Transcranial magnetic stimulation motion threshold measurement method and equipment based on ultrasonic real-time detection

Abstract

The invention discloses a transcranial magnetic stimulation motion threshold measurement method and device based on ultrasonic real-time detection, and belongs to the technical field of medical treatment, and the method comprises the following steps: S1, marking a target muscle dissection target spot; s2, making a 30 * 30mm grid with 1mm as a unit by taking the dissecting target spot as a center; s3, marking a functional target spot; s4, after the functional target spot is determined, when the target muscle contracts, stimulation is carried out again, a B-mode ultrasound image is output through the B-mode ultrasound detector for analysis, and a B-mode ultrasound image motion index is calculated; s5, analyzing a lock-time relationship between a motion index and stimulation; s6, selecting the motion index with the best lock-time relationship, implementing stimulation again, continuously adjusting the stimulation intensity, outputting a B-mode ultrasound image through the B-mode ultrasound detector, analyzing and calculating the motion index of the B-mode ultrasound image until the minimum stimulation intensity which is not less than the same value of five times appears in the index in ten times of stimulation with the same intensity, namely the transcranial magnetic stimulation motion threshold value; the problems in the prior art can be solved.

Description

Technical Field

[0001] The present invention belongs to the field of medical technology, and in particular relates to a method and device for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection. Background Art

[0002] Transcranial magnetic stimulation is a magnetic stimulation technology that uses pulsed magnetic fields to act on the central nervous system of the brain, changes the membrane potential of the nerve cells in the cerebral cortex, generates induced current, and thus affects the metabolism and neural electrical activity in the brain. Because it is non-invasive, safe and effective, it has been widely used in neuroscience research, neuropsychiatric disease treatment and rehabilitation, and is used to treat mental illnesses including post-stroke movement disorders, anxiety, depression, insomnia, and functional disorders such as pathological pain, epilepsy and addiction.

[0003] Stimulation intensity is an important parameter of transcranial magnetic stimulation technology, which determines the therapeutic effect and safety of transcranial magnetic stimulation technology. Motor threshold is an important method to quantify the stimulation intensity of transcranial magnetic stimulation technology. Therefore, before using transcranial magnetic stimulation technology for treatment, it is necessary to measure the individual patient's motor threshold to determine the stimulation intensity during transcranial magnetic stimulation technology treatment.

[0004] At present, the method for measuring the motor threshold of an individual is generally to use neuronavigation technology or other imaging methods to accurately locate the cerebral cortex area to be stimulated, and then place the transcranial magnetic stimulation coil on the scalp so that the magnetic field of the coil can penetrate the skull to reach the target cerebral cortex area, and then adjust the position and intensity of the magnetic stimulation coil to ensure that the stimulation can accurately reach the target cerebral cortex area, and then gradually increase the stimulation intensity to cause muscle contraction, and collect the surface electromyography signal during muscle contraction through surface electromyography. The minimum stimulation intensity that causes an electromyography value of not less than 10uv for not less than 5 times out of 10 stimuli is the measured individual motor threshold. That is, the individual motor threshold is measured by collecting the surface electromyography signal during muscle contraction. This method has the following disadvantages:

[0005] 1. Surface electromyography can only collect the motor threshold of superficial muscles, but cannot collect the motor threshold of deep muscles including swallowing muscles, laryngeal muscles, diaphragm and trunk muscles;

[0006] 2. Transcranial magnetic stimulation will affect the electromyographic signal during the stimulation process. The closer to the stimulation position, the greater the interference, which can easily cause data errors and lead to inaccurate motor threshold measurements.

[0007] In view of this, a method and device for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection are designed to solve the above problems. Summary of the invention

[0008] To solve the problems raised in the above background technology, the present invention provides a method and device for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection, which has the characteristics of being able to simultaneously collect the motor thresholds of superficial muscles and deep muscles and improve the accuracy of motor threshold measurement.

[0009] To achieve the above object, the present invention provides the following technical solution: a method for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection, comprising the following steps:

[0010] S1: Input the MNI coordinates of the target muscle, determine the location of the motor cortex of the target muscle on the individual head model, and mark it as the anatomical target point of the target muscle;

[0011] S2: Based on the marked anatomical target, a 30*30mm grid with a unit of 1mm is made on the individual head model with this position as the center;

[0012] S3: Under the guidance of neuronavigation, transcranial magnetic stimulation is performed in each grid area to activate the cerebral cortex, and a stimulation marking signal is synchronously sent to the B-ultrasound detector. After receiving the signal, the B-ultrasound detector collects and records the contraction of the target muscle in real time, and saves and outputs the B-ultrasound image of the whole process in real time, analyzes the characteristics of the B-ultrasound image, continuously increases the stimulation intensity and moves the stimulation position until the muscle length is shortened and the thickness is increased in the output B-ultrasound image, it is determined that the target muscle has contracted, and this grid area is marked as a functional target;

[0013] S4: After the functional target is determined, when the target muscle contracts, stimulation is performed again, and a stimulation mark signal is synchronously sent to the B-ultrasound detector. After receiving the signal, the B-ultrasound detector collects and records the contraction of the target muscle in real time, and saves and outputs the B-ultrasound image of the whole process in real time, analyzes the characteristics of the B-ultrasound image, and calculates the motion index of the B-ultrasound image. The stimulation intensity is continuously increased until the set number of stimulations is reached, and then the stimulation stops.

[0014] S5: Based on multiple B-ultrasound image features and motion indices, the time-locking relationship between motion indices and stimulation is analyzed;

[0015] S6: Select the motion index with the best timing relationship with the stimulation, implement stimulation again, and synchronously send a stimulation marking signal to the B-ultrasound detector. After receiving the signal, the B-ultrasound detector collects and records the contraction of the target muscle in real time, saves and outputs the B-ultrasound image of the whole process in real time, analyzes the characteristics of the B-ultrasound image, and calculates the motion index of the B-ultrasound image. The stimulation intensity is continuously adjusted until the minimum stimulation intensity in which the index has the same value for no less than five times in ten stimulations of the same intensity is reached, which is the transcranial magnetic stimulation motion threshold.

[0016] Furthermore, in step S1, the individual head model selected is a head model reconstructed according to the individual patient, and the reconstruction step is to obtain the original MRI DICOM image of the individual patient, and then reconstruct the individualized MRI three-dimensional head model based on the original MRI DICOM image of the individual patient, that is, the individual head model.

[0017] Furthermore, in step S3, the step of increasing the stimulation intensity is to divide the stimulation intensity into 0-100%, and each stimulation intensity is increased by 10% on the basis of the previous stimulation intensity.

[0018] Furthermore, in step S4, the step of increasing the stimulation intensity is to divide the stimulation intensity into 0-100%, and each stimulation intensity is increased by 10% on the basis of the previous stimulation intensity, that is, ten stimulations are implemented.

[0019] Furthermore, in step S4, the B-ultrasound image motion indicators include muscle movement speed, muscle deformation rate and muscle contraction start time.

[0020] Furthermore, in step S6, the stimulation intensity is adjusted by increasing the stimulation intensity by 10% each time based on the previous stimulation intensity.

[0021] The device of the transcranial magnetic stimulation motor threshold measurement method under real-time ultrasonic detection includes: a memory and a processor, the memory stores at least one instruction, a program, a code set or an instruction set, and the processor loads and executes at least one instruction, a program, a code set or an instruction set stored in the memory to implement any method described in claims 1-6.

[0022] Compared with the prior art, the present invention has the following beneficial effects:

[0023] 1. The present invention can not only collect the motor threshold of superficial muscles, but also collect the motor threshold of deep muscles including swallowing muscles, laryngeal muscles, diaphragm and trunk muscles, that is, it can solve the problems existing in the prior art.

[0024] 2. The present invention is not easily interfered by external signals and can improve the accuracy of motion threshold measurement, that is, it can solve the problems existing in the prior art. BRIEF DESCRIPTION OF THE DRAWINGS

[0025] Figure 1 The present invention is a flow chart of a method for measuring motor threshold of transcranial magnetic stimulation under real-time ultrasonic detection. DETAILED DESCRIPTION

[0026] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0027] See also Figure 1 The present invention provides the following technical solution: a method for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection, comprising the following steps:

[0028] S1: Input the MNI coordinates of the target muscle, determine the location of the motor cortex of the target muscle on the individual head model, and mark it as the anatomical target point of the target muscle;

[0029] The individual head model is a head model reconstructed according to the individual patient. The reconstruction step is to obtain the original MRI DICOM image of the individual patient, and then reconstruct the individualized MRI three-dimensional head model based on the original MRI DICOM image of the individual patient, that is, the individual head model;

[0030] S2: Based on the marked anatomical target, a 30*30mm grid with a unit of 1mm is made on the individual head model with this position as the center;

[0031] S3: Under the guidance of neuronavigation, transcranial magnetic stimulation is performed in each grid area to activate the cerebral cortex, and a stimulation marking signal is synchronously sent to the B-ultrasound detector. After receiving the signal, the B-ultrasound detector collects and records the contraction of the target muscle in real time, and saves and outputs the B-ultrasound image of the whole process in real time, analyzes the characteristics of the B-ultrasound image, continuously increases the stimulation intensity and moves the stimulation position until the muscle length is shortened and the thickness is increased in the output B-ultrasound image, it is determined that the target muscle has contracted, and this grid area is marked as a functional target;

[0032] The step of increasing the stimulation intensity is to divide the stimulation intensity into 0-100%, and each stimulation intensity is increased by 10% on the basis of the previous stimulation intensity;

[0033] S4: After the functional target is determined, when the target muscle contracts, stimulation is performed again, and a stimulation mark signal is synchronously sent to the B-ultrasound detector. After receiving the signal, the B-ultrasound detector collects and records the contraction of the target muscle in real time, and saves and outputs the B-ultrasound image of the whole process in real time, analyzes the characteristics of the B-ultrasound image, and calculates the motion index of the B-ultrasound image. The stimulation intensity is continuously increased until the set number of stimulations is reached, and then the stimulation stops.

[0034] The step of increasing the stimulation intensity is to divide the stimulation intensity into 0-100%, and each stimulation intensity is increased by 10% on the basis of the previous stimulation intensity, that is, ten stimulations are performed;

[0035] B-ultrasound image motion indicators include muscle movement speed, muscle deformation rate, and muscle contraction start time;

[0036] The formula for calculating muscle movement speed is: initial muscle length - muscle contraction length / muscle contraction time;

[0037] The muscle deformation rate includes the muscle length change rate and the muscle thickness change rate, where:

[0038] The formula for calculating the rate of change of muscle length is: initial muscle length - muscle contraction length / initial muscle length;

[0039] The calculation formula of muscle thickness change rate is: initial muscle thickness - muscle contraction thickness / initial muscle length;

[0040] The formula for calculating the start time of muscle contraction is: end time of muscle contraction - start time of muscle contraction;

[0041] S5: Based on multiple B-ultrasound image features and motion indices, the time-locking relationship between motion indices and stimulation is analyzed;

[0042] S6: Select the motion index with the best timing relationship with the stimulation, implement stimulation again, and synchronously send a stimulation marker signal to the B-ultrasound detector. After receiving the signal, the B-ultrasound detector collects and records the contraction of the target muscle in real time, saves and outputs the B-ultrasound image of the whole process in real time, analyzes the characteristics of the B-ultrasound image, and calculates the motion index of the B-ultrasound image. The stimulation intensity is continuously adjusted until the minimum stimulation intensity in which the index has the same value for no less than five times in ten stimulations of the same intensity is reached, which is the transcranial magnetic stimulation motion threshold;

[0043] The steps of adjusting the stimulation intensity are that each stimulation intensity is increased by 10% based on the previous stimulation intensity;

[0044] A device for measuring transcranial magnetic stimulation motor threshold under real-time ultrasonic detection, characterized in that it includes: a memory and a processor, the memory storing at least one instruction, a program, a code set or an instruction set, and the processor loads and executes at least one instruction, a program, a code set or an instruction set stored in the memory to implement any method described in claims 1-6.

[0045] Although embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that various changes, modifications, substitutions and variations may be made to the embodiments without departing from the principles and spirit of the present invention, and that the scope of the present invention is defined by the appended claims and their equivalents.

Claims

1. A method for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection, characterized in that: The following steps are involved: S1: Input the MNI coordinates of the target muscle, determine the location of the motor cortex of the target muscle on the individual head model, and mark it as the anatomical target point of the target muscle; S2: Based on the marked anatomical target, a 30*30mm grid with a unit of 1mm is made on the individual head model with this position as the center; S3: Under the guidance of neuronavigation, transcranial magnetic stimulation is performed in each grid area to activate the cerebral cortex, and a stimulation marking signal is synchronously sent to the B-ultrasound detector. After receiving the signal, the B-ultrasound detector collects and records the contraction of the target muscle in real time, and saves and outputs the B-ultrasound image of the whole process in real time, analyzes the characteristics of the B-ultrasound image, continuously increases the stimulation intensity and moves the stimulation position until the muscle length is shortened and the thickness is increased in the output B-ultrasound image, it is determined that the target muscle has contracted, and this grid area is marked as a functional target; S4: After the functional target is determined, when the target muscle contracts, stimulation is performed again, and a stimulation mark signal is synchronously sent to the B-ultrasound detector. After receiving the signal, the B-ultrasound detector collects and records the contraction of the target muscle in real time, and saves and outputs the B-ultrasound image of the whole process in real time, analyzes the characteristics of the B-ultrasound image, and calculates the motion index of the B-ultrasound image. The stimulation intensity is continuously increased until the set number of stimulations is reached, and then the stimulation stops. S5: Based on multiple B-ultrasound image features and motion indices, the time-locking relationship between motion indices and stimulation is analyzed; S6: Select the motion index with the best timing relationship with the stimulation, implement stimulation again, and synchronously send a stimulation marking signal to the B-ultrasound detector. After receiving the signal, the B-ultrasound detector collects and records the contraction of the target muscle in real time, saves and outputs the B-ultrasound image of the whole process in real time, analyzes the characteristics of the B-ultrasound image, and calculates the motion index of the B-ultrasound image. The stimulation intensity is continuously adjusted until the minimum stimulation intensity in which the index has the same value for no less than five times in ten stimulations of the same intensity is reached, which is the transcranial magnetic stimulation motion threshold.

2. The method for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection according to claim 1, characterized in that: In step S1, the individual head model selected is a head model reconstructed according to the individual patient, and the reconstruction step is to obtain the original MRI DICOM image of the individual patient, and then reconstruct the individualized MRI three-dimensional head model based on the original MRI DICOM image of the individual patient, that is, the individual head model.

3. The method for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection according to claim 1, characterized in that: In step S3, the step of increasing the stimulation intensity is to divide the stimulation intensity into 0-100%, and each stimulation intensity is increased by 10% on the basis of the previous stimulation intensity.

4. The method for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection according to claim 1, characterized in that: In step S4, the step of increasing the stimulation intensity is to divide the stimulation intensity into 0-100%, and each stimulation intensity is increased by 10% on the basis of the previous stimulation intensity, that is, ten stimulations are implemented.

5. The method for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection according to claim 1, characterized in that: In step S4, the B-ultrasound image motion indicators include muscle movement speed, muscle deformation rate and muscle contraction start time.

6. The method for measuring the motor threshold of transcranial magnetic stimulation based on real-time ultrasonic detection according to claim 1, characterized in that: In step S6, the stimulation intensity is adjusted by increasing the stimulation intensity by 10% each time based on the previous stimulation intensity.

7. The device according to claim 1-6, characterized in that: include: A memory and a processor, wherein the memory stores at least one instruction, a program, a code set or an instruction set, and the processor loads and executes at least one instruction, a program, a code set or an instruction set stored in the memory to implement any method described in claims 1-6.

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