Multi-channel device for directional shaping of electric fields such as tumor therapy electric fields (TTFIELDS)

Abstract

The path of the alternating electric field through the body part can be controlled by providing at least eight electrically isolated signal generators, each of the at least eight electrically isolated signal generators is configured to apply an electrical signal between a respective electrode element on one side of the target region and a respective electrode element on an opposite side of the target region. This replaces a single wide cross-section electric field of the prior art with eight independently controllable electric fields, each of which has a relatively narrow cross-section. The use of the electric fields with relatively narrow cross-sections alone or in combination can improve the aiming of the electric fields, thereby improving the field strength in the target area. Optionally, activation of these relatively narrow-cross-section electric fields can be shifted over time to enable manipulation of the overall electric field.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of U.S. Provisional Application No. 63 / 435,370, filed December 27, 2022, which is incorporated herein by reference in its entirety. Background Art

[0003] Tumor Treating Fields (TTFields) therapy is a proven method for treating tumors using alternating electric fields with a frequency between 50kHz and 1MHz (e.g., 150kHz and 200kHz). See, for example, U.S. Patent 7,565,205, which is incorporated herein by reference in its entirety. Alternating electric fields can also be used to treat medical conditions other than tumors. For example, as described in U.S. Patent No. 10,967,167 (which is incorporated herein by reference in its entirety), alternating electric fields can be used to increase the permeability of the blood-brain barrier, allowing, for example, chemotherapy drugs to reach the brain.

[0004] Figure 1 Describes the prior art A system that delivers TTFields to a patient via four transducer arrays 90 placed on the skin near the patient's tumor. These transducer arrays 90 are arranged in two pairs, with one pair of transducer arrays 90L, 90R located on the left and right sides of the tumor, and the other pair of transducer arrays 90A, 90P located on the front and back sides of the tumor. Each transducer array is connected to an AC signal generator 95 via a multi-conductor cable. The AC signal generator (a) sends AC current through the pair of anterior / posterior (A / P) transducer arrays for 1 second, which produces an electric field with a first direction through the tumor; then (b) sends AC current through the pair of left / right (L / R) arrays for 1 second, which produces an electric field with a second direction through the tumor; then steps (a) and (b) are repeated for the duration of the treatment. Each transducer array includes a plurality (e.g., between 9 and 30) electrode elements. And all electrode elements on any given transducer array are wired together (e.g., in series or in parallel).

[0005] Figure 2 A more detailed view of a set of four transducer arrays 90 is depicted in which the individual electrode elements that make up each of the transducer arrays can be seen. In this example, each of the transducer arrays 90 includes nine circular electrode elements supported by a self-adhesive backing. Figure 2 In FIG, each of the four transducer arrays 90 is located at a specific location on the patient's head.

[0006] Increasing the intensity of the alternating electric field in the target area of interest (e.g., in a tumor such as a glioblastoma) generally improves the efficacy of the treatment. This can often be achieved by moving the transducer array 90 away from the target area. Figure 2 The precise location depicted can be used to increase the strength of the electric field in the target area. More specifically, moving the position of the transducer array 90 over the relevant body part (e.g., by a few centimeters in the up, down, right, left, front, and / or back directions) can change the path of the alternating electric field traveling through the body part. Changing the electric field path can increase the field strength in the target area, which in turn can improve the efficacy of the treatment.

[0007] But it turns out there's a limit to how much you can control the path of the electric field by moving the position of the transducer array, and that, in turn, limits how much the field strength can be increased. Summary of the Invention

[0008] One aspect of the present invention relates to an apparatus for applying an electric field to a target area using at least eight first electrode elements located on a first side of the target area and at least eight second electrode elements located on a second side of the target area opposite the first side of the target area. The first apparatus includes at least eight electrically isolated first signal generators. Each of the first signal generators has a corresponding first control input. Each of the first signal generators is configured to apply an electric signal between a corresponding first electrode element of the at least eight first electrode elements and a corresponding second electrode element of the at least eight second electrode elements in response to a corresponding first control signal arriving at the corresponding first control input. The first apparatus also includes a controller programmed to generate each of the first control signals.

[0009] In some embodiments of the first device, each of the first signal generators is configured to: (a) apply a positive electrical signal between the corresponding one of the at least eight first electrode elements and the corresponding one of the at least eight second electrode elements in response to a corresponding first control signal arriving at the corresponding first control input; and (b) apply a negative electrical signal between the corresponding one of the at least eight first electrode elements and the corresponding one of the at least eight second electrode elements in response to a corresponding second control signal arriving at the corresponding second control input. Note that the use of identifiers (a) and (b) does not mean that (a) must precede (b) in time.

[0010] Optionally, in the embodiment described in the preceding paragraph, the controller may be further programmed to apply the corresponding first control signal and the corresponding second control signal at corresponding times in an alternating sequence to each of the first signal generators, so that the corresponding first signal generator will generate an output alternating between a positive electrical signal and a negative electrical signal.

[0011] Optionally, in the embodiment described in the preceding paragraph, the controller may be further programmed to insert a time break between each first control signal and each second control signal.

[0012] In some embodiments of the first device, the controller is further programmed to generate each of the first control signals in a sequence that causes each of the at least eight first signal generators to generate an output having a given waveform, wherein the output of each of the at least eight first signal generators is temporally shifted relative to the output of at least one other first signal generator. Optionally, in these embodiments, the controller can be further programmed to control the temporal shift to manipulate the electric field within the target area.

[0013] In some embodiments of the first device, the controller is further programmed to generate each of the first control signals in a sequence such that each of the at least eight first signal generators generates an output having a given waveform, wherein the output of each of the at least eight first signal generators is shifted in time relative to the output of at least one other first signal generator. The controller is further programmed to generate each of the first control signals in a sequence such that each of the at least eight first signal generators generates an output that alternates between a positive electrical signal and a negative electrical signal.

[0014] Some embodiments of the first apparatus further include the at least eight first electrode elements and the at least eight second electrode elements.

[0015] Some embodiments of the first device further include at least eight electrically isolated second signal generators. Each of the second signal generators has a corresponding second control input. Each of the second signal generators is configured to apply an electrical signal between a corresponding third electrode element of the at least eight third electrode elements and a corresponding fourth electrode element of the at least eight fourth electrode elements in response to a corresponding second control signal received at the corresponding second control input. In these embodiments, the controller is further programmed to generate each of the second control signals.

[0016] Optionally, in the embodiment described in the preceding paragraph, the controller may be further programmed to generate each of the first control signals in a sequence such that each of the at least eight first signal generators generates an output having a first given waveform, wherein the output of each of the at least eight first signal generators is shifted in time relative to the output of at least one other first signal generator. Furthermore, the controller may be further programmed to generate each of the second control signals in a sequence such that each of the at least eight second signal generators generates an output having a second given waveform, wherein the output of each of the at least eight second signal generators is shifted in time relative to the output of at least one other second signal generator.

[0017] Another aspect of the present invention relates to a first method for applying an electric field to a target area using at least eight first electrode elements located on a first side of the target area and at least eight second electrode elements located on a second side of the target area opposite the first side of the target area. The first method includes applying a corresponding first electrical signal between a corresponding first electrode element of the at least eight first electrode elements and a corresponding second electrode element of the at least eight second electrode elements. The first electrical signals all have a given first waveform. Each of the first electrical signals is shifted in time relative to at least one other first electrical signal. Each of the first electrical signals is electrically isolated from all other first electrical signals.

[0018] In some examples of the first method, the first electrical signals are applied in a temporally shifted manner to manipulate the electric field in the target area. Optionally, in these examples, each of the first electrical signals alternates between positive and negative polarity.

[0019] Some examples of the first method further include positioning the at least eight first electrode elements on the first side of the target area, and positioning the at least eight second electrode elements on the second side of the target area.

[0020] Some examples of the first method further include applying a corresponding second electrical signal between a corresponding third electrode element among the at least eight third electrode elements and a corresponding fourth electrode element among the at least eight fourth electrode elements. The second electrical signals all have a given second waveform. Each of the second electrical signals is shifted in time relative to at least one other second electrical signal. Each of the second electrical signals is electrically isolated from all other second electrical signals.

[0021] Optionally, in the embodiments described in the preceding paragraph, the first electrical signal is applied in a temporally shifted manner to manipulate the electric field in the target area, and the second electrical signal is applied in a temporally shifted manner to manipulate the electric field in the target area. Optionally, in these examples, each of the first electrical signals alternates between positive and negative polarity, and each of the second electrical signals alternates between positive and negative polarity. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] Figure 1 is an existing technology for delivering TTFields Block diagram of the system.

[0023] Figure 2 yes Figure 1 A more detailed view of the transducer array.

[0024] Figure 3 Depicted is a set of four transducer arrays positioned on a patient's skin near a tumor.

[0025] Figure 4 It is used to Figure 3 Block diagram of a system for applying electrical signals to electrode elements in a transducer array is depicted.

[0026] Figure 5 Depicted is controlling the phases of signals generated by a set of signal generators to produce a particular set of output signals.

[0027] Various embodiments are described in detail below with reference to the drawings, wherein like reference numerals represent like elements. DETAILED DESCRIPTION

[0028] This application discloses an alternative method for moving the path of an alternating electric field traveling through a body part of interest, and in many cases, this method can increase the field strength in the target area to levels that exceed those achievable using prior art methods that move the position of a transducer array.

[0029] More specifically, instead of using a single signal generator to apply a signal between all electrode elements on one side of the target area and all electrode elements on the opposite side of the target area (as in the prior art), the following description is made in conjunction with Figures 3 to 5The described embodiment uses at least eight electrically isolated signal generators to apply an electrical signal between corresponding electrode elements on one side of the target area and corresponding electrode elements on the opposite side of the target area. This replaces the single wide cross-section electric field of the prior art with eight independently controllable electric fields, each of which has a relatively narrow cross-section. Using these relatively narrow cross-section electric fields alone or in combination can improve the aiming of the electric field, and thus can increase the field strength in the target area. And optionally, the activation of these relatively narrow cross-section electric fields can be shifted in time (e.g., phase shifted) to achieve manipulation of the overall electric field.

[0030] Figure 3 A set of four transducer arrays 10 are depicted placed on the patient's skin near a tumor. These transducer arrays 10 are arranged in two pairs, with one pair of transducer arrays 10L, 10R located to the left and right of the tumor and the other pair of transducer arrays 10A, 10P located in front and behind the tumor. Each of the transducer arrays 10 is similar in most respects to the prior art described above. Transducer array 90. But with Unlike transducer arrays, all electrode elements on any given transducer array 10 are not wired together in series or parallel. Instead, each of the electrode elements A1 to A9 on the front transducer array 10A is provided with its own separate wire so that it can be driven independently. Similarly, each of the electrode elements P1 to P9 on the rear array 10P, the electrode elements L1 to L9 on the left array 10L, and the electrode elements R1 to R9 on the right array 10R is provided with its own corresponding separate wire so that it can be driven independently.

[0031] Providing separate wires for each electrode element on each transducer array in the transducer array 10 enables individualized signals to be applied individually to each of the electrode elements on each transducer array without affecting other electrode elements on the transducer array. The benefits provided by this arrangement are described below.

[0032] Figure 4 It is used to Figure 3A block diagram of a system for applying electrical signals to electrode elements A1 to A9, P1 to P9, L1 to L9, and R1 to R9 is depicted. The system in the illustrated embodiment includes nine first signal generators X1 to X9. Each of these first signal generators X1 to X9 is wired to apply a signal between a corresponding single electrode element among electrode elements L1 to L9 on the left array 10L and a corresponding single electrode element among electrode elements R1 to R9 on the right array 10R. More specifically, signal generator Xi is wired to apply a signal between electrode element Li and electrode element Ri, where i is an integer between 1 and 9. In some embodiments, the output of any given one of the first signal generators Xi can be positive (i.e., where the corresponding L terminal is an anode and the corresponding R terminal is a cathode), negative (i.e., where the corresponding L terminal is a cathode and the corresponding R terminal is an anode), or off (i.e., where no pulse is generated).

[0033] Each of the first signal generators X1 to X9 is electrically isolated from all other signal generators. Therefore, the signal applied by signal generator X1 between electrode element L1 and electrode element R1 will not affect the signal applied to any of the other electrode elements L2 to L9, R2 to R9, A1 to A9, or P1 to P9. A similar situation exists for all other first signal generators X2 to X9, such that the signals sent by those signal generators to their respective electrode elements will not affect the signals applied to any of the other electrode elements.

[0034] Each of the first signal generators X1 to X9 has a corresponding first control input terminal, and each of the first signal generators X1 to X9 is configured to apply an electrical signal between a corresponding one of the electrode elements L1 to L9 and a corresponding one of the electrode elements R1 to R9 in response to a corresponding first control signal arriving at the corresponding first control input terminal. The controller 30 is programmed to generate each of these first control signals.

[0035] Each of the first signal generators X1 to X9 can be configured to: (a) apply a positive electrical signal between the corresponding one of the electrode elements L1 to L9 and the corresponding one of the electrode elements R1 to R9 in response to the corresponding first control signal arriving at the corresponding first control input terminal; and (b) apply a negative electrical signal between the corresponding one of the electrode elements L1 to L9 and the corresponding one of the electrode elements R1 to R9 in response to the corresponding second control signal arriving at the corresponding second control input terminal. It should be noted that the use of the identifiers (a) and (b) does not mean that (a) must precede (b) in time.

[0036] When the first signal generator is implemented as described in the preceding paragraph, the controller 30 can be programmed to apply the corresponding first control signal and the corresponding second control signal to each of the first signal generators X1 to X9 at corresponding times in an alternating sequence, so that the corresponding first signal generator will generate an output that alternates between a positive electrical signal and a negative electrical signal. Optionally, in these embodiments, the controller 30 can be further programmed to insert a time break between each first control signal and each second control signal.

[0037] The system in the illustrated embodiment also includes nine second signal generators Y1 to Y9. And each of these second signal generators Y1 to Y9 is wired to apply a signal between a corresponding single electrode element among the electrode elements A1 to A9 on the front array 10A and a corresponding single electrode element among the electrode elements P1 to P9 on the rear array 10P. More specifically, signal generator Yj is wired to apply a signal between electrode element Aj and electrode element Pj, where j is an integer between 1 and 9. In some embodiments, the output of any given one of the second signal generators Yj can be positive (i.e., where the corresponding A terminal is an anode and the corresponding P terminal is a cathode), negative (i.e., where the corresponding A terminal is a cathode and the corresponding P terminal is an anode), or off (i.e., where no pulse is generated).

[0038] Each of the second signal generators Y1 to Y9 is electrically isolated from all other signal generators. Therefore, the signal applied by signal generator Y1 between electrode element A1 and electrode element P1 will not affect the signal applied to any of the other electrode elements A2 to A9, P2 to P9, L1 to L9, or R1 to R9. A similar situation exists for all other second signal generators Y2 to Y9, such that the signals sent by those signal generators to their respective electrode elements will not affect the signals applied to any of the other electrode elements.

[0039] Each of the second signal generators Y1 to Y9 has a corresponding second control input, and each of the second signal generators Y1 to Y9 is configured to apply an electrical signal between a corresponding electrode element A1 to A9 and a corresponding electrode element P1 to P9 in response to a corresponding second control signal received at the corresponding second control input. The controller 30 is further programmed to generate each of these second control signals. The operation of the second signal generators Y1 to Y9 is similar to the operation of the first signal generators X1 to X9 described above.

[0040] exist Figure 1In a prior art system, in which all electrode elements on left transducer array 90L are wired together in series or parallel, and all electrode elements on right transducer array 90R are wired together in series or parallel, a single electric field travels from all electrode elements on left transducer array 90L to all electrode elements on right transducer array 90R. Furthermore, a single electric field travels from all electrode elements on front transducer array 90A to all electrode elements on rear transducer array 90P. Consequently, the resulting electric field will have a relatively large cross-section and, therefore, may resemble a floodlight.

[0041] On the contrary, Figure 3 / Figure 4 In the embodiment, when signal generator X1 is activated, one electric field propagates from electrode element L1 to electrode element R1; when signal generator X2 is activated, a second electric field propagates from electrode element L2 to electrode element R2; when signal generator X3 is activated, a third electric field propagates from electrode element L3 to electrode element R3, and so on. Thus, depending on which of signal generators X1 to X9 are activated, nine different electric fields can propagate from the corresponding electrode elements L1 to L9 to the corresponding electrode elements R1 to R9. When any given individual signal generator among signal generators X1 to X9 is activated, the generated electric field will have a relatively small cross-section and, therefore, can resemble a spotlight.

[0042] It should be noted that more than one of the signal generators X1 to X9 can be activated simultaneously (e.g., any two signal generators can be activated at a time, any three signal generators can be activated at a time, and so on, up to a maximum of all nine signal generators activated at a time). When all nine of the signal generators X1 to X9 are activated simultaneously, the resulting electric field will have a similar cross-section to the electric field generated using the prior art transducer array 90L / 90R. This latter situation can be analogous to the light from nine individual spotlights collectively illuminating the same area, much like a floodlight.

[0043] Similarly, when signal generator Y1 is activated, one electric field propagates from electrode element A1 to electrode element P1; when signal generator Y2 is activated, a second electric field propagates from electrode element A2 to electrode element P2; when signal generator Y3 is activated, a third electric field propagates from electrode element A3 to electrode element P3, and so on. Thus, depending on which of signal generators Y1 to Y9 are activated, nine different electric fields can propagate from the corresponding electrode elements A1 to A9 to the corresponding electrode elements P1 to P9. When any given individual signal generator among signal generators Y1 to Y9 is activated, the generated electric field will have a relatively small cross-section and, therefore, can resemble a spotlight.

[0044] As described above with respect to the first signal generators X1 to X9, more than one of the second signal generators Y1 to Y9 can be activated simultaneously (e.g., any two of the second signal generators can be activated at a time, any three of the second signal generators can be activated at a time, and so on, up to a maximum of all nine of the second signal generators being activated at a time). When all nine of the signal generators Y1 to Y9 are activated simultaneously, the generated electric field will have a cross-section similar to that generated using the prior art transducer array 90A / 90P. This latter situation can also be similar to the situation where light from nine separate spotlights collectively illuminates the same area, much like a floodlight.

[0045] As mentioned above, breaking the electric field into its individual narrower components is very useful for concentrating the electric field onto a target area. This is perhaps similar to how nine individually controllable spotlights can concentrate light onto a given target area more efficiently than a single floodlight.

[0046] In addition to and in addition to the additional level of control provided by breaking the electric field into separate narrower components so as to focus the electric field to the target area, a further level of control over the electric field in the target area can be obtained by controlling the phase of the signals generated by signal generators X1 to X9 and Y1 to Y9.

[0047] Figure 5 An example of how the controller 30 controls the phases of the signals generated by the signal generators X1 to X9 so that these signal generators generate output signals that resemble piecewise approximations of phase-shifted sine waves S1 to S9 is depicted. More specifically, the controller 30 is programmed to generate control signals in a sequence that causes each of the signal generators X1 to X9 to generate an output having a given waveform, such that the output of each of the signal generators X1 to X9 is shifted in time relative to the output of at least one other signal generator X1 to X9. An example of a control signal sent by the controller 30 to the signal generator X1 is shown in FIG. Figure 5 The lower half of the diagram shows a positive signal generated by +, a zero signal generated by 0, and a negative signal generated by -. The outputs sent by the signal generators X1 to X9 to the corresponding groups of electrode elements L1 / R1 to L9 / R9 are shown in FIG. Figure 5 The upper part is shown.

[0048] When the signal generator X1 receives Figure 5 When the + / - / 0 control signal is applied as depicted in the top row of the lower part, the signal generator X1 will generate Figure 5The digital signals depicted in the top row of the upper half. More specifically, the signal generator X1 will: (a) apply a positive signal to the electrode elements L1 and R1 in time intervals 1 to 4; (b) not apply a signal to those electrode elements in time interval 5; (c) apply a negative signal to those electrode elements in time intervals 6 to 9; (d) not apply a signal to those electrode elements in time interval 10; (e) apply a positive signal to those electrode elements in time intervals 11 to 14; (f) not apply a signal to those electrode elements in time interval 15; and (f) apply a negative signal to those electrode elements in time interval 16. And it should be noted that the sine wave S1 is Figure 5 The superposition of the digital signals depicted in the top row clearly shows that the digital signal is a first-order piecewise approximation of the sine wave S1.

[0049] The controller 30 sends similar signals to the other signal generators X2 to X9, but shifted in time relative to the signal sent to the signal generator X1, such as Figure 5 The signal generators X2 to X9 will respond by applying digital signals to their corresponding electrode element pairs L2 / R2 to L9 / R9, as shown in FIG. Figure 5 And these digital symbols are similar to the digital signals for electrode elements L1 and R1 described above, except that these digital signals are shifted in time, as shown in FIG. Figure 5 Here, too, the superposition of the sine waves S2 to S9 and the digital signals applied to the electrode element pairs L2 / R2 to L9 / R9 clearly shows that each of these digital signals is a first-order piecewise approximation of a corresponding one of the sine waves S2 to S9, and that each of these sine waves (except S6) is phase-shifted relative to the sine wave S1.

[0050] Alternatively, the controller 30 can be programmed to control the temporal shift to manipulate the electric field within the target area. Under certain conditions, particularly when the number of signal generators is large, the ability to generate phase-shifted sinusoidal waves can be exploited to control the direction of the electric field by implementing beam steering techniques similar to those used in phased array radar systems. Thus, these techniques can be used to direct the electric field to the target area with an even finer degree of control, which can be achieved using the above combined with Figures 3 and 4 The described spotlight-shaped electric field is realized.

[0051] The operation of the other group of signal generators Y1 to Y9 is similar to the operation of the first group of signal generators X1 to X9 described above.

[0052] Note that although the transducer array 10 is described in the context of an example including nine electrode elements A1 to A9, P1 to P9, L1 to L9, and R1 to R9 on each transducer array, Figure 3 / Figure 4 , but the number of electrode elements on each transducer array in the transducer array 10 can vary (e.g., between 8 and 64). Similarly, instead of the depicted nine first signal generators X1 to X9 and nine second signal generators Y1 to Y9, the number of first signal generators X can vary, as long as there are at least eight (e.g., between 8 and 64). The number of second signal generators Y can also vary, as long as there are at least eight (e.g., between 8 and 64). The number of signal generators generally matches the number of electrode elements in the corresponding transducer array 10.

[0053] Finally, in some anatomical locations, only one pair of transducer arrays 10 is used. In these embodiments, one row of signal generators (e.g., Figure 4 Y1 to Y9 in ) and two transducer arrays in the transducer arrays (e.g., 10A and 10P).

[0054] Although the present invention has been disclosed with reference to certain embodiments, numerous modifications, variations, and changes may be made to the described embodiments without departing from the sphere and scope of the invention as defined in the appended claims. It is therefore intended that the present invention not be limited to the described embodiments, but rather have the full scope defined by the language of the appended claims and their equivalents.

Claims

1. An apparatus for applying an electric field to a target area using at least eight first electrode elements located on a first side of the target area and at least eight second electrode elements located on a second side of the target area opposite the first side of the target area, the apparatus comprising: at least eight electrically isolated first signal generators, wherein each of the first signal generators has a respective first control input, and wherein each of the first signal generators is configured to apply an electrical signal between a respective one of the at least eight first electrode elements and a respective one of the at least eight second electrode elements in response to a respective first control signal arriving at the respective first control input; and A controller is programmed to generate each of the first control signals.

2. The apparatus according to claim 1 , wherein each of the first signal generators is configured to: (a) apply a positive electrical signal between the corresponding one of the at least eight first electrode elements and the corresponding one of the at least eight second electrode elements in response to a corresponding first control signal arriving at the corresponding first control input terminal; and (b) apply a negative electrical signal between the corresponding one of the at least eight first electrode elements and the corresponding one of the at least eight second electrode elements in response to a corresponding second control signal arriving at the corresponding second control input terminal.

3. The apparatus of claim 2 , wherein the controller is further programmed to apply, to each of the first signal generators, the respective first control signal and the respective second control signal at respective times in an alternating sequence such that the respective first signal generator will generate an output alternating between a positive electrical signal and a negative electrical signal. 4 . The apparatus of claim 3 , wherein the controller is further programmed to insert a time break between each first control signal and each second control signal.

5. The apparatus of claim 1 , wherein the controller is further programmed to generate each of the first control signals in an order that causes each of the at least eight first signal generators to generate an output having a given waveform, wherein the output of each of the at least eight first signal generators is shifted in time relative to an output of at least one other first signal generator.

6. The apparatus of claim 5, wherein the controller is further programmed to control the temporal shift to manipulate the electric field within the target area.

7. The apparatus of claim 5, wherein the controller is further programmed to generate each of the first control signals in a sequence that causes each of the at least eight first signal generators to generate an output that alternates between a positive electrical signal and a negative electrical signal.

8. The apparatus according to claim 1, further comprising: the at least eight first electrode elements; and The at least eight second electrode elements.

9. The device according to claim 1, further comprising: at least eight electrically isolated second signal generators, wherein each of the second signal generators has a respective second control input, and wherein each of the second signal generators is configured to apply an electrical signal between a respective one of the at least eight third electrode elements and a respective one of the at least eight fourth electrode elements in response to a respective second control signal arriving at the respective second control input, Wherein the controller is further programmed to generate each of the second control signals.

10. The apparatus of claim 9 , wherein the controller is further programmed to generate each of the first control signals in an order that causes each of the at least eight first signal generators to generate an output having a first given waveform, wherein the output of each of the at least eight first signal generators is shifted in time relative to the output of at least one other first signal generator, and wherein the controller is further programmed to generate each of the second control signals in an order such that each of the at least eight second signal generators generates an output having a second given waveform, wherein the output of each of the at least eight second signal generators is shifted in time relative to the output of at least one other second signal generator.

11. A method for applying an electric field to a target area using at least eight first electrode elements located on a first side of the target area and at least eight second electrode elements located on a second side of the target area opposite the first side of the target area, the method comprising: Respective first electrical signals are applied between corresponding first electrode elements among the at least eight first electrode elements and corresponding second electrode elements among the at least eight second electrode elements, wherein the first electrical signals all have a given first waveform, wherein each of the first electrical signals is shifted in time relative to at least one other first electrical signal, and wherein each of the first electrical signals is electrically isolated from all other first electrical signals.

12. The method of claim 11, wherein the first electrical signal is applied in a temporally shifted manner to manipulate the electric field within the target region. 13 . The method of claim 12 , wherein each of the first electrical signals alternates between positive and negative polarity.

14. The method according to claim 11, further comprising: positioning the at least eight first electrode elements on the first side of the target area; The at least eight second electrode elements are positioned on the second side of the target area.

15. The method according to claim 11, further comprising: A respective second electrical signal is applied between a respective third electrode element of the at least eight third electrode elements and a respective fourth electrode element of the at least eight fourth electrode elements, wherein the second electrical signals all have a given second waveform, wherein each of the second electrical signals is shifted in time relative to at least one other second electrical signal, and wherein each of the second electrical signals is electrically isolated from all other second electrical signals.

16. The method of claim 15, wherein the first electrical signal is applied in a temporally shifted manner to manipulate the electric field in the target area, and The second electric signal is applied in a temporally shifted manner to manipulate the electric field in the target area.

17. The method of claim 16, wherein each of the first electrical signals alternates between positive and negative polarity, and Each of the second electrical signals alternates between positive polarity and negative polarity.

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