WO2023066020A1 - 用于经颅磁的治疗靶点自动定位方法、系统及头盔 - Google Patents

用于经颅磁的治疗靶点自动定位方法、系统及头盔 Download PDF

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WO2023066020A1
WO2023066020A1 PCT/CN2022/123391 CN2022123391W WO2023066020A1 WO 2023066020 A1 WO2023066020 A1 WO 2023066020A1 CN 2022123391 W CN2022123391 W CN 2022123391W WO 2023066020 A1 WO2023066020 A1 WO 2023066020A1
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transcranial magnetic
helmet
search
transcranial
head
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PCT/CN2022/123391
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English (en)
French (fr)
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孙陈林
谢宇航
高飞
仇凯
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南京伟思医疗科技股份有限公司
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N2/00—Magnetotherapy
    • A61N2/12—Magnetotherapy using variable magnetic fields obtained by mechanical movement
    • 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
    • A61B5/389—Electromyography [EMG]
    • A61B5/395—Details of stimulation, e.g. nerve stimulation to elicit EMG response
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N2/00—Magnetotherapy
    • A61N2/004—Magnetotherapy specially adapted for a specific therapy
    • A61N2/006—Magnetotherapy specially adapted for a specific therapy for magnetic stimulation of nerve tissue

Definitions

  • the invention relates to the medical technical field of transcranial magnetic stimulation, in particular to an automatic positioning method, system and helmet for transcranial magnetic treatment target.
  • Depression is one of the most common mental illnesses, affecting more than 350 million people worldwide, and has become the second largest disease in human health after heart disease. Its main manifestations are low mood, slow thinking, cognitive Obstacles, etc., in severe cases, recurrent suicidal thoughts.
  • depression Treatment for depression is divided into medication, psychotherapy, and physical therapy.
  • depression is mainly treated with drugs to relieve symptoms, but this method is expensive and requires long-term medication, which can easily lead to serious toxic side effects and drug resistance.
  • Psychotherapy requires a lot of time of a large number of professional psychotherapists. At present, there is a huge gap in China and it is difficult to improve in the short term.
  • Physiotherapy is more and more popular because of its non-toxic and side effects, greatly improved consultation rate and treatment efficiency, and obvious therapeutic effect, especially Transcranial Magnetic Stimulation (TMS), which is non-invasive, painless, safe and non-invasive. Intrusive, quick-acting features.
  • TMS Transcranial Magnetic Stimulation
  • Transcranial magnetic stimulation therapy uses pulsed magnetic fields to penetrate the skull, generate induced currents in the brain nerve tissue, and cause depolarization of neurons in the target area to produce physiological effects and achieve the effect of treating depression.
  • the study found that the functional activity of the left dorsolateral prefrontal cortex (DLPFC) was weakened and the functional activity of the right DLPEC was enhanced in depressed users.
  • High-frequency transcranial magnetic stimulation of the left DLPEC to enhance its cortical activity or low-frequency stimulation of the right DLPFC to suppress its cortical activity can improve the symptoms of depressed users.
  • TMS is also a variety of neurological (epilepsy, Parkinson's disease, attention deficit hyperactivity disorder, amyotrophic lateral sclerosis, etc.), mental (personality disorder, schizophrenia, etc.), sports rehabilitation ( Recommended treatment for diseases such as stroke.
  • transcranial magnetic therapy depends on the correct therapeutic target. However, since the target is inside the brain and cannot be seen, it is difficult to determine whether it has been found. At present, the vast majority of transcranial magnetic products require professional physicians to find targets based on anatomical knowledge and medical experience. The operation is cumbersome and usually takes more than 15 minutes to find the target and perform treatment. However, inexperienced doctors are very easy to find the wrong target, and the treatment position is greatly deviated, resulting in poor or even ineffective treatment.
  • the present invention discloses a method and system for automatically finding a treatment target by transcranial magnetism.
  • the method and system for automatically finding the treatment target for depression are realized.
  • the system can find the treatment target within 30 seconds on average, shortening the search time by more than 90%.
  • the operation is simple, the cost is greatly reduced, and the whole process is fully automated, which can effectively improve the therapeutic effect of transcranial magnetic stimulation.
  • the object of the present invention is to provide an automatic positioning method, system and helmet for transcranial magnetic treatment targets.
  • the user wears a transcranial magnetic stimulation helmet, and the target positioning method based on action-evoked potentials collects the motion-induced motion of the contralateral target muscle.
  • the first aspect disclosed in the embodiments of the present invention provides a method for automatic positioning of treatment targets using transcranial magnetism, including the following steps: transcranial magnetic stimulation of brain regions, and collecting skin surface EMG values in corresponding regions according to action-evoked potentials Based on the search algorithm, the coordinates of the transcranial magnetic racket head are updated to find the coordinate point whose EMG value is greater than the judgment threshold to determine that the transcranial magnetic racket head reaches the primary motor cortex area. According to the positional relationship between the primary motor cortex area and the corresponding treatment target, the transcranial The magnetic racket head is positioned to the treatment target.
  • the second aspect disclosed by the embodiments of the present invention provides an automatic positioning system for transcranial magnetic treatment targets, including a signal processing module, a transcranial magnetic stimulation host connected to the signal processing module, a racket head control module and Myoelectric acquisition module; wherein,
  • the myoelectric collection module is used to collect the myoelectric signal on the skin surface of the corresponding area of the user;
  • the signal processing module determines the primary motor cortex area of the brain area and the magnetic stimulation parameters according to the electromyographic signal of the skin surface;
  • the transcranial magnetic stimulation host sends the corresponding magnetic stimulation trigger command to the transcranial magnetic racket head;
  • the racket head control module moves the transcranial magnetic racket head to the designated therapeutic target according to the positional relationship between the primary motor cortex of the brain area and the corresponding therapeutic target.
  • the third aspect disclosed by the embodiments of the present invention provides a helmet for transcranial magnetic magnetic stimulation, including a helmet body, a transcranial magnetic racket head, and a racket head rotation module that controls the rotation of the transcranial magnetic racket head in the helmet body
  • the helmet body includes an upper helmet shell and a lower helmet shell, the upper helmet shell is provided with an arc-shaped guide rail for the front and rear movement of the racket head rotation module, and the racket head rotation module is provided with a magnetic racket head for driving
  • the up and down motion mechanism moves back and forth along the arc-shaped guide rail and the horizontal motion mechanism for driving the helmet upper shell to move left and right along the helmet lower shell.
  • the racket head rotation module is connected to the automatic positioning system for transcranial magnetic treatment targets.
  • the beneficial effects of the present invention include:
  • the treatment target can be found in a short period of time, and the search time can be shortened by more than 90%. Stimulating therapeutic effect.
  • Fig. 1 is the flowchart of the automatic positioning of the treatment target according to the embodiment of the present invention
  • Fig. 2 is a flow chart of updating the coordinates of the head of the transcranial magnetic racket according to the embodiment of the present invention
  • Fig. 3 is the flow chart of the brain area localization algorithm based on dichotomy according to the embodiment of the present invention.
  • Fig. 4 is a flow chart for judging that a new coordinate point enters a standard library according to an embodiment of the present invention
  • Fig. 5 is a schematic diagram of determining an optimal search path according to an M1 coordinate library according to an embodiment of the present invention
  • Fig. 6 is a coordinate point update process diagram during the actual positioning process of the system of the embodiment of the present invention.
  • FIG. 7 is a schematic diagram of updating an optimal search path according to an embodiment of the present invention.
  • Figure 8 is a diagram showing the relationship between head size and height and weight according to an embodiment of the present invention.
  • Fig. 9 is the MEP value of the embodiment of the present invention along with the helmet coordinate distribution figure
  • FIG. 10 is a motor-evoked potential waveform diagram of an embodiment of the present invention.
  • Fig. 11 is a working schematic diagram of the automatic positioning system for therapeutic targets used in transcranial magnetism according to the embodiment of the present invention.
  • Fig. 12 is a schematic diagram of pasting electrodes for collecting motor-evoked potentials of the contralateral target muscle according to the embodiment of the present invention.
  • Fig. 13 is a schematic diagram of the external structure of the helmet of the embodiment of the present invention.
  • Fig. 14 is a schematic diagram of the internal structure of the helmet of the embodiment of the present invention.
  • Fig. 15 is a top view structural schematic diagram of Fig. 14;
  • Fig. 16 is a side view structural schematic diagram of Fig. 14;
  • Fig. 17 is a schematic diagram of the A-A sectional structure of Fig. 16;
  • Fig. 18 is a schematic structural diagram of a weight-reducing support cantilever mechanism according to an embodiment of the present invention.
  • Fig. 19 is a schematic diagram of the use state of the helmet according to the embodiment of the present invention.
  • 3-horizontal movement mechanism 31-the first motor, 32-the first gear, 33-horizontal guide rail; 4-up and down movement mechanism, 41-the first
  • Second motor 42-the second gear, 43-arc guide rail, 44-slider seat; 5-rotary mechanism, 51-the third motor, 52-the third tooth
  • a method for automatic positioning of treatment targets by transcranial magnetism is proposed.
  • Transcranial magnetism stimulates the brain area, and the signal of the contralateral target muscle is collected according to the action-evoked potential.
  • the skin surface EMG value is based on the search algorithm to update the coordinates of the transcranial magnetic racket head to find the coordinate point whose EMG value is greater than the judgment threshold to determine that the transcranial magnetic racket head has reached the primary motor cortex area.
  • the positional relationship positions the transcranial magnetic head to the therapeutic target.
  • the primary motor cortex of the brain moves 5 to 6 cm forward along the scalp and is the target for treatment of depression: the left dorsolateral prefrontal cortex (DLPFC).
  • DLPFC left dorsolateral prefrontal cortex
  • MEP Motor Evoked Potentials
  • transcranial magnetic stimulation of the brain's primary motor cortex M1 can induce involuntary movement of the thumb.
  • the myoelectric collector uses the myoelectric collector to capture the transcranial magnetic head reaches the M1 area.
  • the minimum intensity that causes the M1 brain area to generate action-evoked potential amplitudes greater than the judgment threshold is usually called the motor threshold or reference value, and it is used as the stimulation intensity of other cortex.
  • the system automatically adjusts the magnetic stimulation intensity and records the MEP value until the stimulation intensity for other cortical stimulation treatments is found.
  • the optimal magnetic stimulation intensity as S, usually 100%-0%, and lower the intensity step by step until the MEP value is lower than the judgment threshold MEP_Threshold for the first time, usually set to 50uv, then the last magnetic stimulation intensity is the optimal intensity of magnetic stimulation.
  • D is adjusted from 10 to 0, and MEP_i_0 decreases step by step.
  • MEP_i_0>MEP_Threshold and MEP_i-1_0 ⁇ MEP_Threshold D is determined to be i-1.
  • the present invention has collected the basic information of 11 volunteers and the coordinates of the M1 brain area, and carried out statistical analysis, and found that the head size of adult males has a strong regularity:
  • the size of the head circumference has little relationship with the body weight
  • the size of the head circumference has little relationship with the height
  • the size of head circumference has little relationship with fat and thin (BMI);
  • the length of the sagittal line (from the base of the nose to the back of the occipital) has little to do with body weight;
  • the length of the coronal line (from the left auricular notch to the right auricular notch) has little relationship with body weight;
  • the present invention proposes a dichotomous brain area positioning method based on action evoked potentials: use TMS to stimulate the brain area, collect thumb myoelectricity, and update the next transcranial magnetic shot according to the comparison of myoelectric values corresponding to different coordinates Head coordinates until the target therapeutic target is found.
  • Theta_n is the circumference angle of the helmet
  • R_n is the radius scale of the helmet
  • Alpha_n is the transcranial magnetic shot
  • the spin angle of the head because the spin angle of the transcranial magnetic head has a strong regularity, most of the cases are 35, so the position of the transcranial magnetic head on the helmet is mainly determined by (Theta_n, R_n).
  • the coordinates of the M1 brain area of most people are in a small area, and an optimal search path can be fitted.
  • the formula is:
  • the optimal search path stage has been successfully searched, there is no need to enter the vertical search path stage.
  • Table 1 discloses the MEP-based brain area location statistics of 11 male volunteers:
  • the first stage searching based on the optimal search path
  • L_Scale is the reduction factor on the left side, and the value range is (0,1], and R_Scale is the amplification factor on the right side, and the value range is (1,2].
  • L_Scale is 0.9, and R_Scale is 1.1.
  • the maximum number of searches affects the accuracy and speed of the search coordinates. The larger the maximum number of searches, the higher the accuracy of the final coordinates. At the same time, the number of searches increases and the search time increases.
  • the maximum number of searches Search_Count_Max in the first stage is calculated according to the leftmost search point and the rightmost search point:
  • Search_Count_Max 2+[log 2 (X_max-X_min)] (4)
  • 2 represents the leftmost and rightmost search points
  • [log 2 (X_max-X_min)] is the number of searches required in the middle
  • the search resolution is 1.
  • the second point the abscissa is X_Right, control the racket head to move to the coordinates (Theta_Right, R_Right, Alpha_0), trigger magnetic stimulation, record the myoelectric value Right_Mep of the thumb at this time, if Right_Mep is greater than the judgment threshold Mep_Threshold, the search is successful, Stop searching, set Flag_Success to 1, and set Success_X to X_Right; otherwise, search for the next point.
  • the transcranial magnetic racket head moves to the coordinates (Theta_Mid, R_Mid, Alpha_0)
  • triggers magnetic stimulation and records the muscles of the thumb at this time
  • the electric value Mid_Mep if Mid_Mep is greater than the determination threshold Mep_Threshold, the search is successful, the search is stopped, Flag_Success is set to 1, and Success_X is set to X_Mid.
  • search is unsuccessful, update: If the myoelectric value Left_Mep>Right_Mep, update X_Right to X_Mid, update Right_Mep to Mid_Mep, otherwise, update X_Left to X_Mid, update Left_Mep to Mid_Mep, and search for the next point until the Search_Count_Max point stop.
  • the abscissa Opt_1_X of the first stage search optimal point P_1_Opt is set to X_Mid. If the myoelectric value Left_Mep>Right_Mep, Opt_1_X is updated to X_Left; if Left_Mep ⁇ Right_Mep, Opt_1_X is updated to X_Right.
  • the search success flag Flag_Success is initialized to 0, and the decision threshold Mep_Threshold is set to 50.
  • the second stage search based on vertical search path
  • D_Scale is the reduction coefficient on the left side, and the value range is (0,1], and U_Scale is the amplification factor on the right side, and the value range is (1,2]. Typically, D_Scale takes 0.85, and U_Scale takes 1.15.
  • 3 represents the leftmost search point, the rightmost search point and the last search point to improve the search resolution
  • log 2 (X_Ver_max-X_Ver_min) is the number of searches required in the middle
  • the search resolution is 0.5. According to the experiment, it is better to set the vertical search resolution to one-half of the optimal search resolution.
  • set the intermediate variables X_Ver_Left, X_Ver_Right, X_Ver_Mid initialize X_Ver_Left to X_Ver_Min, and X_Ver_Right to X_Ver_Max.
  • the transcranial magnetic head moves to the coordinates (Theta_Ver_Mid, R_Ver_Mid, Alpha_0)
  • triggers magnetic stimulation and records the muscles of the thumb at this time
  • Electricity value Mid_Ver_Mep if Mid_Ver_Mep is greater than the determination threshold Mep_Threshold, the search is successful and the search is stopped, Flag_Success is set to 1, and Success_X is set to X_Ver_Mid.
  • search is unsuccessful, update: if Left_Ver_Mep>Right_Ver_Mep, update X_Ver_Right to X_Ver_Mid, update Right_Ver_Mep to Mid_Ver_Mep, otherwise, update X_Ver_Left to X_Ver_Mid, update Left_Ver_Mep to Mid_Ver_Mep, and search for the next point until the search reaches the Search_Ver_Count_Max point .
  • the abscissa Opt_1_X of the second-stage search optimal point P_2_Opt is set to X_Ver_Mid. If Left_Ver_Mep>Right_Ver_Mep, Opt_1_X is updated to X_Ver_Left; if Left_Ver_Mep ⁇ Right_Ver_Mep, Opt_2_X is updated to X_Ver_Right.
  • the value Mid_Ver_Mep 55.98 is greater than Mep_Threshold, the search is successful, Flag_Success is set to 1, and Success_X is set to 9.87. Therefore, the abscissa of the successfully searched target is 9.87, and the polar coordinate point converted into the helmet is the target coordinate of the brain area.
  • the coordinates of the transcranial magnetic head are the closest point to the M1 area among all the searched points.
  • the coil of the transcranial magnetic head spins and searches by changing Alpha_n.
  • Alpha_n is initially 35, and the typical values are searched sequentially and arranged according to the frequency of occurrence. Typical values are 30, 40, 0.
  • the spin search After the spin search is completed, if the target point is still not found, it will output the failure of the automatic search, and remind the physician to search manually according to the outlier coordinate library.
  • currently implemented algorithms include analytical classes, such as gradient descent method, Fibonacci method, golden section method, interpolation method, tangent method, dichotomy method, etc.; probability classes, such as simulated annealing, genetic algorithm, tabu search, Ant colony algorithm, etc. and analytic and probabilistic hybrid classes.
  • analytical classes such as gradient descent method, Fibonacci method, golden section method, interpolation method, tangent method, dichotomy method, etc.
  • probability classes such as simulated annealing, genetic algorithm, tabu search, Ant colony algorithm, etc.
  • analytic and probabilistic hybrid classes such as simulated annealing, genetic algorithm, tabu search, Ant colony algorithm, etc.
  • the brain area positioning algorithm based on the dichotomy has the best time complexity and space complexity, which is logarithmic order O(logN).
  • the formula for a point t: t_i a+(b-a)*F_n-i/F_n, search accuracy: (b-a)/F_n.
  • Interpolation method collect the values of points P_i and MEP_i, continuously use a polynomial no more than three times to approximate MEP, and then use the extreme point of the interpolation polynomial to approach the optimal point P_Opt.
  • the present invention discloses in detail the brain region positioning algorithm based on the dichotomy method. Based on the same or similar reasoning, the coordinates of the specific points are determined according to the MEP value. Generally speaking, the method of taking points is to take points in the direction where the MEP value increases , the analytical class, the probabilistic class, and the hybrid algorithm of the analytical class and the probabilistic class can judge whether to find the optimal point P_Opt by the size of the MEP value.
  • the collection electrode was pasted on the first interosseous dorsal muscle of the right hand, and the reference electrode was pasted on the right pisiform bone, with a distance of 2 cm between the two collection electrodes.
  • the stimulation artifact is much larger than the normal MEP value
  • set the stimulation artifact threshold as Artifact_Vpp
  • take the k+Artf time to k +Duration time is the calculation range of Mep, where Artf is the duration of the artifact, which is 0.003 in this case, and Duration is the duration of Mep. If it is 0.03 in this case, the value of Mep is:
  • the optimal search path is the straight line closest to all known user treatment target coordinates, and the selection of its parameters largely affects the speed and accuracy of target coordinate search.
  • an embodiment of the present invention discloses an automatic update algorithm for the optimal search path, records the coordinates of the brain area where the new user successfully locates, and performs a statistical outlier judgment. If it does not belong to the outlier value, it will be stored in the standard coordinate library. The path parameters are then updated. With the increase in the number of treatment users, the data in the coordinate database will gradually increase, the description of the distribution of the brain regions of the crowd will become more and more accurate, the optimal path parameters will be more and more optimized, and the speed of finding the target will be faster and faster. Faster and more accurate.
  • the optimal search path parameters are K_1 and B_1, the distance to the optimal path is Dis_m, and its calculation method is:
  • the coordinates of the M+1th user (Theta_m+1, R_m+1, Alpha_m+1) are automatically searched, and the rectangular form of the coordinates (X_m+1) is calculated according to the above conversion formula from polar coordinates to rectangular coordinates , Y_m+1) and its distance Dis_m+1.
  • Dis_m+1 ⁇ Dis_Mea_M+3*Dis_Std_M there is 99.73% certainty that the point is regarded as a normal value, and it is added to the coordinate library of the brain area, otherwise, the point is considered an outlier value, and added to the outlier coordinate library.
  • a target positioning system based on evoked potentials including a transcranial magnetic stimulation host, a pat head control module, an EMG acquisition module, and a signal processing module , communication module and display module; among them,
  • the electromyography acquisition module is used to acquire electromyography signals on the skin surface of the contralateral target muscle of the user, and consists of an acquisition electrode and a reference electrode.
  • transcranial magnetic stimulation is used to stimulate the brain area of the patient, the current is transmitted to the corresponding body parts through the neural pathway, such as hands and feet, and the corresponding body parts will produce movements.
  • the myoelectric collector attached to the corresponding part of the body can collect the corresponding muscle. electric signal.
  • the signal processing module calculates the transcranial magnetic racket head coordinates and magnetic stimulation parameters according to the electromyographic signals of the skin surface.
  • the collected EMG needs to be processed to obtain the MEP value of the corresponding area stimulated by TMS, as the basis for updating the coordinates.
  • the EMG signal contains stimulation artifacts, which need to be removed to extract the actual MEP value.
  • the treatment plan calculate the frequency, intensity, pulse number, interval, duration and other parameters of the transcranial magnetic stimulation. Send the transcranial magnetic racket head coordinates and magnetic stimulation trigger commands to the transcranial magnetic stimulation host, receive the MEP value, update the transcranial magnetic racket head coordinates through automatic positioning calculations, until the target treatment target is found.
  • the transcranial magnetic stimulation host sends the corresponding intensity magnetic stimulation trigger command to the transcranial magnetic racket head through the communication module, including electromagnetic waves with corresponding frequency, intensity, pulse number, interval and duration.
  • the racket head control module moves the transcranial magnetic racket head to the designated treatment target according to the coordinates of the transcranial magnetic racket head.
  • the transcranial magnetic head is controlled by three motors to reach the designated position of the helmet to treat the user's treatment target.
  • the patient wears a helmet, and the transcranial magnetic racket head is attached to the user's head inside the hemispherical helmet, and the helmet can be controlled by a motor to rotate along the circumference and slide along the radius to determine the treatment target; at the same time ,
  • the transcranial magnetic head can also rotate the coil to adjust the direction of the magnetic field focus.
  • the coordinates of the transcranial magnetic racket head are determined by the helmet circumference angle (Theta), the helmet radius scale (R), and the racket head angle (Alpha).
  • Theta helmet circumference angle
  • R helmet radius scale
  • Alpha racket head angle
  • the transcranial magnetic racket head is not necessarily inside the helmet, but is also designed in a three-degree-of-freedom mechanical system, and the position of the transcranial magnetic racket head is positioned through the coordinates of the three degrees of freedom.
  • the EMG acquisition module consists of acquisition electrodes and reference electrodes attached to the corresponding body parts.
  • the current is transmitted to the corresponding body parts through the neural pathway, and the EMG signals can be collected when the corresponding body parts move. .
  • the system also includes a display module connected to the transcranial magnetic stimulation host, which is used to display information such as user information, transcranial magnetic treatment plan, EMG data and waveform, real-time coordinates of the transcranial magnetic racket head, and evoked potential values.
  • a display module connected to the transcranial magnetic stimulation host, which is used to display information such as user information, transcranial magnetic treatment plan, EMG data and waveform, real-time coordinates of the transcranial magnetic racket head, and evoked potential values.
  • the communication module is used to connect the signal processing module, transcranial magnetic stimulation host, pat head control module, myoelectric acquisition module and display module.
  • wired including but not limited to STD and CAMAC bus, ISA bus, VXI bus, PCI, Compact and PXI bus, RS-232C, RS-422A, RS-485, USB, IEEE-1943, IEEE488, SCSI bus, MXI bus
  • wireless including but not limited to custom protocol, IEEE802.15.4 protocol, ZigBee protocol, Bluetooth protocol, LoRa and UWB communication methods).
  • the user wears a helmet equipped with a transcranial magnetic racket head, triggers a single transcranial magnetic stimulation, collects the motor evoked potential of the contralateral target muscle, compares the evoked potentials of different coordinates to update the position of the transcranial magnetic racket head, until the primary motion is found district.
  • the motion control module positions the transcranial magnetic head to the treatment target.
  • the present invention utilizes the biofeedback principle of the action-evoked potential phenomenon to find the treatment target within 30 seconds, shortening the search time by more than 90%. Therapeutic effects of cranial magnetic stimulation.
  • the coordinates of the corresponding brain regions can also be determined according to visual evoked potentials, auditory evoked potentials, olfactory evoked potentials and event-related potentials, and then according to the relative positional relationship between specific brain regions and treatment targets, the transcranial magnetic head can be moved to Target therapeutic target for treatment.
  • the therapeutic target can also be neurological (epilepsy, Parkinson's disease, attention deficit hyperactivity disorder in children, amyotrophic lateral sclerosis, etc.), mental (personality disorder, schizophrenia, etc.) etc.), sports rehabilitation (stroke, etc.) disease treatment target area.
  • the user wears an EEG cap with electrodes, and the EEG signal is transmitted to the signal processing module in real time.
  • the user enters the visually evoked state from the resting state by watching videos or pictures.
  • the signal processing module determines the coordinates of the visual brain area (Theta_VEP, R_VEP, Alpha_VEP) according to the difference between the EEG before and after, and then according to the relative coordinates of the visual brain area and the treatment target Difference (Diff_Theta_VEP, Diff_R_VEP, Diff_Alpha_VEP), calculate the coordinates of the treatment target (Theta_VEP+Diff_Theta_VEP, R_VEP+Diff_R_VEP, Alpha_VEP+Diff_Alpha_VEP), and control the transcranial magnetic head to reach the corresponding coordinates for treatment.
  • the embodiment of the present invention discloses a structural diagram of a transcranial magnetic stimulation helmet, including a helmet body 1, a transcranial magnetic racket head 2 and a control transcranial magnetic racket head 2 in the helmet body 1
  • the rotating racket head rotation module 21 is connected to the treatment target automatic positioning system for transcranial magnetism.
  • the shape of the helmet body 1 is similar to the existing helmets, but the inner cavity should meet the requirements of ergonomics.
  • the helmet body 1 includes a helmet upper shell 11 and a helmet lower shell 12 .
  • the helmet upper shell 11 is provided with an arc-shaped guide rail 43 for the racket head rotating module 21 to move back and forth, and the racket head rotating module 21 includes an up-and-down movement mechanism for driving the transcranial magnetic racket head 2 to move forward and backward along the arc-shaped guide rail 43 4 and a horizontal motion mechanism 3 for driving the helmet upper shell 11 to move left and right along the helmet lower shell 12.
  • a helmet inner lining is built into the upper helmet shell 11, and a neck collar inner lining is connected to the lower helmet shell 12. Both the helmet inner lining and the neck collar inner lining are wrapped with soft materials to wrap the hard headband. Made of cotton, the middle is filled with sponge pads, making the position close to the head soft and comfortable.
  • the helmet liner and neck collar liner are designed to be detachable and replaceable.
  • the bottom of the inner lining of the neck collar is movably connected with a strap, and the strap is connected to the inner lining of the neck collar in a rotating manner, so that the chin strap can be pulled down to fit on the user's chin after wearing.
  • the helmet body 1 and the human head are fastened together through the neck collar lining and the straps, which facilitates positioning and improves the accuracy of magnetic stimulation therapy. Regardless of whether the user's head shakes or not, because the two are closely integrated, the treatment can be accurately stimulated, and it will be better to improve the comfort and experience of the treatment.
  • the horizontal movement mechanism 3 of the embodiment of the present invention includes a first motor 31, a first gear 32, and a horizontal guide rail 33, wherein the output end of the first motor 31 is connected to the first gear 32 in transmission, and of course the output of the first motor 31 can also be directly
  • the axis of the shaft and the first gear 32 is fixed to drive the first gear 32 to rotate.
  • the horizontal guide rail 33 is fixed on the inner edge of the helmet lower shell 12 and is arc-shaped.
  • the horizontal guide rail 33 is provided with teeth that mesh with the first gear 32.
  • the upper helmet shell 11 moves horizontally on the horizontal guide rail 33 through the first motor 31 and the first gear 32. Because the edge of the helmet is circular, the trajectory of the horizontal movement is arc-shaped.
  • the two ends of the horizontal guide rail 33 are provided with a limit block
  • the bottom of the helmet upper shell 11 is fixed with a limit plate
  • the two sides of the limit plate match the shape of the limit block, when the horizontal movement mechanism 3 When it reaches the end of the horizontal guide rail 33 driven by the first motor 31, it is blocked by the limit block, thereby stopping the movement.
  • the first motor 31 drives the first gear 32 to rotate, drives the helmet upper shell 11 to move horizontally through the horizontal guide rail 33, and the helmet upper shell 11 simultaneously drives the transcranial magnetic racket head 2 to move left and right
  • the movement of its movement is arc-shaped.
  • the rotating mechanism 5 of the embodiment of the present invention includes a driven gear 53, a third motor 51 and a third gear 52 installed on the slide 44, the third motor 51 passes through the arc guide rail 43 and is connected to the third gear 52, and the slide 44 One side bottom is connected with the rotation of driven gear 53, and a rotating shaft can be fixed at slide seat 44 at the axle center place of driven gear 53, is convenient to the free rotation of driven gear 53.
  • the bottom surface of the other side of the passive gear 53 is connected with the transcranial magnetic racket head 2, the tooth surface of the passive gear 53 meshes with the third gear 52, and the sliding seat 44 drives the transcranial magnetic racket through the meshing movement of the passive gear 53 and the third gear 52.
  • the racket head 2 rotates.
  • the working principle of the rotating mechanism after the second motor is connected to the working signal, the output shaft rotates, and the second gear connected to the output shaft of the second motor drives the driven gear at the bottom of the slide to rotate, and the driven gear drives the bottom of the slide to rotate.
  • the transcranial magnetic racket head rotates together, thereby achieving the purpose that the transcranial magnetic racket head can rotate.
  • a damping spring is provided at the bottom of the driven gear, one side of the damping spring abuts against the driven gear, and the other side of the damping spring abuts against the transcranial magnetic racket head.
  • the up and down movement mechanism 4 of the embodiment of the present invention includes a sliding seat 44 , a second motor 41 mounted on the sliding seat 44 , and a second gear 42 connected by transmission of the second motor 41 , and the sliding seat 44 passes through the second gear 42
  • the meshing movement with the arc guide rail 43 moves back and forth on the arc guide rail 43 . Because the helmet body is a curved surface structure, the trajectory of the up and down movement is arc-shaped.
  • the second motor 41 moves along the track on the arc-shaped guide rail 43 through the second gear 42, thereby bringing the transcranial magnetic racket head at the bottom of the slide seat 44 to move up and down.
  • the first motor drives the upper shell of the helmet to run horizontally along the lower shell of the helmet, thereby also driving the transcranial magnetic head to move in the horizontal direction;
  • the second motor drives the sliding seat to move up and down along the arc guide rail, thereby driving the transcranial magnetic
  • the racket head moves forward and backward;
  • the third motor drives the transcranial magnetic racket head at the bottom of the slide seat to rotate.
  • the conveying position of the three motors should have a feedback function, and the torque should be ⁇ 10Kg cm. It should support half-duplex serial port communication, and the number of rotations, angles, and rotational speeds can be controlled by the serial port instructions of the single-chip microcomputer, and the conveying position information can be recorded.
  • the weight-reducing support cantilever mechanism 6 includes a boom bracket 61 and a cantilever bracket 62,
  • the boom support 61 is fixed on the helmet body 1, can be fixed with the helmet upper shell 11, or is fixed with the helmet lower shell 12, and the boom support 61 is connected with the cantilever support 62 by steel wire or sling.
  • the cantilever support 62 includes a column, a cantilever, and a limit hanging block.
  • the top of the column is connected to one end of the cantilever in rotation, and the other end of the cantilever is fixedly connected to the limit hanging block through an internal telescopic rod.
  • the bottom of the hanging block is fixedly connected, and the bottom of the lifting rope or steel wire is fixedly connected with the boom bracket.
  • the mass of the transcranial magnetic stimulation positioning helmet itself is relatively heavy, and it will be uncomfortable when it is all borne by the human head. Therefore, this product is equipped with a weight-reducing support cantilever mechanism to achieve the purpose of weight reduction and allow users to wear the helmet. relatively comfortable.
  • the racket head rotation module is connected to an automatic positioning system for transcranial magnetic treatment targets.
  • the user wears a transcranial magnetic stimulation helmet, and based on the target positioning method of the motion evoked potential, collects the motor evoked potential of the contralateral target muscle, and compares the evoked potential of the transcranial magnetic head with different coordinates to update the position of the transcranial magnetic head until finding To the primary motor cortex area, according to the relative positional relationship between the target point and the primary motor cortex area, the transcranial magnetic head is positioned to the treatment target.

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Abstract

本发明涉及一种用于经颅磁的治疗靶点自动定位方法、系统及头盔，经颅磁刺激脑区，根据动作诱发电位采集对侧靶肌的皮肤表面肌电值，基于查找算法更新经颅磁拍头坐标寻找肌电值大于判定阈值的坐标点以判定经颅磁拍头到达初级运动皮层区，根据初级运动皮层区与对应治疗靶点的位置关系移动经颅磁拍头至治疗靶点。本发明根据解剖学统计规律，利用动作诱发电位现象和生物反馈原理，可以在较短时间内找到治疗靶点，将寻找时间缩短90％以上，操作简单，成本大幅降低，全程自动化，能有效提高经颅磁刺激的治疗效果。

Description

用于经颅磁的治疗靶点自动定位方法、系统及头盔 技术领域
本发明涉及经颅磁刺激医疗技术领域，尤其涉及一种用于经颅磁的治疗靶点自动定位方法、系统及头盔。
背景技术
抑郁症是最常见的精神疾病之一，在世界范围内影响着超过3.5亿人，已成为仅次于心脏病的人类健康的第二大疾病，其主要表现为情绪低落、思维迟缓、认知障碍等，严重者会反复出现自杀念头。
抑郁症的治疗分为药物治疗、心理治疗和物理治疗。目前，抑郁症主要通过药物治疗来缓解症状，但该方法费用昂贵而且需要长期服药容易导致严重的毒副作用与耐药性。心理治疗需要大量专业的心理治疗师的大量时间，目前国内缺口极大且短期内难以改善。物理治疗方法因为其无毒副作用、大幅提高接诊率和医治效率、治疗效果明显越来越得到推崇，特别是经颅磁技术(Transcranial Magnetic Stimulation,TMS)，具有无创、无痛、安全、非侵入性、见效快的特点。
经颅磁刺激治疗是利用脉冲磁场穿透颅骨，在大脑神经组织产生感应电流，引起靶区神经元的去极化从而产生生理效应，达到治疗抑郁症的效果。研究发现抑郁症用户的左侧背外侧前额叶(The dorsolateral prefrontal cortex,DLPFC)功能活动减弱，右侧DLPEC功能活动增强。高频经颅磁刺激左侧DLPEC增强其皮质活动或者低频刺激右侧DLPFC抑制其皮质活动均可改善抑郁症用户的症状。
除了治疗抑郁症，TMS还是多种神经类(癫痫、帕金森病、儿童注意缺陷多动障碍、肌萎缩侧索硬化症等)、精神类(人格障碍、精神分裂症等)、运动康复类(脑卒中等)疾病的推荐治疗方案。
经颅磁治疗的效果依赖于正确的治疗靶点。但是由于靶点在大脑内部，无法看见，难以确定是否找到。目前，绝大多数的经颅磁产品需要专业的医师根据解剖学知识和行医经验寻找靶点，操作繁琐，通常需要花费15分钟以上的时间才能找到靶点，进行治疗。而缺乏经验的医生十分容易找错靶点，治疗位置偏差较大，导致治疗效果不好，甚至无效。
为了解决这一问题，业界提出了使用结合磁共振(MRI)断层扫描的脑结构三维重建进行脑区靶点的定位与导航，但是该方法及其昂贵且复杂，难以普及。针对这一问题，本发明公开了一种用于经颅磁自动寻找治疗靶点的方法及系统。根据解剖学统计规律，利用动作诱 发电位现象，电机控制方法和生物反馈原理，实现自动寻找抑郁症治疗靶点的方法与系统。本系统平均可以在三十秒内找到治疗靶点，将寻找时间缩短90％以上，操作简单，成本大幅降低，全程自动化，能有效提高经颅磁刺激的治疗效果。
发明内容
本发明的目的在于提供用于经颅磁的治疗靶点自动定位方法、系统及头盔，用户佩戴经颅磁磁刺激头盔，基于动作诱发电位的靶点定位方法，采集对侧靶肌的运动诱发电位，比较不同坐标经颅磁拍头诱发电位从而更新经颅磁拍头位置，直至寻找到初级运动皮层区域，根据靶点和初级运动皮层区域的相对位置关系，将经颅磁拍头定位到治疗靶点。
为实现上述目的，本发明的技术方案如下：
本发明实施例公开的第一方面，提供一种用于经颅磁的治疗靶点自动定位方法，包括如下步骤：经颅磁刺激脑区，根据动作诱发电位采集对应区域的皮肤表面肌电值，基于查找算法更新经颅磁拍头坐标寻找肌电值大于判定阈值的坐标点以判定经颅磁拍头到达初级运动皮层区，根据初级运动皮层区与对应治疗靶点的位置关系将经颅磁拍头定位至治疗靶点。
本发明实施例公开的第二方面，提供一种用于经颅磁的治疗靶点自动定位系统，包括信号处理模块和与所述信号处理模块相连的经颅磁刺激主机、拍头控制模块和肌电采集模块；其中，
肌电采集模块用于采集用户对应区域皮肤表面的肌电信号；
信号处理模块根据皮肤表面的肌电信号确定脑区初级运动皮层区和磁刺激参数；
经颅磁刺激主机根据磁刺激参数，发送对应强度的磁刺激触发指令至经颅磁拍头；
拍头控制模块根据脑区初级运动皮层区与对应治疗靶点的位置关系将经颅磁拍头移动至指定治疗靶点。
本发明实施例公开的第三方面，提供了一种用于经颅磁磁刺激头盔，包括头盔本体、经颅磁拍头以及控制经颅磁拍头在头盔本体内转动的拍头转动模组；所述头盔本体包括头盔上壳和头盔下壳，所述头盔上壳设有用于拍头转动模组前后运动的弧形导轨，所述拍头转动模组设有用于驱动经颅磁拍头沿弧形导轨前后移动的上下运动机构和用于驱动头盔上壳沿头盔下壳左右运动的水平运动机构，所述拍头转动模组连接用于经颅磁的治疗靶点自动定位系统。
与现有技术相比，本发明的有益效果包括：
根据解剖学统计规律，利用动作诱发电位现象的生物反馈原理，可以在较短内找到治疗靶点，将寻找时间缩短90％以上，操作简单，成本大幅降低，全程自动化，能有效提高经颅磁刺激的治疗效果。
附图说明
为了更清楚地说明本发明实施例的技术方案，下面将对实施例描述中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本发明的一些实施例。其中：
图1为本发明实施例治疗靶点自动定位流程图；
图2为本发明实施例经颅磁拍头坐标的更新流程图；
图3为本发明实施例基于二分法的脑区定位算法流程图；
图4为本发明实施例新坐标点入标准库判断流程图；
图5为本发明实施例根据M1坐标库确定最优搜索路径示意图；
图6为本发明实施例系统实际定位过程中坐标点更新过程图；
图7为本发明实施例最优搜索路径更新示意图。
图8为本发明实施例头部尺寸与身高体重关系图；
图9为本发明实施例MEP值随头盔坐标分布图；
图10为本发明实施例运动诱发电位波形图；
图11为本发明实施例用于经颅磁的治疗靶点自动定位系统工作示意图；
图12为本发明实施例对侧靶肌运动诱发电位采集电极粘贴示意图；
图13为本发明实施例头盔的外部结构示意图；
图14为本发明实施例头盔的内部结构结构示意图；
图15为图14的俯视结构示意图；
图16为图14的侧视结构示意图；
图17为图16的A-A剖面结构示意图；
图18为本发明实施例减重支撑悬臂机构结构示意图；
图19为本发明实施例头盔使用状态示意图。
附图说明：1-头盔本体，11-头盔上壳，12-头盔下壳；2-经颅磁拍头，21-拍头转动模组；
3-水平移动机构，31-第一电机，32-第一齿轮，33-水平导轨；4-上下运动机构，41-第
二电机，42-第二齿轮，43-弧形导轨，44-滑座；5-旋转机构，51-第三电机，52-第三齿
轮，53-被动齿轮；6-减重支撑悬臂机构，61-吊臂支架，62-悬臂支架。
具体实施方式
下面结合附图和实施例对本发明的技术方案做进一步的详细说明。
作为本发明的一实施例，如图1-10所示，提出了一种用于经颅磁的治疗靶点自动定位方法，经颅磁刺激脑区，根据动作诱发电位采集对侧靶肌的皮肤表面肌电值，基于查找算法更 新经颅磁拍头坐标寻找肌电值大于判定阈值的坐标点以判定经颅磁拍头到达初级运动皮层区，根据初级运动皮层区与对应治疗靶点的位置关系将经颅磁拍头定位至治疗靶点。
大量临床研究和解剖学统计结论表明：
大脑初级运动皮层区沿着头皮向前移动5到6cm是抑郁症的治疗靶点：左侧背外侧前额叶(The dorsolateral prefrontal cortex,DLPFC)。
动作诱发电位(Motor Evoked Potentials,MEP)：刺激运动皮质，可以检测到对侧靶肌的肌肉运动复合电位。
使用经颅磁刺激大脑初级运动皮层区M1，可以使大拇指产生不由自主地运动。使用肌电采集器，可以捕捉到大拇指运动的肌电信号，从而判断经颅磁拍头是否到达M1区域。临床上，通常把使M1脑区产生动作诱发电位波幅大于判定阈值的最小强度称为运动阈值或参考值，作为其他皮层的刺激强度。根据当前经颅磁拍头坐标，控制经颅磁拍头沿着头皮向前运动相应地距离，即可找到抑郁症治疗靶点。
当找到M1脑区后，系统自动调节磁刺激强度，记录MEP值，直至找到用于其他皮层刺激治疗的刺激强度。
记最优磁刺激强度为S，通常强度为100％—0％，逐级下调强度，直至MEP值首次小于判定阈值MEP_Threshold，通常设置为50uv，则上一次磁刺激强度为磁刺激最优强度。
S＝D*10+U，D取0至10的整数，U取0至9的整数，记S强度时MEP值为MEP_D_U。
首先，十位查找：D从10向0调整，MEP_i_0逐级下降，当MEP_i_0>MEP_Threshold而且MEP_i-1_0<MEP_Threshold，D确定为i-1。
其次，个位查找：U从9向0调整，MEP_D_j逐级下降，当MEP_D_j>MEP_Threshold而且MEP_D_j-1<MEP_Threshold，D确定为j。
由此确定最优磁刺激强度S＝D*10+U。
如图8所示，本发明采集了11位志愿者的基本信息和M1脑区坐标，进行了统计学分析，发现成年男性的头部大小有很强的规律性：
头围尺寸大小与体重关系不大；
头围尺寸大小与身高关系不大；
头围尺寸大小与胖瘦(BMI)关系不大；
矢状线(鼻根到枕后)长度与体重关系不大；
冠状线(左耳前凹至右耳前凹)长度与体重关系不大；
成年男性的头部大小差别不大，有些人看起来头大其实是脸大，脸部脂肪多导致视觉上 看起来较大。由头部大小差别不大，可以推论内部特定脑区的位置在经颅磁头盔上的坐标差别也不会太大，从而可以通过自动搜索算法找到。
目前，大部分经颅磁治疗靶点根据国际脑电图学会规定的10-20标准导联系统确定。实际上，标准系统无法解决每个人的脑袋的形状不同，不同人功能脑区的大小分布不同的问题，通常定位误差较大。
为了解决这一问题，本发明提出了基于动作诱发电位的二分法脑区定位方法：使用TMS刺激脑区，采集大拇指肌电，根据不同坐标对应的肌电值对比更新下一次经颅磁拍头坐标，直至找到目标治疗靶点。
采集N位志愿者M1脑区坐标，记第n位志愿者脑区坐标为(Theta_n,R_n,Alpha_n)，其中Theta_n为头盔的圆周角度，R_n为头盔的半径标度，Alpha_n为经颅磁拍头的自旋角度，由于经颅磁拍头的自旋角度规律性较强，绝大多数情况为35，故经颅磁拍头在头盔上的位置主要由(Theta_n,R_n)决定。大部分人的M1脑区坐标在一个较小的区域内，可以拟合出一个最优搜索路径。为了计算方便，需要将头盔的极坐标系转换成直接坐标系，公式为：
Figure PCTCN2022123391-appb-000001
具体的，搜索路径由最优搜索路径y＝K_1*x+B_1和垂直搜索路径y＝K_2*x+B_2组成。当最优搜索路径阶段已搜索成功，则不需要进入垂直搜索路径阶段。
表1公开了11位男性志愿者基于MEP的脑区定位统计表：
序号 圆周角度(度) 半径标度(度) 经颅磁拍头角度(度)
1 48 40 35
2 65 21 35
3 63 31 35
4 61 30 35
5 65 21 35
6 51 40 35
7 52 33 35
8 64 27 35
9 58 32 35
10 62 25 35
11 67 27 35
如图7所示，基于11个M1脑区的具体坐标点，在一个狭长的区域内，计算出离所有点最近的直线，即最优搜索路径的参数：K_1＝0.54，B_1＝16.90，则最优搜索路径的直角坐标系表达式：y＝0.54*x+16.90。
第一阶段：基于最优搜索路径搜索
根据收集到的脑区坐标集合(X_n,Y_n)，确定最优搜索路径，计算公式为：
Figure PCTCN2022123391-appb-000002
确定最优搜索路径上最左侧的搜索点(X_Min,K_1*X_Min+B_1)，最右侧搜索点(X_Max,K_1*X_Max+B_1)。
为满足大部分人群符合两侧搜索点的范围，设置左侧缩小系数和右侧放大系数：
Figure PCTCN2022123391-appb-000003
其中，L_Scale为左侧缩小系数，取值范围为(0,1]，R_Scale为右侧放大系数，取值范围为(1,2]。典型地，L_Scale取0.9，R_Scale取1.1。
最大搜索次数影响搜索坐标的精度和搜索速度，最大搜索次数增大，最终坐标精度提高，同时搜索次数变多，搜索时间加大。为了平衡精度和速度，根据最左侧搜索点和最右侧搜索点计算第一阶段最大搜索次数Search_Count_Max：
Search_Count_Max＝2+[log 2(X_max-X_min)]   (4)
公式(4)中，2代表最左侧和最右侧的搜索点，[log 2(X_max-X_min)]为中间需要进行的搜索次数，搜索分辨率为1。为搜索方便，设置中间变量X_Left，X_Right，X_Mid，初始化X_Left为X_Min,X_Right为X_Max；设置搜索成功标志Flag_Success，初始化为0；设置搜索成功治疗靶点的横坐标为Success_X。
第一个点：横坐标为X_Left，控制拍头移动到坐标(Theta_Left,R_Left,Alpha_0)，其中直角坐标转化成极坐标的公式为：
Figure PCTCN2022123391-appb-000004
触发磁刺激，记录此时大拇指的肌电值Left_Mep，若Left_Mep大于判定阈值Mep_Threshold，则搜索成功，停止搜索，此时Flag_Success设为1，Success_X设为X_Left；否则进行下一个点的搜索。
第二个点：横坐标为X_Right，控制拍头移动到坐标(Theta_Right,R_Right,Alpha_0)， 触发磁刺激，记录此时大拇指的肌电值Right_Mep，若Right_Mep大于判定阈值Mep_Threshold，则搜索成功，停止搜索，Flag_Success设为1，Success_X设为X_Right；否则进行下一个点的搜索。
第三个点至第Search_Count_Max个点：横坐标为X_Mid＝(X_Left+X_Right)/2，经颅磁拍头移动到坐标(Theta_Mid,R_Mid,Alpha_0)，触发磁刺激，记录此时大拇指的肌电值Mid_Mep，若Mid_Mep大于判定阈值Mep_Threshold，则搜索成功，停止搜索，Flag_Success设为1，Success_X设为X_Mid。若搜索不成功，进行更新：若肌电值Left_Mep>Right_Mep，更新X_Right为X_Mid，更新Right_Mep为Mid_Mep，否则，更新X_Left为X_Mid，更新Left_Mep为Mid_Mep，进行下一个点的搜索，直至第Search_Count_Max个点停止。
搜索完最后一个点，若搜索成功标志Flag_Success仍然为0，第一阶段搜索最优点P_1_Opt的横坐标Opt_1_X设置为X_Mid。若肌电值Left_Mep>Right_Mep，Opt_1_X更新为X_Left；若Left_Mep<Right_Mep，Opt_1_X更新为X_Right。
作为本发明最优搜索路径的实施例，根据最优搜索路径的直角坐标系表达式：y＝0.54*x+16.90，确定最优搜索路径上最左侧点横坐标X_Min＝0.9*8.87＝7.98，最右侧点横坐标X_Max＝1.1*23.76＝29.44。第一阶段最大搜索次数Search_Count_Max＝2+[log2(29.44-7.98)]＝6。搜索成功标志Flag_Success初始化为0，判定阈值Mep_Threshold设置为50。
第1个点：横坐标为X_Left＝X_Min＝7.98，换算成头盔极坐标(19.35，22.65，35)，电机控制拍头运动到该点，触发磁刺激，采集到MEP值Left_Mep＝47.49，小于Mep_Threshold，进行下一点搜索。
第2个点：横坐标为X_Right＝X_Max＝29.44，换算成头盔极坐标(48.02，44.01)，电机控制拍头运动到该点，触发磁刺激，采集到MEP值Right_Mep＝4.95，小于Mep_Threshold，进行下一点搜索。
第3个点：横坐标为X_Mid＝(X_Left+X_Right)/2＝18.71，换算成头盔极坐标(55.22，32.81,35)，电机控制拍头运动到该点，触发磁刺激，采集到MEP值Mid_Mep＝32.09，小于Mep_Threshold，由于Left_Mep>Right_Mep，更新X_Right为X_Mid，更新Right_Mep为Mid_Mep，进行下一点搜索。
第4个点：横坐标为X_Mid＝(X_Left+X_Right)/2＝13.35，换算成头盔极坐标(60.99，27.53,35)，电机控制拍头运动到该点，触发磁刺激，采集到MEP值Mid_Mep＝40.84，小于Mep_Threshold，由于Left_Mep>Right_Mep，更新X_Right为X_Mid，更新Right_Mep为Mid_Mep，进行下一点搜索。
第5个点：横坐标为X_Mid＝(X_Left+X_Right)/2＝10.67，换算成头盔极坐标(64.76，25.02,35)，电机控制拍头运动到该点，触发磁刺激，采集到MEP值Mid_Mep＝49.24，小于Mep_Threshold，由于Left_Mep>Right_Mep，更新X_Right为X_Mid，更新Right_Mep为Mid_Mep，进行下一点搜索。
第6个点：横坐标为X_Mid＝(X_Left+X_Right)/2＝9.33，换算成头盔极坐标(66.94，23.81,35)，电机控制拍头运动到该点，触发磁刺激，采集到MEP值Mid_Mep＝45.77，小于Mep_Threshold。
由于达到第一阶段最大搜索次数Search_Count_Max＝6，Flag_Success仍然为0，第一阶段搜索结果Opt_1_X设置为X_Mid。若Right_Mep>Left_Mep，Right_Mep<Mid_Mep，Opt_1_X更新为X_Right＝10.67，进行下一阶段搜索。
第二阶段：基于垂直搜索路径搜索
根据第一阶段搜索结果Opt_1_X和最优搜索路径参数K_1计算垂直搜索路径y＝K_2*x+B_2的参数：
Figure PCTCN2022123391-appb-000005
确定垂直搜索路径上最左侧的搜索点(X_Ver_Min,K_2*X_Ver_Min+B_2)，最右侧搜索点(X_Ver_Max,K_2*X_Ver_Max+B_2)。其中
Figure PCTCN2022123391-appb-000006
其中，D_Scale为左侧缩小系数，取值范围为(0,1]，U_Scale为右侧放大系数，取值范围为(1,2]。典型地，D_Scale取0.85，U_Scale取1.15。
根据最左侧搜索点和最右侧搜索点计算第二阶段最大搜索次数Search_Ver_Count_Max：
Search_Ver_Count_Max＝3+log 2(X_Ver_max-X_Ver_min)  (8)
公式(8)中，3代表最左侧搜索点、最右侧搜索点以及为提高搜索分辨率的最后一个搜索点，log 2(X_Ver_max-X_Ver_min)为中间需要进行的搜索次数，搜索分辨率为0.5。根据实验发现，垂直搜索分辨率为最优搜索分辨率的二分之一较优。为搜索方便，设置中间变量X_Ver_Left，X_Ver_Right，X_Ver_Mid，初始化X_Ver_Left为X_Ver_Min,X_Ver_Right为X_Ver_Max。
第一个点：横坐标为X_Ver_Left，经颅磁拍头移动至坐标(Theta_Ver_Left,R_Ver_Left,Alpha_0)，触发磁刺激，记录此时大拇指的肌电值Left_Ver_Mep，若Left_Ver_Mep大于判定阈值Mep_Threshold，则搜索成功，停止搜索，Flag_Success设为1，Success_X设为X_ Ver_Left；否则进行下一个点的搜索。
第二个点：横坐标为X_Ver_Right，经颅磁拍头移动到坐标(Theta_Ver_Right,R_Ver_Right,Alpha_0)，触发磁刺激，记录此时大拇指的肌电值Right_Ver_Mep，若Right_Ver_Mep大于判定阈值Mep_Threshold，则搜索成功，停止搜索，Flag_Success设为1，Success_X设为X_Ver_Right；否则进行下一个点的搜索。
第三个点至第Search_Ver_Count_Max个点：横坐标为X_Ver_Mid＝(X_Ver_Left+X_Ver_Right)/2，经颅磁拍头移动到坐标(Theta_Ver_Mid,R_Ver_Mid,Alpha_0)，触发磁刺激，记录此时大拇指的肌电值Mid_Ver_Mep，若Mid_Ver_Mep大于判定阈值Mep_Threshold，则搜索成功，停止搜索，Flag_Success设为1，Success_X设为X_Ver_Mid。若搜索不成功，进行更新：若Left_Ver_Mep>Right_Ver_Mep，更新X_Ver_Right为X_Ver_Mid，更新Right_Ver_Mep为Mid_Ver_Mep，否则，更新X_Ver_Left为X_Ver_Mid，更新Left_Ver_Mep为Mid_Ver_Mep，进行下一个点的搜索，直至搜索至第Search_Ver_Count_Max个点停止。
搜索完最后一个点，若搜索成功标志Flag_Success仍然为0，第二阶段搜索最优点P_2_Opt的横坐标Opt_1_X设置为X_Ver_Mid。若Left_Ver_Mep>Right_Ver_Mep，Opt_1_X更新为X_Ver_Left；若Left_Ver_Mep<Right_Ver_Mep，Opt_2_X更新为X_Ver_Right。
作为本发明垂直搜索路径的实施例，根据第一阶段搜索结果Opt_1_X＝10.67和最优搜索路径参数K_1＝0.54，计算垂直搜索路径的参数：K_2＝-1.86，B_2＝42.49，则直角坐标系表达式：y＝-1.86*x+42.49。
设定垂直搜索路径上最左侧点横坐标X_Ver_Min＝0.85*10.67＝9.07，最右侧点横坐标X_Ver_Max＝1.15*10.67＝12.27。第二阶段最大搜索次数Search_Ver_Count_Max＝3+[log2(12.27-9.07)]＝4。
第1个点：横坐标为X_Ver_Left＝X_Ver_Min＝9.07，换算成头盔极坐标(70.5，27.17，35)，经颅磁拍头运动到该点，触发磁刺激，采集到MEP值Left_Ver_Mep＝48.33，小于Mep_Threshold，进行下一点搜索。
第2个点：横坐标为X_Ver_Right＝X_Ver_Max＝12.27，换算成头盔极坐标(58.02，23.17，35)，经颅磁拍头运动到该点，触发磁刺激，采集到MEP值Right_Mep＝46.85，小于Mep_Threshold，进行下一点搜索。
第3个点：为第一阶段最优点，横坐标为X_Ver_Mid＝Opt_1_X＝10.67，换算成头盔极坐标(64.76，25.02,35)，MEP值Mid_Ver_Mep＝49.24，小于Mep_Threshold，由于Left_Ver _Mep>Right_Ver_Mep，更新X_Ver_Right为X_Ver_Mid，更新Right_Ver_Mep为Mid_Ver_Mep，进行下一点搜索。
第4个点：横坐标为X_Ver_Mid＝(X_Ver_Left+X_Ver_Right)/2＝9.87，换算成头盔极坐标(67.75，26.06,35)，经颅磁拍头运动到该点，触发磁刺激，采集到MEP值Mid_Ver_Mep＝55.98，大于Mep_Threshold，搜索成功，Flag_Success设为1，Success_X设为9.87。因此，搜索成功靶点的横坐标为9.87，换算成头盔的极坐标点即为脑区靶点坐标。
第三阶段：经颅磁拍头自旋搜索
若垂直搜索路径搜索完毕，仍未搜索成功，即Flag_Success仍然为0，此时经颅磁拍头的坐标为所有已搜索点中离M1区最近的点。经颅磁拍头的线圈进行自旋，通过改变Alpha_n进行搜索。Alpha_n初始为35，依次搜索典型值按照出现频次进行排列，典型值如30，40，0。
自旋搜索完毕，如果仍未找到靶点，输出自动搜索失败，提醒医师根据离群坐标库进行手动查找。
同理，目前已实现的算法有解析类，如梯度下降法、斐波那契法、黄金分割法、插值法、切线法、二分法等；概率类，如模拟退火、遗传算法、禁忌搜索、蚁群算法等以及解析和概率混合类。其中基于二分法的脑区定位算法，时间复杂度和空间复杂度最优，为对数阶O(logN)。
梯度下降法：从点P_k出发，到达点P_k+1,迭代公式P_k+1＝P_k+t_k*D_k，其中t_K为步长，D_k为点P_k出发使MEP值变化最快的方向(梯度)，直至MEP值不再变化，搜索停止。
斐波那契法：斐波那契数列：F_n＝F_n-2+F_n-1，F_0＝F_1＝1，斐波那契分数：F_n-1/F_n，从初始点P_a和P_b开始搜索第i个点t的公式：t_i＝a+(b-a)*F_n-i/F_n，搜索精度：(b-a)/F_n。
黄金分割法：从初始点P_a和P_b开始搜索第i个点t的公式：t_i＝a+(b-a)*0.618^i
插值法：采集点P_i和MEP_i的数值，不断用不超过三次的多项式来近似MEP，再用插值多项式的极值点来逼近最优点P_Opt。
概率类算法:
从点P_k出发，到达点P_k+1,迭代公式P_k+1＝P_k+t_k*D_k，其中t_K为步长，D_k为点P_k出发的随机方向。若MEP变大则接受此方向，否则拒绝。如此迭代，直至MEP值不再变化，搜索停止。
本发明详细公开了基于二分法的脑区定位算法，基于相同或相似同理，根据MEP值确定具体取点的坐标，取点的方法笼统的来说，即往MEP值增大的方向取点，解析类、概率类以及解析类与概率类的混合算法均能通过MEP值的大小判定是否找到最优点P_Opt。
根据解剖学和临床统计规律，确定待治疗疾病k的治疗靶点和找到的M1区相对坐标差为(Theta_Diff_k，R_Diff_k)。若用户m找到的M1区坐标为(Theta_m，R_m,Alpha_m)，运动控制模块将经颅磁拍头运动至治疗靶点(Theta_Treat_k，R_Treat_k,Alpha_0)＝(Theta_m+Theta_Diff_k，R_m+R_Diff_k,Alpha_m)。
如图10和图13所示，在右手第一骨间背侧肌处贴采集电极，在右侧豌豆骨处贴参考电极，两个采集电极相距2cm。设t时刻采集到的肌电值为p(t)，通常刺激伪迹远大于正常MEP值，设置刺激伪迹阈值为Artifact_Vpp，查找第k时刻的值大于Artifact_Vpp，取第k+Artf时刻至k+Duration时刻为Mep计算范围，其中，Artf为伪迹持续时间，本案取0.003，Duration为Mep持续时间，如本案为0.03，则Mep数值为：
Figure PCTCN2022123391-appb-000007
最优的搜索路径是距离所有已知用户治疗靶点坐标最近的直线，其参数的选取很大程度上影响着靶点坐标搜索的速度和准确度。
因此，本发明的一实施例公开了最优搜索路径的自动更新算法，记录新用户定位成功的脑区坐标，进行统计学离群性判断，若不属于离群值将存入标准坐标库，随后对路径参数进行更新。随着治疗用户数量的增多，坐标库的数据将逐渐增大，对人群脑区的分布规律的描述将越来越准确，最优路径参数会越来越优化，寻找靶点的速度会越来越快且越来越准。
治疗第M+1个用户前，标准脑区坐标库共有M个坐标值(Theta_m，R_m，Alpha_m)，根据上述极坐标到直角坐标转换公式，计算出坐标的直角坐标(X_m，Y_m)，最优搜索路径参数为K_1和B_1，到最优路径的距离为Dis_m,其计算方法为：
Figure PCTCN2022123391-appb-000008
根据上述二分法自动搜索到第M+1个用户的坐标值(Theta_m+1，R_m+1，Alpha_m+1)，根据上述极坐标到直角坐标转换公式，计算出坐标的直角形式(X_m+1，Y_m+1)及其距离Dis_m+1。
医学上难以有100％的规律，比如绝大多数人的心脏在左侧，但大概有十万分之一的概率长在右侧。使用符合大数规律的数据优化参数，可以使得系统的性能越来越好。但是使用特殊情况训练系统，则可能导致系统性能变差，越更新越发散。因此需要对新的坐标点进行统计学分析，判断为正常值后加入脑区坐标库指导最优路径更新，否则加入离群坐标库。
先计算坐标库的数学期望Dis_Mean_M和标准差Dis_Std_M
Figure PCTCN2022123391-appb-000009
根据上述参数判断新坐标是否为正常值。若Dis_m+1<Dis_Mea_M+3*Dis_Std_M，则有99.73％的把握认为该点为正常值，将其加入脑区坐标库，否则认为该点为离群值，加入离群坐标库。
若有新坐标加入坐标库，则进行最优路径参数的更新。计算出新参数K_1_New,B_1_New，将K_1更新为K_1_New，将B_1更新为B_1_New：
Figure PCTCN2022123391-appb-000010
根据上述垂直搜索路径得到的脑区坐标(67.75，26.06,35)，判断其是否加入标准坐标库。
原坐标库各点和最优路径的距离均值Dis_Mean_M＝1.56，标准差Dis_Std_M＝0.7。
新坐标与最优搜索路径的距离Dis_m+1＝1.74<Dis_Mea_M+3*Dis_Std_M，为正常值，加入标准脑区坐标库，计算新的最优搜索路径参数：K_1_N＝0.51，B_1_N＝17.43；
因此，最优搜索路径的直角坐标系表达式：y＝0.51*x+17.43。
如图11-12所示，作为本发明的另一实施例，提出了一种基于诱发电位的靶点定位系统，包括经颅磁刺激主机、拍头控制模块、肌电采集模块、信号处理模块、通讯模块和显示模块；其中，
肌电采集模块用于采集用户对侧靶肌的皮肤表面的肌电信号，由采集电极和参考电极组成。经颅磁刺激患者运动脑区时，电流经过神经通路传递到相应身体部位，如手、脚等，相应身体部位会产生动作，贴于身体相应部分的肌电采集器，可以采集到相应的肌电信号。
信号处理模块根据皮肤表面的肌电信号计算经颅磁拍头坐标和磁刺激参数。
为进一步对肌电信号处理，采集到的肌电需要进行处理得到TMS刺激相应区域的MEP值，作为坐标更新的依据。通常肌电信号中包含刺激伪迹，需要对其进行去除，提取出实际的MEP值。
根据治疗方案，计算经颅磁刺激的频率、强度、脉冲数、间隔、时长等参数。向经颅磁刺激主机发送经颅磁拍头坐标和磁刺激触发指令，接受MEP值，通过自动定位算更新出经颅磁拍头坐标，直至找到目标治疗靶点。
经颅磁刺激主机根据磁刺激参数，通过通信模块发送对应强度的磁刺激触发指令至经颅 磁拍头，包括相应频率、强度、脉冲数、间隔和时长的电磁波。
拍头控制模块根据经颅磁拍头坐标将经磁颅拍头移动至指定治疗靶点。通过三个电机控制经颅磁拍头到达头盔的指定位置，对用户的治疗靶点进行治疗。治疗时，患者佩戴头盔，经颅磁拍头在半球形头盔内部贴着用户头部，可以在头盔上通过电机控制进行沿圆周的转动，以及沿半径的滑动，以此确定治疗靶点；同时，经颅磁拍头还可以进行线圈自转，调整磁场聚焦的方向。具体的，经颅磁拍头的坐标由头盔圆周角度(Theta)、头盔半径标度(R)、拍头角度(Alpha)确定。当然，经颅磁拍头不一定处于头盔内部，也设计在一个三自由度的机械系统内，通过三个自由度的坐标实现经颅磁拍头位置的定位。
肌电采集模块由贴于相应身体部位的采集电极和参考电极组成，经颅磁拍头刺激脑区时，电流经过神经通路传递到相应身体部位，相应身体部位产生动作即可采集到肌电信号。
本系统还包括与经颅磁刺激主机相连的显示模块，用于显示用户信息，经颅磁治疗方案，肌电信号数据及波形、经颅磁拍头的实时坐标以及诱发电位值等信息。
通信模块用于连接信号处理模块、经颅磁刺激主机、拍头控制模块、肌电采集模块和显示模块，目前实现了有线(包括但不限于STD和CAMAC总线、ISA总线、VXI总线、PCI、Compact及PXI总线、RS-232C、RS-422A、RS-485、USB、IEEE-1943、IEEE488、SCSI总线、MXI总线)和无线(包括但不限于自定义协议、IEEE802.15.4协议、ZigBee协议、蓝牙协议、LoRa以及UWB通信方式)方式。
用户佩戴装有经颅磁拍头的头盔，触发单次经颅磁刺激，采集对侧靶肌的运动诱发电位，比较不同坐标的诱发电位更新经颅磁拍头的位置，直至寻找到初级运动区。根据治疗靶点和初级运动区的相对位置关系，运动控制模块将经颅磁拍头定位到治疗靶点。
本发明根据解剖学统计规律，利用动作诱发电位现象的生物反馈原理，可以在30秒内找到治疗靶点，将寻找时间缩短90％以上，操作简单，成本大幅降低，全程自动化，能有效提高经颅磁刺激的治疗效果。
同理，还可根据视觉诱发电位，听觉诱发电位，嗅觉诱发电位和事件相关电位等确定对应脑区坐标，再根据特定脑区和治疗靶点的相对位置关系，将经颅磁拍头移动到目标治疗靶点，进行治疗。治疗靶点除了抑郁症的侧背外侧前额叶，还可以是神经类(癫痫、帕金森病、儿童注意缺陷多动障碍、肌萎缩侧索硬化症等)、精神类(人格障碍、精神分裂症等)、运动康复类(脑卒中等)疾病的治疗靶区。以视觉诱发电位为例，用户头戴有电极的脑电帽，脑电信号实时传递给信号处理模块。用户由静息状态通过观看视频或图片进入视觉诱发状态，信号处理模块根据前后脑电图的差异确定视觉脑区坐标(Theta_VEP,R_VEP,Alpha_VEP), 再根据视觉脑区和治疗靶点的相对坐标差(Diff_Theta_VEP,Diff_R_VEP,Diff_Alpha_VEP)，计算出治疗靶点的坐标(Theta_VEP+Diff_Theta_VEP,R_VEP+Diff_R_VEP,Alpha_VEP+Diff_Alpha_VEP)，控制经颅磁拍头到达相应坐标进行治疗。
图13至图19所示，本发明实施例公开了一种经颅磁磁刺激头盔的结构示意图，包括头盔本体1、经颅磁拍头2以及控制经颅磁拍头2在头盔本体1内转动的拍头转动模组21，所述拍头转动模组21连接用于经颅磁的治疗靶点自动定位系统。头盔本体1的外形跟现有的头盔类似，但内部的腔体应符合人体工程学的要求。头盔本体1包括头盔上壳11和头盔下壳12。所述头盔上壳11设有用于拍头转动模组21前后运动的弧形导轨43，拍头转动模组21包括用于驱动经颅磁拍头2沿弧形导轨43前后移动的上下运动机构4和用于驱动头盔上壳11沿头盔下壳12左右运动的水平运动机构3。
为了便于佩戴后固定用户颈部位置，在头盔上壳11内置有头盔内衬，头盔下壳12连接有颈托内衬，头盔内衬和颈托内衬均采用软性材料包裹硬质头箍制成，中间填充海绵垫，使与头部贴合的位置柔软舒服。头盔内衬和颈托内衬设计成可拆卸更换方式。颈托内衬的底部活动连接有绑带，绑带与颈托内衬采用转动方式连接，便于佩戴后下拉下巴绑带使其套在用户的下巴部位。通过颈托内衬和绑带使头盔本体1与人体头部紧固在一起，便于定位，也有利于提高磁刺激治疗时的准确度。无论用户的头部是否出现晃动，因两者紧密结合在一起，也可以准确刺激治疗，能够提高治疗舒适度及体验感会较好。
本发明实施例水平移动机构3包括第一电机31、第一齿轮32、水平导轨33，其中第一电机31的输出端与第一齿轮32传动连接，当然也可以直接让第一电机31的输出轴与第一齿轮32的轴心固定来驱动第一齿轮32转动，水平导轨33固定在头盔下壳12的内沿边且呈弧形状，水平导轨33上设有与第一齿轮32相啮合的齿型，头盔上壳11通过第一电机31和第一齿轮32在所述水平导轨33上水平移动，因头盔的边缘为圆形，所以该水平移动的轨迹为圆弧状。
作为另一种优选的方案，水平导轨33的两端设有限位块，头盔上壳11的底部固定有限位板，限位板的两侧与限位块的外形相匹配，当水平移动机构3在第一电机31的驱动下到达水平导轨33的端部时，被限位块所阻挡，从而停止运动。
具体的，水平移动机构的工作原理：第一电机31驱动第一齿轮32转动，通过水平导轨33带动头盔上壳11进行水平位置移动，头盔上壳11同时带动经颅磁拍头2做左右方向的移动，其移动的轨迹为圆弧状。
本发明实施例旋转机构5包括被动齿轮53、安装在滑座44上的第三电机51和第三齿轮 52，第三电机51穿过弧形导轨43与第三齿轮52传动连接，滑座44一侧底部与被动齿轮53的转动连接，可在被动齿轮53的轴心处固定一个转轴在滑座44，便于被动齿轮53的自由转动。被动齿轮53另一侧底部表面与经颅磁拍头2连接，被动齿轮53的齿面与第三齿轮52相啮合，滑座44通过被动齿轮53和第三齿轮52的啮合运动带动经颅磁拍头2转动。
具体的，旋转机构的工作原理：第二电机接通工作信号后作输出轴旋转运动，通过第二电机的输出轴连接的第二齿轮带动滑座底部的被动齿轮转动，由被动齿轮带动底部的经颅磁拍头一起转动，从而达到经颅磁拍头可以旋转的目的。
作为另一种优选的方案，在被动齿轮的底部设有减震弹簧，减震弹簧一侧与被动齿轮相抵靠，减震弹簧另一侧与经颅磁拍头相抵靠。通过该减震弹簧在佩戴头盔本体时，具有使经颅磁拍头更好的利用支撑力贴近人体头部的头顶，并在三种运动装置工作过程中减缓三种移动装置带动经颅磁拍头移动而造成的轻微震动力，提高用户用户的舒适度。
本发明实施例上下运动机构4包括滑座44，安装在滑座44上的第二电机41，以及所述第二电机41传动连接的第二齿轮42，所述滑座44通过第二齿轮42和弧形导轨43的啮合运动在所述弧形导轨43上前后移动。因头盔本体为曲面结构，所以该上下移动的轨迹为圆弧状。
上下运动装置的工作原理：第二电机41通过第二齿轮42在弧形导轨43沿着轨迹进行运动，从而带着滑座44底部的经颅磁拍头作上下方向的移动。
在本发明实施例采用三台电机，三台电机所采用的型号均为：A15-ST。其中，第一电机驱动头盔上壳沿头盔下壳水平运行，从而也带动经颅磁拍头在水平方向移动；第二电机驱动滑座沿弧形导轨作上下方向的运动，从而带动经颅磁拍头在前后方向移动；第三电机驱动滑座底部的经颅磁拍头作旋转运动。三台电机的输送位置应具有反馈功能，扭矩≥10Kg·cm，应支持半双工串口通信，可由单片机用串口指令控制旋转圈数、角度、旋转速度，并记录输送的位置信息。
如图18和图19所示，作为另一种优选的方案，在上述方案的基础上，还包括减重支撑悬臂机构，所述减重支撑悬臂机构6包括吊臂支架61和悬臂支架62，吊臂支架61固定在头盔本体1上，可与头盔上壳11固定，或与头盔下壳12固定，吊臂支架61通过钢丝或吊绳与悬臂支架62连接。
悬臂支架62包括立柱、悬臂、限位吊块，立柱的顶部与悬臂的一端转动连接，悬臂的另一端通过内部套装的伸缩杆与限位吊块固定连接，吊绳或钢丝的顶部与限位吊块的底部固定连接，吊绳或钢丝的底部与吊臂支架固定连接。
经颅磁刺激定位头盔自身质量比较重，全部由人的头部来承受时会显得不舒服，因此给 本产品配备了减重支撑悬臂机构，从而达到减重的目的，让用户在配戴头盔时相对舒适。
在本实施例中，拍头转动模组连接用于经颅磁的治疗靶点自动定位系统。用户佩戴经颅磁磁刺激头盔，基于动作诱发电位的靶点定位方法，采集对侧靶肌的运动诱发电位，比较不同坐标经颅磁拍头诱发电位从而更新经颅磁拍头位置，直至寻找到初级运动皮层区域，根据靶点和初级运动皮层区域的相对位置关系，将经颅磁拍头定位到治疗靶点。
以上所述的具体实施方式，对本发明的目的、技术方案和有益效果进行了进一步详细说明,所应理解的是，以上所述仅为本发明的具体实施方式，并不用于限定本发明保护范围，凡在本发明的精神和原则之内，所做的任何修改、等同替换、改进等，均应含在本发明的保护范围之内。

Claims (18)

  1. 一种用于经颅磁的治疗靶点自动定位方法，其特征在于，包括如下步骤：
    根据事先采集的若干用户大脑初级运动皮层区坐标，拟合最优搜索路径y＝K_1*x+B_1，其中，K_1和B_1为坐标拟合参数；
    基于查找算法中的二分法确定最优搜索路径上的左侧搜索点和右侧搜索点，触发经颅磁刺激脑区，根据动作诱发电位采集对应区域的皮肤表面肌电值，寻找肌电值大于判定阈值对应的坐标点以判定经颅磁拍头到达初级运动皮层区，采用左侧搜索点和右侧搜索点的中间点替换左侧搜索点和右侧搜索点中较小MEP值对应的搜索点后，重新计算下一次搜索点的坐标；
    若在最优搜索路径阶段已进行最大搜索次数仍未搜索到初级运动皮层区，则进入垂直搜索路径；
    所述最大搜索次数为Search_Count_Max＝N+[log 2(X_max-X_min)]，其中，N根据搜索分辨率决定搜索次数，X_max为最右侧搜索点横坐标，X_min为最左侧搜索点横坐标；
    所述垂直搜索路径y＝K_2*x+B_2，其中，
    Figure PCTCN2022123391-appb-100001
    B_2＝Opt_1_Y-Opt_1_X*K_2，(Opt_1_X，Opt_1_Y)为最优搜索路径阶段得到的最优搜索点坐标；
    再次基于二分法确定垂直搜索路径的搜索点，触发经颅磁刺激，根据皮肤肌电值与判定阈值的大小，设置下一次搜索点坐标，直至搜索到初级运动皮层区；
    最后，根据初级运动皮层区与对应治疗靶点的位置关系将经颅磁拍头定位至治疗靶点。
  2. 根据权利要求1所述的方法，其特征在于，若完成垂直搜索路径的最大搜索次数仍未搜索成功，则最近的初级运动皮层区坐标由垂直搜索路径最大搜索次数的上一次搜索中左侧搜索点或右侧搜索点中较大MEP值确定。
  3. 根据权利要求1所述的方法，其特征在于，当治疗靶点确定后，最优磁刺激强度为脑区初级运动皮层区产生波幅大于判定阈值的运动诱发电位的最小强度，当经颅磁拍头位于初级运动皮层区时，自动逐级调节磁刺激强度，直至MEP值首次小于判定阈值，则上一次磁刺激强度为最优磁刺激强度。
  4. 根据权利要求1所述的方法，其特征在于，所述经颅磁拍头的坐标由头盔的圆周角度、半径标度以及经颅磁拍头的自转角度组成。
  5. 根据权利要求1所述的方法，其特征在于，所述皮肤表面肌电值为经颅磁刺激相应区域得到的实际MEP值。
  6. 根据权利要求1所述的方法，其特征在于，初级运动皮层区与待治疗疾病靶点位置关系的坐标差由国际脑电图学会规定的10-20标准导联系统确定。
  7. 根据权利要求1所述的方法，其特征在于，所述最优搜索路径还包括自动更新算法，基于二分法的脑区定位方法自动搜索用户的经颅磁拍头坐标，计算其最优路径距离、脑区坐 标集的数学期望及标准差，比较最优路径距离与数学期望及三倍标准差之和的大小，判定此次经颅磁拍头坐标是否为可以加入脑区坐标集，并更新最优路径参数。
  8. 一种根据权利要求1-7任一所述的用于经颅磁的治疗靶点自动定位方法的用于经颅磁的治疗靶点自动定位系统，其特征在于，包括信号处理模块和与所述信号处理模块相连的经颅磁刺激主机、拍头控制模块和肌电采集模块；其中，
    肌电采集模块用于采集用户对侧靶肌的皮肤表面的肌电信号；
    信号处理模块根据皮肤表面的肌电信号并基于经颅磁的治疗靶点自动定位方法确定脑区初级运动皮层区，根据磁刺激方案确定磁刺激参数；
    经颅磁刺激主机根据磁刺激参数，发送对应强度的磁刺激触发指令至经颅磁拍头；
    拍头控制模块根据脑区初级运动皮层区与对应治疗靶点的位置关系将经颅磁拍头移动至指定治疗靶点。
  9. 根据权利要求8所述的系统，其特征在于，所述肌电采集模块包括贴于相应身体部位的采集电极，经颅磁拍头刺激脑区时，电流经过神经通路传递到相应身体部位，相应身体部位产生动作即可采集到皮肤表面肌电信号。
  10. 根据权利要求8所述的系统，其特征在于，所述经颅磁拍头安装在头盔内且贴近用户脑部侧，拍头控制模块控制经颅磁拍头沿头盔圆周和半径运动，以确定治疗靶点；经颅磁拍头可自旋，用于调整磁场聚焦的方向。
  11. 根据权利要求8至10任一所述的系统，其特征在于，还包括与信号处理模块相连的显示模块，用于显示经颅磁治疗方案，肌电信号数据及波形、经颅磁拍头的实时坐标以及诱发电位值。
  12. 一种用于经颅磁磁刺激头盔，其特征在于，包括头盔本体、经颅磁拍头以及控制经颅磁拍头在头盔本体内转动的拍头转动模组；所述头盔本体包括头盔上壳和头盔下壳，所述头盔上壳设有用于拍头转动模组前后运动的弧形导轨，所述拍头转动模组设有用于驱动经颅磁拍头沿弧形导轨前后移动的上下运动机构和用于驱动头盔上壳沿头盔下壳左右运动的水平运动机构，所述拍头转动模组连接权利要求8-11任一所述的用于经颅磁的治疗靶点自动定位系统。
  13. 根据权利要求12所述的用于经颅磁磁刺激头盔，其特征在于，所述水平运动机构包括第一电机、第一齿轮和水平导轨，所述第一电机和第一齿轮安装在头盔上壳上，第一电机的输出端与第一齿轮传动连接，所述水平导轨内嵌在头盔下壳内且设有与第一齿轮相啮合的齿型。
  14. 根据权利要求12所述的用于经颅磁磁刺激头盔，其特征在于，所述上下运动机构 包括滑座，安装在滑座上的第二电机，以及所述第二电机传动连接的第二齿轮，所述滑座通过第二齿轮和弧形导轨啮合运动，使得滑座在所述弧形导轨上前后移动。
  15. 根据权利要求12-14任一所述的用于经颅磁磁刺激头盔，其特征在于，所述拍头转动模组还设有驱动经颅磁拍头自旋的旋转机构。
  16. 根据权利要求15所述的用于经颅磁磁刺激头盔，其特征在于，所述旋转机构包括安装在滑座上的第三电机、第三齿轮以及与第三齿轮相啮合的被动齿轮，所述第三电机穿过弧形导轨与第三齿轮传动连接，所述被动齿轮一侧面与滑座转动连接，被动齿轮另一侧面连接经颅磁拍头。
  17. 根据权利要求16所述的用于经颅磁磁刺激头盔，其特征在于，所述被动齿轮与经颅磁拍头之间设有减震弹簧。
  18. 根据权利要求12至17任一所述的用于经颅磁磁刺激头盔，其特征在于，还包括与头盔本体相连的减重支撑悬臂机构，所述减重支撑悬臂机构包括吊臂支架和悬臂支架，所述吊臂支架一端与头盔本体固定连接，另一端通过钢丝或吊绳连接悬臂支架。
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