Controller for Neuromuscular Testing

• US 20080312551A1
• Filed: 08/21/2006
• Published: 12/18/2008
• Est. Priority Date: 08/30/2004
• Status: Active Grant

• Current Assignee: Neuronetrix Solutions LLC
• Original Assignee: Neuronetrix Solutions LLC
• Inventors: Fadem, Kalford C.
• Granted Patent: US 9,259,164 B2
• Time in Patent Office: Days
• US Class Current: 600/554
• CPC Class Codes: A61B 2560/0276 Determining malfunction
• CPC Class Codes: A61B 2560/0475 Special features of memory means, e.g. removable memory cards
• CPC Class Codes: A61B 2562/08 Sensors provided with means for identification, e.g. barcodes or memory chips
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0051 by applying vibrations
• CPC Class Codes: A61B 5/1106 to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/377 using evoked responses
• CPC Class Codes: A61B 5/388 Nerve conduction study, e.g. detecting action potential of peripheral nerves
• CPC Class Codes: A61B 5/4041 Evaluating nerves condition
• CPC Class Codes: A61B 5/4047 afferent nerves, i.e. nerves that relay impulses to the central nervous system
• CPC Class Codes: A61B 5/6824 Arm or wrist
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick

Abstract

A peripheral nervous system (PNS) neuromuscular disorder testing system incorporates a testing apparatus that is affixed to a patients skin, positioning a stimulus transducer (e.g., electrical contact(s), movable sharp point, etc.) into a nerve pathway of interest with an electrode and reference electrodes appropriately positioned relative thereto to measure the electrical signal produced. A wireless connection to a control box relays the data associated with the time of the stimulus and the sensed response to a diagnostic system that analyzes the waveform per selectable testing protocols with user tailorable view capabilities and data dissemination communication paths.

Claims

1. A peripheral nervous system (PNS) testing apparatus, comprising:

a testing device positionable upon a subject'"'"'s skin having a signal electrode, a reference electrode and a tactile stimulus producer; and

a test programmer operably configured to communicate a plurality of control administration parameters to the testing device for performing a peripheral nervous system nerve conduction test.

2. The PNS testing apparatus of claim 1, wherein the tactile stimulus producer comprises an electrically actuated projecting member to jab the skin.

3. The PNS testing apparatus of claim 1, wherein the tactile stimulus producer comprises a pair of selectively electrified contacts.

4. The PNS testing apparatus of claim 1, wherein the plurality of control administration parameters are selected from a group consisting of a stimuli start time, a stimuli selection, a stimuli sequence, a failure determination, and sample mode.

5. The PNS testing apparatus of claim 1, further comprising a remote repository operatively configured to transmit control administration parameters to the test programmer, to store PNS test results from the test programmer and associated subject identification information and testing paradigm, and to perform PNS diagnostic analyses on the PNS test results.

6. The PNS testing apparatus of claim 1, wherein the test programmer further comprises:

a memory;

a paradigm logic library, a stimulus library database, and a program contained in memory; and

a controller operatively configured to access the memory to perform the program, the program operably configured to access a selected testing paradigm contained in the paradigm logic library, to access stimuli specified by the selected testing paradigm contained in the stimulus library database, to calculate sequence and interstimulus delays between selected stimuli in accordance with the selected testing paradigm, and to output a testing stream.

7. The PNS testing apparatus of claim 6, wherein the controller is further operatively configured to receive PNS test results, to store the PNS test results in association with subject identification information and selected testing paradigm.

8. The PNS testing apparatus of claim 1, wherein the testing device is further operatively configured to detect an artifact contained in a sensed test results, to access an epoch grouping of stimuli associated with the artifact, and to replay the associated epoch grouping.

9. The PNS testing apparatus of claim 1, wherein the testing device includes a unique registration code associated with sensed testing results acquired by the testing device.

10. The PNS testing apparatus of claim 1, wherein the testing device further comprises a user input responsive to a manual input from the subject performed in response to a stimulus, the test programmer operatively configured to receive and store testing results in association with the manual inputs.

11. The PNS testing apparatus of claim 1, further comprising a repository data system and a graphical user interface operatively configured to access testing results associates with subject identification information and selected testing paradigms, to generate a display of a template of a stored data manipulation parameters, and to generate a display of automatic paradigm-specific grouping.

12. The PNS testing apparatus of claim 1, further comprising a repository data system and graphical user interface operatively configured to access PNS testing results associates with subject identification information and selected testing paradigms, to access a selected digital signal processing parameter, to access a selected PNS grouping criteria, to access an algebraic combination configuration, to calculate an algebraic combination of the PNS testing results, to pattern match the combined PNS test results against a neurological PNS model.

13. The PNS testing apparatus of claim 12, further comprising correlating subsequent neurological diagnoses associated with subject identification information and refining a selected neurological PNS model to correlate with PNS test results associated with the neurological diagnoses.

14. The PNS testing apparatus of claim 1, further comprising a user rights management system controlling access to the test programmer.