DEVICE AND METHOD FOR EVALUATING ANALGESIC NEUROSTIMULATION DEVICES

• US 20160220178A1
• Filed: 08/14/2014
• Published: 08/04/2016
• Est. Priority Date: 09/13/2013
• Status: Active Grant

• Current Assignee: Centre Hospitalier Universitaire de Poitiers
• Original Assignee: Centre Hospitalier Universitaire de Poitiers
• Inventors: RIGOARD, Philippe, GUETARNI, Farid
• Granted Patent: US 9,999,387 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 5/1072 measuring distances on the body, e.g. measuring length, height or thickness A61B5/1076 takes precedence
• CPC Class Codes: A61B 5/4824 Touch or pain perception evaluation A61B5/4821 takes precedence
• CPC Class Codes: A61B 5/4827 assessing touch sensitivity, e.g. for evaluation of pain threshold
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: G06F 2203/04803 Split screen, i.e. subdividing the display area or the window area into separate subareas
• CPC Class Codes: G06F 3/0481 based on specific properties of the displayed interaction object or a metaphor-based environment, e.g. interaction with desktop elements like windows or icons, or assisted by a cursor's changing behaviour or appearance
• CPC Class Codes: G06F 3/0482 Interaction with lists of selectable items, e.g. menus
• CPC Class Codes: G06F 3/04842 Selection of displayed objects or displayed text elements G06F3/0482 takes precedence
• CPC Class Codes: G06F 3/04845 for image manipulation, e.g. dragging, rotation, expansion or change of colour
• CPC Class Codes: G06F 3/04883 for inputting data by handwriting, e.g. gesture or text
• CPC Class Codes: G06T 11/001 Texturing; Colouring; Generation of texture or colour inpainting G06T5/77
• CPC Class Codes: G06T 11/206 Drawing of charts or graphs
• CPC Class Codes: G06T 11/40 Filling a planar surface by adding surface attributes, e.g. colour or texture
• CPC Class Codes: G06T 11/60 Editing figures and text; Combining figures or text
• CPC Class Codes: G06T 11/80 Creating or modifying a manually drawn or painted image using a manual input device, e.g. mouse, light pen, direction keys on keyboard
• CPC Class Codes: G06T 2207/30004 Biomedical image processing
• CPC Class Codes: G06T 2207/30196 Human being; Person
• CPC Class Codes: G06T 2210/62 : Semi-transparency
• CPC Class Codes: G06T 2215/16 : Using real world measurements to influence rendering
• CPC Class Codes: G09G 2320/0693 : Calibration of display systems
• CPC Class Codes: G09G 2380/08 : Biomedical applications
• CPC Class Codes: G09G 5/14 : Display of multiple viewports
• CPC Class Codes: G16H 10/20 : for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 40/63 : for local operation

Abstract

In order to assist in evaluating/monitoring pain, and in treating same, a touch-sensitive graphics tool is provided with a local application (TGapps) for displaying a graphical representation of a patient'"'"'s body, on which the patient can delimit a zone. A control application cooperates with the local application in order to record each delimited zone together with the corresponding surface data. The control application has a first mode in which the local application (TGapps) can be used by the patient to delimit zones of pain and a second mode in which the local application can be used by the patient to delimit treated zones. The tool is configured to activate graphical and/or numerical comparisons between the surface areas of the pain zones and the surface areas of the treated zones. In this way, it is possible to evaluate pain and the effects of treatment.

Claims

1. A tool assisting in the evaluation/monitoring of pain and of a treatment, comprising:

a graphics tool (TG) equipped with a screen (102), such as a graphics tablet,

a local application (TGapps) installed in the graphics tool for the purpose of displaying on the screen (102) a graphical representation (100) of a patient'"'"'s body, while allowing a user, for example the patient, to delimit a zone (104) on the graphical representation (100) displayed on the screen (102),

a control application (TGappmain) cooperating with the local application (TGapps) in order to record (CCSapps) each delimited zone (104) together with corresponding surface data,

the control application (TGappmain) having a first mode (S5) in which the local application (TGapps) allows the patient to delimit pain zones,

the control application having a second mode (S6) in which the local application (TGapps) allows the patient to delimit treated zones,

the control application (TGappmain) being configured to activate graphical and/or numerical comparisons between the surface areas of the pain zones and the surface areas of the treated zones,

which makes it possible to evaluate the pain and the effects of the treatment.

2. The tool according to claim 1, wherein, in the first mode (S5), the local application (TGapps) is configured to allow a patient to delimit pain zones selectively according to the type and the intensity of the pain.

3. The tool according to claim 2, wherein the types of pain comprise at least some of the types from the following group:

nociceptive pain, trigger pain, neuropathic pain, mechanical pain.

4. The tool according to claim 1, wherein the treated zones correspond to paresthesia zones resulting from the excitation by a neurostimulation device implanted in the patient, and in that, in the second mode (S6), the local application (TGapps) is configured to allow paresthesia zones to be delimited selectively depending on whether the device is a neurostimulation electrode of the central nervous system or a neurostimulation electrode of the peripheral nervous system.

5. The tool according to claim 1, wherein the local application (TGapps) is configured to evaluate first surface data (Sdol) relating to at least one pain zone and second surface data (Spar) relating to at least one paresthesia zone,

while the control application (TGappmain) is configured to compare these surface data and also to calculate a rate of paresthetic coverage and a rate of specificity of the paresthetic coverage,

which allows the paresthetic coverage to be adapted by improving the specificity.

6. The tool according to claim 1, wherein each graphical delimitation is realized by filling zones with selective graphical attributes, in particular of color, at least some of the zones being partially transparent.

7. The tool according to claim 1, wherein the local application (TGapps) is configured to allow a real metric to be assigned to said graphical delimitations.

8. The tool according to claim 7, wherein the real metric is obtained by applying a real scale to the silhouette (100) of the patient, on the basis of a measured real size, such as the height of the patient.

9. The tool according to claim 7, wherein the real metric is obtained by processing images of the patient that are obtained from medical imaging.

10. The tool according to claim 1, wherein the local application (TGapps) is provided with a functionality for splitting the screen (102) into two zones, one for the patient, and the other for medical personnel, and on which zones the mode of display of at least some of the data is different.

11. The tool according to claim 1, wherein the control application (TGappmain) is configured to control a patient auto calibration function (appCalib2) capable of determining the deviations between a plurality of target points designated by contact on the physical body of the patient and corresponding points indicated by the patient pointing to the cartographic representation (100) displayed on the screen (102), while the delimitation, on the screen (102), of a zone (104) on the cartographic representation (100) by the patient is modified as a function of these patient auto calibration deviations (appCalib2).

12. The tool according to claim 1, wherein the graphics tool (TG) is equipped with a screen (102), and in that the control application (TGappmain) is likewise configured to call up a patient/screen calibration function (appCalib1) capable of determining the deviations between target points on the screen (102) and the zones of the touch-sensitive screen (102) that the patient actually touches, while the delimitation, on the screen (102), of a zone (104) on the cartographic representation (100) by the patient is modified as a function of these patient/screen calibration deviations (appCalib1).

13. The tool according to claim 1, wherein the data relating to graphical delimitation and to surfaces are stored in a dated record attached to a patient file.

14. The tool according to claim 1, wherein the graphics tool (TG) is set up in a network with at least one other computer (CCS), in a manner permitting mobility.

15. The tool according to claim 14, wherein the central computer (CCS) is equipped with applications (CCSapps) capable of managing a database (Neuro-DB) and of performing statistical analyses on the data of this base.

16. The tool according to claim 15, wherein the statistical analyses on the data of said base (Neuro-DB) are configured to supply predictors of treatment, as a function of subpopulations of patients.

17. The tool according to claim 15, wherein the statistical analyses on the data of said base (Neuro-DB) are configured to supply comparative tests on different electrode models.

18. The tool according to claim 1, wherein the local application (TGapps) is configured to determine, between the results of two visits:

a coefficient of raw performance,

a coefficient of weighted performance, as a function of the relationship between a treatment zone and zones of pain intensity, and

a coefficient of specificity/dispersion, as a function of the relationship between the treatment zone and at least some of the zones of pain intensity,

all of these coefficients (R index) providing a powerful indicator of the suitability of a treatment.

19. The tool according to claim 18, wherein the coefficients are represented graphically by telltale lights, including a comparison with respective thresholds, accompanied by at least one diagram of rectangles representing, on the one hand, the relationships between the zones of pain intensity and the part of the treatment zone which respectively affects them, and, on the other hand, the part of the treatment zone which does not affect at least some of the zones of pain intensity (FIG. 18).

20. The tool according to claim 1, wherein the local application (TGapps) is configured to determine, between the results of two visits:

at least three coefficients (YS, YI, YPC) representing, respectively, the reduction of the surface area of pain, the reduction of the pain intensity, and the change of typology of the pain, and

at least three coefficients (XP, XS, XP3) representing, respectively, the performance of the treatment device, the selectivity of the treatment device, and the duration of the effects of the treatment device,

all of these coefficients (index RFG) providing another powerful indicator of the suitability of a treatment.

21. The tool according to claim 20, wherein the coefficients are represented graphically in the form of at least one multiaxial polygonal diagram.

22. The tool according to claim 20, wherein the multiaxial polygonal diagram supports the representation of at least two groups of said coefficients, with different graphical attributes, in particular of color, the two groups being related to at least partially different treatment conditions.

23. The tool according to claim 20, wherein the graphical representation comprises at least two juxtaposed multiaxial polygonal diagrams, corresponding to at least partially different treatment conditions or different times.