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WO1983001742A1 - Appareil et procede permettant de generer des signaux de stimulation des nerfs ou des muscles - Google Patents

Appareil et procede permettant de generer des signaux de stimulation des nerfs ou des muscles Download PDF

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Publication number
WO1983001742A1
WO1983001742A1 PCT/NL1982/000042 NL8200042W WO8301742A1 WO 1983001742 A1 WO1983001742 A1 WO 1983001742A1 NL 8200042 W NL8200042 W NL 8200042W WO 8301742 A1 WO8301742 A1 WO 8301742A1
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WO
WIPO (PCT)
Prior art keywords
impulse
impulses
amplitude
stimulus
generator
Prior art date
Application number
PCT/NL1982/000042
Other languages
English (en)
Inventor
Voor Wetenschappelijk Onderwijs Op ... Vereniging
Original Assignee
Van Rij, Gerhard, Leendert
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Van Rij, Gerhard, Leendert filed Critical Van Rij, Gerhard, Leendert
Priority to AU1011382A priority Critical patent/AU1011382A/xx
Publication of WO1983001742A1 publication Critical patent/WO1983001742A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36003—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of motor muscles, e.g. for walking assistance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/025—Digital circuitry features of electrotherapy devices, e.g. memory, clocks, processors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/3603—Control systems
    • A61N1/36034—Control systems specified by the stimulation parameters

Definitions

  • the invention relates to an apparatus and method for generating stimulation signals which are supplied from a generator to a stimulation electrode in the proximity of a nerve or muscle of a human being or an animal, to stimulate said nerve or muscle, which stimulation signals are comprising a number of impulse trains of stimulus impulses of alternating polarity, whereby the pairs of succeeding positive and negative impulses have an equal impulse width.
  • stimulation signals are supplied from a generator to a stimulation electrode in the proximity of a nerve or muscle of a human being or an animal, to stimulate said nerve or muscle, which stimulation signals are comprising a number of impulse trains of stimulus impulses of alternating polarity, whereby the pairs of succeeding positive and negative impulses have an equal impulse width.
  • the stimulation impulses are transferred from the generator to the muscle or nerve by means of electrodes, which are positioned in the proximity of the nerve or muscle to be stimulated.
  • electrodes can be manufactured from several metals such as Au, Pt, Ti, Ta, Zn, Re, W, Ni or alloys thereof. In recent years also an alloy of platinum with 10% iridium is used very successfully.
  • the stimulation of a nerve or muscle through metal electrode is, when looking at it as a physical-chemical system, a very complex process.
  • the transport of charges is carried out by electrons, however into the tissue and in the tissue fluids the transport of charges is carried out by ions.
  • the surface of the stimulation electrode is never homogeneous. Damages, mechanical tensions and differences in crystal structure are causing the forming of micro areas each with different characteristics. Furthennore it is possible that the surface as a whole or in part is covered with an oxidation layer and/or with a coating of organic material.
  • the layer between said electrode and the physiological medium is in constant dynamic equilibrium; currents are running from and to the surface of the electrode; the sum of these currents is zero when no external voltage is connected.
  • Said transition layer comprises at least two sub layers of which the inner layer (the so called Helmholtz-layer), positioned near the surface of the electrode, contains ions of the body fluid which have lost their hydration layer and which are able to become specifically bounded to said surface.
  • the outer layer the so called diffusion e layer, has a more diffuse character.
  • Currents are also running into the surface self, i.e. between the several micro areas, which have a mutually different electrical potential because of their structural differences. Layers onto the surface are not permanent, they are constantly formed and distructed, which means that the micro areas are changing in character. The stimulation current has to run through this physiological chemical complex.
  • the reactions which can take place at a platinum stimulation electrode in a chlorine ions containing medium are known for themselves. These reactions can be subdivided into irreversible reactions and reversible reactions.
  • the amount of charge per stimulus impulse should be ⁇ 3 C per real surface unit in m 2
  • the current density should be ⁇ 300 A per real surface unit in m 2 .
  • the electrode should first be used as cathode.
  • the stimulation electrode viewed as electric component, can in many regards be considered as a non linear system.
  • the relation between the voltage onto and the current through the electrode is partly non linear, and also the relation between the voltage or current and the frequency is non linear.
  • Using- a voltage with constant frequency the relation between voltage and current, or better between voltage and current density, is only linear in a restricted area above which the relation becomes non linear.
  • the divid ing line between both areas is frequency dependent. With a frequency of 0 Hz (direct current/voltage) there is no linear area, above approximately 10 kHz the dividing line between linear and non linear area is constant.
  • the linear area is of great importance for stimulation purposes.
  • this area only reversible reactions are taking place which do not change the medium in which the electrode is positioned, even over a longer time period, and which also do not effect the electrode itself.
  • the size of this area is determined by the choice of the material for the electrode, the surrounding medium and the frequency. If the electrode is working in the non linear area, then said electrode is behaving different for positive and negative voltages; the electrode shows the characteristics of a bad rectifier. That means that also when the electrode is controlled by a voltage or current which is symmetrical in relation to the zero level, there will be a dc component.
  • a stimulation electrode is in the frequency domain a non linear element.
  • the electrode reacts into a different way onto impulses with equal charge but with different impulse width, even when the amplitude of said impulses is such that the electrode is operating in the amplitude linear area.
  • the width of the stimulation impulses (of for instance 100.10 -6 -300.10 -6 s) is much smaller than the interval period between said impulses (of for instance 10.10 -3 -50.10 -3 s).
  • the frequency spectrum of the stimulation impulse differs clearly from the spectrum of the impulse which is represented by the interval period. The seeming balance is therefore not complete and gradually the electrode as well as its environment are changing. That explains the still appearing fatiqueness phenomena.
  • biphase stimulation signals consisting of a series of pulse trains of stimulation impulses with alternating polarity, equal impulse width, equal interval time and equal restricted charge.
  • a disadvantage of an impulse series of this type is, that at the beginning and at the end of each pulse train the speed, with which the stimulated muscle has to react changes abruptly from zero to a certain value respectively from a certain value to zero, whereas furthermore at the beginning and the end of the stimulating pulse train the acceleration theoretically becomes infinitely.
  • An object of the invention Is now to provide a method and an apparatus for generating nerve or muscle stimulating signals not subjected to the above mentioned disadvantages.
  • Said object is achieved with a method of the- type described in the first paragraph in which the charge content and the frequency of pairs of successive positive and negative stimulus impulses are modulated according to a function which Is at least twice time differ- entiable.
  • the result thereof is that the speed as well as the acceleration of the physical system, which itself has a certain inertion, maintains a finite value within a finite time interval.
  • the raodul ation of the charge content of the impulses is realized by amplitude modulation of the pairs of impulses .
  • the modulation of the charge content of the Impulses is realized by pulse width modulation of the pairs of impulses.
  • a stimulus impulse of a predetermined impulse width should have a certain minimum amplitude. If the impulse trains are modulated in correspondence with the invention such that the first impulses in each impulse train have a value beneath said minimum threshold value, then these first stimulus impulses in each impulse train have no effect, and furthermore it appears in practice that the generation of said non effective stimulus impulses decreases the influence of the first stimulus impulses above said threshold value. According to a preferred embodiment of the invention the modulation is carried out such that the first stimulus impulse in each impulse train has an amplitude above a predetermined threshold value. To achieve a fluent contraction of the stimulated muscle the impulse frequency of the stimulating impulses is in a preferred embodiment of the method according to the invention at least 20 Hz.
  • the maintain an undisturbed charge balance preferably measures are taken to choose the number of impulses in each impulse train such that the number of positive impulses in each impulse train equals the number of negative impulses in each impulse train.
  • the interval times between both impulses in each impulse pair are equal.
  • the effect of the stimulus is, apart from the temporal addition, determined by the amplitude and the pulse width of the stimulation impulse width.
  • the impulse width of the stimulation impulses is determined from said hyperbolic amplitude-impulse width-characteristic such, that per impulse a minimum energy amount is supplied to the muscle or nerve.
  • the object of the invention is furthermore achieved with an apparatus for generating stimulation signals
  • a generator supplying said signals to a stimulation electrode positioned in the proximity of a nerve or muscle of a human being or an animal, to stimulate said nerve or muscle, which generator comprises means for generating series of impulse trains of stimulus impulses of alternating polarity, whereby pairs of succeeding positieve and negative pulses have an equal Impulse width, which is according to the invention characterized in that said generator further comprises means for modulating the frequency of the pairs of succeeding positive and negative impulses according to a function which is at least twice time differentiable.
  • Fig. 1 illustrates a stimulation signal consisting of a number of impulse trains modulated in correspondence with the invention.
  • Fig. 2 shows in detail a number of impulses near the beginning and near the end of each impulse train.
  • Fig. 3 illustrates a number of impulses near the beginning and near the end of a modulated Impulse train.
  • Fig. 4 illustrates a part of a coded pulse series.
  • Fig. 5 illustrates the schematical general diagram of a generator for generating stimulation signals.
  • Fig. 6 Illustrates a detailed circuit diagram of the main oscillator and function generator of Fig. 5.
  • Fig. 7 illustrates a detailed circuit diagram of the adding and sampling circuits in Fig. 5.
  • Fig. 8 illustrates a detailed diagram of the amplitude, frequency and pulse width modulators in Fig. 5.
  • Figs. 9 and 10 show wave forms on various points in the Figures 5-8.
  • Fig. 11 illustrates a transmitter for coding and transmitting signals.
  • Fig. 12 illustrates a receiver for receiving and decoding signals.
  • Fig. 13 illustrates a number of signals on various points In Figs.11 and 12.
  • Fig. 1 shows a stimulation signal comprising a number of succeeding impulse trains appearing each into an interval T I , interchanged by resting periods T E .
  • the stimulation is carried out in the interval T I .
  • the physical system is left alone during the interval T E , so that the system is slowed down by its own inertion and turns to the resting position.
  • the length of the intervals T I and T E is dependent onto the physically determined stimulation and resting periods.
  • the method or apparatus according to the invention is for instance used for stimulating one or more of the motoric nerves influencing the breathing muscles, for instance diaphragm stimulation or stimulation of the nerves belonging to the midriff (nn.phrenici), then the Intervals T I and T E will be determined by the desired breathing pattern.
  • the inhaling movement is made during T I and the exhaling movement as well as the rest period between the breathing movements fits into T E .
  • Fig. 2 shows in more detail a number of impulses near the beginning and near the end of each impulse train.
  • the amplitude of each impulse is denoted with A 1 , A 2 .... A n
  • the impulse width is denoted with t p
  • the impulse interval time is denoted by t i 1, t i 2... t ⁇ n.
  • the amplitude, the impulse width and the impulse interval time is equal for pairs of succeeding impulses.
  • the amplitude as well as the frequency of each impulse train is modulated, maintaining the above mentioned relation between the pairs of suceeding positive and negative impulses, using a twice time differentiable modulating function.
  • it is also possible to use a sine function or a function of the form f( t) a . t n .
  • a positive and negative threshold value d is indicated. It appears in practice that stimulating Impulses having an amplitude A ⁇ d do not have any influence. With such impulses there is no contraction in the stimulated muscle. Only if Impulses with an amplitude equal to or exceeding said threshold value d are used, then the muscle will react onto said impulses.
  • the first impulse A 1 in each impulse train will have a value A 1 d so that the stimulation is in fact increasing from approximately zero according to an e power function. Because said e power function is twice time differentiable also the speed and the acceleration will gradually increase so that the whole physical system is not forced to carry out a movement which because of the inertion of the system in fact is impossible.
  • the interval time in a preferred embodiment should be smaller than 50 ms , or in other words the impulse frequency should be at least 20 Hz.
  • measures are taken to generate an equal number of positive and negative Impulses in each impulse train.
  • the optimal value of is that value of the impulse width whereby for a predetermined response the minimum amount of energy has to be supplied.
  • the amplitude of the stimulating Impulses is modulated.
  • the impulse width can be modulated such, that the first impulse of each impulse train has a small width and the width of the succeeding impulses is increasing according to an e power function.
  • the amplitude of each of the impulses is in that case equal and can be determined at a value above the in Fig. 1 illustrated threshold value d.
  • Fig. 3 illustrates a number of impulses near the beginning and near the end of an impulse train modulated in this way.
  • the amplitude of each of the impulses is A ⁇ d
  • the impulse width of the im pulses is denoted with ⁇ , ii ' " n
  • the lmPulse interval time is denoted with t il , t i2, ... tin.
  • the method according to the invention is applied to an electrode implanted in the body of a human being or an animal, and said electrode is connected to a wireless receiver receiving signals from the generator, then preferably the stimulating signals generated by said generator are coded in such a way that disturbances onto the transmission path between the generator and the electrode are eliminated. Furthermore one has to take into account the energy consumption of the receiver circuit. Especially when receivers have to be used during a extended period, then it is important that the energy consumption of the receiver is as low as possible.
  • the signal supplied by the generator is before transmission to the receiver coded into a time code modulated signal using a start pulse, a stop pulse and a number of clock pulses, whereby the time distance between the succeeding start pulses determines the frequency, the time distance between start and stop pulse is determining the momentaneous impulse width and between each of the further clock pulses an information pulse may be present indicating together the impulse amplitude of the stimulating impulse.
  • Fig. 4 illustrates a part of a coded pulse series between two start pulses, indicated by "start". After the first start pulse there is in this example a period of 30 ⁇ sec increased by the Impulse width of the coded impulse. Thereafter a stop pulse Is received determining the end of the above mentioned period. If said stop pulse is not received within a predetermined interval, then the receiver can be deactivated. The receiver is also deactivated after reception of the last information bit.
  • a number of equidistant clock pulses ell, c12,... c110 are received each of which may be followed within a predetermined period of 9 ⁇ sec by an information pulse.
  • the succeeding information bits b9... b1 are representing in binary coding the amplitude of the coded impulse. In the illustrated example said information bits represent the decimal value +339.
  • the interval time between the succeeding stimulus Impulses is determined by the time between two successive start pulses.
  • Fig. 5 illustrates a general diagram of the circuit for generating stimulation impulses in agreement with the invention.
  • the configuration comprises a main oscillator 1 and a function generator 2.
  • the main oscillator 1 is a linear sawtooth generator, generating a linear sawtooth voltage (MO in Fig. 9) of which the frequency is adjustable. Said linear sawtooth voltage is supplied to the function generator 2, delivering a number of differently shaped output voltages at a corresponding number of outputs.
  • These outputs voltages of the function generator 2, the voltages ⁇ B, ⁇ Z, ⁇ K and ⁇ e can be described in mathematical form as follows:
  • B is a voltage which is constant during tg and is zero during Tg-tg:
  • K ⁇ Et(H(t+nTg)-H(t+nTg-tg)) (sawtooth voltage)
  • K Is a voltage which is increasing according to a square law during tg and is zero during Tg-tg :
  • K ⁇ Et 2 (H( t+nTg)-H( t+nTg-tg) )
  • e is a voltage which Is logarithmicly increasing during tg and is zero during Tg-tg :
  • e ⁇ E(I-e -t (H(t+nTg)-H(t+nTg-tg) ) . ( e-power)
  • the time constant can be varied using a switch and furthermore n
  • Fig. 6 illustrates a more detailed diagram of the main oscillator and function generator 1 respectively 2.
  • the sawtooth voltage MO in Fig. 9 is generated in the circuit built around icla, and the frequency of said sawtooth voltage is adjustable by means of P1.
  • a comparator built around ic2a
  • said sawtooth voltage is compared with a dc voltage of which the amplitude is adjustable by means of P2.
  • a square wave voltage having an on time of tg (0 ⁇ tg ⁇ Tg) is generated.
  • Said square wave voltage is brought to a fixed amplitude of E Volt in the buffer amplifiers ic2b and ic3a, delivering at their outputs the square wave voltages +B and -B.
  • the d.c. voltage derived from PI is converted into a linear sawtooth voltage.
  • the integration time in this circuit is adjustable by means of P3.
  • the integrator is maintained in the reset state during tg ⁇ t ⁇ Tg. Because both potentiometers P3 and P2 are coupled the normalized ultimate amplitude E of the sawtooth voltage Z is independent of the time period tg. Said normalized sawtooth voltage is supplied at the outputs of the buffer amplifiers ic4a and ic4b (+Z and -Z).
  • the signal -Z is furthermore supplied through an adjustable potentiometer P4 to a further integrator, built around ic5a of which the integration time is adjustable by means of P5.
  • the potentiometer P4 is coupled to P1 and the potentiometer P5 is coupled to P2.
  • the result thereof is that at the output of said integrator a variable voltage +K, varying according to a square law is generated of which the highest amplitude is independent of the main oscillator frequency fg and independent of tg.
  • the integrator is maintained in the reset state during tg ⁇ t ⁇ Tg.
  • the buffer amplifier ic5b also the inverted voltage -K. is generated. Both signals +K and -K are normalised to a voltage of E Volt.
  • the potentiometer P6 is coupled to P2.
  • the resulting voltage e, which Is varying according to an e power has, notwithstanding a varying tg, a fixed shape.
  • the wave forms +e and -e are generated at the output of the buffer amplifiers ic6a and ic6b.
  • the generated voltages +3, -B, +K, -K, +Z, -Z, +e and -e are supplied to a number of summing amplifiers 3, 4, 5 and 6 in Fig. 5.
  • the summing amplifier 3 delivers at his output the signal ⁇ AM+
  • the summing amplifier 4 delivers at his output the signal ⁇ M-
  • the summing amplifier 5 delivers at his output the signal ⁇ PBM
  • the summing amplifier 6 delivers at his output the signal ⁇ .FM.
  • Said resulting voltage signals 2 ⁇ M+, ⁇ AM-, ⁇ .PBM and ⁇ .FM can be considered as modulates of respectively the positive amplitude, the negative amplitude, the impulse width and the impulse frequency.
  • Said four modulates are sampled using sample-and-hold amplifiers 7, 8, 9 and 10 in Fig. 5. The sampling step is necessary for generating pairs of impulses of which the amplitude (positive and negative), the impulse width and the impulse frequency are equal.
  • Fig. 7 illustrates a more detailed diagram of the summing- and sampling-circuits, whereby it is denoted that only one of the summing circuits is illustrated which is however representative for the further circuits.
  • the summing amplifier in Fig. 7 is built around an operational amplifier (four of which are actually present Indicated by icl0ab, 11ab ), and the signals ⁇ B, ⁇ Z, ⁇ K and ⁇ e are supplied through a resistor network to one input of said summing amplifier through adjustable potentiometers P1-4 for adjusting the amplitude of each of said signals.
  • the signal from the sample-and-hold circuit 10 (Fig.5) is supplied to a frequency modulator 11, embodied as a linear sawtooth oscillator of which the frequency is proportional to the Input voltage ⁇ FM' , the sampled frequency modulator output ⁇ FM, delivered by the sample-and-hold stage 10.
  • Said frequency modulator (11) delivers at one of the outputs a voltage RES2, which is supplied to the pulse width modulator 12 in Fig. 5.
  • said frequency modulator generates the sampling signals for the sample-and-hold stages 7, 8, 9 and 10.
  • the pulse width modulator 12 comprises a comparator in which the output voltage PBM' of the sample-and-hold stage 9 is compared with an integrated dc voltage.
  • the integrator used for integrating said dc voltage is periodically reset by the signal RES2.
  • said pulse width modulator delivers at his output a voltage PB, of which the frequency is linearly proportional to ⁇ FM' (the sampled signal ⁇ FM) and of which the pulse width is linearly proportional to 1PBM' (the sampled ⁇ PBM) .
  • the signal PB is used as switching signal for the amplitude modulators 13 and 14 in Fig. 5.
  • PB determines the time in which 2AM+'( the sampled ⁇ AM) respectively ⁇ AM-' (the sampled ⁇ AM-) are switched through said amplitude modulators.
  • impulse shaped signals are generated of which the amplitude is determined by ⁇ AM' , the width is determined by ⁇ PBM' and the frequency is determined by ⁇ FM' .
  • the impulse voltage is by means of a voltage to current convertor 16 converted into an impulse current forming the output of the whole system.
  • Fig. 8 provides more details of the amplitude-, frequency- and pulse width modulators 14, 13, 12 and 11 of Fig.5.
  • the sample-and-hold stages 7 and 8 are illustrated in more detail, built around the sample-and-hold amplifiers shl and sh2, which are combined into the two amplitude modulators (13, 14 in Fig. 5).
  • the signals ⁇ PBM' and ⁇ FM' are used in the already described way to generate the signal PB.
  • the frequency modulator 11 comprises as already said a linear sawtooth generator built around the ic ⁇ a and the frequency of the generated sawtooth voltage is proportional to the input voltage ⁇ FM' .
  • the output voltage of said sawtooth generator is through a buffer stage ic8b supplied to the monostable multivibrator MSlb which generates the reset signal RES2.
  • the flip flop FFla is used for generating the sampling signal SMPL.
  • the pulse width modulator 12 comprises a comparator built around ic9b for comparing the voltage ⁇ PBM' with an Integrated d.c. voltage.
  • the integrator integrates the d.c. voltage as his negative input.
  • the signal PB at the output of ic9b is supplied to the amplitude modulator configuration and used therein for switching the amplitude modulator circuits.
  • the output voltages of the summing circuits 3 and 4 of Fig.5 are supplied to the sample-and-hold stages built around shl and sh2 and the output voltages thereof ⁇ AM+' and ⁇ AM-' are switched through under control of the signal PB to the output buffer stages built around ic7a and ic7b.
  • FIGs 9 and 10 illustrate several wave forms on various points in the detailed diagram of the Figures 6, 7 and 8.
  • the used reference symbols in Figs. 9 and 10 are identical to the reference symbols used in the Figs. 6, 7 and 8.
  • Fig. 11 illustrates the transmitter used for generating the time coded control signals based on the output voltages of the external generator PB, ⁇ AM+ and ⁇ AM-.
  • 11 comprises a number of monostable multivibrator circuits MS1a,b, MS2a,b, MS3a,b, MS4a,b, an analogue to digital convertor A.D.conv, a flip flop FF1 and furthermore a number of or-gates, and-gates and nand-gates as well as a number of transistors, capacitors, resistors and further elements.
  • the transmitter generates the time coded messages which are already discussed In more detail with reference to Fig. 4.
  • the functioning of said transmitter is not described in detail because it is assumed that the expert in this field finds in Figs. 11 and 13 and in the following list of components enough information to build a properly functioning circuit. The same applies to the receiver/ internal stimulator illustrated in Fig. 12.
  • Fig. 13 shows in the upper half section a number of signals at various points in the circuit diagram of Fig. 11. This signals are 1. incoming signal PB 1 ⁇ s Q 1a
  • the circuit diagram of the receiver/internal stimulator is illustrated in Fig.12.
  • the power section is illustrated consisting of a resonance circuit receiving the HF energy transmitted by the transmittor, which HF energy is rectified and used as supply voltage for the remaining circuits of the receiver.
  • the actual receiver comprises two monostable multivibrator circuits MS5a,b and MS6a,b, a flip flop circuit FM2, a digital to analogue convertor DAconv and a number of operational amplifiers ic1, ic2 and ic3 and further small components.
  • Fig. 13 illustrates In the lower section a number of signals appearing at various points in this receiver circuit. These various The digital input signal to the digital/analogue convertor is decoded and the output signals of said digital/analogue convertor are supplied to operational amplifiers which are only activated during the switch-on period of the stimulation impulse. For the remaining periods they are switched to a very low energy consumption level, so that the voltage delivered by the power circuit is sufficient to supply to whole receiver circuit.
  • CMOS DUAL FLIPFLOP
  • CMOS INV CD4049 HEX INVERTER

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  • Electrotherapy Devices (AREA)

Abstract

Appareil et procédé de génération de signaux de stimulation à l'aide d'un générateur envoyant les signaux à une électrode de stimulation placée à proximité d'un nerf ou d'un muscle d'un être humain ou d'un animal pour stimuler ce nerf ou ce muscle, lequel générateur comprend des moyens générant des séries de trains d'impulsions de stimulus de polarité alternée, de sorte que des paires d'impulsions successives positives et négatives ont une largeur d'impulsion égale. Ce générateur comprend en outre des moyens de modulation de la fréquence des paires d'impulsions successives positives et négatives selon une fonction qui est au moins deux fois différenciable dans le temps.
PCT/NL1982/000042 1981-11-23 1982-11-23 Appareil et procede permettant de generer des signaux de stimulation des nerfs ou des muscles WO1983001742A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU1011382A AU1011382A (en) 1981-11-23 1982-11-23 Apparatus and method for generating nerve or muscle stimulation signals

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL8105297A NL8105297A (nl) 1981-11-23 1981-11-23 Werkwijze voor het opwekken van zenuw- of spierstimulatiesignalen.
NL8105297811123 1981-11-23

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WO1983001742A1 true WO1983001742A1 (fr) 1983-05-26

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PCT/NL1982/000042 WO1983001742A1 (fr) 1981-11-23 1982-11-23 Appareil et procede permettant de generer des signaux de stimulation des nerfs ou des muscles

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EP (1) EP0094407A1 (fr)
NL (1) NL8105297A (fr)
WO (1) WO1983001742A1 (fr)

Cited By (15)

* Cited by examiner, † Cited by third party
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US4827935A (en) * 1986-04-24 1989-05-09 Purdue Research Foundation Demand electroventilator
WO1989004191A1 (fr) * 1987-11-10 1989-05-18 Piet Hein Dispositif permettant d'exercer une influence sur un organisme
WO1995033514A1 (fr) * 1994-06-09 1995-12-14 Magnetic Resonance Therapeutics, Inc. Procede d'electrotherapie
WO1997038751A1 (fr) * 1996-04-12 1997-10-23 Siemens Aktiengesellschaft Neurostimulateur transcutane
US8343027B1 (en) 2012-01-30 2013-01-01 Ivivi Health Sciences, Llc Methods and devices for providing electromagnetic treatment in the presence of a metal-containing implant
US8415123B2 (en) 2004-04-19 2013-04-09 Ivivi Health Sciences, Llc Electromagnetic treatment apparatus and method for angiogenesis modulation of living tissues and cells
US8961385B2 (en) 2003-12-05 2015-02-24 Ivivi Health Sciences, Llc Devices and method for treatment of degenerative joint diseases with electromagnetic fields
US9320913B2 (en) 2014-04-16 2016-04-26 Rio Grande Neurosciences, Inc. Two-part pulsed electromagnetic field applicator for application of therapeutic energy
US9415233B2 (en) 2003-12-05 2016-08-16 Rio Grande Neurosciences, Inc. Apparatus and method for electromagnetic treatment of neurological pain
US9427598B2 (en) 2010-10-01 2016-08-30 Rio Grande Neurosciences, Inc. Method and apparatus for electromagnetic treatment of head, cerebral and neural injury in animals and humans
US9433797B2 (en) 2003-12-05 2016-09-06 Rio Grande Neurosciences, Inc. Apparatus and method for electromagnetic treatment of neurodegenerative conditions
US9440089B2 (en) 2003-12-05 2016-09-13 Rio Grande Neurosciences, Inc. Apparatus and method for electromagnetic treatment of neurological injury or condition caused by a stroke
US9656096B2 (en) 2003-12-05 2017-05-23 Rio Grande Neurosciences, Inc. Method and apparatus for electromagnetic enhancement of biochemical signaling pathways for therapeutics and prophylaxis in plants, animals and humans
US10350428B2 (en) 2014-11-04 2019-07-16 Endonovo Therapetics, Inc. Method and apparatus for electromagnetic treatment of living systems
US10806942B2 (en) 2016-11-10 2020-10-20 Qoravita LLC System and method for applying a low frequency magnetic field to biological tissues

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WO1989004191A1 (fr) * 1987-11-10 1989-05-18 Piet Hein Dispositif permettant d'exercer une influence sur un organisme
GB2230455A (en) * 1987-11-10 1990-10-24 Piet Hein A device for influencing an organism
GB2230455B (en) * 1987-11-10 1991-08-21 Piet Hein Electronic device producing light, sound or vibrational signals
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US5723001A (en) * 1994-06-09 1998-03-03 Electropharmacology, Inc. Apparatus and method for therapeutically treating human body tissue with electromagnetic radiation
WO1997038751A1 (fr) * 1996-04-12 1997-10-23 Siemens Aktiengesellschaft Neurostimulateur transcutane
US9415233B2 (en) 2003-12-05 2016-08-16 Rio Grande Neurosciences, Inc. Apparatus and method for electromagnetic treatment of neurological pain
US10226640B2 (en) 2003-12-05 2019-03-12 Endonovo Therapeutics, Inc. Devices and method for treatment of degenerative joint diseases with electromagnetic fields
US8961385B2 (en) 2003-12-05 2015-02-24 Ivivi Health Sciences, Llc Devices and method for treatment of degenerative joint diseases with electromagnetic fields
US10207122B2 (en) 2003-12-05 2019-02-19 Endonovo Therapeutics, Inc. Method and apparatus for electromagnetic enhancement of biochemical signaling pathways for therapeutics and prophylaxis in plants, animals and humans
US9656096B2 (en) 2003-12-05 2017-05-23 Rio Grande Neurosciences, Inc. Method and apparatus for electromagnetic enhancement of biochemical signaling pathways for therapeutics and prophylaxis in plants, animals and humans
US9440089B2 (en) 2003-12-05 2016-09-13 Rio Grande Neurosciences, Inc. Apparatus and method for electromagnetic treatment of neurological injury or condition caused by a stroke
US9433797B2 (en) 2003-12-05 2016-09-06 Rio Grande Neurosciences, Inc. Apparatus and method for electromagnetic treatment of neurodegenerative conditions
US8415123B2 (en) 2004-04-19 2013-04-09 Ivivi Health Sciences, Llc Electromagnetic treatment apparatus and method for angiogenesis modulation of living tissues and cells
US9427598B2 (en) 2010-10-01 2016-08-30 Rio Grande Neurosciences, Inc. Method and apparatus for electromagnetic treatment of head, cerebral and neural injury in animals and humans
US8343027B1 (en) 2012-01-30 2013-01-01 Ivivi Health Sciences, Llc Methods and devices for providing electromagnetic treatment in the presence of a metal-containing implant
US9320913B2 (en) 2014-04-16 2016-04-26 Rio Grande Neurosciences, Inc. Two-part pulsed electromagnetic field applicator for application of therapeutic energy
US10350428B2 (en) 2014-11-04 2019-07-16 Endonovo Therapetics, Inc. Method and apparatus for electromagnetic treatment of living systems
US10806942B2 (en) 2016-11-10 2020-10-20 Qoravita LLC System and method for applying a low frequency magnetic field to biological tissues
US11344741B2 (en) 2016-11-10 2022-05-31 Qoravita LLC System and method for applying a low frequency magnetic field to biological tissues
US11826579B2 (en) 2016-11-10 2023-11-28 Mannavibes Inc. System and method for applying a low frequency magnetic field to biological tissues
US12257429B2 (en) 2016-11-10 2025-03-25 Mannavibes, Inc. System and method for applying a low frequency magnetic field to biological tissues

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