Apparatus and methods for delivery of transcranial magnetic stimulation

• US 20050113630A1
• Filed: 10/29/2004
• Published: 05/26/2005
• Est. Priority Date: 05/04/2001
• Status: Active Grant

• Current Assignee: Jack Lancaster, Peter Fox
• Original Assignee: Jack Lancaster, Peter Fox
• Inventors: Fox, Peter, Lancaster, Jack
• Granted Patent: US 7,658,704 B2
• Time in Patent Office: Days
• US Class Current: 600/13
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 2034/305 Details of wrist mechanisms at distal ends of robotic arms
• CPC Class Codes: A61B 2090/067 for measuring angles
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/32 operating autonomously
• CPC Class Codes: A61B 34/37 Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61N 2/006 for magnetic stimulation of nerve tissue
• CPC Class Codes: A61N 2/02 using magnetic fields produced by coils, including single turn loops or electromagnets A61N2/12 takes precedence

Abstract

Disclosed are apparatus and methods for delivery of transcranial magnetic stimulation. The apparatus includes a TMS coil which when energized generates an electric field substantially parallel to a long axis of the coil and substantially normal to a surface of the coil. Furthermore disclosed an apparatus for delivery of TMS in which a coil is adapted to a robotic member for computer-aided control and delivery. Further disclosed are methods of TMS planning and delivery in which subject images are utilized to plan, position and orient the TMS coil for precise delivery. Disclosed also are TMS coils having unique designs to better focus and direct magnetic stimulation.

Claims

1-17. -17. (canceled)

18. A method of transcranial magnetic stimulation, comprising:

defining a cerebral cortical region of interest for a subject;

determining a stimulator position and orientation disposed to deliver an induced electric field substantially perpendicular to said cerebral cortical region of interest;

positioning said subject to immobilize said cerebral cortical region of interest;

directing said stimulator to said subject so that said stimulator is focused to said cerebral cortical region of interest, said directing based on said determined stimulator position and orientation; and

delivering said TMS to said subject, said delivering comprising generating an electric field substantially perpendicular to said cerebral cortical region of interest.

19. The method of claim 18, further comprising performing at least one spatial calibration of a delivery device to a data set of said subject.

20. The method of claim 19, wherein said directing is further based on said at least one spatial calibration.

21. The method of claim 19, wherein said at least one spatial calibration comprises a digitizer to a subject image calibration.

22. The method of claim 18, wherein said defining comprises using a functional image to obtain said region of interest.

23. The method of claim 18, wherein said determining comprises calculating said stimulator position and orientation based on a scalar product of a model of said induced electric field times a vector model of said region of interest.

24. The method of claim 22, wherein said determining comprises superimposing a model of said stimulator on a model of said functional image and an anatomical image.

25. The method of claim 24, wherein said directing further comprises modeling said immobilized subject to obtain a scalp surface model and registering said scalp surface model to said model of said functional image and said anatomical image.

26. The method of claim 18, wherein said directing is performed by a robotic arm to which said stimulator is adapted.

27-50. -50. (canceled) claim 51. A method of transcranial magnetic stimulation, comprising:

positioning a subject to receive the transcranial magnetic stimulation;

moving a transcranial magnetic stimulator to a first treatment position, the first treatment position computed to obtain maximum biological efficacy at a first target point of the subject; and

delivering the transcranial magnetic stimulation.

52. The method of claim 51, further comprising delivering the transcranial magnetic stimulation via an electric field generated substantially perpendicular to the first target point.

53. The method of claim 51, further comprising computing the first treatment position based on a functional image and an anatomical image of the subject.

54. The method of claim 51, further comprising moving the transcranial magnetic stimulator to the first treatment position automatically.

55. The method of claim 51, further comprising:

moving the transcranial magnetic stimulator to a second treatment position; and

delivering the transcranial magnetic stimulation to the second treatment position.

56. The method of claim 51, wherein delivering the transcranial magnetic stimulation comprises generating an electric field perpendicular to a sulcus, wherein the sulcus comprises the first target point.

57. A method comprising:

positioning a subject to receive transcranial magnetic stimulation;

locating a transcranial magnetic stimulator at a first treatment position that is perpendicular to a cerebral cortical region of interest of the subject; and

delivering the transcranial magnetic stimulation to the subject.

58. The method of claim 57, further comprising computing a position and orientation of the transcranial magnetic stimulator at the first treatment position based on a conjoined functional/anatomical model.

59. The method of claim 58, further comprising storing the position and orientation in a storage medium.

60. The method of claim 59, further comprising moving the transcranial magnetic stimulator to the first treatment position automatically based on the stored position and orientation.

61. The method of claim 57, further comprising locating the transcranial magnetic stimulator in accordance with a cortical column cosine aiming principle.

62. The method of claim 57, further comprising selecting the cerebral cortical region of interest using an anatomical image to determine a cortical column orientation.

63. The method of claim 62, further comprising determining a position and orientation of the transcranial magnetic stimulator at the first treatment position such that the transcranial magnetic stimulator generates an electric field parallel to the cortical column orientation.