United States Patent |
6,488,617
|
Katz
|
December 3, 2002
|
Method and device for producing a desired brain state
Abstract
A method and device for the production of a desired brain state in an
individual contain means for monitoring and analyzing the brain state
while a set of one or more magnets produce fields that alter this state. A
computational system alters various parameters of the magnetic fields in
order to close the gap between the actual and desired brain state. This
feedback process operates continuously until the gap is minimized and/or
removed.
Inventors:
|
Katz; Bruce F. (Haverford, PA)
|
Assignee:
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Universal Hedonics (Haverford, PA)
|
Appl. No.:
|
687599 |
Filed:
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October 13, 2000 |
Current U.S. Class: |
600/26; 600/544 |
Intern'l Class: |
A61M 021/00; A61B 005/04 |
Field of Search: |
600/9-15,300,544,545,26-27,409
128/897
607/45
|
References Cited
U.S. Patent Documents
3882850 | May., 1975 | Bailin et al.
| |
4227516 | Oct., 1980 | Meland et al.
| |
4700135 | Oct., 1987 | Hoenig.
| |
4736751 | Apr., 1988 | Gevins et al. | 600/545.
|
4940453 | Jul., 1990 | Cadwell.
| |
5036858 | Aug., 1991 | Carter et al.
| |
5092835 | Mar., 1992 | Schurig et al. | 600/9.
|
5215086 | Jun., 1993 | Terry, Jr. et al.
| |
5280793 | Jan., 1994 | Rosenfeld.
| |
5309923 | May., 1994 | Leuchter et al. | 600/544.
|
5356368 | Oct., 1994 | Monroe.
| |
5495853 | Mar., 1996 | Yasushi.
| |
5732702 | Mar., 1998 | Mueller.
| |
5743854 | Apr., 1998 | Dobson et al. | 600/409.
|
5769778 | Jun., 1998 | Abrams et al.
| |
5813993 | Sep., 1998 | Kaplan et al. | 600/544.
|
5954629 | Sep., 1999 | Yanagidaira et al.
| |
6266556 | Jul., 2001 | Ives et al.
| |
6304775 | Oct., 2001 | Iasemidis et al. | 600/544.
|
Other References
John R. Hughes, et al; "Conventional and Quantitative
Electroencephalography in Psychiatry"; The Journal of Neuropsychiatry and
Clinical Neuroscience, 1999; 11:2 190-208.
Daniel L. Menkes et al., "Right frontal lobe slow frequency repetitive
transcranial magnetic stimulation (SF r-TMS) is an effective treatment for
depression: a case-control pilot study of safety and efficacy;" J. Neurol
Neurosurgery Psychiatry 1999; 67:113-115.
Andreas Killen; "Magnetic headbangers"; www.salon.com, Oct. 3, 2000.
|
Primary Examiner: Shaver; Kevin
Assistant Examiner: Veniaminov; Nikita R
Attorney, Agent or Firm: Wolf, Block, Schorr and Solis-Cohen LLP, Zielinski; Robert F., Dichter; Eric A.
Claims
What is claimed:
1. A method for producing a desired brain state in an individual by
measuring and controlling a brain signal comprising;
measuring a brain signal indicating a brain state of an individual;
comparing characteristics of the measured brain state to characteristics of
a desired brain state to determine the difference between the measured
brain state and the desired brain state;
selecting a magnetic field having at least one parameter selected from the
group consisting of magnet position, field magnitude, pulse frequency, and
pulse train duration to alter the brain state, wherein the at least one
parameter is selected to most reduce the gap between the measured and
desired brain states;
applying the selected magnetic field to the brain of the individual;
measuring a brain signal indicating the altered brain state, the altered
brain state corresponding to the application of the magnetic field;
comparing the characteristics of the altered brain state to characteristics
of the desired brain state to determine the difference between the altered
brain state and the desired brain state; and
repeating the selecting, applying, and measuring a brain signal indicating
the altered brain state steps until an acceptable brain state is achieved.
2. The method of claim 1 wherein the steps are under computer control and
the steps are performed continuously.
3. The method of claim 1 wherein the brain signal is measured by a
technique selected from the group consisting of an electroencephalography,
magnetoencephalography, and functional magnetic resonance imaging.
4. The method of claim 1 wherein the brain signal is an
electroencephalogram signal measured by electrodes positioned on the head
of the individual and the magnetic field is generated by magnets
positioned on the head of the individual.
5. The method of claim 4 wherein the electroencephalogram signal is
amplified and converted into a digital signal.
6. The method of claim 5 wherein at least one parameter is varied to alter
the brain state.
7. The method of claim 6 wherein a gradient descent algorithm varies the
parameters by:
altering a preselected subset of the parameters selected of the group
consisting of magnet position, field magnitude, pulse frequency, and pulse
train duration;
measuring distance metrices between a desired electroencephalogram signal
and each electroencephalogram signal resulting from the alteration of each
parameter of the subset of parameters;
choosing the parameter and the parameter alteration having the distance
metric with the least value;
adjusting the chosen parameter by the chosen parameter alteration;
measuring a resulting electroencephalogram signal, the resulting
electroencephalogram signal corresponding to the chosen parameter
alteration, and a resulting distance metric between the desired
electroencephalogram signal and the resulting electroencephalogram signal;
and
repeating the adjusting and measuring a resulting electroencephalogram
signal steps until a desired threshold is achieved.
8. The method of claim 6 wherein a gradient descent algorithm varies the
parameters by:
altering a preselected subset of the parameters by alteration distances,
the parameters being selected from the group consisting of magnet
position, field magnitude, pulse frequency, and pulse train duration,
wherein more than one parameter is altered at a time,
measuring distance metrices between a desired electroencephalogram signal
and each electroencephalogram signal resulting from the alteration of each
parameter of the subset of parameters;
realtering the preselected subset of parameters, the parameter realteration
distances being decreased from the alteration step, more Man one parameter
being realtered at a time; and
measuring a resulting electroencephalogram signal, the resulting
electroencephalogram signal corresponding to the chosen parameter
realteration, and a resulting distance metric between the desired
electroencephalogram signal and the resulting electroencephalogram signal,
wherein if a desired threshold is not achieved, each parameter of the
subset of parameters is realtered a random amount to shift the parameter
space and the altering, realteing, and measuring steps are repeated until
a desired threshold is achieved.
9. The method of claim 5 wherein at least one parameter is increased and
decreased by a fixed amount and the resulting brain state is measured.
10. The method of claim 9 wherein a gradient descent algorithm varies the
parameters by:
measuring distance metrices between a desired electroencephalogram signal
and each electroencephalogram signal resulting from the increase and
decrease of each parameter;
choosing the parameter and the parameter increase or decrease having the
distance metric with the least value;
adjusting the chosen parameter by the chosen parameter increase or
decrease;
measuring a resulting electroencephalogram signal, the resulting
electroencephalogram signal corresponding to the chosen parameter increase
or decrease, and a resulting distance metric between the desired
electroencephalogram signal and the resulting electroencephalogram signal;
and
repeating the adjusting and measuring a resulting electroencephalogram
steps until a desired threshold is achieved.
11. The method of claim 9 wherein a gradient descent algorithm varies the
parameters by:
measuring distance metrices between a desired electroencephalogram signal
and each electroencephalogram signal resulting from the increase and
decrease of each parameter,
choosing for each parameter the parameter increase or decrease having the
distance metric with the least value;
adjusting more than one parameter by the chosen parameter increase or
decrease having the distance metric with the least value, each parameter
being increased or decreased an amount inversely proportional to the
measured distance metric for each increase or decrease;
measuring a resulting electroencephalogram signal, the resulting
electroencephalogram signal corresponding to the chosen parameter increase
or decrease, and a resulting distance metric between the desired
electroencephalogram signal and the resulting electroencephalogram signal;
and
repeating the adjusting and measuring a resulting electroencephalogram
signal steps until a desired threshold is achieved.
12. The method of claim 9 wherein a gradient descent algorithm varies the
parameters by:
measuring distance metrices between a desired electroencephalogram signal
and each electroencephalogram signal resulting from the increase and
decrease of each parameter;
choosing the parameter and the parameter increase or decrease having the
distance metric with the least value;
adjusting the chosen parameter by the chosen parameter increase or
decrease;
measuring a resulting electroencephalogram signal, the resulting
electroencephalogram signal corresponding to the chosen parameter increase
or decrease, and a resulting distance metric between the desired
electroencephalogram signal and the resulting electroencephalogram signal;
and
repeating the adjusting and measuring a resulting electroencephalogram
steps until a desired threshold is achieved, wherein the adjustment of the
chosen parameter decreases for each repeated adjustment step.
13. The method of claim 9 wherein a gradient descent algorithm varies the
parameters by:
measuring distance metrices between a desired electroencephalogram signal
and each electroencephalogram signal resulting from the increase and
decrease of each parameter;
choosing the parameter and the parameter increase or decrease having the
distance metric with the least value;
adjusting the chosen parameter by the chosen parameter increase or
decrease; and
measuring the resulting electroencephalogram signal, the resulting
electroencephalogram signal corresponding to the chosen parameter increase
or decrease, and a resulting distance metric between the desired
electroencephalogram signal and the resulting electroencephalogram signal,
wherein if a desired threshold is not achieved, each parameter is altered
a random amount to shift the parameter space and the increasing,
decreasing, first and second measuring, choosing, and adjusting steps are
repeated until a desired threshold is achieved.
14. The method of claim 1 wherein the magnets are positioned using a bar
holding the magnets, the bar being movable along a track by a motor.
15. The method of claim 1 wherein the brain signal is altered to correct
asymmetry in the brain signal between the left and right hemispheres
associated with clinical depression.
16. The method of claim 1 wherein alpha rhythms of the brain state are
altered to produce a greater degree of relaxation.
17. The method of claim 1 wherein the brain signal is altered to achieve an
arbitrary electroencephalogram signal corresponding to a desired brain
state.
18. The method of claim 1 wherein the parameters are selected based on
known brain signals corresponding to brain states.
19. The method of claim 18 wherein the brain states are selected from the
group consisting of lower frequency states, alpha frequency states,
frequencies suppressing activity in the cortex, and frequencies producing
excitation of the cortex.
20. The method of claim 1 wherein the parameters of the magnetic field are
selected based on treatment regimes for known conditions.
21. A method for producing a desired brain state in an individual by
continuously measuring and controlling a brain signal comprising:
measuring an electroencephalogram signal indicating a brain state of an
individual by electrodes positioned on the head of the individual;
amplifying the measured electroencephalogram signal;
converting the amplified electroencephalogram signal into a digital signal;
comparing the characteristics of the digital electroencephalogram signal to
the characteristics of a desired electroencephalogram signal using a
computational system to determine the difference between the digital
electroencephalogram signal and the desired electroencephalogram signal;
applying a magnetic field having parameters, the parameters being magnet
position, field magnitude, pulse frequency, and pulse train duration, to
alter the brain state of the individual by positioning magnets on the head
of the individual, wherein a value for at least one parameter is selected
to alter the brain state and achieve the desired electroencephalogram
signal;
measuring a resulting electroencephalogram signal, the resulting
electroencephalogram signal corresponding to the selected value of the at
least one parameter; and
comparing the characteristics of the resulting electroencephalogram signal
to the characteristics of the desired electroencephalogram signal to
determine the need to further alter the brain state, wherein the steps are
under computer control, the method is continuous, and the at least one
parameter is varied according to a gradient descent algorithm.
22. A device for producing a desired brain state in an individual by
measuring and controlling a brain signal comprising;
means for measuring a brain signal indicating a brain state of an
individual;
a computational system for comparing characteristics of the measured brain
state to characteristics of a desired brain state to determine the
difference between the measured brain state and the desired brain state;
and
means for applying a magnetic field having parameters to the brain of the
individual to alter the brain state, the parameters being magnet position,
field magnitude, pulse frequency, and pulse train duration.
23. The device of claim 22 wherein the means for applying a magnetic field
are magnets.
24. The device of claim 23 wherein the means for measuring the brain signal
is selected from the group consisting of an electroencephalogram, a
magnetoencephalogram, and a functional magnetic resonance imager.
25. The device of claim 24 wherein the brain signal is measured by an
electroencephalogram using electrodes positioned on the head of the
individual.
26. The device of claim 25 further comprising an amplifier for amplifying
the electroencephalogram signal.
27. The device of claim 26 further comprising an analog/digital converter
to convert the amplified electroencephalogram signal into a digital
signal.
28. The device of claim 23 further comprising a positioning apparatus for
controlling the position of the magnets on the skull of the individual,
the positioning apparatus using a bar holding the magnets, the bar being
movable along a track by a motor.
29. The device of claim 28 wherein the positioning apparatus enables
movement of the magnets between the front and back of a skull.
30. A device for producing a desired brain state in an individual by
measuring and controlling an electroencephalogram signal comprising:
electrodes for measuring the electroencephalogram signal of an individual,
the electrodes being adapted to be positioned on the surface of the skull
and having wires for relaying the electroencephalogram signal;
a lattice for holding the electrodes on the surface of the skull;
a multi-channel opto-isolation amplifier for receiving the
electroencephalogram signal from the wires of the electrodes and
amplifying the electroencephalogram signal relayed by the electrodes;
an analog/digital converter for converting the measured signal into a
digital signal;
a computational system including quantitative electroencephalogram software
for monitoring the electroencephalogram signal and comparing the signal to
a desired electroencephalogram signal to determine the difference between
the measured electroencephalogram signal and the desired
electroencephalogram signal;
a pulse train generator for generating a magnetic field having a field
magnitude, a pulse frequency, and a pulse train duration in accordance
with the determination of the computational system;
magnets to apply the magnetic field to the brain of the individual to alter
the brain state; and
a positioning apparatus for controlling the position of the magnets on the
skull of the individual in accordance with the determination of the
computational system, the positioning apparatus using a bar holding the
magnets, the bar being moveable along a track by a motor, and the
positioning apparatus enabling movement of the magnets between the front
and back of the skull.
Description
FIELD OF THE INVENTION
The present invention relates to monitoring and altering an individual's
brain state. More particularly, the present invention is directed to the
continuous real-time alteration of the brain state from a less desirable
to a more desirable state through the use of multiple magnetic fields and
a system monitoring the effect of the fields.
BACKGROUND OF THE INVENTION
Most techniques for altering the brain state of a subject have concentrated
on altering a measure of this state, i.e., the electroencephalogram (EEG)
signal. The EEG is an electrical signal that is read on the surface of the
skull which reflects the average activity of large groups of neurons and
may, if properly interpreted, be indicative of the psychological state of
the subject. EEG frequency bands are usually divided into (1) delta
rhythms, having a frequency range of 1.5-3.5 Hz, (2) theta rhythms, having
a frequency range of 3.5-7.5 Hz, (3) alpha rhythms, having a frequency
range of 7.5-12.5 Hz, and (4) beta rhythms, having a frequency range of
12.5-20 Hz. Some frequencies above 20 Hz, such as the gamma range (around
40 Hz) have been implicated in various types of cognitive processing,
although their role in indicating overall mood is still unclear. In
general, the lower the mean frequency of the EEG signal, the lower the
state of alertness, although many other factors may influence the
interpretation of the EEG signal, including the location on the scalp of
the EEG readings, the degree of synchronization between readings, and
whether any psychological pathology is present.
Conventional EEG monitoring techniques have involved a skilled technician
processing the raw signals by hand. A well-trained technician can often
pinpoint abnormalities in such signals, although well-defined correlates
between EEG signals and pathological brain states have only been made
possible with the advent of quantitative EEG (QEEG) methods, in which the
analog EEG signal is converted to a digital signal for further
computational manipulation and analysis. Among the many features that QEEG
can easily detect are precise power levels in different bandwidths,
dynamic changes in bandwidths over time, and coherence between different
parts of the brain. In conjunction with some theoretical assumptions, QEEG
may also be used to provide a three-dimensional picture of brain activity.
QEEG has also revealed a number of correlates between abnormal electrical
activity and pathological states, including but not limited to, the states
of dementia, schizophrenia, mood disorders, Attention Deficit Disorders
(ADD), and alcohol and substance abuse (Hughes & John, 1999). In addition,
it has been known for some time that relatively high activity in the alpha
frequency band (8-13 Hz) in normal subjects is correlated with a feeling
of relaxation.
These sorts of results have encouraged researchers to attempt to improve
deficient or otherwise non-optimal mental states by attempting to
manipulate the EEG. For example, depression has been correlated with an
asymmetry in activity between the right and left prefrontal cortices, with
greater activity in the right. To treat this condition, one would want to
achieve an EEG signal which is more balanced between the hemispheres.
Likewise, one might attempt an increase in the power level of the alpha
band to increase relaxation.
One method for altering the brain signals is by biofeedback (see, e.g.,
U.S. Pat. No. 3,882,850), in which a patient is given a visual or auditory
feedback proportional to the desired EEG signal. The patient attempts to
increase the level of this feedback in order produce more of the desired
signal. For example, in alpha feedback, the intensity of a sound may
represent the degree of alpha present. By concentrating on raising the
intensity of this sound, the patient thereby indirectly increases the
intensity of the degree of alpha present, and presumably thereby increases
her degree of relaxation. U.S. Pat. No. 5,280,793 describes a similar
feedback mechanism for the correction of hemispheric asymmetry in activity
levels associated with depression.
There are, however, limitations on what can be accomplished with this
treatment paradigm. First and most fundamentally, the method can only work
if it is conceivable that conscious effort can alter the brain in the
desired way. The exact neural dynamics of biofeedback are unknown, but it
is known that conscious effort is localized to specific areas of the
brain, most likely those of the neocortex. If the right connections to
other areas of the brain that are in need of change are not present, or
are of the wrong sort, then biofeedback will not be possible. In short,
the situation is one of a part of a dynamic system attempting to influence
the state of the dynamic system as a whole, which may work in certain
cases, but is less likely to work when large-scale, and/or long-term
change must be effected. Secondly, biofeedback may be providing duplicate
information. For example, presumably one either knows or can be taught to
pay attention to how relaxed one is. In this case, audible feedback of the
EEG signal may be simply a more complex method of achieving what can be
done with simpler means.
For these reasons and others, researchers have turned to other means of
altering the underlying brain state, while maintaining the basic mechanism
of EEG feedback. For example, U.S. Pat. No. 5,495,853 uses photic
stimulation delivered to the eyes through specially constructed glasses in
order to alter the brain state. Meanwhile, the EEG signal is monitored. If
the desired EEG signal is not being produced, then certain parameters of
the stimulation, such as the frequency of the flashing of the lights, are
changed until the desired signal is achieved.
This method, however, suffers from a similar problem to that of
biofeedback. Visual stimulation is routed primarily through the optic
tract to the thalamus and then to the occipital cortex, where most primary
visual processing is accomplished. It is only routed to other areas of the
brain, if at all, after a number of filters have been applied to the
visual signal, such as those responsible for line and shape extraction,
those that divide the color information into three channels (red/green,
blue/yellow, and black/white), and those that divide static from motion
information. Thus, any attempt to influence a part of the brain other than
the occipital cortex itself will be a hit and miss affair.
A method that has a more global effect on the brain is electro-convulsive
therapy (ECT). ECT is achieved by applying a controlled current to the
patient's skull for a period of 1-10 seconds, and is chiefly used in
treatment of refractory depression. In recent years, ECT has been made
much more safe than previously, although as U.S. Pat. No. 5,769,778, to
Abrams et al. describes, it still suffers from a number of side effects,
including burns to the scalp and skin and unwanted effects of the induced
seizure, including memory loss. Furthermore, because the signal strength
must be large enough to penetrate the skull, its effect on the rest of the
brain is indiscriminate. It cannot be localized to change activity in
certain parts of the brain without affecting others.
Abrams also argues that transcranial magnetic stimulation (TMS) is both a
less dangerous and more controlled way of stimulating the brain. U.S. Pat.
No. 4,940,453, to Cadwell, describes the type of magnetic coil used in
TMS. The ability to produce a localized magnetic field, which in turn
triggers localized electrical activity in the brain, has enabled TMS to be
successful in the treatment of depression. Reduced activity in the left
prefrontal cortex has been implicated in depression, and TMS may work by
restoring activity in this area to normal levels. One problem with TMS is
that high frequency stimulation may induce seizures. U.S. Pat. No.
5,769,778 describes a method of monitoring the EEG signal in order to
prevent such seizures. When incipient features of a seizure are detected,
the treatment is halted. Thus, the '778 patent describes a kind of limited
feedback system, albeit one for preventing the adverse effects of TMS
treatment, rather than one that attempts to improve the delivery of such.
Even though the aforementioned techniques have allowed some degree of
alteration of brain signals incorporating the EEG signal as an indicator,
there still exists a need for a system with a continuous feedback
mechanism for monitoring and altering brain signals to treat certain
diseases and conditions.
BRIEF SUMMARY OF THE INVENTION
The present invention comprises a method and device for producing a desired
brain state in an individual. In its most general form, the method of the
present invention comprises measuring the activity of the brain, analyzing
the measured activity by comparing it to a desired brain activity, and
directing one or more magnets to produce magnetic fields which will close
the gap between the actual and desired brain state.
In its most general form, the device of the present invention comprises
means for measuring the activity of the brain, a computational system for
analyzing the measured activity by comparing it to a desired brain
activity, and means for directing one or more magnets to produce magnetic
fields which will close the gap between the actual and desired brain
state.
In one embodiment of the invention, brain activity is revealed by the EEG
signal, as measured with multiple electrodes on the surface of the skull.
In another embodiment, brain activity is measured with
magnetoencephalography (MEG), which is able to detect the weak magnetic
fields emanating from the brain. In yet another embodiment, brain activity
is measured by functional magnetic resonance imaging (fMRI), which
measures blood flow in the brain and from which activity may be inferred.
In one embodiment, the computational system determines the single parameter
(the parameters comprise spatial position, pulse strength, pulse
frequency, and pulse duration for each magnet) controlling the magnets
that most reduces the gap between the actual and desired brain state and
alters this parameter accordingly. In another embodiment of the
computational system, multiple parameters are altered simultaneously to
reduce the gap between the actual and the desired brain states more
efficiently. In another embodiment of the computational system, a subset
of parameters are chosen for consideration based on a priori knowledge or
based on experimentation. In yet another embodiment of the computational
system, the mean magnitude of the changes to the parameters is reduced
with time so that an approximate solution may be found first and fine
tuned later. In a further computational embodiment, a random jump in the
values of the parameters is effected if the current set of values is not
yielding good results.
In one embodiment of the present invention, multiple magnets are used to
produce magnetic fields to stimulate the brain and, optionally, each
magnet may be positioned independently on the surface of the skull.
In an embodiment of the present invention, the device comprises electrodes
for measuring the EEG signal; an amplifier for amplifying the EEG signal;
a converter for converting the measured analog EEG signal into a digital
signal; magnets for applying the magnetic field to the brain of the
individual; and a positioning apparatus for controlling the position of
the magnets on the skull of the individual.
In a further embodiment of the present invention, two magnets are used to
treat depression, one exciting the left prefrontal cortex, and one
inhibiting the right prefrontal cortex.
In another embodiment of the present invention, multiple magnets are used
to induce relaxation by increasing the magnitude of the alpha rhythm and
by increasing synchronization between the left and right hemispheres.
In the most general embodiment of the system, an arbitrary psychological
state with a known correlated activity state as revealed by EEG,
magnetoencephalography (MEG), or functional MRI may be achievable.
It is to be understood that both the foregoing general description and the
following detailed description are exemplary, but are not restrictive, of
the invention.
BRIEF DESCRIPTION OF THE DRAWINGS
The present invention is best understood from the following detailed
description when read in connection with the accompanying drawings. It is
emphasized that, according to common practice, the various features of the
drawings are not to scale, rather, the dimensions of the various features
are arbitrarily expanded or reduced for clarity. Included in the drawings
are the following figures:
FIG. 1 shows the mechanism of the method and device of the present
invention;
FIG. 2 is a top view of the magnet positioning system used in the method
and device of the present invention; and
FIG. 3 shows the mechanism of gradient descent used for altering parameters
of the magnetic field in the method of the present invention.
DETAILED DESCRIPTION OF THE INVENTION
The present invention comprises a method and device (system) for altering
brain states of individuals by continuously monitoring EEG signals
simultaneous with magnetic treatment in order to improve the efficacy of
the treatment in a "closed loop feedback" system. A feedback system is
necessary because it is problematic, if not impossible, to provide an
explicit solution to the problem of predicting the effect of multiple
magnetic pulsed signals on the brain. The three primary reasons supporting
this are:
(1) the circuitry of the brain is not completely mapped and, thus, even if
the original locus of stimulation on the surface of the cortex is known,
it cannot always be predicted which areas of the brain will be affected by
the spread of neural activation;
(2) the dynamics of the brain are not fully understood and, thus, even with
a full connectivity map of the brain, it is still not possible to predict
activation as a function of time; and
(3) even if the problems discussed for (1) and (2) are solved, there will
still be variations in the organization of the brain among individuals
stemming from innate, neuroanatomical differences and differences in
experience affecting synaptic efficacy, neither of which, in general, will
be known prior to actual treatment.
Thus, there exists the need for an alternative mechanism to explicitly
predicting and calculating the effect on the brain of changes in the
applied magnetic field in order to provide an optimal magnetic signal to
the brain in view of the desired treatment aimed at altering the brain
state.
FIG. 1 shows an overview of the mechanism of the method and device used for
adjusting the magnetic field delivered to the brain on the basis of EEG
signals. There are five sets of components in the method and device: (1)
those used in the direct monitoring of the EEG (or other type of) signal;
(2) those that preprocess this signal for further computational
processing; (3) those that process the EEG signals and determine the
variation in the appropriate parameters for the magnetic field; (4) those
producing the appropriate current for the magnetic field on the basis of
these parameters; and (5) those responsible for delivering the magnetic
field, itself, to the individual.
A set of electrodes 1 is placed in strategic positions on the surface of
the skull as a means for measuring the EEG signal of an individual. The
electrodes 1 may be placed individually on the skull, or may be held in
place by a positioning apparatus, such as a lattice 2, as shown in FIG. 1.
The lattice 2, in conjunction with a chin strap (not shown), holds the
electrodes tightly against the skull, reducing impedance between the
electrodes and the skull, thus improving the signal-to-noise ratio. Caps
with pre-placed electrodes, which fit tightly over the head, can also be
used to hold the electrodes on the skull. For purposes of the present
invention, any structure which holds the electrodes tightly against the
skull and does not interfere with the EEG signal can be used.
EEG wires connect each electrode 1 to a multi-channel opto-isolation
amplifier 5. The amplifier 5 increases the relatively weak EEG signal
received from the electrodes 1 and the amplified signal is then converted
to a digital signal by a multi-channel analog to digital converter 6 for
further processing by QEEG techniques. The amplifier 5 also optically
isolates the electrodes from the rest of the system in order to prevent
current from being accidentally shunted to them. Typically, the EEG signal
will be monitored a short time after the magnetic field is generated, so
that the EEG signal is not affected by the magnetic field created by the
magnets. It may also be necessary in certain treatment regimes to allow
the initial wave of activity to die down for a period of about 5 to 20
seconds before monitoring, to ensure that the field is generating more
than a very short-term effect.
Although EEG is currently the most cost-effective means of monitoring the
dynamic state of the brain for a given space and time resolution, other
means are possible which do not in principle alter the nature of the
proposed invention. Magnetoencephalography (MEG) directly detects the
extremely weak magnetic fields produced by the brain with the use of one
or more Superconducting Quantum Interference Devices (SQUIDS), as
described in U.S. Pat. No. 4,700,135. It provides time resolution of
approximately 1 millisecond, comparable to EEG, and spatial resolution of
approximately 10 cm, also comparable to EEG. In addition, MEG does not
suffer from some of the distortion effects due to the skull to which EEG
signals are subject. However, MEG devices are considerably more expensive
than EEG systems due to the need to keep the SQUIDS at a temperature near
absolute zero, typically costing on the order of millions of dollars.
Thus, the widespread use of MEG awaits a less costly apparatus.
Functional magnetic resonance imaging (fMRI) is another possible approach
in acquiring a snapshot of brain activity (see U.S. Pat. No. 5,732,702).
fMRI works by detecting differential blood flow to various regions of the
brain, and from the blood flow levels, it infers brain activity. It uses a
more powerful magnet than conventional MRI and it provides excellent
spatial resolution (approximately 1 millimeter) with worse temporal
resolution (on the order of seconds) than either EEG or MEG. Thus, to use
it in a continuous feedback system, the parameters of the magnetic
stimulation must be reduced by a priori means, effectively limiting the
amount of time needed to search for the settings of the magnets that will
provide optimal response. The temporal resolution of fMRI is improving
with time, which will make it more amenable to monitoring tasks.
The brain state, however it is measured, is funneled to a computation
system 7 (FIG. 2), which lies at the heart of the feedback process. The
system 7 compares the characteristics of the actual brain state to those
of the desired brain state. The characteristics of the brain state are the
temporal and spatial distributions of the various frequency bands of the
brain signal, detectable by EEG or other methods and as described above,
e.g., the mean frequency corresponding to various magnitudes of alpha,
beta, delta, and theta rhythms. The therapeutic goal determines the gap
between the measured and desired brain state, how the system 7 adjusts key
parameters of the magnetic stimulation in order to reduce the gap between
the actual and desired state, and what constitutes an acceptable brain
state. For example, an acceptable brain state may be achieved by obtaining
lower frequency states, between 1.5 and 7.5 Hz, to induce and/or maintain
sleep, producing alpha frequency brain waves (between 8 and 13 Hz) to
achieve calm or relaxation, etc. The algorithm for this adjustment process
is described further below. The significant parameters which are altered
are as follows:
(1) Magnet position--each magnet 3 may be moved to its optimal position by
the magnet positioning apparatus 4, the mechanism of which is shown in
FIG. 2.
(2) Magnitude of the magnetic field--each magnet will generate a unique
field, a key component of which is the field strength. Greater magnitude
implies more influence on the intended focus, although the size of that
focus will also increase as the magnitude increases.
(3) Pulse frequency--each magnet will pulse at a unique frequency. Because
the induced voltage in the brain is proportional to the change in the
magnetic field strength, the effect on the brain is proportional to the
pulse frequency. More specifically, frequencies below approximately 1 Hz
suppress activity in the cortex, while frequencies above 1 Hz produce
excitation in proportion to the frequency after an initial period of
suppression. Thus, the focal area of the brain can be suppressed or
excited depending on the magnet frequency.
(4) Pulse train duration--the object of most treatments will be to effect
long-term synaptic change in the brain. The longer the train duration, the
more likely that this will occur, although very long durations may be
counterproductive, in that they can produce seizure-like conditions or
other unknown side effects. Typical pulse train durations are in the range
of 5 to 25 seconds.
The computational system 7 sends the determined parameters (2)-(4) to the
pulse train generator 8, which, in turn, directs the magnets, i.e., means
for applying a magnetic field, to produce the field as required by these
parameter settings. The computational system 7 also sends the parameter
values (1) directly to the positioning apparatus 4 which positions the
magnets in the desired positions above the skull. FIG. 2 shows a system
with two magnets, 3A and 3B, positioned above opposite cortical
hemispheres, although not necessarily symmetrically. They are held in
place by a circular bar 9 along which each magnet may be moved by a small
motor from a lateral, anterior position along the side of the skull to a
superior medial position above the skull midline. The bar 9 should be
positioned such that the magnets 3A and 3B are as close as possible to the
skull without touching the electrode mesh 2. The bar 9 contains a track 10
on which the bar 9 moves as a whole, also via a small motor, along with
the magnets 3A and 3B. This mechanism allows positioning of the magnets 3A
and 3B along the anterior/posterior dimension, i.e., from the front to the
back of the skull. Thus, a magnet's movement over a combination of the bar
9 and the track 10 allow an arbitrary position to be achieved for the
magnet in that magnet's hemisphere.
More bars 9 may be added if more magnets are needed in order to generate
the requisite magnetic field characteristics. The entire positioning
apparatus is suspended from above and may be lowered onto the head before
the treatment session takes place. Ideally, the two bars 9 and 10 should
also be adjustable to ensure that the magnets are close to the skull.
The chosen values for non-positional parameters for each magnet, i.e., the
magnitude of the magnetic field, the pulse frequency, and the pulse train
duration, are decided by and relayed from the computational system 7 to
the pulse train generator 8, which, in turn, directs the magnets 3 to
produce the calculated field. The non-positional (2)-(4) and the
positional parameters (1) are set so as to minimize the distance between
the desired EEG signal and the actual EEG signal. The following algorithm
attempts to achieve this, assuming that a distance metric between the two
EEG signals has been defined:
(1) an initial set of parameter values is chosen based on prior knowledge;
(2) for each parameter P.sub.i of n parameters the 2n .DELTA.'s resulting
from increasing P.sub.i a fixed amount and decreasing P.sub.i a fixed
amount are measured;
(3) the .DELTA. among the 2n .DELTA.'s with the least value is determined;
(4) the corresponding parameter is adjusted in this direction; and
(5) steps (1)-(4) are repeated until .DELTA. is below a predetermined
threshold.
FIG. 3 illustrates the parameter adjustment process with n=2. The
concentric ovals are lines of equal .DELTA. as a function of the 2
parameters, P.sub.1 and P.sub.2, with the center oval the lowest. Among
the four possible movements from the set of current parameter values ((1)
increasing P.sub.1, (2) decreasing P.sub.1, (3) increasing P.sub.2, and
(4) decreasing P.sub.2), increasing P.sub.2 results in the lowest .DELTA..
Thus, parameter P.sub.2 is increased and, assuming that the cortical
dynamics are relatively constant, the new EEG state resulting from this
parameter change will be closer to the desired state. It can also be seen
in FIG. 3 that the next change that will reduce .DELTA. the most will be
to increase P.sub.1. The process continues until .DELTA. is sufficiently
small, i.e., something close to the desired EEG is being produced.
A number of variations of the basic algorithm may improve real-time
performance, including:
(1) More than one parameter may be altered at once, in proportion to the
decrease in .DELTA. effected. Thus, in FIG. 3, P.sub.2 would be increased
and P.sub.1 would be increased to a lesser extent. However, because the
shape of the parameter space is not known in advance, it is uncertain at
the outset whether this will improve performance. Empirical results will
reveal if altering more than one parameter is useful for a given type of
treatment.
(2) A subset of the parameters may be chosen, i.e., preselected, for
modification such that the size of the search space is reduced. There may
be too many parameters to alter in a timely manner (e.g., in the
embodiment in FIG. 2, there are a total of eight parameters--movement,
frequency, magnitude, and duration for each of the two magnets). The
critical parameters may be chosen based on a priori knowledge or on the
basis of experimentation.
(3) Parameter adjustment distance is decreased over time. This annealing
process will ensure that larger changes occur at the start when the
gradient is steepest and those changes will decrease toward the end when
the gradient is much reduced.
(4) It may be necessary to induce a jump, or shift, in the parameter space
if the minimization process does not produce an adequate result, i.e., no
desired threshold is achieved. Such a jump or shift is effected by
altering any or all of the parameters a random amount. The random amount
may be determined by any computer program or other means for generating
random numbers. This will be necessary, for example, if the system is
stuck in a local minimum which is not adequate for the given treatment.
An example of the method and device of the present invention in operation
is the treatment of depression. Currently, there are two TMS-based methods
to redress the deficit in the cortical activity of the left prefrontal
cortex relative to the right cortex. The first and most frequently used
method is to apply rapid stimulation (greater than 1 Hz), to the left
prefrontal cortex directly. The second method is to inhibit activity in
the right cortex with low frequency stimulation. Both have proved
effective (Menkes, et. al., 1999), however, neither method has shown
success in greater than 50% of cases.
FIG. 2 shows the method and device with the current invention to increase
treatment efficacy over the case in which only one hemisphere at a time is
stimulated. One magnet would be centered over the left prefrontal cortex,
while the other magnet would be centered over the right prefrontal cortex.
The initial setting of the parameters would be approximately 5 Hz (high
frequency) for the left magnet and 0.5 Hz (low frequency) for the right
magnet. Magnitude levels would be set to be equivalent for both magnets.
The desired EEG state is symmetry in the magnitude between the readings of
the electrodes centered over the left and right prefrontal cortices,
possibly with an additional preference given to signals that show
coherence (waves with the same frequency and in phase) in these readings.
The EEG signal is measured about 5 to 20 seconds after magnetic
stimulation, after the initial wave of activation has died down, in order
to ensure that the stimulation effected medium term and/or long term
synaptic change; the feedback system of the present invention will adjust
the position and frequency until there is firm evidence of an increase in
bilateral symmetry.
As another example of the method of the present invention, it is known that
the production of alpha waves (8-13 Hz) is correlated with a state of calm
or relaxation. In addition, there is evidence that synchronization in this
band between various parts of the brain, as revealed by the correlation
between the EEG signals taken from those regions, is also associated with
such a state. Using the prior technology, most likely with a larger magnet
set in order to achieve large-scale synchronization, it should be possible
to help invoke the alpha state regardless of the initial state of the
brain. Furthermore, the method can be used to "lock-in" this state,
prolonging the relaxation session. This is necessary because a
sufficiently strong distracter, whether internal to the brain or from an
external source, can cause the EEG signal to become desynchronized and to
move to a higher frequency, interrupting relaxation and causing the mind
to move to a state of alert readiness. The method of the present invention
will prevent this interruption because, as soon as the EEG signal begins
to become desynchronized, the device will immediately reapply the magnetic
field originally found to induce the relaxed state (which will vary from
patient to patient), or, if this fails, can reapply the feedback
methodology to return to the desired state, returning the subject to the
relaxed state.
Other variations of this method are also possible, such as producing and
sustaining lower frequency states (1.5-7.5 Hz) as a means of inducing and
maintaining sleep. In principle, an arbitrary EEG state can be achieved,
as long as there exists a configuration and parameter setting of the
current magnet set that can produce such an EEG signal.
Although illustrated and described above with reference to certain specific
embodiments, the present invention is nevertheless not intended to be
limited to the details shown. Rather, the present invention is directed to
a continuous feedback method and device for altering brain states, and
various modifications may be made in the details within the scope and
range of equivalents of the claims and without departing from the spirit
of the invention.
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