reciprocating movement along the perforation direction of the mounting hole on the coil housing within the elastic limit of the silicone rubber, which is convenient for the optical fiber probe and The patient’s scalp fits more closely to prevent the optical fiber probe from falling off and affecting the test results, and at the same time, it will not cause damage to the patient’s scalp due to excessive compression;
  • the present invention passes cooling liquid into the coil (hollow copper tube) , To dissipate the heat of the TMS coil, and the hollow copper tube is used as the TMS coil and the cooling water pipe at the same time, which saves the space inside the TMS coil and improves the heat dissipation effect.
  • FIG. 1 is a schematic diagram of the overall structure of an integrated TMS coil beat for brain function detection and treatment of the present invention
  • Figure 2 is a schematic diagram of the structure of the optical fiber holder in the present invention.
  • FIG. 3 is a schematic diagram of the arrangement structure of the mounting holes on the coil housing and the coil in the present invention.
  • Figure 4 is a schematic diagram of the distribution of through holes on the silica gel skin in the present invention.
  • FIG. 5 is a schematic diagram of the connection between the TMS coil beat and the transcranial magnetic stimulator and the near-infrared brain function imaging device in the embodiment of the present invention
  • Coil housing 1. Coil; 2. Coil; 3. Waist-shaped boss; 4. First mounting hole; 5. Second mounting hole; 6. Optical fiber probe; 7. Optical fiber holder; 8. Buffer silicone head; 9. Cable tie hole; 10. Ring boss; 11. Screw cap; 12. Silicone rubber; 13. Through hole; 14. Transcranial magnetic stimulator; 15. Near-infrared brain function imaging device.
  • this embodiment provides an integrated TMS coil beat for brain function detection and treatment, which includes a coil housing 1 with an "8" shape inside the coil housing 1.
  • Coil 2 the coil housing 1 is provided with two waist-shaped bosses 3, and the two waist-shaped bosses 3 are embedded in the two inner rings of the coil 2 to limit the position of the coil 2;
  • the two waist-shaped bosses 3 are respectively provided with two mounting holes, and the outer ring of the coil 2 is respectively provided with two mounting holes on the upper and lower sides;
  • the mounting holes are each provided with an optical fiber holder 7 for Install the optical fiber probe 6;
  • the coil housing 1 is provided with a silicone rubber 12, and the silicone rubber 12 is provided with 8 through holes 13, and the positions of the 8 through holes 13 are respectively the same as those on the coil housing 1.
  • the position of the mounting hole corresponds to the position of the mounting hole.
  • the through hole 13 on the silicone rubber 12 is sleeved inside the fiber holder 7 to limit the movement of the fiber holder 7; the lead wire of the coil 2 passes through the bottom of the coil housing 1 and connects to the transcranial magnet.
  • the stimulator 14 is connected; the signal end of the optical fiber probe 6 is connected to the near-infrared brain function imager 15, and the detection end of the optical fiber probe 6 passes through the back and the front of the coil housing 1, and is arranged on the coil housing 1
  • the internal optical fiber holder 7 and the silicone rubber 12 restrict the movement of the optical fiber probe 6; the detection principle of the near-infrared functional brain imager 15 and the working principle of the transcranial magnetic stimulation diagnosis and treatment equipment are all existing technologies, so there is not much here. Explain.
  • the positions of the eight mounting holes on the coil housing 1 are defined as: taking the center point of the coil 2 as the origin, the horizontal direction as the X axis, and the vertical direction as the Y axis, establishing Plane rectangular coordinate system; the coordinates of the mounting holes on the two waist-shaped bosses 3 from left to right are: (-45, 0), (-15, 0), (15, 0) and (45, 0); The coordinates of the two mounting holes on the upper side of the outer ring of the coil 2 from left to right are: (-15, 30) and (15, 30); the two mounting holes on the lower side of the outer ring of the coil 2 The coordinates of the holes from left to right are: (-15, -30) and (15, -30); the two mounting holes on the waist-shaped boss 3 are arranged next to the edge of the inner ring of the coil 2.
  • the four mounting holes on the upper and lower sides of the outer ring of the coil housing 1 are arranged close to the outer ring edge of the coil 2; the edge extreme point coordinates of the coil 2 in the left, right, up and down directions are: (- 65,0), (65,0), (-30,32.5)/(30,32.5) and (-30,-32.5)/(30,-32.5); through this arrangement, the coil 2 can be
  • the treatment area overlaps with the detection area of the optical fiber probe 6 to the utmost extent, thus ensuring the detection and treatment effects, while also making full use of the space inside the TMS coil shot.
  • the detection and treatment operate independently and synchronously without interfering with each other.
  • the optical fiber probe 6 includes four transmitting optical fiber probes and four receiving optical fiber probes; the eight mounting holes include four first mounting holes 4 and four second mounting holes 5, and the first mounting holes 4 is used to install the transmitting optical fiber probe, the second mounting hole 5 is used to install the receiving optical fiber probe; the left mounting hole on the waist-shaped boss 3 is the first mounting hole 4, which is used to install the transmitting optical fiber probe; The mounting hole on the right side of the waist-shaped boss 3 is the second mounting hole 5, which is used to install the receiving optical fiber probe; the mounting hole on the left side of the upper/lower side of the coil 2 is the first mounting hole 4, which is used to install the transmitter Optical fiber probe; the mounting hole on the upper/lower right side of the outer ring of the coil 2 is the second mounting hole 5 for installing and receiving the optical fiber probe.
  • the eight mounting holes include four first mounting holes 4 and four second mounting holes 5, and the first mounting holes 4 is used to install the transmitting optical fiber probe, the second mounting hole 5 is used to install the receiving optical fiber probe;
  • the optical fiber holder 7 includes an annular boss 10 and a nut 11, the nut 11 and the annular boss 10 are connected by threads; the inner diameter of the annular boss 10 is slightly smaller than the optical fiber probe The outer diameter of 6 is used to cover the optical fiber; the outer diameter of the upper part of the ring boss 10 is larger than the diameter of the through hole 13 on the silicone rubber 12, and the through hole 13 on the silicone rubber 12 is sleeved on the ring boss 10.
  • the upper part of the optical fiber holder 7 can be linearly reciprocated within the elastic limit of the silicone rubber 12 along the perforation direction of the mounting hole; the silicone rubber 12 plays a fixed role on the optical fiber holder 7, while allowing the optical fiber holder 7 to have a certain Movement space; it is convenient for the optical fiber probe 6 to fit closer to the patient's scalp, preventing the optical fiber probe 6 from falling off and affecting the detection results, and at the same time, it will not cause damage to the patient's scalp due to excessive compression;
  • the eight through holes 13 on the silicone rubber 12 are respectively sleeved on the annular bosses 10 of the eight fiber holders 7, and then the nut 11 is tightened; then the coil 2 Place in the coil housing 1, and clamp the two inner rings of the coil 2 through the two waist-shaped bosses 3; then place the silicone rubber 12 on the coil 2, so that the 8 through holes 13 on the silicone rubber 12 are paired
  • the 8 mounting holes on the quasi-shell, and then 8 optical fiber probes 6 are inserted through the back cover of the coil housing 1 and inserted into the optical fiber holder 7, and pass through the front of the coil housing 1 about 3 cm; then cover the coil housing 1. cover.
  • the end of the optical fiber probe 6 in contact with the patient’s scalp is provided with a buffer silicone head 8, which is used to buffer the damage caused by the silicone probe to the patient’s scalp and improve the patient’s comfort; the buffer silicone head 8 is dark and can Play a certain role in avoiding light and prevent the interference of external light, thereby further improving the accuracy of detection.
  • the optical fiber holder 7 is made of non-metallic material, and its purpose is to avoid interference with the magnetic field generated by the TMS coil 2, thereby affecting the therapeutic effect.
  • the side of the coil housing 1 is provided with a number of tie holes 9 whose function is to fix the TMS coil pat with the patient's head through the tie or ribbon through the tie hole 9 to prevent the TMS coil pat from contacting the patient.
  • the head does not fit tightly.
  • the front of the coil housing 1 is a concave curved surface, and the radius of the concave curved surface is 100 ⁇ 10mm; the front of the coil housing 1 is set as a concave curved surface in order to make the TMS coil beat and the human head More fit.
  • This embodiment provides an integrated TMS coil beat for brain function detection and treatment.
  • the coil 2 is wound by a hollow copper tube.
  • the inside of the hollow copper tube is used to circulate cooling liquid;
  • the part where the coil 2 is connected to the transcranial magnetic stimulator 14 is provided with a water inlet and a water outlet, and the water inlet and the water outlet are respectively connected to the two ports of the hollow copper tube
  • the transcranial magnetic stimulator 14 is provided with a transcranial magnetic stimulation host, a water pump, a water tank, and a radiator; the water pump is connected to the water tank and the water inlet, and the radiator is connected to the water outlet and the water tank;
  • the cooling liquid circulates in the water tank, hollow copper tube, and radiator to dissipate heat for coil 2.
  • the hollow copper tube is used as a TMS coil and a cooling water tube at the same time, which saves the internal heat of the TMS coil. Space, while improving the heat dissi
  • the TMS coil beat When it is necessary to disassemble the TMS coil beat from the transcranial magnetic stimulator 14, a water pump must be used for drainage treatment, and the TMS coil beat can be removed only after the coolant inside the TMS coil is drained; the water pump of this embodiment , The radiator runs synchronously with the transcranial magnetic stimulation host. When the TMS coil is energized, the coolant will be introduced to dissipate the coil 2, which can effectively reduce the temperature of the TMS coil during operation;
  • the radiator includes a heat dissipation pipe and a heat dissipation fan, and the heat dissipation fan is used to radiate the heat in the heat dissipation pipe to the outside air.

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Abstract

一种用于大脑功能检测与治疗的一体化TMS线圈拍，包括线圈壳体（1），线圈壳体（1）内部设有"8"字形线圈（2），线圈壳体（1）上设有两个腰型凸台（3）用于限制线圈（2）的位置，线圈壳体（1）上设有8个安装孔，安装孔内均设有光纤座（7），用于安装光纤探头（6）；线圈壳体（1）内部设有硅胶皮（12），用于限制光纤座（7）的运动；线圈（2）的引出线穿过线圈壳体（1）底部与经颅磁刺激仪（14）相连；光纤探头（6）的信号端与近红外脑功能成像仪（15）连接。该装置将光纤探头（6）安装在TMS线圈拍上，通过近红外脑功能成像仪（15）实时检测治疗效果，并根据治疗效果调整TMS线圈的刺激参数，从而达到最优的治疗效果。

Description

一种用于大脑功能检测与治疗的一体化TMS线圈拍 技术领域
本发明属于大脑功能检测与经颅磁刺激诊疗设备技术领域，具体是一种用于大脑功能检测与治疗的一体化TMS线圈拍。
背景技术
经颅磁刺激诊疗技术是1985年以后出现的无创性大脑皮质刺激和调制的新技术，在脑科学研究与临床诊断、治疗方面得到广泛的应用；TMS用脉冲瞬变的磁场无阻无痛穿过颅骨，在颅内产生感应电流刺激大脑皮质神经而产生一系列生理作用和生化反应。TMS在神经科学中影响到分子、突触、细胞、网络、功能区、系统结构以及决策行为的各个层次；近年来，在康复医学、精神医学、神经科学等领域日益受到人们的重视，在临床和科研方面已被逐渐推广。
TMS调制神经功能的原理是用不同刺激模式和刺激参数作用于局部神经和网络，双向调控神经的突触连接强度，即调制神经功能的长时程增强或长时程抑制，双向调节神经兴奋性，调节局部脑血流量和新陈代谢，并以此来调控神经功能，治疗神经功能障碍性疾病。
TMS常用于刺激大脑皮质运动区，可以使运动神经控制的靶肌收缩抖动，常用靶肌上的运动诱发电位的幅度来检测刺激效果，来决定刺激参数、按照预定目标，人为的干预神经功能来调制运动神经的兴奋性；现在又发现刺激大脑其余部位，(如额叶背外侧、颞叶、顶叶)可以治疗一些神经精神功能障碍性疾病，如抑郁症、精神分裂症等等，但是刺激这些部位没有靶器官可以检测到刺激效果，常规的高频刺激的效果受到多因素的影响，这些不确定因素需要正确的选择刺激模式和参数，如果不能实时检测到刺激效果，不能确定刺激部位的耗氧量的变化就难以确定TMS对刺激部位的影响，难以确定TMS的治疗效果，妨碍了TMS的应用、发展与推广。
因为大脑的兴奋与活动使代谢增加，耗氧量增加；目前只有用功能性磁共振和正电子发射计算机断层扫描成像系统来检测TMS刺激大脑非运动区对脑血流与生化代谢的改变来判断TMS刺激后的治疗效果；但这两种设备都十分昂贵，检测时间长、在检测过程中头部不能移动，且不能在治疗的过程中实时检测治疗效果，不能根据实时的治疗效果来调节TMS磁刺激治疗的参数，从而降低了治疗效果。
公开号为CN103007432B的中国专利于2015年7月1日公开了一种大脑功能调制与检测的一体化装置，在经颅磁刺激线圈的表面套上一层硅胶套，硅胶套的内圈和外圈设有 若干个距离不同的孔洞，便于近红外发射与接收的探头插入，利用硅胶的弹性，可牢固握持探头并能随意调节探头的上下方位，保证探头与检测部位的头皮紧密接触；微型近红外脑功能检测装置用微处理器设定690nm、830nm两种波长的近红外线分别发射与接收的频率，采用分时复用模式依次轮流点亮分布在刺激线圈中心部位的若干个LD/LED发射光源，周围探头检测到的信号经过处理在液晶屏上显示出去氧血红蛋白和血流量的变化，反映经颅磁刺激时各检测通道部位所对应脑区功能活动的强弱、范围与深度发生的变化。现有技术中的线圈拍还存在诸多亟待解决的问题，例如探头布置方案，如何布置探头才能将光纤探头的检测区域与TMS线圈的治疗区域完美融合，使治疗效果和检测效果达到最佳，同时保证光纤探头和TMS线圈结构互不干扰；如何增强患者在接受治疗、检测过程中的舒适度；且TMS线圈在工作时产生的热量较大，如何布置散热系统才能即保证良好的散热效果，同时不影响TMS线圈拍内部结构。
发明内容
本发明的目的是针对现有技术存在的问题，提供一种用于大脑功能检测与治疗的一体化TMS线圈拍，将光纤探头安装在TMS线圈拍上，通过近红外脑功能成像仪实时检测治疗效果，并根据治疗效果调整TMS线圈的刺激参数，从而达到最优的治疗效果。
为实现上述目的，本发明采用的技术方案是：
一种用于大脑功能检测与治疗的一体化TMS线圈拍，包括线圈壳体，所述线圈壳体内部设有“8”字形线圈，所述线圈壳体上设有两个腰型凸台，所述两个腰型凸台嵌设在线圈的两个内圈中，用于限制线圈的位置；所述两个腰型凸台上分别设有两个安装孔，所述线圈的外圈上、下侧分别设有两个安装孔；所述安装孔内均设有光纤座，用于安装光纤探头；所述线圈壳体内部设有硅胶皮，所述硅胶皮上设有8个通孔，所述8个通孔的位置分别与线圈壳体上8个安装孔的位置对应，所述硅胶皮上的通孔套在光纤座内部，用于限制光纤座的运动；所述线圈的引出线穿过线圈壳体底部与经颅磁刺激仪相连；所述光纤探头的信号端与近红外脑功能成像仪连接，所述光纤探头的探测端穿过线圈壳体的背面和正面，通过设置在所述线圈壳体内部的光纤座和硅胶皮限制所述光纤探头的运动。
具体地，所述线圈壳体上8个安装孔的位置定义为：以所述线圈的中心点为原点，水平方向为X轴，竖直方向为Y轴，建立平面直角坐标系；所述两个腰型凸台上的安装孔从左到右的坐标分别为：(-45，0)、(-15，0)、(15，0)和(45，0)；所述线圈外圈上侧的两个安装孔从左到右的坐标分别为：(-15，30)和(15，30)；所述线圈外圈下侧的两个安装孔从左到右的坐标分别为：(-15，-30)和(15，-30)；所述腰型凸台上 的两个安装孔紧挨线圈的内圈边缘布置，所述线圈壳体外圈上、下侧的4个安装孔紧挨线圈的外圈边缘布置；通过这种布置方式，可以使线圈的治疗区域与光纤探头的检测区域最大限度的重合，从而保证了检测、治疗效果的同时，还充分利用了TMS线圈拍内部的空间，检测和治疗独立同步运行，互不干扰。
具体地，所述光纤探头包括4个发射光纤探头和4个接收光纤探头；所述8个安装孔分别用于安装4个发射光纤探头和4个接收光纤探头；所述腰型凸台上的两个安装孔分别用于安装一个发射光纤探头和一个接收光纤探头；所述线圈外圈上侧/下侧的两个安装孔分别用于安装一个发射光纤探头和一个接收光纤探头。
具体地，所述线圈为空心铜管绕制而成，所述空心铜管内部用于流通冷却液；所述线圈与经颅磁刺激仪连接的部位设有进水口和出水口，所述进水口、出水口分别与空心铜管的两个端口连通；所述经颅磁刺激仪内部设有经颅磁刺激主机、水泵、水箱以及散热器；所述水泵分别与水箱和进水口连通，所述散热器分别与出水口和水箱连通；所述冷却液在水箱、空心铜管、散热器中循环流通，为线圈散热；通过在空心铜管内部通入冷却液，空心铜管同时作为TMS线圈和冷却水管使用，节省了TMS线圈拍内部的空间，同时提升了散热效果。
具体地，所述光纤座包括环形凸台和螺帽，所述螺帽与环形凸台通过螺纹连接；所述环形凸台的内径略小于光纤探头的外径，用于套住光纤；所述环形凸台上部的外径大于所述硅胶皮上通孔的口径，所述硅胶皮上的通孔套在环形凸台的上部；所述光纤座可沿安装孔的穿孔方向在硅胶皮的弹性限度内做直线往复运动；硅胶皮对光纤座起到固定的作用，同时又允许光纤座有一定的活动空间；方便光纤探头与患者头皮更紧密的贴合，防止光纤探头脱落给检测结果造成影响，同时又不至于因为压迫过紧对患者头皮造成损伤。
具体地，所述光纤探头与患者头皮接触的一端设有缓冲硅胶头，用于缓冲光纤探头对患者头皮造成的损伤，提升患者的舒适度。
具体地，所述光纤座为非金属材质，其目的是避免对TMS线圈产生的磁场造成干扰，从而影响治疗效果。
具体地，所述线圈壳体的侧面设有若干扎带孔，其作用是通过扎带或丝带穿过扎带孔将TMS线圈拍与患者头部进行固定，防止TMS线圈拍与患者头部贴合不紧密。
具体地，所述线圈壳体正面为凹弧面，所述凹弧面的半径为100mm；将所述线圈壳体正面设为凹弧面是为了使TMS线圈拍与人体头部更加贴合。
具体地，所述线圈壳体为绝缘、隔热材质。
与现有技术相比，本发明的有益效果是：(1)本发明通过在线圈壳体上设置安装孔来安装光纤探头，光纤探头的信号端与近红外脑功能成像仪连接，从而实现在TMS线圈进行磁刺激治疗的过程中，通过近红外脑功能成像仪实时检测治疗效果，再根据治疗效果调节TMS线圈的参数，从而极大地提升了TMS线圈的治疗效果；(2)本发明线圈壳体上光纤探头的安装布置与TMS线圈互不烦扰，独立且同时工作，充分地利用了线圈拍的内部空间，极大地缩减了TMS线圈拍的体积；且光纤探头都是紧挨TMS线圈的内圈/外圈边缘布置，使得光纤探头的检测区域与TMS线圈的治疗区域最大限度的重合，检测与治疗实时反馈，相互印证，从而提升了检测的准确性和治疗的有效性；(3)本发明的光纤探头通过光纤座嵌设在硅胶皮上的通孔内，使得光纤探头只能在硅胶皮的弹性限度范围内沿线圈壳体上安装孔的穿孔方向做直线往复运动，方便光纤探头与患者头皮更紧密的贴合，防止光纤探头脱落给检测结果造成影响，同时又不至于因为压迫过紧对患者头皮造成损伤；(4)本发明通过在线圈(空心铜管)内部通入冷却液，对TMS线圈进行散热，空心铜管同时作为TMS线圈和冷却水管使用，节省了TMS线圈拍内部的空间，同时提升了散热效果。
附图说明
图1为本发明一种用于大脑功能检测与治疗的一体化TMS线圈拍的整体结构示意图；
图2为本发明中光纤座的结构示意图；
图3为本发明中线圈壳体上安装孔与线圈的布置结构示意图；
图4为本发明中硅胶皮上通孔的分布示意图；
图5为本发明实施例中TMS线圈拍与经颅磁刺激仪、近红外脑功能成像仪的连接示意图；
图中：1、线圈壳体；2、线圈；3、腰型凸台；4、第一安装孔；5、第二安装孔；6、光纤探头；7、光纤座；8、缓冲硅胶头；9、扎带孔；10、环形凸台；11、螺帽；12、硅胶皮；13、通孔；14、经颅磁刺激仪；15、近红外脑功能成像仪。
具体实施方式
下面将结合本发明中的附图，对本发明的技术方案进行清楚、完整地描述，显然，所描述的实施例仅仅是本发明一部分实施例，而不是全部的实施例。基于本发明中的实施例，本领域普通技术人员在没有做出创造性劳动条件下所获得的所有其它实施例，都属于本发明保护的范围。
实施例1
如图1、4、5所示，本实施例提供了一种用于大脑功能检测与治疗的一体化TMS线圈 拍，包括线圈壳体1，所述线圈壳体1内部设有“8”字形线圈2，所述线圈壳体1上设有两个腰型凸台3，所述两个腰型凸台3嵌设在线圈2的两个内圈中，用于限制线圈2的位置；所述两个腰型凸台3上分别设有两个安装孔，所述线圈2的外圈上、下侧分别设有两个安装孔；所述安装孔内均设有光纤座7，用于安装光纤探头6；所述线圈壳体1内部设有硅胶皮12，所述硅胶皮12上设有8个通孔13，所述8个通孔13的位置分别与线圈壳体1上8个安装孔的位置对应，所述硅胶皮12上的通孔13套在光纤座7内部，用于限制光纤座7的运动；所述线圈2的引出线穿过线圈壳体1底部与经颅磁刺激仪14相连；所述光纤探头6的信号端与近红外脑功能成像仪15连接，所述光纤探头6的探测端穿过线圈壳体1的背面和正面，通过设置在所述线圈壳体1内部的光纤座7和硅胶皮12限制所述光纤探头6的运动；近红外脑功能成像仪15的检测原理和经颅磁刺激诊疗设备的工作原理均为现有技术，在此就不多做阐述。
具体地，如图3所示，所述线圈壳体1上8个安装孔的位置定义为：以所述线圈2的中心点为原点，水平方向为X轴，竖直方向为Y轴，建立平面直角坐标系；所述两个腰型凸台3上的安装孔从左到右的坐标分别为：(-45，0)、(-15，0)、(15，0)和(45，0)；所述线圈2外圈上侧的两个安装孔从左到右的坐标分别为：(-15，30)和(15，30)；所述线圈2外圈下侧的两个安装孔从左到右的坐标分别为：(-15，-30)和(15，-30)；所述腰型凸台3上的两个安装孔紧挨线圈2的内圈边缘布置，所述线圈壳体1外圈上、下侧的4个安装孔紧挨线圈2的外圈边缘布置；所述线圈2左、右、上、下四个方向的边缘极值点坐标分别为：(-65，0)、(65，0)、(-30，32.5)/(30，32.5)和(-30，-32.5)/(30，-32.5)；通过这种布置方式，可以使线圈2的治疗区域与光纤探头6的检测区域最大限度的重合，从而保证了检测、治疗效果的同时，还充分利用了TMS线圈拍内部的空间，检测和治疗独立同步运行，互不干扰。
具体地，所述光纤探头6包括4个发射光纤探头和4个接收光纤探头；所述8个安装孔包括4个第一安装孔4和4个第二安装孔5，所述第一安装孔4用于安装发射光纤探头，所述第二安装孔5用于安装接收光纤探头；所述腰型凸台3上左边的安装孔为第一安装孔4，用于安装发射光纤探头；所述腰型凸台3上右边的安装孔为第二安装孔5，用于安装接收光纤探头；所述线圈2外圈上侧/下侧左边的安装孔为第一安装孔4，用于安装发射光纤探头；所述线圈2外圈上侧/下侧右边的安装孔为第二安装孔5，用于安装接收光纤探头。
具体地，如图2所示，所述光纤座7包括环形凸台10和螺帽11，所述螺帽11与环形凸台10通过螺纹连接；所述环形凸台10的内径略小于光纤探头6的外径，用于套住光纤； 所述环形凸台10上部的外径大于所述硅胶皮12上通孔13的口径，所述硅胶皮12上的通孔13套在环形凸台10的上部；所述光纤座7可沿安装孔的穿孔方向在硅胶皮12的弹性限度内做直线往复运动；硅胶皮12对光纤座7起到固定的作用，同时又允许光纤座7有一定的活动空间；方便光纤探头6与患者头皮更紧密的贴合，防止光纤探头6脱落给检测结果造成影响，同时又不至于因为压迫过紧对患者头皮造成损伤；
进一步地，本实施例的TMS线圈拍在组装时，首先将硅胶皮12上的8个通孔13分别套在8个光纤座7的环形凸台10上，再拧紧螺帽11；然后将线圈2放置在线圈壳体1内，通过两个腰型凸台3卡住线圈2的两个内圈；再将硅胶皮12放置在线圈2上，使硅胶皮12上的8个通孔13对准壳体上的8个安装孔，再将8个光纤探头6分别穿过线圈壳体1后盖、插入光纤座7，穿出线圈壳体1正面3cm左右；再盖上线圈壳体1后盖。
具体地，所述光纤探头6与患者头皮接触的一端设有缓冲硅胶头8，用于缓冲硅胶探头对患者头皮造成的损伤，提升患者的舒适度；所述缓冲硅胶头8为深色，可以起到一定的避光作用，防止外界光线的干扰，从而进一步提升检测的准确度。
具体地，所述光纤座7为非金属材质，其目的是避免对TMS线圈2产生的磁场造成干扰，从而影响治疗效果。
具体地，所述线圈壳体1的侧面设有若干扎带孔9，其作用是通过扎带或丝带穿过扎带孔9将TMS线圈拍与患者头部进行固定，防止TMS线圈拍与患者头部贴合不紧密。
具体地，所述线圈壳体1正面为凹弧面，所述凹弧面的半径为100±10mm；将所述线圈壳体1正面设为凹弧面是为了使TMS线圈拍与人体头部更加贴合。
实施例2
本实施例提供了一种用于大脑功能检测与治疗的一体化TMS线圈拍，与上述实施例1的区别点在于，本实施例中，所述线圈2为空心铜管绕制而成，所述空心铜管内部用于流通冷却液；所述线圈2与经颅磁刺激仪14连接的部位设有进水口和出水口，所述进水口、出水口分别与空心铜管的两个端口连通；所述经颅磁刺激仪14内部设有经颅磁刺激主机、水泵、水箱以及散热器；所述水泵分别与水箱和进水口连通，所述散热器分别与出水口和水箱连通；所述冷却液在水箱、空心铜管、散热器中循环流通，为线圈2散热；通过在空心铜管内部通入冷却液，空心铜管同时作为TMS线圈和冷却水管使用，节省了TMS线圈拍内部的空间，同时提升了散热效果；
当需要将所述TMS线圈拍与经颅磁刺激仪14拆开时，首先需要通过水泵进行排液处理，将TMS线圈内部的冷却液排完后才能取下TMS线圈拍；本实施例的水泵、散热器与经 颅磁刺激主机同步运行，当所述TMS线圈通电后即开始通入冷却液对线圈2进行散热，可以有效降低TMS线圈工作时的温度；
进一步地，所述散热器包括散热排管和散热风扇，所述散热风扇用于将散热排管内的热量散发到外界空气中。
尽管已经示出和描述了本发明的实施例，对于本领域的普通技术人员而言，可以理解在不脱离本发明的原理和精神的情况下可以对这些实施例进行多种变化、修改、替换和变型，本发明的范围由所附权利要求及其等同物限定。

Claims (10)

  1. 一种用于大脑功能检测与治疗的一体化TMS线圈拍，其特征在于，包括线圈壳体，所述线圈壳体内部设有“8”字形线圈，所述线圈壳体上设有两个腰型凸台，所述两个腰型凸台嵌设在线圈的两个内圈中，用于限制线圈的位置；所述两个腰型凸台上分别设有两个安装孔，所述线圈的外圈上、下侧分别设有两个安装孔；所述安装孔内均设有光纤座，用于安装光纤探头；所述线圈壳体内部设有硅胶皮，所述硅胶皮上设有8个通孔，所述8个通孔的位置分别与线圈壳体上8个安装孔的位置对应，所述硅胶皮上的通孔套在光纤座内部，用于限制光纤座的运动；所述线圈的引出线穿过线圈壳体底部与经颅磁刺激仪相连；所述光纤探头的信号端与近红外脑功能成像仪连接，所述光纤探头的探测端穿过线圈壳体的背面和正面，通过设置在所述线圈壳体内部的光纤座和硅胶皮限制所述光纤探头的运动。
  2. 根据权利要求1所述的一种用于大脑功能检测与治疗的一体化TMS线圈拍，其特征在于，所述线圈壳体上8个安装孔的位置定义为：以所述线圈的中心点为原点，水平方向为X轴，竖直方向为Y轴，建立平面直角坐标系；所述两个腰型凸台上的安装孔从左到右的坐标分别为：(-45，0)、(-15，0)、(15，0)和(45，0)；所述线圈外圈上侧的两个安装孔从左到右的坐标分别为：(-15，30)和(15，30)；所述线圈外圈下侧的两个安装孔从左到右的坐标分别为：(-15，-30)和(15，-30)。
  3. 根据权利要求2所述的一种用于大脑功能检测与治疗的一体化TMS线圈拍，其特征在于，所述光纤探头包括4个发射光纤探头和4个接收光纤探头；所述8个安装孔分别用于安装4个发射光纤探头和4个接收光纤探头；所述腰型凸台上的两个安装孔分别用于安装一个发射光纤探头和一个接收光纤探头；所述线圈外圈上侧/下侧的两个安装孔分别用于安装一个发射光纤探头和一个接收光纤探头。
  4. 根据权利要求1所述的一种用于大脑功能检测与治疗的一体化TMS线圈拍，其特征在于，所述线圈为空心铜管绕制而成，所述空心铜管内部用于流通冷却液；所述线圈与经颅磁刺激仪连接的部位设有进水口和出水口，所述进水口、出水口分别与空心铜管的两个端口连通；所述经颅磁刺激仪内部设有经颅磁刺激主机、水泵、水箱以及散热器；所述水泵分别与水箱和进水口连通，所述散热器分别与出水口和水箱连通；所述冷却液在水箱、空心铜管、散热器中循环流通，为线圈散热。
  5. 根据权利要求1所述的一种用于大脑功能检测与治疗的一体化TMS线圈拍，其特征在于，所述光纤座包括环形凸台和螺帽，所述螺帽与环形凸台通过螺纹连接；所述环形凸台的内径略小于光纤探头的外径，用于套住光纤；所述环形凸台上部的外径大于所述硅 胶皮上通孔的口径，所述硅胶皮上的通孔套在环形凸台的上部。
  6. 根据权利要求1所述的一种用于大脑功能检测与治疗的一体化TMS线圈拍，其特征在于，所述光纤探头与患者头皮接触的一端设有缓冲硅胶头。
  7. 根据权利要求1所述的一种用于大脑功能检测与治疗的一体化TMS线圈拍，其特征在于，所述光纤座为塑料材质。
  8. 根据权利要求1所述的一种用于大脑功能检测与治疗的一体化TMS线圈拍，其特征在于，所述线圈壳体的侧面设有若干扎带孔。
  9. 根据权利要求1所述的一种用于大脑功能检测与治疗的一体化TMS线圈拍，其特征在于，所述线圈壳体正面为凹弧面，所述凹弧面的半径为100mm。
  10. 根据权利要求1所述的一种用于大脑功能检测与治疗的一体化TMS线圈拍，其特征在于，所述线圈壳体为绝缘、隔热材质。
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