Method and device for testing motion threshold value of transcranial magnetic stimulation magnetic therapy

Abstract

The invention discloses a method and a device for testing a motion threshold value of transcranial magnetic stimulation magnetic therapy, and relates to the technical field of brain regulation and control, the method comprises the following steps: acquiring an original electromyographic signal collected by an electrode slice at a preset sampling rate, and sequentially performing high-pass filtering, low-pass filtering, notch filtering with a preset frequency and zero baseline regression processing on the original electromyographic signal; controlling the magnetic stimulation coil to stimulate according to preset stimulation intensity, determining a corresponding incubation period according to data after the stimulation, and determining the amplitude after the stimulation according to a wave crest and a wave trough in the electromyographic signal after the incubation period; and determining an adjustment mode of the stimulation intensity of the next stimulation according to the current amplitude, determining the amplitude of the adjusted stimulation intensity under a preset stimulation cycle until the amplitude meets a measurement condition of a motion threshold value, and determining a corresponding motion threshold value according to the current stimulation intensity. According to the invention, the problems of low efficiency and low accuracy during motion threshold testing in the prior art are solved.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of brain regulation, in particular to a motor threshold test method and device for transcranial magnetic stimulation magnetic therapy. BACKGROUND

[0002] Motor threshold measurement is a neurophysiological examination method designed to check the function of the motor nervous system. It is the lowest stimulation intensity required to induce a target muscle to produce a motor evoked potential (MEP) of more than 50 μV when stimulating the motor cortex with TMS. The judgment is made by determining how many times the standard is met in a predetermined number of stimuli, for example, at least 5 times in 10 stimuli.

[0003] The traditional motor threshold measurement method uses visual observation. When the muscle is in a completely relaxed state, the motor cortex is stimulated with TMS, and the minimum stimulation intensity required to induce a motor evoked potential is determined by observing the fingers and the slight twitching reaction with the naked eye. Although it has been widely used for many years, it has several inherent and interrelated shortcomings: 1. Strong subjectivity, low reliability (reliability), limitations of human eye judgment, and naked eye cannot accurately measure peak-to-peak value like algorithm. Lack of objective standard, judgment is based on "looks like" rather than accurate numerical measurement. Different visual tolerance will lead to different results.

[0004] 2. Time-consuming and low efficiency, this method is essentially a "wrong method". The operator needs to adjust up and down in an uncertain intensity range and stimulate multiple times at multiple intensity points to calculate the success rate. This strategy itself requires a large number of trials.

[0005] 3. Difficulty in monitoring the state of the subject. During the long and repeated measurement process, the subject is likely to feel tired, bored, or lack of concentration, which makes it difficult for the muscle to maintain a completely relaxed state.

[0006] 4. Poor repeatability, the values measured by the same subject on different days fluctuate greatly. This fluctuation may be due to changes in the subject's own physiological state, but it may also be due to differences in subjective judgment by different operators or the same operator in different tests.

[0007] Therefore, the current motor threshold measurement method has the problems of low efficiency and low accuracy. SUMMARY

[0008] Therefore, the present application provides a motor threshold test method and device for transcranial magnetic stimulation magnetic therapy, which solves the problem of low efficiency and low accuracy of the motor threshold measurement method in the prior art.

[0009] This invention proposes a method for testing the motor threshold of transcranial magnetic stimulation (TMS) therapy. This method is applied to a motor evoked potential (MAP) module, which includes electrode wires and a magnetic stimulation coil. The electrode wires are connected to electrode pads containing positive and negative poles. The positive and negative poles of the electrode pads are respectively attached to the belly and tendon of the abductor pollicis brevis muscle. The magnetic stimulation coil is placed in the corresponding motor cortex area of ​​the head. The method includes: The raw electromyographic signals collected by the electrode pads are acquired at a preset sampling rate. The raw electromyographic signals are then subjected to high-pass filtering, low-pass filtering, notch filtering at a preset frequency, and zero baseline regression processing in sequence. The magnetic stimulation coil is controlled to stimulate according to the preset stimulation intensity. The corresponding latency is determined based on the data after this stimulation. The amplitude after this stimulation is determined based on the peaks and troughs in the electromyographic signal after the latency. The method of adjusting the intensity of the next stimulus is determined based on the current amplitude. The intensity of the next stimulus is adjusted, and the amplitude of the adjusted stimulus intensity under the preset stimulus cycle is determined until the amplitude meets the measurement conditions of the motion threshold. The corresponding motion threshold is then determined based on the current stimulus intensity.

[0010] Furthermore, in the above-mentioned transcranial magnetic stimulation (TMS) method for testing the motor threshold, the latency period is the transmission time from nerve stimulation to muscle response. The incubation period is determined as follows: Determine the trigger point at which the magnetic stimulation coil begins stimulation, calculate the baseline mean of the data before the trigger point, and find the first peak or trough after the trigger point; Search forward from the peak or trough to find the point where the signal returns to the baseline, and calculate the time difference between the trigger point and the point where the signal returns to the baseline to obtain the latency.

[0011] Furthermore, in the above-mentioned transcranial magnetic stimulation (TMS) method for testing the motor threshold, the step of determining the amplitude of the stimulation based on the peaks and troughs in the electromyographic signal after the latency period includes: The first peak and trough, as well as the second peak and trough, were identified in the electromyographic signals after the latency period. The mean of the absolute values ​​of the differences between the first peak and the trough, and the second peak and the trough, is used as the amplitude after this stimulus.

[0012] Furthermore, in the above-mentioned method for testing the motion threshold of transcranial magnetic stimulation (TMS), the high-pass filtering method is as follows: Smooth the signal, retain low-frequency components, and attenuate above the cutoff frequency. High-frequency noise; The expression for high-pass filtering is:

[0013] in, For the current moment The output value, For the previous moment The output value, For the current moment Input value, For the previous moment Input value, These are the coefficients of the filter. , For the desired cutoff frequency, The sampling rate of the signal. Pi is the mathematical constant of a circle.

[0014] Furthermore, in the above-mentioned method for testing the motion threshold of transcranial magnetic stimulation (TMS), the low-pass filtering and the preset frequency notch filtering are performed as follows: Smooth the signal and remove high-frequency and preset frequency power frequency noise; The expression for low-pass filtering is: ; in, This is the current output value. This is the current input value. These are the first two input values, These are the first two output values, Forward coefficients, The feedback coefficient is 1. The feedback coefficient is 2; The method for regressing to zero baseline is as follows: Remove DC offset to bring the signal mean back to zero.

[0015] Furthermore, in the above-mentioned transcranial magnetic stimulation (TMS) method for testing the motor threshold, the step of determining the adjustment method for the stimulation intensity of the next stimulation based on the current amplitude, adjusting the stimulation intensity of the next stimulation, and determining the amplitude of the adjusted stimulation intensity under a preset stimulation cycle until the amplitude meets the measurement conditions for the motor threshold includes: If, under stimulation cycle, the frequency of the amplitude falling into the first preset amplitude range reaches the preset stop threshold, then the detection is terminated. If, under the stimulation cycle, the frequency with which the amplitude falls within the first preset amplitude range is the same as the first preset frequency, then an additional judgment cycle is added, and the amplitude data of the additional judgment cycle is analyzed: If, during the supplementary judgment loop, the amplitude falls within the first preset amplitude range at least once, the detection is terminated. If the amplitude does not fall into the first preset amplitude interval in the supplementary judgment cycle, the frequency of the amplitude falling into the second preset amplitude interval and the third preset amplitude interval in the supplementary judgment cycle is counted; The second preset amplitude interval is lower than the lower limit of the first preset amplitude interval, and the third preset amplitude interval is higher than the upper limit of the first preset amplitude interval. If the frequency of the third preset amplitude interval is higher than the preset threshold, the stimulation intensity of the next stimulation is reduced. If the frequency of the second preset amplitude interval is higher than the preset threshold, the stimulation intensity of the next stimulation is increased. If the frequency of the amplitude falling into the first preset amplitude interval under the stimulation cycle is the second preset frequency, which is lower than the first preset frequency, the stimulation intensity of the next stimulation is adjusted according to the frequency of the amplitude falling into the second preset amplitude interval or the third preset amplitude interval under the stimulation cycle. If the frequency of the amplitude falling into the first preset amplitude interval under the stimulation cycle is lower than the second preset frequency, the second judgment condition is executed. The second judgment condition is: If the frequency of the amplitude falling into the second preset amplitude interval under the stimulation cycle is determined, the increase step of the stimulation intensity of the next stimulation is determined according to different levels of the frequency, and the higher the frequency level, the larger the increase step. If the frequency is lower than the lowest level, the third judgment condition is executed. The third judgment condition is: The frequency of the amplitude falling into the fourth preset amplitude interval under the stimulation cycle is counted, and the decrease step of the stimulation intensity of the next stimulation is determined according to different levels of the frequency, and the higher the frequency level, the larger the decrease step. If no amplitude falls into the fourth preset amplitude interval under the stimulation cycle, the fourth judgment condition is executed. The fourth judgment condition is: The frequency of the amplitude falling into the fifth preset amplitude interval under the stimulation cycle is counted, and the decrease step of the stimulation intensity of the next stimulation is determined according to different levels of the frequency, and the higher the frequency level, the larger the decrease step. The adjustment of the stimulation intensity of the next stimulation is repeatedly executed until the amplitude in the stimulation cycle meets the termination detection requirement in the first judgment condition.

[0016] Further, the motor threshold test method of the transcranial magnetic stimulation magnetic therapy, wherein the method further comprises: The electromyographic signal is converted into a waveform and displayed in real time, wherein the waveforms of different directions are mirror flipped, and all the waveforms are unified into a standard form.

[0017] Another object of the present application is to provide a kind of motor threshold testing device for transcranial magnetic stimulation magnetic therapy, applied in motor evoked potential module, motor evoked potential module includes electrode wire and magnetic stimulation coil, electrode wire is connected with the electrode piece including anode and cathode, the anode and cathode of electrode piece are pasted to thumb short muscle belly and thumb short muscle tendon respectively, magnetic stimulation coil is placed in corresponding motor cortex area of head, the device includes: The acquisition module is used to acquire the original electromyographic signal collected by the electrode piece at a preset sampling rate, and sequentially perform high-pass filtering, low-pass filtering, and trap wave filtering of a preset frequency and zero baseline processing on the original electromyographic signal. The control module is used to control the magnetic stimulation coil to stimulate according to a preset stimulation intensity, determine the corresponding latency according to the data after this stimulation, and determine the amplitude after this stimulation according to the wave crest and wave trough in the electromyographic signal after the latency. The measurement module is used to determine the adjustment mode of the stimulation intensity of the next stimulation according to the current amplitude, adjust the stimulation intensity of the next stimulation, determine the amplitude of the adjusted stimulation intensity under the preset stimulation cycle, until the amplitude meets the measurement condition of the motor threshold, and determine the corresponding motor threshold according to the current stimulation intensity.

[0018] Another object of the present application is to provide a readable storage medium having a computer program stored thereon, wherein the program, when executed by a processor, implements the steps of the above-mentioned method.

[0019] Another object of the present application is to provide an electronic device comprising a memory, a processor, and a computer program stored on the memory and running on the processor, wherein the processor implements the steps of the above-mentioned method when executing the program.

[0020] The present application acquires the original electromyographic signal collected by the electrode piece at a preset sampling rate, and sequentially performs high-pass filtering, low-pass filtering, and trap wave filtering of a preset frequency and zero baseline processing on the original electromyographic signal. The magnetic stimulation coil is controlled to stimulate according to a preset stimulation intensity, the corresponding latency is determined according to the data after this stimulation, and the amplitude after this stimulation is determined according to the wave crest and wave trough in the electromyographic signal after the latency. The adjustment mode of the stimulation intensity of the next stimulation is determined according to the current amplitude, the stimulation intensity of the next stimulation is adjusted, the amplitude of the adjusted stimulation intensity under the preset stimulation cycle is determined, until the amplitude meets the measurement condition of the motor threshold, and the corresponding motor threshold is determined according to the current stimulation intensity. The algorithm automatically determines the latency and amplitude instead of visual observation, and the stimulation intensity is intelligently adjusted according to the current amplitude instead of trial and error, so as to determine the final motor threshold according to the numerical standard. The problem of low efficiency and low accuracy in the prior art during motor threshold testing is solved. BRIEF DESCRIPTION OF DRAWINGS

[0021] Figure 1 This is a flowchart of the motion threshold testing method for transcranial magnetic stimulation (TMS) in the first embodiment of the present invention; Figure 2 This is a structural block diagram of the motion threshold testing device for transcranial magnetic stimulation (TMS) in the third embodiment of the present invention.

[0022] The following detailed description, in conjunction with the accompanying drawings, will further illustrate the present invention. Detailed Implementation

[0023] To facilitate understanding of the present invention, a more complete description will be given below with reference to the accompanying drawings. Several embodiments of the invention are illustrated in the drawings. However, the invention can be implemented in many different forms and is not limited to the embodiments described herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete.

[0024] It should be noted that when a component is said to be "fixed to" another component, it can be directly on the other component or there may be an intervening component. When a component is said to be "connected to" another component, it can be directly connected to the other component or there may be an intervening component. The terms "vertical," "horizontal," "left," "right," and similar expressions used in this document are for illustrative purposes only.

[0025] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention pertains. The terminology used herein in the description of the invention is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. The term "and / or" as used herein includes any and all combinations of one or more of the associated listed items.

[0026] Example 1 Please see Figure 1 The image shows a transcranial magnetic stimulation (TMS) method for testing the motor threshold in the first embodiment of the present invention. This method is applied to a motor evoked potential (PEP) module. The PEP module includes an electrode wire and a magnetic stimulation coil. The electrode wire is connected to an electrode pad containing a positive and a negative electrode. The positive and negative electrodes of the electrode pad are respectively attached to the belly of the abductor pollicis brevis muscle and the tendon of the abductor pollicis brevis muscle. The magnetic stimulation coil is placed in the corresponding motor cortex area of ​​the head. The method includes steps S10 to S12.

[0027] Step S10: Obtain the raw electromyographic signal collected by the electrode pads at a preset sampling rate, and sequentially perform high-pass filtering, low-pass filtering, notch filtering at a preset frequency, and zero baseline return processing on the raw electromyographic signal.

[0028] This step is the core component of the transcranial magnetic stimulation (TMS) motor threshold test. Its purpose is to obtain high-quality, low-noise electromyographic signals from the human body, providing accurate data support for subsequent calculations of latency, amplitude, and determination of motor threshold.

[0029] The first step is the acquisition of electromyographic signals, which is accomplished through the electrode pads and electrode wires of the motor evoked potential module: the positive electrode of the electrode pad has been attached to the belly of the abductor pollicis brevis muscle, the negative electrode to the tendon of the abductor pollicis brevis muscle, and the ground wire to the back of the patient's hand. The two form a potential difference to accurately capture the original electromyographic signals generated by the muscle due to nerve stimulation. Simultaneously, signal acquisition must be performed according to the "preset sampling rate," which is a reasonable value preset based on the effective frequency range of electromyographic signals (usually 0.1-500Hz). It must meet the Nyquist sampling criterion (i.e., the sampling rate is at least twice the highest frequency of the signal) to ensure that key information of the original signal is not lost during the acquisition process and to avoid signal distortion.

[0030] For example, the motion evoked potential module data cable is connected to the computer via a serial port with a sampling rate of 2kHz. The Nyquist frequency corresponding to a 2kHz sampling rate is 1kHz, which is much higher than the highest effective frequency of the motion evoked potential module signal (500Hz). The 2kHz sampling rate can capture all valuable information components of the motion evoked potential module completely without aliasing or distortion.

[0031] Next, the acquired raw electromyography (EMG) signals are preprocessed, with each step targeting specific noise or signal defects: the first step is high-pass filtering, the second is low-pass filtering, the third is notch filtering at a preset frequency, and the fourth step is baseline resetting. First, a gentle high-pass filter roughly eliminates drift, then mathematical calculations precisely reset the baseline to zero. This combination is more effective and produces higher waveform fidelity than relying solely on a single aggressive high-pass filter. The 50Hz notch filtering, along with the high-pass and low-pass filtering, is performed in real-time within the same workflow, ensuring processing efficiency and data consistency. Slow baseline drift caused by slight patient breathing and body movement is automatically filtered out.

[0032] Specifically, the high-pass filtering method is as follows: Smooth the signal, retain low-frequency components, and attenuate above the cutoff frequency. High-frequency noise; The expression for high-pass filtering is:

[0033] in, For the current moment The output value, For the previous moment The output value, For the current moment input value of the previous time, input value of the previous time, input value of the previous time, coefficient of the filter, , desired cut-off frequency, sampling rate of the signal, pi.

[0034] The low-pass filtering and the trap filtering of the preset frequency are in the following ways: smooth the signal and remove high frequency and power frequency noise of the preset frequency; The expression of the low-pass filtering is as follows: ; wherein, current output value, current input value, respectively, the previous two input values, respectively, the previous two output values, forward coefficient, feedback coefficient 1, feedback coefficient 2; The way of the regression zero baseline processing is as follows: remove the direct current offset and make the mean value of the signal return to zero.

[0035] In step S11, the magnetic stimulation coil is controlled to stimulate according to the preset stimulation intensity, the latency corresponding to the data after this stimulation is determined, and the wave crest and wave trough in the electromyographic signal after the latency are determined to determine the amplitude after the stimulation.

[0036] In the specific implementation, the coil is placed in the corresponding motor cortex area of the patient's head and has a 45-degree cutting angle. The motor evoked potential module outputs a driving current with specific parameters to the magnetic stimulation coil according to the initial stimulation intensity (or the stimulation intensity adjusted after the previous test) preset by the test process. When the current passes through the coil, a high-strength alternating magnetic field is generated instantaneously. Since the magnetic stimulation coil has been previously fixed in the corresponding motor cortex area of the head and generates an electromyographic signal, the electrode sheet attached to the muscle belly and tendon of the short abductor pollicis muscle will collect this electromyographic signal caused by the stimulation in real time to form the data after the stimulation.

[0037] The latency is essentially the time interval from the application of the magnetic stimulation to the appearance of the effective electrical reaction of the muscle, which reflects the speed of the neural signal from the motor cortex of the brain to the short abductor pollicis muscle. Specifically, the determination way of the latency is as follows: determine the trigger point at which the magnetic stimulation coil starts to stimulate, determine the baseline mean value of a certain amount of data before the trigger point, and find the first wave crest or wave trough after the trigger point; search forward from the wave crest or wave trough to find the point at which the signal returns to the baseline, and calculate the time difference between the trigger point and the point at which the signal returns to the baseline to obtain the latency.

[0038] The trigger point is the exact moment when the magnetic stimulation coil starts to release the magnetic field, which is marked by the internal synchronization signal of the motor evoked potential module (e.g., the moment when the coil is powered on, the module generates a synchronization pulse at this time point, which is the trigger point, as the "zero point" for the entire time calculation). The baseline mean needs to be calculated based on the "data before the trigger point", which is usually the electromyographic signal 50 milliseconds before the trigger point - at this time, the magnetic stimulation has not yet affected the muscle, the signal is mainly composed of skin noise, equipment background noise, etc., and is in a relatively stable "non-response state". The mean value of this data (i.e., the baseline mean) is calculated to establish a "signal reference level when the muscle is not responding", providing a reference for subsequent judgment of "true response signal" (to avoid misjudging noise as response).

[0039] After the trigger point, the neural signal is transmitted from the brain to the muscle and causes contraction, which causes the electromyographic signal to fluctuate significantly from the baseline level. At this time, the signal analysis algorithm needs to locate the "first peak or trough" in the electromyographic data after the trigger point - the peak / trough here needs to meet the condition of "amplitude exceeding the preset threshold" (the threshold is usually set to 2-3 times the standard deviation of the baseline noise), to ensure that it is the true electrical response of the muscle to the magnetic stimulation (rather than accidental noise fluctuation). The peak / trough is the "significant feature point" of the response signal, indicating that the muscle has produced detectable electrical activity.

[0040] Since the peak / trough is the "top point" of the response signal (not the starting time of the response), it needs to be searched from the peak or trough to the "trigger point direction" (i.e., the time backtracking direction) to find the "point where the signal returns to the baseline" - the judgment standard for this point is that the signal amplitude falls within the "baseline mean ± preset deviation range" (e.g., baseline mean ± 1 times standard deviation), which means that this point is the dividing point between the response signal "exceeding the baseline noise level" and "returning to the stable baseline", and it is also the "actual starting time" of the muscle electrical response; Finally, the time difference between the "trigger point" and the "point where the signal returns to the baseline" is calculated, which is the latency. It truly reflects the total time of the neural signal from the motor cortex of the brain to the short abductor muscle of the thumb, and is a key parameter for determining the motor threshold.

[0041] Finally, the amplitude calculation section, in the effective response period after the latency, the signal analysis algorithm identifies the characteristic extreme values of the electromyographic signal: one is the "peak", which is the highest potential value reached during the signal rising process (positive peak), and the other is the "trough", which is the lowest potential value reached during the signal falling process (negative peak). Then calculate the absolute difference between the peak and the trough (if the peak is positive and the trough is negative, the difference is the sum of the absolute values of the two). The difference is the amplitude corresponding to this stimulation.

[0042] Exemplarily, the first peak and the trough and the second peak and the trough are determined respectively in the myoelectric signal after the latency period; The mean of the absolute values of the difference between the first peak and the trough and the second peak and the trough is used as the amplitude after the stimulation.

[0043] Among the signals after the trigger, the most obvious peak and the trough are searched, and two key points are determined: the first peak / trough, the second peak / trough, the third peak / trough, the difference between the first and the second key points is used as the amplitude, and the absolute value is taken to ensure that the amplitude is positive.

[0044] In addition, the absolute calm period of 50 ms before each stimulation is calculated, and the entire waveform is shifted so that the stimulation starting point is strictly zero.

[0045] Step S12, according to the current amplitude, the adjustment mode of the stimulation intensity of the next stimulation is determined, the stimulation intensity of the next stimulation is adjusted, the amplitude of the adjusted stimulation intensity under the preset stimulation cycle is determined, until the amplitude meets the measurement condition of the motor threshold, and the corresponding motor threshold is determined according to the current stimulation intensity.

[0046] Among them, according to the amplitude calculated after the current stimulation, the relationship with the preset "motor threshold determination standard amplitude range" is judged: if the current amplitude is lower than the range, the next stimulation needs to be enhanced; if the current amplitude is higher than the range, the next stimulation needs to be reduced; And the step size of intensity adjustment (i.e. the specific value of increase or decrease) is determined according to the degree of deviation of the amplitude from the target range (the greater the deviation, the greater the step size, to speed up the approach to the target). Then, the next stimulation is carried out according to the adjusted stimulation intensity, and the amplitude is repeatedly measured in the "preset stimulation cycle". Here, the preset cycle usually refers to a fixed number of repeated stimulations (such as 5-10 times per round). After each cycle ends, the amplitude distribution in the cycle is analyzed again: if most of the amplitudes have fallen into the preset motor threshold determination range (i.e. can stably induce muscle electrical response meeting the standard), it is considered that the current stimulation intensity has approached the motor threshold; if not, continue to adjust the stimulation intensity of the next round based on the amplitude results of the cycle (repeat the process of "analyze amplitude-adjust intensity-cycle measurement"). This dynamic control process continues until a certain stimulation intensity, the amplitude in the preset cycle continuously and stably meets the measurement condition of the motor threshold, at which time the stimulation intensity is determined as the corresponding motor threshold.

[0047] In summary, the motor threshold test method for transcranial magnetic stimulation magnetic therapy in the above embodiments of the present application, by acquiring the original electromyographic signal collected by the electrode sheet at a preset sampling rate, sequentially performing high-pass filtering, low-pass filtering, and trap wave filtering of a preset frequency, and zero baseline processing on the original electromyographic signal; controlling the magnetic stimulation coil to stimulate according to a preset stimulation intensity, determining the corresponding latency according to the data after this stimulation, and determining the amplitude after this stimulation according to the wave crest and wave trough in the electromyographic signal after the latency; determining the adjustment mode of the stimulation intensity of the next stimulation according to the current amplitude, adjusting the stimulation intensity of the next stimulation, determining the amplitude of the adjusted stimulation intensity under the preset stimulation cycle, until the amplitude meets the measurement condition of the motor threshold, and determining the corresponding motor threshold according to the current stimulation intensity. The algorithm automatically determines the latency and amplitude instead of visual inspection, intelligently adjusts the stimulation intensity according to the current amplitude instead of trial and error, and determines the final motor threshold according to the numerical standard. The problems of low efficiency and low accuracy in the prior art during motor threshold testing are solved.

[0048] Embodiment two The present embodiment also proposes a motor threshold test method for transcranial magnetic stimulation magnetic therapy. The motor threshold test method for transcranial magnetic stimulation magnetic therapy in the present embodiment is different from the motor threshold test method for transcranial magnetic stimulation magnetic therapy in embodiment one in that: The step of determining the adjustment mode of the stimulation intensity of the next stimulation according to the current amplitude, adjusting the stimulation intensity of the next stimulation, determining the amplitude of the adjusted stimulation intensity under the preset stimulation cycle, and terminating the detection until the amplitude meets the measurement condition of the motor threshold includes: If the frequency of the amplitude falling into the first preset amplitude interval under the stimulation cycle reaches a preset stop threshold, the detection is terminated; If the frequency of the amplitude falling into the first preset amplitude interval under the stimulation cycle is a first preset frequency, a supplementary judgment cycle is added, and the amplitude data of the supplementary judgment cycle is analyzed: If the amplitude falls into the first preset amplitude interval at least once in the supplementary judgment cycle, the detection is terminated; If the amplitude does not fall into the first preset amplitude interval in the supplementary judgment cycle, the frequencies of the amplitudes falling into the second preset amplitude interval and the third preset amplitude interval in the supplementary judgment cycle are counted; Wherein, the second preset amplitude interval is lower than the lower limit of the first preset amplitude interval, and the third preset amplitude interval is higher than the upper limit of the first preset amplitude interval: If the frequency of the third preset amplitude interval is higher than a preset threshold, the stimulation intensity of the next stimulation is lowered; If the frequency of the second preset amplitude interval is higher than a preset threshold, the stimulation intensity of the next stimulation is increased; If the frequency of the amplitude falling into the first preset amplitude interval under the stimulation cycle is the second preset frequency, and the second preset frequency is lower than the first preset frequency, then the stimulation intensity of the next stimulation is adjusted according to the frequency of the amplitude falling into the second preset amplitude interval or the third preset amplitude interval under the stimulation cycle; If the frequency of the amplitude falling into the first preset amplitude interval under the stimulation cycle is lower than the second preset frequency, then the second judgment condition is executed; The second judgment condition is: If the frequency of the amplitude falling into the second preset amplitude interval under the stimulation cycle is determined, then the increase step of the stimulation intensity of the next stimulation is determined according to different levels of the frequency, and the higher the frequency level is, the larger the increase step is; If the frequency is lower than the lowest level, then the third judgment condition is executed; The third judgment condition is: The frequency of the amplitude falling into the fourth preset amplitude interval under the stimulation cycle is counted, the decrease step of the stimulation intensity of the next stimulation is determined according to different levels of the frequency, and the higher the frequency level is, the larger the decrease step is; If there is no amplitude falling into the fourth preset amplitude interval under the stimulation cycle, then the fourth judgment condition is executed; The fourth judgment condition is: The frequency of the amplitude falling into the fifth preset amplitude interval under the stimulation cycle is counted, the decrease step of the stimulation intensity of the next stimulation is determined according to different levels of the frequency, and the higher the frequency level is, the larger the decrease step is; The adjustment of the stimulation intensity of the next stimulation is repeatedly executed until the amplitude in the stimulation cycle meets the termination detection requirement in the first judgment condition.

[0049] For example, the increase or decrease direction and step of the next stimulation intensity are intelligently determined according to the result of the current stimulation.

[0050] The measurement judgment condition method is as follows (one cycle every 10 times): Judgment condition one 1. 5 times or more amplitudes are greater than or equal to 50 and less than or equal to 200: stop measuring.

[0051] 2. 4 times amplitudes are greater than or equal to 50 and less than or equal to 200: 1 time is not in the range, then continue to stimulate for one cycle of 5 times (1) When 1 time amplitude in the range of greater than or equal to 50 and less than or equal to 200 appears, stop measuring.

[0052] (2) If the amplitude is not present once in the range of 50 or more and 200 or less, but the amplitude is present more than 3 times in 5 stimulations, then decrease 1 point. If the amplitude is present more than 3 times in 5 stimulations, then increase 1 point. If the above conditions are not met, then enter the second determination condition.

[0053] 3. 3 amplitudes are greater than or equal to 50 and less than or equal to 200: 2 of which are greater than 200, then decrease 1 point; 2 of which are less than 50, then increase 1 point; 1 of which is less than 50 and 1 of which is greater than 200, then increase 1 point.

[0054] 4. 2 amplitudes are greater than or equal to 50 and less than or equal to 200: enter the second determination condition.

[0055] 5. 1 amplitude is greater than or equal to 50 and less than or equal to 200: enter the second determination condition.

[0056] Second determination condition 1. 5 or more amplitudes are less than 50: increase 3 points.

[0057] 2. 4 amplitudes are less than 50: increase 2 points.

[0058] 3. 3 amplitudes are less than 50: increase 2 points.

[0059] 4. 2 amplitudes are less than 50: enter the third and fourth determination conditions.

[0060] 5. 1 amplitude is less than 50: enter the third and fourth determination conditions.

[0061] Third determination condition 1. 5 or more amplitudes are greater than or equal to 500: decrease 3 points.

[0062] 2. 4 amplitudes are greater than or equal to 500: decrease 3 points.

[0063] 3. 3 amplitudes are greater than or equal to 500: decrease 2 points.

[0064] 4. 2 amplitudes are greater than or equal to 500: decrease 2 points.

[0065] 5. 1 amplitude is greater than or equal to 500: decrease 2 points.

[0066] Fourth determination condition 1. 5 or more amplitudes are greater than 200 and less than 500: decrease 2 points.

[0067] 2. 4 amplitudes are greater than 200 and less than 500: decrease 2 points.

[0068] 3. 3 amplitudes are greater than 200 and less than 500: decrease 2 points.

[0069] 4. 2nd wave amplitude greater than 200 less than 500: reduce 1 point.

[0070] 5. 1st wave amplitude greater than 200 less than 500: reduce 1 point.

[0071] Firstly, the first determination condition is executed, and then the second determination condition, the third determination condition and the fourth determination condition are executed; the third determination condition is executed, and the fourth determination condition is not executed, and vice versa, wherein the number of points to be increased or decreased can be corresponding percentage points or basic unit values of the last stimulation intensity.

[0072] In addition, in some optional embodiments of the present application, the method further comprises: Real-time display of the converted waveforms of the electromyographic signals, wherein the waveforms of different directions are mirror-inverted, and all the waveforms are unified into a standard form.

[0073] Wherein, the algorithm automatically mirror-inverts the "first negative and then positive" into a standardized "first up and then down" form.

[0074] In summary, the motor threshold test method of the transcranial magnetic stimulation magnetic therapy in the above embodiments of the present application, by acquiring the original electromyographic signals collected by the electrode sheet at a preset sampling rate, sequentially performing high-pass filtering, low-pass filtering and pre-set frequency notch filtering on the original electromyographic signals, and processing the zero baseline, controlling the magnetic stimulation coil to stimulate according to the pre-set stimulation intensity, determining the corresponding latency according to the data after this stimulation, determining the amplitude after this stimulation according to the wave peak and wave trough in the electromyographic signal after the latency, determining the adjustment mode of the stimulation intensity of the next stimulation according to the current amplitude, adjusting the stimulation intensity of the next stimulation, determining the amplitude of the adjusted stimulation intensity under the pre-set stimulation cycle, until the amplitude meets the measurement condition of the motor threshold, and determining the corresponding motor threshold according to the current stimulation intensity. The algorithm automatically determines the latency and amplitude instead of visual measurement, and intelligently adjusts the stimulation intensity according to the current amplitude instead of trial and error, so as to determine the final motor threshold according to the numerical standard. The problems of low efficiency and low accuracy in the prior art during the motor threshold test are solved.

[0075] Embodiment three Please refer to Figure 2 , which is a motor threshold test device of transcranial magnetic stimulation magnetic therapy proposed in the third embodiment of the present application, applied in a motor evoked potential module, the motor evoked potential module comprising an electrode wire and a magnetic stimulation coil, the electrode wire being connected with an electrode sheet comprising a positive electrode and a negative electrode, the positive electrode and the negative electrode of the electrode sheet being respectively attached to the short abductor muscle of the thumb and the tendon of the short abductor muscle of the thumb, the magnetic stimulation coil being placed in the corresponding motor cortex area of the head, the device comprising: The acquisition module 100 is configured to acquire the original electromyography signal collected by the electrode sheet at a preset sampling rate, and sequentially perform high-pass filtering, low-pass filtering, trap wave filtering at a preset frequency and regression zero baseline processing on the original electromyography signal. The control module 200 is configured to control the magnetic stimulation coil to stimulate at a preset stimulation intensity, determine a corresponding latency according to the data after this stimulation, and determine a wave amplitude after this stimulation according to the wave crest and wave trough in the electromyography signal after the latency. The measurement module 300 is configured to determine an adjustment mode of the stimulation intensity of the next stimulation according to the current wave amplitude, adjust the stimulation intensity of the next stimulation, determine the wave amplitude of the adjusted stimulation intensity under the preset stimulation cycle until the wave amplitude meets the measurement condition of the motor threshold, and determine the corresponding motor threshold according to the current stimulation intensity.

[0076] The functions or operation steps realized when the above modules are executed are generally the same as those of the above method embodiments, and will not be described here.

[0077] Embodiment Four Another aspect of the present application also provides a readable storage medium having a computer program stored thereon, wherein the program is executed by a processor to realize the steps of the method in any one of the above embodiments one to two.

[0078] Embodiment Five Another aspect of the present application also provides an electronic device, which comprises a memory, a processor and a computer program stored in the memory and running on the processor, wherein the processor executes the program to realize the steps of the method in any one of the above embodiments one to two.

[0079] The technical features of each of the above embodiments can be combined arbitrarily, and to make the description concise, all possible combinations of the technical features in the above embodiments are not described, however, as long as the combinations of the technical features do not exist contradictory, they should be considered as the scope of the present application.

[0080] Those skilled in the art will appreciate that the logic and / or steps represented in the flow diagrams, or otherwise described herein, can be embodied in

[0081] More specific examples (a non-exhaustive list) of the computer readable storage medium include the following: an electrical connection having one or more wires (electrical device), a portable computer diskette (magnetic device), a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or Flash memory), an optical fiber device, and a portable compact disc read-only memory (CDROM). Additionally, the computer readable storage medium can also be paper or another suitable medium upon which the program is printed, as the program can be electronically captured, for example, via optical scanning of the paper or other medium, then compiled, interpreted, or otherwise processed in a suitable manner, if necessary, and then stored in a computer memory.

[0082] It should be understood that aspects of the application can be implemented in hardware, software, firmware or combinations thereof. In the above embodiments, various steps or methods can be implemented in software or firmware that is stored in memory and executed by a suitable instruction execution system. For example, if implemented in hardware, as in another embodiment, any of the following technologies, known in the art, or combinations thereof, can be used: a discrete logic circuit having logic gates for implementing logic functions upon data signals, an application specific integrated circuit having appropriate combinational logic gates, a programmable gate array (PGA), a field programmable gate array (FPGA), or the like.

[0083] In the description of the present specification, the description of the terms "one embodiment", "some embodiments", "an example", "a specific example", or "some examples" and the like means that the specific features, structures, materials or characteristics described in connection with the embodiment or example are included in at least one embodiment or example of the present application. In the present specification, the illustrative expressions of the above terms do not necessarily refer to the same embodiment or example. Also, the specific features, structures, materials or characteristics described can be combined in any one or more embodiments or examples in an appropriate manner.

[0084] The above embodiments only express several implementation manners of the present application, and the description is more specific and detailed, but it should not be understood as a limitation on the patent scope of the present application. It should be noted that for ordinary skilled persons in the art, without departing from the concept of the present application, several modifications and improvements can be made, which are all within the protection scope of the present application. Therefore, the protection scope of the patent of the present application should be subject to the appended claims.

Claims

1. A method for testing the motor threshold of transcranial magnetic stimulation (TMS) therapy, characterized in that, The method is applied in a motor evoked potential module, which includes electrode wires and a magnetic stimulation coil. The electrode wires are connected to electrode pads containing positive and negative electrodes. The positive and negative electrodes are respectively attached to the belly of the abductor pollicis brevis muscle and the tendon of the abductor pollicis brevis muscle. The magnetic stimulation coil is placed in the corresponding motor cortex area of ​​the head. The raw electromyographic signals collected by the electrode pads are acquired at a preset sampling rate. The raw electromyographic signals are then subjected to high-pass filtering, low-pass filtering, notch filtering at a preset frequency, and zero baseline regression processing in sequence. The magnetic stimulation coil is controlled to stimulate according to the preset stimulation intensity. The corresponding latency is determined based on the data after this stimulation. The amplitude after this stimulation is determined based on the peaks and troughs in the electromyographic signal after the latency. The method of adjusting the intensity of the next stimulus is determined based on the current amplitude. The intensity of the next stimulus is adjusted, and the amplitude of the adjusted stimulus intensity under the preset stimulus cycle is determined until the amplitude meets the measurement conditions of the motion threshold. The corresponding motion threshold is then determined based on the current stimulus intensity.

2. The method for testing the motor threshold of transcranial magnetic stimulation (TMS) according to claim 1, characterized in that, The latency period is the time it takes for nerve stimulation to lead to a muscle response. The incubation period is determined as follows: Determine the trigger point at which the magnetic stimulation coil begins stimulation, calculate the baseline mean of the data before the trigger point, and find the first peak or trough after the trigger point; Search forward from the peak or trough to find the point where the signal returns to the baseline, and calculate the time difference between the trigger point and the point where the signal returns to the baseline to obtain the latency.

3. The method for testing the motor threshold of transcranial magnetic stimulation (TMS) according to claim 2, characterized in that, The step of determining the amplitude of the stimulus based on the peaks and troughs in the electromyographic signal after the latency period includes: The first peak and trough, as well as the second peak and trough, were identified in the electromyographic signals after the latency period. The mean of the absolute values ​​of the differences between the first peak and the trough, and the second peak and the trough, is used as the amplitude after this stimulus.

4. The method for testing the motor threshold of transcranial magnetic stimulation (TMS) according to claim 1, characterized in that, The high-pass filtering method is as follows: Smooth the signal, retain low-frequency components, and attenuate above the cutoff frequency. High-frequency noise; The expression for high-pass filtering is: in, For the current moment The output value, For the previous moment The output value, For the current moment Input value, For the previous moment Input value, These are the coefficients of the filter. , For the desired cutoff frequency, The sampling rate of the signal. Pi is the mathematical constant of a circle.

5. The method for testing the motor threshold of transcranial magnetic stimulation (TMS) according to claim 4, characterized in that, The methods for low-pass filtering and preset frequency notch filtering are as follows: Smooth the signal and remove high-frequency and preset frequency power frequency noise; The expression for low-pass filtering is: ； in, This is the current output value. This is the current input value. These are the first two input values, These are the first two output values, Forward coefficients, The feedback coefficient is 1. The feedback coefficient is 2; The method for regressing to zero baseline is as follows: Remove DC offset to bring the signal mean back to zero.

6. The method for testing the motor threshold of transcranial magnetic stimulation (TMS) according to claim 1, characterized in that, The step of determining the stimulation intensity of the next stimulus based on the current amplitude, adjusting the stimulation intensity of the next stimulus, and determining the amplitude of the adjusted stimulation intensity under a preset stimulation cycle until the amplitude meets the measurement conditions of the motion threshold includes: If, under stimulation cycle, the frequency of the amplitude falling into the first preset amplitude range reaches the preset stop threshold, then the detection is terminated. If, under the stimulation cycle, the frequency with which the amplitude falls within the first preset amplitude range is the same as the first preset frequency, then an additional judgment cycle is added, and the amplitude data of the additional judgment cycle is analyzed: If, during the supplementary judgment loop, the amplitude falls within the first preset amplitude range at least once, the detection is terminated. If no amplitude falls within the first preset amplitude range within the supplementary judgment loop, then count the frequency of the amplitude falling within the second preset amplitude range and the third preset amplitude range within the supplementary judgment loop, respectively. Among them, the second preset amplitude range is lower than the lower limit of the first preset amplitude range, and the third preset amplitude range is higher than the upper limit of the first preset amplitude range: If the frequency of the third preset amplitude range is higher than the preset threshold, the intensity of the next stimulus will be reduced. If the frequency of the second preset amplitude range is higher than the preset threshold, the stimulation intensity of the next stimulus will be increased. If, during a stimulation cycle, the frequency at which the amplitude falls into the first preset amplitude range is the second preset frequency, and the second preset frequency is lower than the first preset frequency, then the stimulation intensity of the next stimulation is adjusted accordingly based on the frequency at which the amplitude falls into the second preset amplitude range or the third preset amplitude range during the stimulation cycle. If, under the stimulation cycle, the frequency of the amplitude falling into the first preset amplitude range is lower than the second preset frequency, then the execution of the second judgment condition will proceed. The second judgment condition is: If, under stimulation cycle, the frequency at which the amplitude falls into the second preset amplitude range is determined, the increase step of the stimulation intensity of the next stimulus is determined according to the different frequency levels, and the higher the frequency level, the larger the increase step. If the frequency is lower than the lowest level, then proceed to the execution of the third judgment condition; The third condition for judgment is: The frequency of the amplitude falling into the fourth preset amplitude range under the statistical stimulus cycle is determined. Based on the different frequency levels, the reduction step of the stimulus intensity of the next stimulus is determined accordingly. The higher the frequency level, the larger the reduction step. If no amplitude falls within the fourth preset amplitude range under the stimulation cycle, then the execution of the fourth judgment condition will proceed. The fourth condition for judgment is: The frequency of the amplitude falling into the fifth preset amplitude range under the statistical stimulus cycle is determined. Based on the different frequency levels, the reduction step of the stimulus intensity of the next stimulus is determined accordingly. The higher the frequency level, the larger the reduction step. Repeat the adjustment of the stimulus intensity for the next stimulus until the amplitude within the stimulus cycle meets the termination detection requirement in the first judgment condition.

7. The method for testing the motor threshold of transcranial magnetic stimulation (TMS) according to claim 1, characterized in that, The method further includes: The electromyography signal is converted into a waveform and displayed in real time. Waveforms with different directions are mirrored and flipped to unify all waveforms into a standard shape.

8. A device for testing the motor threshold of transcranial magnetic stimulation (TMS) therapy, characterized in that, This device is used in a motor evoked potential module, which includes electrode wires and a magnetic stimulation coil. The electrode wires are connected to electrode pads containing positive and negative electrodes. The positive and negative electrodes of the electrode pads are respectively attached to the belly of the abductor pollicis brevis muscle and the tendon of the abductor pollicis brevis muscle. The magnetic stimulation coil is placed in the corresponding motor cortex area of ​​the head. The device includes: The acquisition module is used to acquire the raw electromyographic signals collected by the electrode pads at a preset sampling rate, and to perform high-pass filtering, low-pass filtering, notch filtering at a preset frequency, and zero baseline regression processing on the raw electromyographic signals in sequence. The control module is used to control the magnetic stimulation coil to stimulate according to the preset stimulation intensity, determine the corresponding latency based on the data after the stimulation, and determine the amplitude after the stimulation based on the peaks and troughs in the electromyographic signal after the latency. The measurement module is used to determine the adjustment mode of the stimulation intensity of the next stimulus based on the current amplitude, so as to adjust the stimulation intensity of the next stimulus, determine the amplitude of the adjusted stimulation intensity under the preset stimulation cycle, until the amplitude meets the measurement conditions of the motion threshold, and determine the corresponding motion threshold based on the current stimulation intensity.

9. A readable storage medium having a computer program stored thereon, characterized in that, When the program is executed by the processor, it implements the steps of the method as described in any one of claims 1 to 7.

10. An electronic device, characterized in that, The method includes a memory, a processor, and a computer program stored in the memory and running on the processor, wherein the processor, when executing the program, implements the steps of the method as described in any one of claims 1 to 7.

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