Electrophysiological monitoring equipment for spinal cord and spinal nerve root functions

Abstract

The invention relates to the technical field of electrophysiological monitoring equipment, in particular to spinal cord and spinal nerve root function electrophysiological monitoring equipment which comprises a stimulating electrode, a programmable amplifier, a signal processing device, a stimulator, a first recording electrode and a second recording electrode. The second recording electrode is installed at the back of the center of the brain, the signal processing device judges whether signals collected by the first recording electrode are valid or not according to the state of the signals collected by the second recording electrode, and the state of the signals collected by the second recording electrode comprises whether the second recording electrode collects the signals or not or the strength of the signals collected by the second recording electrode; in the somatosensory evoked potential process, the second recording electrode is installed in front of the center of the brain, whether signals collected by the first recording electrode are effective or not can be judged according to the state of the signals collected by the second recording electrode, and therefore the final judgment result is more accurate.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of electrophysiological monitoring equipment, in particular to a kind of electrophysiological monitoring equipment of spinal cord and spinal nerve root function. BACKGROUND

[0002] High-risk groups (such as athletes, patients with spinal disease) should be regularly subjected to nerve electrophysiological examination, and nerve electricity can accurately diagnose and evaluate spinal cord diseases, such as determining whether there is a neurodegenerative disease (multiple sclerosis), a spinal cord injury sequelae and a hereditary nerve disease (spinal muscular atrophy or peroneal muscular atrophy) through nerve electricity, and in the evaluation aspect, it can be determined whether there is a possibility of rehabilitation according to the performance of the spinal cord nerves, or it can be prompted to guide the intensity and direction of rehabilitation training. The existing spinal cord and spinal nerve root function monitoring equipment mainly monitors the somatosensory evoked potential and the motor evoked potential to realize the monitoring and judgment of the function of the spinal cord and the spinal nerve root.

[0003] The somatosensory evoked potential is obtained by stimulating the somatosensory nerves of the human body and then monitoring whether there is a corresponding electrical signal in the human brain central posterior gyrus region. The somatosensory evoked potential is mainly used to reflect the function of the posterior column of the spinal cord and the sensory conduction pathway, and is used to evaluate sensory disorders, so as to indirectly determine whether the function of the posterior column of the spinal cord of the human body is abnormal.

[0004] The motor evoked potential is mainly obtained by stimulating the precentral gyrus of the human brain, and then detecting whether there is an electrical signal on the corresponding target muscle. The motor evoked potential is mainly used to reflect the function of the anterior horn cells of the spinal cord, the corticospinal tract and the motor conduction pathway, and is used to evaluate motor disorders, so as to indirectly determine whether the function of the anterior horn cells of the spinal cord and the corticospinal tract of the human body is abnormal.

[0005] The existing technology has the problem that when the somatosensory evoked potential indirectly monitors whether the posterior column of the spinal cord and the sensory conduction pathway are abnormal, the signal collected by the recording electrode often appears abnormal due to the body movement of the personnel, which affects the final result of the signal processing device. Based on this problem, a kind of electrophysiological monitoring equipment of spinal cord and spinal nerve root function is needed to solve the above problems. SUMMARY

[0006] The present application provides a kind of electrophysiological monitoring equipment of spinal cord and spinal nerve root function, which installs second recording electrode in the process of somatosensory evoked potential in the precentral gyrus of brain, can judge whether the signal collected by first recording electrode is effective by the state of the signal collected by second recording electrode, so that the final judgment result is more accurate.

[0007] The technical problem solved by the present application is realized by the following technical scheme: The present invention provides an electrophysiological monitoring device for the function of the spinal cord and spinal nerve roots, comprising: a stimulator for generating precisely controlled electrical stimulation signals; a stimulation electrode connected to the stimulator for transmitting the electrical signals generated by the stimulator to the target nerve; a recording electrode for collecting electrical signals generated by nerve or muscle tissue after stimulation; a programmable amplifier connected to the recording electrode for amplifying weak bioelectrical signals; a signal processing device connected to the programmable amplifier for centrally processing and analyzing the signals from the programmable amplifier after reaching an effective number of times to determine whether there are any abnormalities in the nerve conduction path; the stimulation electrode acts on the somatosensory nerve position of the body, the recording electrode comprises a first recording electrode installed in the postcentral gyrus of the brain and a second recording electrode installed in the precentral gyrus of the brain, and the signal processing device determines whether the signal collected by the first recording electrode is valid based on the signal status collected by the second recording electrode.

[0008] Preferably, the signal status collected by the second recording electrode includes whether the second recording electrode collects a signal or the strength of the signal collected by the second recording electrode, and the signal processing device determines whether the signal collected by the first recording electrode is recorded as a valid number of times based on whether the second recording electrode collects a signal or the strength of the signal collected by the second recording electrode.

[0009] Preferably, when the second recording electrode does not collect any signal or the collected signal strength is weak and does not exceed the set threshold, the signal processing device records the signal currently collected by the first recording electrode as a valid number of times.

[0010] Preferably, when the signal intensity collected by the second recording electrode exceeds a set threshold, the signal processing device does not count the signal currently collected by the first recording electrode as a valid number of times.

[0011] Preferably, when the signal intensity collected by the second recording electrode exceeds a set threshold, the signal processing device will not count the signals collected by the first recording electrode several times in advance and several times in the future as valid times.

[0012] Preferably, there are multiple first recording electrodes, and all of the multiple first recording electrodes are non-invasive patch electrodes.

[0013] Preferably, the signal processing device is a computer.

[0014] Preferably, the second recording electrode corresponds to collecting data from a part or all of the precentral gyrus of the brain.

[0015] Preferably, the first recording electrode is also used to collect electrical signals from the spine.

[0016] The beneficial effect of the present application is that, in the process of somatosensory evoked potential, the signal processing device judges whether the signal state collected by the second recording electrode will affect the signal collected by the first recording electrode, when the signal processing device judges that the signal collected by the first recording electrode will be affected or the effect is large, the signal collected by the first recording electrode in the last few times is eliminated and is not counted as the effective number, when the signal processing device judges that the signal collected by the first recording electrode will not be affected or the effect is small, the signal collected by the first recording electrode is counted as the effective number, so that the final result can be more accurately judged. BRIEF DESCRIPTION OF DRAWINGS

[0017] In order to more clearly illustrate the technical solutions in the embodiments of the present application or the prior art, the drawings needed to be used in the following embodiment or prior art description will be briefly introduced. Obviously, the drawings in the following description are only some embodiments of the present application, and other drawings can also be obtained according to these drawings without creative labor for those skilled in the art.

[0018] Figure 1 The structural schematic diagram provided by the present application; Figure 2 The existing circuit block diagram provided by the present application; Figure 3 The path diagram of motion evoked potential provided by the present application; Figure 4 The path diagram of somatosensory evoked potential provided by the present application; Figure 5 The existing principle step flow chart of somatosensory evoked potential provided by the present application; Figure 6 The existing processing step logic block diagram of somatosensory evoked potential provided by the present application; Figure 7 The first embodiment processing step logic block diagram of somatosensory evoked potential provided by the present application; Figure 8 The second embodiment processing step logic block diagram of somatosensory evoked potential provided by the present application; Figure 9 The circuit principle block diagram of somatosensory evoked potential provided by the present application.

[0019] In the figure, 1, signal processing device; 2, program-controlled biological amplifier; 3, stimulator; 4, recording electrode; 401, first recording electrode; 402, second recording electrode; 5, stimulating electrode; 6, printer. DETAILED DESCRIPTION

[0020] In order to make the technical means, creative features, objectives and effects achieved by the present invention easier to understand, the present invention is further described below with reference to specific illustrations.

[0021] In order to enable those skilled in the art to clearly understand the inventive point of the present invention, the prior art structure involved in the present invention and the use of the prior art are first introduced, so as to assist those skilled in the art to understand the differences between the present invention and the prior art, as well as the significant progress of the present invention over the prior art. Figure 1 and Figure 2 The existing electrophysiological monitoring equipment for spinal cord and spinal nerve root function includes a stimulator 3, a stimulating electrode 5, and a recording electrode 4 (in addition to the stimulating electrode 5 and the recording electrode 4, there are also a reference electrode, a ground electrode, and an attached Figure 1 Display printer 6, etc., which are irrelevant to the inventive point of the present invention and belong to the well-known prior art and will not be elaborated in detail here), programmable amplifier and signal processing device 1, wherein the stimulation electrode 5 is connected to the stimulator 3, and is used to transmit the precisely controlled electrical stimulation signal generated by the stimulator 3 to the target nerve or muscle, and the recording electrode 4 is used to collect the electrical signal generated by the nerve or muscle tissue after stimulation, and the recording electrode 4 is connected to the programmable amplifier, and the programmable amplifier (with a built-in bandpass filter to remove low-frequency drift and high-frequency noise and improve the signal-to-noise ratio) amplifies the weak bioelectric signal from the recording electrode 4, and the amplified electrical signal is transmitted to the signal processing device 1 connected to the programmable amplifier. When the signal processing device 1 receives the set number of signals, it performs centralized processing and judges whether there is any abnormality in the nerve transmission path based on the processing result.

[0022] Generally, electrophysiological monitoring equipment for spinal cord and spinal nerve root function uses a combination of somatosensory evoked potentials and motor evoked potentials to comprehensively judge the health of the human spinal cord and spinal nerve roots.

[0023] So-called somatosensory evoked potentials, see Figure 4Generally, the stimulating electrode 5 is installed at the position of the somatosensory nerve, and then the recording electrode 4 is installed on the head at the position corresponding to the posterior central gyrus of the brain (generally, the specific positions are C3' and C4', where C3' and C4' are the names of the scalp electrodes, representing specific positions about 2 cm behind the standard C3 and C4 electrode positions, and C3 and C4 represent the standard electrode positions in the international 10-20 system). When the stimulating electrode 5 stimulates the somatosensory nerve, the condition of the spinal cord is indirectly judged based on whether the recording electrode 4 can detect the signal and the time when the signal is detected. Specifically, the stimulation sites generally selected for somatosensory evoked potentials are the median nerve or ulnar nerve of the upper limb, and the posterior tibial nerve or peroneal nerve of the lower limb (stimulation is achieved by applying a short electrical pulse such as a square wave through the stimulating electrode 5). The stimulation signal is conducted along the nerve fiber to the central nervous system, and occurs when it passes through the ganglion (spinal ganglion). Synaptic transmission: After the signal enters the spinal cord, it ascends along the fasciculus gracile and fasciculus cuneate, and is transmitted to the fasciculus gracile and fasciculus cuneate nuclei in the medulla oblongata. At the level of the medulla oblongata, the fasciculus gracile and fasciculus cuneate nuclei send out secondary neuronal fibers, which cross to the opposite side to form the medial lemniscus, continue to ascend to the thalamus, and finally transmit to the postcentral gyrus of the brain (C3', C4'). Since the somatosensory evoked potential signal transmission path passes through the spinal cord, it can indirectly reflect the state of the spinal cord. The monitoring process of somatosensory evoked potential, excluding the time for preliminary preparation (cleaning the skin and attaching electrodes), generally takes 15-20 minutes for only one limb. Since the somatosensory evoked potential signal is weak (μV level), multiple stimulation superpositions (50-200 times) are required to improve the signal-to-noise ratio, which prolongs the total detection time. During the somatosensory evoked potential process, the person needs to remain still to reduce the impact on the final monitoring results.

[0024] The so-called motor evoked potential, Figure 3 It uses a stimulating electrode 5 or a transcranial magnetic stimulation device to stimulate the area of ​​the central anterior gyrus of the brain, simulates the electrical signals generated by the brain, and then monitors whether there are electrical signals on the corresponding target muscles of the human body, and whether the electrical signals are delayed, so as to indirectly judge the good or bad function of the spinal cord. Specifically, the motor evoked potential stimulates the central anterior gyrus of the brain (usually the M1 area), and the stimulation signal reaches the muscle or nerve through the central anterior gyrus of the brain, the corticospinal tract, the anterior horn cells of the spinal cord, and the peripheral nerve motor fibers. Since the signal transmission path of the motor evoked potential passes through the spinal cord, it can indirectly reflect the state of the spinal cord.

[0025] The above is an introduction to the prior art of the present invention. It can be seen from the above introduction that during the process of somatosensory evoked potential, the monitored person needs to remain still. The specific signal processing logic steps of somatosensory evoked potential refer to Figure 4, the signal processing device 1 must receive a sufficient number of electrical signals collected by the first recording electrode 401 (usually dozens to hundreds of times, determined according to the patient's condition and the type of disease) before it can process the signals centrally. The processing steps are existing technologies and will not be elaborated on here. Since the somatosensory evoked potential collects electrical signals many times, the monitoring time is relatively long. It is difficult for ordinary people to remain motionless for a long time. Once a person moves, it will inevitably affect the subsequent judgment results. The fundamental reason why it affects the somatosensory evoked potential is that, for example, during the somatosensory evoked potential process, the person controls the arm equipped with the stimulation electrode 5 to move. In the process of the person controlling the arm movement, the human body's anterior gyrus (M1 area) first generates a corresponding signal, which passes through the spinal cord to the nerves that control the arm. The nerves control the muscles and bones of the arm to realize the arm movement. After the arm movement, the somatosensory nerves on the arm are stimulated, which is fed back from the spine to the central posterior gyrus of the brain, resulting in the signal collected by the first recording electrode 401 being a mixed signal of the stimulation signal generated by the person's arm movement and the stimulation signal emitted by the stimulation electrode 5. When processing the signal, the signal processing device 1 collects the signals collected by the first recording electrode 401 for a sufficient number of effective times for centralized processing, so the mixed signal has a greater impact on the subsequent judgment results.

[0026] To solve the above problems, refer to Figure 7 、 Figure 8 and Figure 9 As shown, the present invention solves the problem through the following scheme: an electrophysiological monitoring device for spinal cord and spinal nerve root function, which has the same point as the prior art in that it also includes a stimulator 3, a stimulating electrode 5, a recording electrode 4, a programmable amplifier and a signal processing device 1, and the connection relationship between the components remains unchanged. The main difference between it and the prior art is that, first, when performing somatosensory induced potential, the recording electrode 4 is not only installed at the corresponding position of the posterior central gyrus of the brain, but also installed at the central anterior gyrus of the brain. For the sake of convenience, the recording electrode 4 installed at the central posterior gyrus of the brain is called the first recording electrode 401, and the recording electrode 4 installed at the central anterior gyrus of the brain is called the second recording electrode 402. The stimulating electrode 5 is also installed at the somatosensory target nerve position of the human body. Second, the difference is that the function of the signal processing device 1 is different. It is not only used to process the signal of the first recording electrode 401 received a sufficient number of times, but also used to judge whether the signal collected by the first recording electrode 401 is valid, that is, the signal processing device 1 judges whether the signal collected by the first recording electrode 401 is valid based on the signal status collected by the second recording electrode 402.

[0027] Furthermore, the signal state collected by the second recording electrode 402 can be whether a signal is collected, that is, when the signal collected by the first recording electrode 401 is transmitted to the signal processing device 1 via the process-controlled amplifier, whether the second recording electrode 402 collects the signal at the same time. If the second recording electrode 402 collects the signal at the same time, it is judged that the human body has made a movement at this time, and the error of the signal collected by the first recording electrode 401 this time is large, and it is not counted as a valid collection number. If the signal collected by the first recording electrode 401 is transmitted to the signal processing device 1 via the process-controlled amplifier, the second recording electrode 402 does not collect the signal, and it is judged that the human body has not made a movement at this time, and the error of the signal collected by the first recording electrode 401 this time is small, and it is counted as a valid collection number. When the valid collection number reaches the set value, the signal processing device 1 performs centralized processing on the signal.

[0028] Furthermore, the signal state collected by the second recording electrode 402 can be the strength of the collected signal, that is, when the signal collected by the first recording electrode 401 is transmitted to the signal processing device 1 through the process-controlled amplifier, the second recording electrode 402 also transmits the signal to the signal processing device 1 through the process-controlled amplifier, and the signal processing device 1 determines that the signal strength exceeds the threshold, then it will cause an error in the signal collected by the first recording electrode 401, and the signal collected by the first electrode this time will not be regarded as a valid number and will be directly eliminated. If when the signal collected by the first recording electrode 401 is transmitted to the signal processing device 1 through the process-controlled amplifier, no signal from the second recording electrode 402 is transmitted to the signal processing device 1 through the process-controlled amplifier, or the signal from the second recording electrode 402 is weak and is determined by the signal processing device 1 to not exceed the threshold, then its impact on the signal error collected by the first recording electrode 401 this time is small (the impact can be basically eliminated through algorithms and other subsequent processing means), and can be recorded as a valid number. After the valid number reaches the set value, the signal processing device 1 centrally processes the signal.

[0029] Furthermore, since the human body has a continuous impact on the electrical signal collected by the first recording electrode 401 when it moves, when the signal processing device 1 determines that the electrical signal collected by the second recording electrode 402 will affect the electrical signal collected by the first recording electrode 401, the signal processing device 1 will eliminate the signals collected by the first recording electrode 401 several times in advance and subsequently, and will not count them as effective times, thereby further improving the subsequent monitoring and judgment results of the spinal cord and spinal nerve roots.

[0030] Furthermore, the above-mentioned signal processing device 1 is preferably a computer, which is connected to the above-mentioned stimulator 3, and the stimulation parameters of the stimulator 3 are regulated by the computer.

[0031] Further, the first recording electrode 401 is multiple in number, and is not limited to being installed in the postcentral gyrus of the brain, for example, and can also be installed in a position of the spinal column to monitor the signal of the process of nerve transmission inside the spinal column. Since the present application is mainly directed to the process of diagnosis of diseases of the human body, and is not directed to intraoperative surgical monitoring, it is preferred that the first recording electrode 401 and the second recording electrode 402 are both non-invasive patch electrodes.

[0032] Further, the second recording electrode 402 can only collect part of the area of the precentral gyrus of the brain, and specifically, for example, only collect the M1 area corresponding to the precentral gyrus of the brain. The M1 area is a core area in the cerebral cortex responsible for regulating voluntary movement. If an electrical signal is generated in this area, it indicates that the human body has moved. Of course, the entire area of the precentral gyrus of the brain can also be collected. The precentral gyrus of the brain has other areas related to movement control in addition to the M1 area. These areas work together to achieve complex motor functions, such as premotor area (planning and execution of complex movements, arranging complex movements), supplementary motor area (coordination of bilateral movements), prefrontal eye area (eye movement), etc. By monitoring this part at the same time, it is possible to more accurately detect whether the precentral gyrus of the brain controls the body to move. Of course, monitoring the entire area of the precentral gyrus of the brain also increases the strength of the signal, making it easy for the signal strength monitored by the second recording electrode 402 to exceed the threshold, thereby causing the signal collected by the first recording electrode 401 to be repeatedly invalid, increasing the overall monitoring time. However, the error of the final judgment result is also relatively accurate, and each has its advantages and disadvantages.

[0033] Through the scheme of the present application, the signal processing device 1 can eliminate the unqualified signal caused by human movement collected by the first recording electrode 401, and does not record the effective collection times, so that when the qualified signals of the effective times are concentrated for processing at a later stage, the accuracy of the judgment can be increased.

[0034] The basic principles and main features of the present application and the advantages of the present application have been shown and described. It should be understood by those skilled in the art that the present application is not limited by the above embodiments, and the above embodiments and descriptions in the specification are only to illustrate the principles of the present application. Without departing from the spirit and scope of the present application, various changes and improvements can be made to the present application, and these changes and improvements all fall within the scope of the present application. The scope of protection of the present application is defined by the appended claims and their equivalents.

Claims

1. An electrophysiological monitoring device for spinal cord and spinal nerve root function, comprising: a stimulator (3) for generating a precisely controlled electrical stimulation signal; a stimulation electrode (5), connected to the stimulator (3), and used to transmit the electrical signal generated by the stimulator (3) to the target nerve; Recording electrodes (4) for collecting electrical signals generated by nerve or muscle tissue after stimulation; A programmable amplifier connected to the recording electrode (4) for amplifying weak bioelectrical signals; The signal processing device (1) is connected to the programmable amplifier, and processes and analyzes the signal from the programmable amplifier after reaching the effective number of times, and determines whether there is any abnormality in the nerve conduction path; it is characterized in that: The stimulation electrode (5) acts on the somatosensory nerve position of the body, the recording electrode (4) includes a first recording electrode (401) installed in the postcentral gyrus of the brain and a second recording electrode (402) installed in the precentral gyrus of the brain, and the signal processing device (1) determines whether the signal collected by the first recording electrode (401) is valid based on the signal state collected by the second recording electrode (402).

2. The electrophysiological monitoring device for spinal cord and spinal nerve root function according to claim 1, characterized in that: The signal status collected by the second recording electrode (402) includes whether the second recording electrode (402) collects a signal or the strength of the signal collected by the second recording electrode (402). The signal processing device (1) determines whether the signal collected by the first recording electrode (401) is recorded as a valid number of times based on whether the second recording electrode (402) collects a signal or the strength of the signal collected by the second recording electrode (402).

3. The electrophysiological monitoring device for spinal cord and spinal nerve root function according to claim 2, characterized in that: When the second recording electrode (402) does not collect any signal or the collected signal strength is weak and does not exceed the set threshold, the signal processing device (1) records the signal currently collected by the first recording electrode (401) as a valid number of times.

4. The electrophysiological monitoring device for spinal cord and spinal nerve root function according to claim 2, characterized in that: When the signal intensity collected by the second recording electrode (402) exceeds a set threshold, the signal processing device (1) does not count the signal currently collected by the first recording electrode (401) as a valid number of times.

5. The electrophysiological monitoring device for spinal cord and spinal nerve root function according to claim 4, characterized in that: When the signal intensity collected by the second recording electrode (402) exceeds a set threshold, the signal processing device (1) does not count the signals collected by the first recording electrode (401) several times before and several times after as valid times.

6. The electrophysiological monitoring device for spinal cord and spinal nerve root function according to claim 1, characterized in that: There are multiple first recording electrodes (401), and all of the multiple first recording electrodes (401) are non-invasive patch electrodes.

7. The electrophysiological monitoring device for spinal cord and spinal nerve root function according to claim 1, characterized in that: The signal processing device (1) is a computer.

8. The electrophysiological monitoring device for spinal cord and spinal nerve root function according to claim 1, characterized in that: The second recording electrode (402) corresponds to collecting part or all of the precentral gyrus of the brain.

9. The electrophysiological monitoring device for spinal cord and spinal nerve root function according to claim 6, characterized in that: The first recording electrode (401) is also used to collect electrical signals from the spine.

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