System for peripheral nerve stimulation

Abstract

The present invention relates to a system (100) for peripheral nerve stimulation, in particular for detecting and / or monitoring neuronal and / or muscular activity, comprising at least one nerve stimulation device (110), comprising at least a first recording means (130) and a second recording means (140), configured to be arranged at a recording means distance (120) from each other and each configured to detect stimuli propagated along a nerve structure, in particular along an efferent nerve and / or an afferent nerve, whereby the speed of the stimuli propagated along the nerve structure can be determined.

Description

[Technical field]

[0001] The present invention relates to a system for peripheral nerve stimulation (PNS) in particular for monitoring neuronal and / or muscular activity. [Background technology]

[0002] In this regard, neural prosthetic devices are powerful tools for monitoring, preventing, and treating neural diseases, disorders, and conditions by electrically interfacing with the nervous system. They can record neural activity and electrically stimulate neural activity when implanted into the nervous tissue or applied as external devices to the patient's body to interact with the nervous tissue. Currently, most neural prosthetic technologies utilize electrodes that interface with the nervous tissue.

[0003] In this context, nerve conduction velocity (NCV) is an important aspect of nerve conduction studies. It describes the speed at which an electrochemical impulse propagates through a nerve pathway / structure / fiber. Nerve conduction velocity and its measurement methods are generally well known in the art.

[0004] In particular, conduction velocity is affected by a wide range of factors, including age, sex, and various medical conditions, among others. Research allows for improved diagnosis of various neurological disorders, particularly demyelinating diseases, since such diseases result in slowed or absent conduction velocity.

[0005] Conventional NCV measurements use, for example, a stimulation pulse to the forearm while measuring the response at a distance, for example 10 cm or more.

[0006] The speeds are relatively low compared to normal electrical propagation (which is equivalent to the speed of light), ranging from 0.5 m / s for IV / C sensory fibres to 120 m / s for Ia sensory / alpha motor fibres.

[0007] As a result, measuring the delay between stimulus and response over long distances on the skin is highly feasible.

[0008] However, for small implanted electrode arrays, such as nerve cuffs or small skin patches for peripheral nerve stimulation, the distances are much shorter and therefore the time it takes to detect delays in the course of stimulus propagation along the corresponding nerve fibers is much shorter.

[0009] This situation poses various challenges for NCV measurement using such miniature recording arrays / devices, e.g., electrode arrays, which can be summarized as follows: - A high sampling frequency is required. - Highly accurate time synchronization between the stimulation and recording channels is required. - Relatively large stimulus intensities can saturate adjacent recording electrodes / recording amplifiers / circuitry, resulting in "dead-times" that are larger than the latency being measured. - The stimulus waveform and its non-infinitely short duration introduce relatively large error terms into the velocity measurements. - Because neural activation (onset time, intensity and wave shape) may depend on the applied stimulation waveform, the actual stimulation waveform used (and its parameters) may affect latency measurements. - It is the combination of tissue, nerve anatomy, and excitation potential field that determines the exact location of activation in the nerve, not the location of the activation / stimulation electrode / device. Therefore, the NCV method is prone to spatial localization errors. A minimum of 3, preferably 4 (2nd differential) wiring / recording channels are required per NCV measurement location.

[0010] In summary, due to geometric constraints, especially in the case of miniature electrode arrays / devices for intrinsic neurostimulation applications, numerous challenges exist that make the results of NCV measurements inaccurate and unreliable. Summary of the Invention

[0011] The object of the present invention is to provide a system for peripheral nerve stimulation which allows monitoring and / or measurement of neuronal and / or muscular activity, in which the measurement process and the handling of the measurements, as well as the handling of the measurement results, are facilitated and simplified in order to receive more reliable and accurate results, in particular by providing a safer, more stable and more reliable type of measuring device along the nerve structures / fibers.

[0012] The above mentioned object is solved by the subject matter of independent claim 1. Advantageous configurations of the invention are set out in the dependent claims.

[0013] According to the present invention, a system for peripheral nerve stimulation, in particular for detecting and / or monitoring neuronal and / or muscular activity, comprises at least one nerve stimulation device, which comprises at least a first recording means and a second recording means, which are configured to be arranged at a recording means distance from each other and are respectively configured to detect / measure / determine a stimulus propagated along a nerve structure, in particular along an efferent nerve and / or an afferent nerve, whereby the speed of the stimulus propagated along the nerve / nerve structure / fiber can be determined.

[0014] The invention is based on the idea of ​​using (predetermined) arrangements of recording means, in particular electrode or coil patterns, with known / defined distances between the electrodes / coils and, optionally, known sensitivity differences, which are preferably combined / connected to one common recording channel / connection.

[0015] To that extent, the present invention can be considered as essentially inspired by fiber optic Bragg gratings for reflection / transmission / wavelength shift of optical light, which has at least some similarity to induced currents in electrodes / coils with respect to the respective time shift.

[0016] As a result, the propagating electrochemical impulses appear not just once but multiple times on the time line / common recording signal of the recording channel, and the relative positions of those pulses in that time line / common recording signal identify the exact position where the pulse appears on the array / pattern / arrangement of the recording means.

[0017] Furthermore, such (common) recorded signals not only provide the propagation velocity, but also, for example, the direction and therefore the type of nerve / nerve structure / fiber that propagated the measured stimulus, i.e. the efferent or afferent type of structure / sensory organ / fiber.

[0018] According to the invention the first and second recording means are preferably arranged at a recording means distance.

[0019] The recording means distance may be a predetermined, fixed distance between the first and second recording means.

[0020] Alternatively, the distance between the first and second recording means placed on the patient's body may be measured and then set as the recording means distance, for example by a corresponding input into a control device of the system.

[0021] Furthermore, the first / second recording means is configured to determine / detect / measure a stimulus propagated along a nerve / nerve structure, such as a nerve fiber, In particular, such a stimulus can be based on natural nerve / muscle activity or can be induced by (external) nerve stimulation.

[0022] Based on such recording means distance and the resulting measured / detected / recorded signals of the first and second recording means, a duration of the propagating stimulus along the recording means distance can be determined.

[0023] As a result, the velocity of the propagated stimulus can be calculated based on the recording means distance and the execution time of the propagated stimulus along such recording means distance.

[0024] Moreover, such a configuration of the system, i.e. of the first / second recording means, also makes it possible to determine further information such as the direction of nerve propagation and the type of nerve structures / fibers propagating the respective stimuli.

[0025] Thus, the system according to the present invention provides an easy-to-use and comprehensive approach on how to proceed with NCV measurements by using a miniature recording / stimulation device such as those utilized in the PNS.

[0026] According to one embodiment of the invention, the first and / or second recording means comprises at least two recording elements, the recording elements of the first recording means being arranged in a first pattern and the recording elements of the second recording means being arranged in a second pattern.

[0027] In particular, the first and / or second recording means may comprise two or more recording elements arranged in a pattern. It is also possible that the first recording means comprises more or less recording elements than the second recording means.

[0028] The first and second patterns may be identical. Preferably, the first and second patterns may be different from each other. In particular, the first / second patterns may differ in the structural / geometrical embodiment of the respective recording elements, in the arrangement of the recording elements of the first / second recording means relative to each other, and / or the like.

[0029] The first and / or second recording means may provide unique signatures when recording / detecting / measuring stimuli, which may enable their identification in a (common) recorded signal provided by the first / second recording means, e.g. to a control device of the system.

[0030] In another preferred embodiment, the first pattern has a first recording element distance between the recording elements of the first recording element and the second pattern has a second recording element distance between the recording elements of the second recording means. In a further preferred embodiment, the first recording element distance and the second recording element distance are the same or different from each other.

[0031] The first and second patterns of the first / second recording means may preferably differ from each other by a first / second recording element distance provided between at least two recording elements of each of the first / second recording means.

[0032] For example, the recording element distance between the recording elements of the second recording means may be greater than in the first recording means.

[0033] Such different recording element distances may allow for unique signatures of the first and second recording means, so that based on the determined (common) recording signal of the neurostimulation, the first and second recording means with their respective patterns of recording elements may each be identified, i.e. by their unique, specific signature.

[0034] Such a signature, for example by a first / second pattern of the first / second recording means, may for example provide easier and more useful signal processing.

[0035] Preferably, the first and second patterns differ from each other only with respect to the first and second recording element distances.

[0036] Therefore, the first / second recording means can be easily identified based on the resulting (common) recording signal transferred by the first / second recording means, in particular by the recording elements of the first / second recording means.

[0037] In this regard, the first recording means and the second recording means provide a unique signature on the (common) recording signal, which reflects the propagation of the detected neural stimulation since different first / second recording element distances are provided between their respective recording elements.

[0038] Furthermore, only one type of recording element needs to be manufactured and provided for the system, whereby only the respective recording element distance is varied within the first / second recording means of the system.

[0039] Thus, easy and cost-effective manufacture of the system according to the invention can be provided.

[0040] According to one preferred embodiment, each recording element is provided in the form of at least one electrode or coil.

[0041] For example, the first / second recording means, i.e. the respective recording elements, may be implemented as recording electrodes in a neurostimulator device for the PNS.

[0042] Alternatively, the first / second recording means, i.e. the respective recording element, may be provided in the form of a recording coil, for example within a corresponding nerve cuff for the PNS.

[0043] In this context, the neurostimulator device may be provided as an electrode device or a coil device.

[0044] The system, and in particular the corresponding recording means, can be implemented in a variety of different forms and in an efficient and suitable manner for the respective field of application.

[0045] In one embodiment of the present invention, the neurostimulation device comprises at least one stimulation means for transmitting a stimulation signal to the patient's tissue in order to initiate neuronal and / or muscular stimulation, the stimulation means preferably being configured in the form of at least one electrode or coil.

[0046] The neurostimulator device of the system according to the invention may be provided as an electrode device comprising at least one stimulation electrode and at least two recording means, the recording means preferably each comprising at least two electrodes as recording elements arranged in a first / second pattern.

[0047] Alternatively, the stimulation means may be implemented as a stimulation coil, preferably in combination with recording means, i.e. a recording element, also implemented in the form of a coil.

[0048] As a further alternative, the stimulation means may be provided in the form of at least one electrode and wherein the recording element is provided in the form of at least one coil respectively, or vice versa.

[0049] The system, comprising a neurostimulation device with at least one stimulation means, can be used in applications such as deep brain stimulation or peripheral nerve stimulation. Due to the inherent implementation of the recording means, the system can further be used for NCV measurements, instead of or in parallel with the stimulation application itself.

[0050] Furthermore, the system can be used to detect / measure / determine natural neural activity, and (neural) stimulation-induced activity can be provided via the stimulation means for performing NCV measurements.

[0051] According to another embodiment, the first recording means and the second recording means, in particular the recording elements of the first recording means and the recording elements of the second recording means, have different recording sensitivities.

[0052] The recording elements of one recording means can have the same or different recording sensitivities. Alternatively, the recording sensitivities of the recording elements of one recording means can be equal and the recording sensitivities of the first and second recording means can be different. Furthermore, it is also possible that each recording element of the system has a different / unique recording sensitivity.

[0053] In particular, the recording / measurement / detection signals transferred by the recording means, ie by each recording element, can be different when one stimulus is detected / determined due to different recording sensitivities.

[0054] In this context, the first / second recording means may, due to their recording sensitivity, provide different signatures not only in terms of a time shift in the (common) recording signal, but also in terms of the intensity of the recording signal provided by the recording means.

[0055] Such different recording sensitivities result in an additional signature of the respective recording means in the recording signal transmitted by the recording means.

[0056] In another embodiment, the system further comprises a controller configured to operate, in particular to control and / or regulate, the operation of the neurostimulator device and / or to provide signal processing of signals received from the first and second recording means.

[0057] The control device may receive the (common) recorded signal(s) from the first / second recording means for subsequent signal processing. Preferably, the control device may be configured to analyze the recorded signals to determine the measured / detected stimuli along with the recorded signals and / or to determine the time between detection of the stimuli by the first and second recording means.

[0058] In particular, the controller may calculate nerve conduction velocity based on the received (common) recording signal(s).

[0059] Furthermore, a control device may be provided in combination with the input and output means of the system, for example to enable a user to provide input regarding the recording means distance and / or the first / second recording element distance. Via the output means, the control device may provide the result of the NCV measurement, i.e. the velocity of the propagating stimulus measured / detected by the recording means, to the user.

[0060] In one further preferred embodiment of the invention, the recording signals from the first and / or second recording means, in particular of the recording elements of the first and / or second recording means, are transferred via a common signal connection, preferably to a control device of the system.

[0061] In particular, the recording signals of each individual recording element may be combined into a single common signal connection, in this context the recording signals may be considered to be combined into a common recording signal.

[0062] Preferably, a common signal connection may be provided as a (data) communication and / or electrical connection between the recording means, i.e. the recording element, and the system's control device, data storage, communication device for further transferring the recorded signal to an external server, etc.

[0063] Furthermore, means may be provided for combining the recording signals of the individual recording elements of the first / second recording means into a combined recording signal for transfer of a single combined recording signal over a common signal connection.

[0064] A common signal connection can simplify the infrastructure of the system, especially with regard to the placement of the recording means near the patient. Furthermore, the size of the whole system, especially the neurostimulation device, can be reduced.

[0065] Furthermore, by transferring a common recording signal via one common signal connection, subsequent signal processing can be directed to that single signal, where the unique configuration of the at least two recording means ensures proper identification of each recorded stimulus.

[0066] In particular, for example (but not limited to) in the context of these applications, the need for and regulation of (neurostimulation) therapy, either by control or regulation of the system, for example with respect to a closed loop system, may be assessed by use of the present invention.

[0067] In summary, the system according to the invention is particularly useful in the unique context of miniature neurostimulation devices / arrays: - Detect neural activity, - measuring its direction of propagation, - Measure its propagation velocity and therefore nerve conduction velocity, - measuring nerve conduction based on natural nerve activity and / or activity induced by stimulation (electrical, optical, ultrasonic, and / or other types); and / or It allows to reduce the amount of conducting wiring / recording channels per NCV measurement, thereby reducing the size / area of ​​the device.

[0068] In summary, the system according to the present invention may be particularly configured for use in PNS applications, and in particular for invasive (e.g. in the form of a microneedle device) or transcutaneous (e.g. in the form of a skin patch) sensors for nerve conduction velocity (NCV) measurements in the context of PNS applications.

[0069] Further details and advantages of the invention are disclosed below in connection with the accompanying drawings. [Brief description of the drawings]

[0070] [Figure 1] FIG. 1 is a schematic diagram of an alternative embodiment of a system including a nerve stimulation device in the form of a nerve cuff. [Diagram 2] FIG. 1 is a schematic diagram of an alternative embodiment of a system including a neurostimulation device in the form of a skin patch. [Diagram 3] 1 is a schematic diagram of an alternative embodiment of a system including a neurostimulation device in the form of a percutaneous device and a paddle device. [Figure 4] FIG. 3 is a schematic diagram of a first embodiment of a measurement principle applicable by the embodiment according to FIG. 1 and / or FIG. 2; [Diagram 5] FIG. 3 is a schematic diagram of a second embodiment of a measurement principle applicable by the embodiment according to FIG. 1 and / or FIG. 2. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0071] 1, a schematic diagram of an alternative embodiment of a system 100 including a nerve stimulation device 110 in the form of a nerve cuff is shown. In particular, two alternative forms of the nerve stimulation device 110 in the form of a nerve cuff are shown.

[0072] According to FIG. 1, the neurostimulator device 110 comprises a first recording means 130 and a second recording means 140 .

[0073] The first and second recording means 130; 140 are spaced a recording means distance 120 from each other.

[0074] The first recording means 130 is provided with two recording elements 132 ; 134 arranged in a first pattern 136 .

[0075] The recording elements 132; 134 of the first recording means 130 are spaced a first recording element distance 138 from each other.

[0076] The second recording means 140 is provided with two recording elements 142 ; 144 arranged in a second pattern 146 .

[0077] The recording elements 142;144 of the second recording means 140 are spaced a second recording element distance 148 from each other.

[0078] 1, the first recording element distance 138 is different from the second recording element distance 148. In particular, the second recording element distance 148 is greater than the first recording element distance 138.

[0079] According to two alternative forms shown in FIG. 1, the recording elements 132; 134; 142; 144 may be provided in the form of at least one coil (upper diagram in FIG. 1) or in the form of at least one electrode (lower diagram in FIG. 1), respectively.

[0080] Preferably, the recording elements 132; 134; 142; 144 are each formed as a coil.

[0081] Alternatively, each recording element 132; 134; 142; 144 may be provided in the form of multiple electrodes as shown in FIG.

[0082] For example, with reference to FIG. 1, multiple electrodes of each recording element 132; 134; 142; 144 may be provided and distributed along the circumference of the neurostimulator device 110 in the form of a nerve cuff.

[0083] The material of the electrodes may be at least partially graphene, in particular reduced graphene oxide (RGO).

[0084] In one embodiment, but also in all embodiments disclosed in the present disclosure, the electrode device has at least one electrode comprising graphene, in particular made from a graphene or graphene-based material, or provided with a graphene(based) coating.

[0085] Preferably, various forms of graphene (based) materials may be used in the context of the present invention, such as reduced graphene oxide (rGO), graphene oxide, chemical vapor deposited graphene (CVD graphene), or any other potential form of graphene.

[0086] In particular, such graphene-based materials can provide enhanced electrical and mechanical properties, such as useful flexibility of the resulting electrodes.

[0087] Such graphene electrodes may in particular provide higher safety charge injection capacity and improved signal-to-noise ratio / performance, thereby allowing electrode size to be reduced while maintaining the same electrode mass.

[0088] Thus, along the cross-section of the electrode device, the cross-sectional area of ​​at least one electrode may be reduced.

[0089] Moreover, such graphene-based electrodes can provide a safe electrical interface in aqueous environments, such as in the context of neuromodulation of neural tissue.

[0090] A first pattern 136 and a second pattern 146 are formed by the recording elements 132 ; 134 ; 142 ; 144 of the first and second recording means 130 ; 140 .

[0091] FIG. 2 shows a schematic diagram of an alternative embodiment of a system 100 including a neurostimulator device 110 in the form of a skin patch specifically intended for PNS applications.

[0092] The neurostimulator device 110 is provided with a first recording means 130 and a second recording means 140 spaced apart from each other along the extension of the neurostimulator device 110 by a recording means distance 120 .

[0093] The recording elements 132 ; 134 of the first recording means 130 are arranged in a first pattern 136 and the recording elements 142 ; 144 of the second recording means 140 are arranged in a second pattern 146 .

[0094] In particular, the neurostimulation device 110 in the form of a skin patch may be provided in a rectangular shape, as shown in FIG. 2, to allow for an increased recording means distance 120 between the first and second recording means 130;140.

[0095] 3 shows a schematic diagram of an alternative embodiment of a system comprising a neurostimulator device 110 in the form of a percutaneous device (left diagram of FIG. 3) and in the form of a paddle device (right diagram of FIG. 3).

[0096] In particular, the percutaneous nerve stimulation device 110 may be formed in a band shape (left diagram in FIG. 3).

[0097] Alternatively, the neurostimulator device 110 may be provided in any geometry and form applicable and suitable for the PNS, such as the percutaneous device 110 shown in FIG.

[0098] According to FIG. 3, the neurostimulator device 110 comprises a first recording means 130 and a second recording means 140 .

[0099] The first and second recording means 130; 140 are spaced a recording means distance 120 from each other.

[0100] The first recording means 130 is provided with two recording elements 132 ; 134 arranged in a first pattern 136 .

[0101] The recording elements 132; 134 of the first recording means 130 are spaced a first recording element distance 138 from each other.

[0102] The second recording means 140 is provided with two recording elements 142 ; 144 arranged in a second pattern 146 .

[0103] The recording elements 142;144 of the second recording means 140 are spaced a second recording element distance 148 from each other.

[0104] According to an alternative embodiment shown in Fig. 3, the recording elements 132; 134; 142; 144 may each be provided in the form of at least one electrode. Alternatively, the recording elements 132; 134; 142; 144 may be provided in the form of a coil.

[0105] A first pattern 136 and a second pattern 146 are provided / formed by the recording elements 132; 134; 142; 144 of the first and second recording means 130; 140.

[0106] As a further alternative in the context of the present invention, electrodes / coils may be distributed along the circumference / extension of the neurostimulator device 110 to form recording elements 132; 134; 142; 144, respectively.

[0107] Furthermore, FIG. 3 shows an embodiment of the transcutaneous device 110 having an additional stimulation means 150 (left diagram in FIG. 2), as well as an embodiment formed specifically for the purpose of NCV measurement and therefore without the additional stimulation means 150 (right diagram in FIG. 2).

[0108] In particular, the stimulation means 150 may be provided between the recording means distance 120 of the neurostimulator device 110 and thus between the first recording means 130 and the second recording means 140 .

[0109] In the context of FIG. 3, the stimulation means 150 are provided in the same form as the recording elements 132; 134; 142; 144 and thus in the form of electrodes.

[0110] Alternatively, the stimulation means 150 may be provided in the form of at least one coil.

[0111] It is further possible that the recording elements 132; 134; 142; 144 are provided, for example, as coils and the stimulation means 150 are provided in the form of electrodes.

[0112] Furthermore, the at least one stimulation means 150 can also be arranged at another location of the stimulation device 110, for example at the top or bottom of the neurostimulator device 110.

[0113] Moreover, a further embodiment according to FIG. 3 (right illustration in FIG. 3), in the form of a paddle device 110, shows in particular an implementation having a plurality of first and second recording means 130;140.

[0114] In particular, the first and second recording means 130; 140 may be arranged alternately multiple times.

[0115] By providing the first recording means 130 and the second recording means 140 each having a unique signature, such as a different first / second recording element distance 138;148 or different sensitivity characteristics, the determination of the propagation of the neurostimulation along the length of the neurostimulation device 110 of the system 100 can be further improved.

[0116] In this context, the first pattern 138 of the first recording means 130 and the second pattern 148 of the second recording means 140 may provide a common and / or homogeneous pattern of recording elements 132;134;142;144, in particular of repetitively arranged recording elements 132;134;142;144.

[0117] In Figures 4 and 5, schematic diagrams of alternative embodiments of the measurement principle applicable by the embodiment according to Figures 1 and / or 2 and / or 3 are shown. In particular, the functioning of a system 100 having a neurostimulator device 110 as exemplarily shown in Figures 1 to 3 can be described as follows.

[0118] In FIG. 4, a stimulus / nerve pulse is propagated along a nerve structure / fiber 200 .

[0119] Along the nerve 200 first and second recording means 130 ; 140 are arranged, for example in the form of coils provided in the nerve cuff-like neurostimulator device 110 of the system 100 .

[0120] The first and second recording means 130; 140 are spaced apart from each other by a recording means distance 120.

[0121] Furthermore, the first marking means 130 forms a first pattern 136 having two marking elements 132 ; 134 spaced apart by a first marking element distance 138 .

[0122] The second marking means 140 forms a second pattern 146 having two marking elements 142 ; 144 spaced apart by a second marking element distance 148 .

[0123] When a propagating stimulus is detected by one of the recording elements 132; 134; 142; 144, a recording signal is provided, showing intensity peaks versus time (lines), as shown in the bottom diagram of FIG.

[0124] In particular, all recording elements 132; 134; 142; 144 may be connected to a controller of the system 100, for example via a common signal line.

[0125] Thus, as shown in FIG. 4, the recording signals of several recording elements 132 ; 134 ; 142 ; 144 may preferably be combined into a common recording signal 160 .

[0126] As a natural nerve stimulus or an induced nerve stimulus induced, for example, by the stimulation means 150 propagates further along the nerve fiber 200, it is detected / determined / measured by each recording element 132; 134; 142; 144 of the first and second recording means 130; 140.

[0127] According to the embodiment of FIG. 4, the resulting common recorded signal 160 exhibits four intensity peaks versus time (lines), each provided / determined by a corresponding one of the recording elements 132; 134; 142; 144.

[0128] The height of the intensity peaks in the corresponding diagrams of the common recording signal depends on the (recording) sensitivity of the respective recording elements 132; 134; 142; 144.

[0129] As can be seen from FIG. 4, the configuration of the neurostimulator device 110, for example with respect to the recording means distance 120 as well as the first / second recording element distance 138; 148, is reflected, which can be inferred from the visualization of the common recording signal 160.

[0130] According to FIG. 4, the recording means distance 120 may represent the distance between the beginning of the first recording means 130 and the beginning of the second recording means 140 .

[0131] Moreover, according to figure 4, the recording elements 132; 134; 142; 144 are of identical construction and in particular have the same sensitivity characteristics, which can be inferred in particular from the equal heights of the peaks of the common recording signal 160.

[0132] Alternatively, each of the recording elements 132 ; 134 ; 142 ; 144 can have a different sensitivity, which can give rise to different peak heights in the common recording signal 160 .

[0133] In particular, the recording elements of the recording means 130;140 can have the same sensitivity or different sensitivities, providing a sensitivity profile, ie a signature, for each recording means 130;140.

[0134] The difference between the first recording means 130 and the second recording means 140 according to FIG. 4 is the distance between the respective recording elements 132 ; 134 ; 142 ; 144 , and thus the difference between the first recording element distance 138 and the second recording element distance 148 .

[0135] The first pattern 136 and the second pattern 146 differ from each other with respect to the first / second recording element distance 138;148.

[0136] In FIG. 5 an embodiment according to FIGS. 1-2 is shown, in particular comprising stimulation means 150 as shown in FIG.

[0137] According to FIG. 5, the stimulation means 150 is located between the first recording means 130 and the second recording means 140 .

[0138] The stimulation means 150 is capable of inducing nerve stimulation to initiate stimulation propagating along the nerve 200 .

[0139] The arrangement of the stimulating means 150 in FIG. 5 provides a first stimulating means distance 152 and a second stimulating means distance 154 .

[0140] Taking into account the first and second stimulator means distances 152;154, the common recorded signal 160 may indicate the propagation of the stimulation over time along the nerve 200, particularly after signal processing by the controller.

[0141] In summary, the system according to the present invention can provide NCV measurements for small neurostimulator devices 110, such as neurostimulator devices 110 for the PNS.

[0142] In particular, natural nerve stimulation or induced nerve stimulation, ie provided via the stimulation means 150, propagating along the nerve 200 can be determined via the nerve stimulation device 110.

[0143] Thereby, NCV measurements and signal (post)processing, particularly in the context of such compact systems 100, may be simplified by utilizing first and second recording means 130; 140 located / arranged within a (predetermined) recording means distance 120.

[0144] Furthermore, by combining the recording signals of the recording means 130; 140, particularly the associated recording elements 132; 134; 142; 144, into a common signal connection, the wiring of the neurostimulator device 110 can be simplified, the size of the system 100, particularly the neurostimulator device 110, can be reduced, and a single common recording signal 160 can be provided for further processing. [Explanation of symbols]

[0145] 100 Systems 110 Neurostimulatory Devices 120 Recording means distance 130 First recording means 132 Recording elements 134 Recording elements 136 First Pattern 138 First recording element distance 140 Second Recording Means 142 Recording elements 144 Recording elements 146 Second Pattern 148 Second recording element distance 150 Stimulation means 152 First Stimulus Distance 154 Secondary Stimulus Distance 160 Common Recording Signals 200 Efferent / afferent nerves

Claims

1. A system for peripheral nerve stimulation, particularly for detecting and / or monitoring neuronal activity and / or muscle activity, comprising at least one nerve stimulation device, wherein the nerve stimulation device comprises at least a first recording means and a second recording means, wherein the first recording means and the second recording means are configured to be arranged at a recording means distance from each other, and each is configured to detect a stimulus propagated along a nerve structure, particularly along a centrifugal nerve and / or a centripetal nerve, whereby the speed of the stimulus propagated along the nerve structure can be determined.

2. The system according to claim 1, wherein the first and / or second recording means comprises at least two recording elements, wherein the recording elements of the first recording means are arranged in a first pattern, and wherein the recording elements of the second recording means are arranged in a second pattern.

3. The system according to claim 2, wherein the first pattern has a first recording element distance between the recording elements of the first recording means, and the second pattern has a second recording element distance between the recording elements of the second recording means.

4. The system according to claim 3, wherein the first recording element distance and the second recording element distance are the same as or different from each other.

5. The system according to claim 2, wherein each recording element is provided in the form of at least one electrode or coil.

6. The system according to any one of claims 1 to 4, wherein the nerve stimulation device comprises at least one stimulation means for transmitting a stimulation signal to the patient's tissue to initiate neuronal stimulation and / or muscle stimulation, and the stimulation means is preferably configured in the form of at least one electrode or coil.

7. The system according to any one of claims 1 to 4, wherein the first recording means and the second recording means, particularly the recording elements of the first recording means and the recording elements of the second recording means, have different recording sensitivities.

8. The system according to any one of claims 1 to 4, further comprising a control device configured to operate, in particular to control and / or adjust, the operation of the nerve stimulation device and / or to provide signal processing of signals received from the first and second recording means. **Claim 9** The system according to any one of claims 1 to 4, characterized in that a recording signal from the first and / or second recording means, in particular from the recording elements of the first and / or second recording means, is transferred via a common signal connection, preferably to a control device of the system.

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