Motor Threshold Detection Device for Use with a Magnetic Stimulation System

Abstract

The system can include a plurality of depressible members, and each depressible member is configured to move in response to the movement of a patient's finger. The system can include a plurality of sensors, each depressible member is associated with at least one sensor, and each sensor is configured to sense the movement of at least one of the plurality of depressible members. The system can receive a feedback signal from each of the plurality of sensors, can receive a signal indicating the timing of the generation of a magnetic stimulation pulse, and can determine that a feedback signal from at least one of the plurality of sensors indicates movement within a time window after the timing of the generation of the magnetic stimulation pulse. The system can generate, via a user interface, a notification indicating that at least one of the depressible members has moved in response to a magnetic stimulation pulse.

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims the benefit of U.S. Provisional Patent Application No. 63 / 355,361, filed on June 24, 2022, the disclosure of which is incorporated herein by reference in its entirety.

Background Art

[0002] Some medical conditions can be treated and / or diagnosed by applying a magnetic field to an affected part of a patient's body. Neurons and muscle cells can be in the form of biological circuits that carry electrical signals and respond to electromagnetic stimulation. When a conductive wire loop passes through a magnetic field or is in the presence of a changing magnetic field, a current can be induced in the wire. The same principle can apply to conductive biological tissue. When a changing magnetic field is applied to a part of the body, neurons can be depolarized and stimulated. Muscles associated with the stimulated neurons can contract as if the neurons were firing due to normal causes.

[0003] Nerve cells or neurons can be stimulated in several ways, for example, transcutaneously by transcranial magnetic stimulation (TMS). In TMS, a rapidly changing magnetic field can be used to induce a current in the nerve cells without having to cut or penetrate the skin. Nerves can "fire" when the membrane potential within the nerve rises relative to its normal negative ambient level of about -90 mV, for example, in response to the type of nerve, the local pH of the surrounding tissue, and / or peripheral nerve stimulation.

[0004] Magnetic stimulation components can be used to generate rapidly changing magnetic fields to induce electric currents in nerve cells. Magnetic stimulation components may malfunction or operate inappropriately during treatment, resulting in inappropriate treatment of the patient. For example, a magnetic component may appear to be operating normally but may actually be generating magnetic field pulses outside of the designed device specifications, and as a result, in some cases, inappropriate diagnosis and / or treatment may be performed on the patient. Applying an inappropriate magnetic field pulse to a patient can have an adverse effect on magnetic stimulation diagnosis and / or treatment. For example, a treatment provider may think that a patient is not responding to treatment when the intended treatment is not actually being administered to the patient. Therefore, the treatment provider and / or diagnostic clinician may make treatment decisions based on incorrect information.

[0005] A typical TMS treatment device may include one or more conductive stimulation coils. A typical TMS treatment device generates a pulsed magnetic field that induces an electric current in electrically sensitive cells (e.g., nerve cells or neurons). These induced electric currents typically form a closed circuit within the body such that a path with zero current through the body is created. The electric current induced by the TMS treatment device typically drops to zero approximately in the middle of this path. The rate of this current drop can be slowed, for example, by spreading the current density generated by the TMS device over a large surface area. However, using this method, the return current becomes concentrated, which can increase the rate of undesirable side effects (e.g., stimulation of non-target areas of the patient's brain).

[0006] Before treatment, the treatment site of the user can first be determined. For example, in TMS, the treatment site is usually determined based on the motor threshold (MT) position of the patient, and this MT position itself is determined by moving the coil near the predicted area determined by the patient's anatomical landmarks until the desired motor response (e.g., single contraction of the thumb) is achieved. The MT position is marked on the patient's head with an ink mark, for example. For example, when using a TMS coil for the treatment of depression, the TMS treatment position is determined by moving the coil a predetermined distance (e.g., the distance is 5 cm) along a line forward from the MT position to identify the treatment site of the patient.

[0007] For example, current methods for determining the MT position and stimulation level for TMS studies rely on visual observation and interpretation of the induced single contraction of the thumb (i.e., abductor pollicis brevis) or on electromyography (EMG) that requires observation and interpretation of the electrical response waveform. Specifically, the general method involves stimulating the motor cortex to observe the single contraction of the thumb or observing when the desired EMG signal exceeds the threshold (i.e., motor evoked potential, MEP) while manually adjusting the stimulation level. Both techniques are time-consuming and highly dependent on the skills and training of the operator. SUMMARY OF THE INVENTION

[0008] Methods, systems, and devices for treating or diagnosing a patient are described herein. A system for detecting movement of one or more body parts (e.g., fingers, toes, hands, feet, etc.) of a human patient is disclosed. This movement can be generated in response to a magnetic stimulation pulse. The system can include a movement detection device, which can include at least one (e.g., a plurality of) depressible members operably coupled to a base member. The plurality of depressible members can be configured to move around the base member in response to movement of each respective body part of the human patient. The movement detection device can include a plurality of sensors (e.g., movement sensors such as accelerometers, tactile switches actuated by movement of a spring arm, etc.). Each sensor can be coupled to a respective one of the plurality of depressible members. Each sensor can be configured to detect movement of the respective depressible member.

[0009] The system can include a processor (e.g., or an equivalent analog circuit with a comparator) configured to receive sensor data associated with one or more detected movements of the plurality of depressible members. The processor can be configured to receive a signal indicating, for example, the timing of a magnetic stimulation pulse, which may be a movement threshold detection test pulse (e.g., used to identify the user's MT site and / or stimulation level). The processor can be configured to determine that the sensor data indicates movement of one or more of the depressible members within a time window associated with the timing of the magnetic stimulation pulse. Signals detected too early or prior to the magnetic stimulation indicate that the movement is not a result of the stimulation. Movements after the time window may indicate a response to the sound of the pulse-driven stimulation coil rather than a single twitch directly caused by the magnetic pulse (e.g., magnetic stimulation). The processor can be configured to generate a notification indicating that at least one of the depressible members has moved in response to the magnetic stimulation pulse.

[0010] Any component of the system may include a processor. For example, a motion detection device may include a processor. A treatment device having a stimulation coil that generates a magnetic field may include a processor. A user interface including a display device (e.g., that generates or displays a notification) may include a processor. Or, components other than the motion detection device, the treatment device, and the user interface may include a processor (e.g., a remote server, etc.).

[0011] In some examples, the notification may indicate the amount of movement of at least one pushable member that moved in response to a magnetic stimulation pulse. In some examples, the notification may include a meter (e.g., a bar meter) for indicating the amount of movement of at least one pushable member that moved in response to a magnetic stimulation pulse. For example, the meter may include a first indication indicating the amount of movement of the pushable member during the current magnetic stimulation pulse and / or a second indication indicating the amount of movement of the pushable member during a previously generated magnetic stimulation pulse.

[0012] The plurality of pushable members can include a first pushable member configured to receive the thumb of a human patient. For example, movement of the first pushable member indicates that the stimulation coil that generated the magnetic stimulation pulse is positioned at the motor threshold site of the human patient. Further, in some examples, the plurality of pushable members may also include a second pushable member configured to receive the index finger and middle finger of the human patient and / or a third pushable member configured to receive the ring finger and little finger of the human patient.

[0013] The system can include a base configured to receive the palm of a patient. The base can be configured to be firmly fixed and remain stable during movement by the fingers of a human patient. In some examples, the system can include a plurality of spring arms. Each of the pushable members can be coupled to at least one spring arm, and the spring arm can be configured to move the pushable member in response to movement of the fingers of a human patient. In some examples, the system includes a user interface device, and the user interface device can include a user interface. The user interface can include a display device.

[0014] The system can include an electromagnet (e.g., a treatment coil) and a drive circuit electrically coupled to the electromagnet. The system can also include a second processor configured to control the drive circuit to supply a current to the electromagnet to generate a magnetic stimulation pulse. In some examples, the second processor can be configured to supply a signal indicating the timing of the generation of the magnetic stimulation pulse to a processor.

[0015] A system for detecting the movement of a human patient when determining a motor threshold site or a treatment site of the human patient can be described herein. The system can include at least one pushable member and a processor. The pushable member can be configured to move in response to movement by a human patient. The processor can be configured to receive a feedback signal indicating the timing of the movement of the pushable member. The processor can receive a signal indicating the timing of the generation of the magnetic stimulation pulse. The processor can determine that the pushable member has moved in response to the magnetic stimulation pulse. The processor can generate a notification indicating that the pushable member has moved in response to the magnetic stimulation pulse via a user interface.

[0016] In some examples, the system may also include a sensor associated with the depressable member, the sensor being configured to sense movement of the depressable member. The system may include a treatment coil configured to generate magnetic stimulation pulses. The system can include a display device, and the notification is a graphical user interface (GUI) generated via the display device. In some examples, the notification may be an audible notification (e.g., via a speaker of the treatment system). In some examples, the notification can be generated using at least one light source. The light source may be part of the movement threshold detection device. For example, the light source may be disposed adjacent to (e.g., directly above or above) each depressable member.

[0017] The notification can indicate one or more things (e.g., to a technician of the system). For example, the notification can indicate that the treatment coil is disposed at the movement threshold site of the patient. The notification can indicate the direction in which the treatment coil should be moved so that the treatment coil is disposed at the movement threshold site or treatment site of the patient. The notification can indicate the amount of movement of the depressable member.

[0018] A system for detecting movement of a human patient is disclosed when determining the location of a patient's motor threshold site during a treatment or diagnostic procedure (e.g., a motor threshold detection procedure or MT procedure performed during (e.g., prior to) a treatment or diagnostic procedure). The system can include a plurality of depressible members (e.g., finger paddles). Each depressible member can be configured to move in response to movement of a patient's finger. The system can include a plurality of sensors, and each depressible member is associated with at least one sensor. Each sensor can be configured to sense movement of at least one of the plurality of depressible members. The system can include a controller configured to receive feedback signals from each of the plurality of sensors. For example, the controller can be configured to receive a signal indicating the timing of the generation of a magnetic stimulation pulse (e.g., a motor threshold detection test pulse). The controller can be configured to determine that a feedback signal from at least one of the plurality of sensors indicates movement that exceeds a threshold within a time window after the timing of the generation of the magnetic stimulation pulse. The controller can be configured to generate, via a user interface, a notification indicating that at least one of the plurality of depressible members has moved in response to the magnetic stimulation pulse.

[0019] A method and a non - transient computer - readable storage medium for detecting movement of a human patient when determining a motor threshold site or a treatment site of the human patient during treatment or a procedure can be described herein. For example, the method can include receiving feedback signals from each of a plurality of sensors, each of the plurality of sensors being associated with a depressible member of a plurality of depressible members, and each sensor being configured to sense movement of at least one of the plurality of depressible members. The method can include receiving a signal indicating a time point of generation of a magnetic stimulation pulse. The method can include determining that a feedback signal from at least one of the plurality of sensors indicates movement exceeding a threshold within a time window after the time point of generation of the magnetic stimulation pulse. The method can include generating, via a user interface, a notification indicating that at least one of the plurality of depressible members has moved in response to the magnetic stimulation pulse.

Brief Description of the Drawings

[0020]

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[0021] In the following discussion, conventional features of treatment or diagnostic systems that will be apparent to those of ordinary skill in the art are omitted or simply described. Note that various embodiments are described in detail with reference to the drawings, in which the same reference numerals represent the same parts and assemblies throughout several figures. The scope of the appended claims is not limited by reference to the various embodiments. Additionally, any examples described herein are not limiting and merely illustrate some of the many possible embodiments of the appended claims. Further, the specific functions described herein can be used in combination with the other functions described, each in various possible combinations and permutations.

[0022] Unless otherwise defined herein, all terms are given their broadest possible interpretation, including the meanings implied from the specification, the meanings understood by those skilled in the art, and / or the meanings defined in dictionaries, agreements, etc. In this specification and the appended claims, the singular forms "a", "an", and "the" include plural referents unless the context clearly dictates otherwise, and the terms "comprise" and / or "comprising", as used herein, specify the presence of the stated features, elements, and / or components, but do not preclude the presence or addition of one or more other features, steps, acts, elements, components, and / or groups thereof.

[0023] In 1831, Michael Faraday discovered that the magnitude of the electric field induced in a conductor is proportional to the rate of change of the magnetic flux across that conductor. Faraday's law, well known to those skilled in the art, can be expressed as E ~ - (A × dB / dt), where E is the induced electric field in volts per meter and dB / dt is the time rate of change of the magnetic flux density in teslas per second. In other words, the amount of electric field induced in an object such as a conductor can be determined using two factors, namely the surface density and the time rate of change of the magnetic flux. The greater the magnetic flux density and its derivative, the greater the induced electric field and the resulting current density. The magnetic flux can be a function of distance. For example, since the magnetic flux density decreases in intensity in relation to the distance from the source of the magnetic field (e.g., 1 / r 3 , 1 / r 5 etc.), the magnetic flux density can be greater the closer the conductor is to the source of the magnetic field. When the conductor is a coil, the current induced in the coil by the electric field can increase in proportion to the number of turns of the coil.

[0024] An overview of exemplary operations and application examples of a magnetic system in which aspects of various embodiments can be implemented can be provided. The magnitude of the electric field induced in a conductor can be proportional to the rate of change of the magnetic flux density across the conductor. When an electric field is induced in a conductor, the electric field can cause a corresponding flow of current in the conductor. The flow of current can be in the same direction as the electric field vector at a given point. The peak electric field occurs when the time rate of change of the magnetic flux density is maximum and can decrease at other times. During the magnetic pulse, the current can flow in a direction that tends to maintain the magnetic field (e.g., Lenz's law).

[0025] Certain parts of anatomical structures (e.g., nerves, tissues, muscles, brain) can act as conductors and can conduct current when a pulsed magnetic field is applied. The pulsed magnetic field can be applied transcutaneously to these parts of the anatomical structure. For example, in the case of TMS, a time-varying magnetic field is applied across the skull to generate an electric field in the brain tissue and a current can be produced. If the density and / or duration of the induced current is sufficient, the neuronal action potential can be reduced to the extent that the membrane sodium channels open and an action potential response occurs. The current impulse propagates along the axonal membrane that transmits information to other neurons via the regulation of neurotransmitters. Such magnetic stimulation can acutely affect glucose metabolism and local blood flow in cortical tissue. In the case of major depressive disorder, abnormal neurotransmitter regulation and abnormal glucose metabolism in the prefrontal cortex and associated limbic structures can be possible pathophysiologies. Repeated magnetic stimulation of the prefrontal cortex can, for example, cause chronic changes in neurotransmitter concentration, metabolism, and / or neural changes in the stimulation threshold, and thus depression may be alleviated.

[0026] Non-cortical neurons (e.g., cranial nerves, peripheral nerves, sensory nerves) can be stimulated by an induced electric field. For example, peripheral nerves can be intentionally stimulated to diagnose neuropathy by observing, for example, the response time and conduction velocity in response to pulsed magnetic field-induced stimulation. When the induced electric field applied to the peripheral nerves and / or cranial nerves is very strong and / or concentrated in a small area of the nerve, discomfort and / or pain may result. This discomfort can be reduced, for example, by intentionally overstimulating the sensory nerves of the affected nerve bundle so that they can no longer respond to external pain stimuli, or by reducing the intensity and / or concentration of the induced electric field causing the pain sensation.

[0027] Transcranial magnetic stimulation is not limited to the treatment of depression. Transcranial magnetic stimulation can be used to treat patients such as humans, for example, epilepsy, schizophrenia, Parkinson's disease, Tourette syndrome, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Alzheimer's disease, attention deficit / hyperactivity disorder, obesity, bipolar disorder / mania, anxiety disorders (e.g., panic disorder with and without agoraphobia, social phobia also known as social anxiety disorder, acute stress disorder and / or generalized anxiety disorder), post-traumatic stress disorder (one of the anxiety disorders in the DSM), obsessive-compulsive disorder (e.g., one of the anxiety disorders in the DSM), pain (e.g., migraine and trigeminal neuralgia, and neuropathic pain, e.g., pain due to diabetic neuropathy, postherpetic neuralgia, and idiopathic pain disorders, e.g., chronic pain disorders including fibromyalgia, local myofascial pain syndrome), post-stroke rehabilitation (neuroplasticity induction), tinnitus, stimulation of transplanted neurons to promote integration, substance-related disorders (e.g., dependence, abuse, and withdrawal diagnosis of alcohol, cocaine, amphetamines, caffeine, nicotine, marijuana, etc.), spinal cord injury and regeneration / rehabilitation, stroke, head injury, recovery from sleep deprivation, primary sleep disorders (primary insomnia, primary hypersomnia, circadian rhythm sleep disorders), cognitive function enhancement, dementia, premenstrual dysphoric disorder (PMS), drug delivery systems (changing cell membrane permeability to drugs), induction of protein synthesis (induction of transcription and translation), stuttering, aphasia, dysphagia, essential tremor, autism spectrum disorder, and / or eating disorders (bulimia, anorexia, and binge eating, etc.).

[0028] The device can utilize the above principle to induce an electric field for various applications. For example, a magnetic device can be used for electrical stimulation of anatomical structures. Although the discussion here focuses on magnetic devices used in relation to magnetic stimulation of anatomical tissues, magnetic devices can be utilized in attempts in all fields. Further, since the device provided here is described with reference to magnetic stimulation such as transcranial magnetic stimulation (TMS), the device can also be used for any therapeutic or diagnostic procedure (e.g., motor threshold detection procedure, i.e., MT procedure).

[0029] The ferromagnetic core can be used in connection with a magnetic device that generates a magnetic field. For example, the ferromagnetic core can include an arcuate (e.g., substantially hemispherical) magnetic material. The ferromagnetic core can include a high-saturation magnetic material having a magnetic saturation of at least 0.5 Tesla. The ferromagnetic core can be shaped to optimize the magnetic field distribution in the treatment area. For example, such a magnetic field can be for the purpose of performing transcutaneous magnetic stimulation, such as transcranial magnetic stimulation (TMS), repetitive TMS (rTMS), magnetic seizure therapy (MST), deep TMS (dTMS), controlled and / or variable pulse shape TMS (cTMS), reduction of peripheral nerve discomfort, etc. The examples described herein may be discussed in connection with TMS and rTMS, but the examples described herein may be utilized in connection with any type of magnetic stimulation, such as transcutaneous magnetic stimulation. Further, the embodiments presented herein are not limited to using a ferromagnetic core magnetic stimulation system, as other core materials, such as an air core, may be used, for example.

[0030] FIG. 1 is a diagram of an example of a treatment system or diagnostic system 100. The treatment system or diagnostic system 100 can include a processor (not shown), a power supply (not shown), a memory (not shown), a transceiver (not shown), a treatment coil 102 (e.g., a stimulation coil), an articulating arm 104, a display device 106, a human patient positioning device 122, and / or a motion detection device, such as a motion threshold detection device. One example of a motion threshold detection device is the motion threshold detection device 200 shown in FIGS. 2A - 2D. Further, in some examples, the treatment system 100 may include a user interface device that cooperates with a motion threshold detection device, such as the motion threshold device 400 shown in FIGS. 4A - 4B. Although described as separate components, the motion threshold detection device and / or the user interface device (e.g., related functional parts) may be incorporated into the treatment system 100.

[0031] The treatment system 100 can be fixed or movable. For example, the treatment system 100 may be incorporated into a movable cart, as shown in FIG. 1. In one or more examples, the treatment system 100 can be a TMS treatment system (e.g., NeuroStar®), and / or any other treatment system and / or diagnostic procedure system.

[0032] The treatment coil 102 (e.g., an electromagnet) can be used to perform a treatment and / or diagnostic procedure (e.g., TMS) on a human patient 120. An exemplary treatment coil 102 can include one or more treatment coils and one or more ferromagnetic components configured to be disposed proximate to corresponding ones of the one or more treatment coils. The one or more treatment coils and ferromagnetic components of each TMS device can cooperate to generate a magnetic field having one or more characteristics different from the magnetic field generated by the one or more treatment coils alone. For example, the treatment system 100 can include a drive circuit (not shown) configured to cause a magnetic field to be generated in the treatment coil 102. An example of a drive circuit that can be used in the treatment system 100 is described in U.S. Patent No. 7,744,523, which is hereby incorporated by reference in its entirety. The processor of the treatment system 100 can be configured to generate one or more drive signals (e.g., via the drive circuit) configured to cause a magnetic field to be generated in the treatment coil 102. The magnetic field can be defined by one or more pulses in one or more pulse bursts (e.g., during TMS treatment). The processor of the treatment system 100 can be configured to transmit a signal indicative of the timing and / or power of the pulses of the magnetic field (e.g., the timing and power of the drive signals used to generate the magnetic field) to a motor threshold device (e.g., to a user indicator associated with the motor threshold device).

[0033] Although illustrated as including the treatment coil 102 and described primarily with respect to TMS, the treatment system 100 can include any device for performing a treatment and / or diagnostic procedure on a human patient. In some examples, the treatment system 100 may be used (e.g., exclusively) for diagnostic procedures. Examples of TMS coils are described in U.S. Patent No. 7,824,324 and U.S. Patent No. 11,000,693, the contents of which are hereby incorporated by reference in their entirety.

[0034] The processor (e.g., controller) of the treatment system 100 can be a general-purpose processor, a special-purpose processor, a conventional processor, a digital signal processor (DSP), multiple microprocessors, one or more microprocessors associated with a DSP core, a microcontroller, an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) circuit, any other type of integrated circuit (IC), a state machine, etc. The processor can perform signal coding, data processing, power control, input / output processing, and / or any other function that enables the treatment system 100 to operate. The processor can be integrated with one or more other components of the treatment system 100 into an electronic package or chip.

[0035] The processor of the treatment system 100 can be coupled to the treatment coil 102, the articulating arm 104, the display device 106 (e.g., a liquid crystal display (LCD) display unit or an organic light emitting diode (OLED) display unit), and / or the human patient positioning device 122, receive user input data from these, and / or output user input data to these. The processor can access information from any suitable type of memory, such as non-removable memory and / or removable memory, and store data in this memory. The non-removable memory can include random access memory (RAM), read-only memory (ROM), a hard disk, or any other type of memory storage device. The removable memory can include a subscriber identity module (SIM) card, a memory stick, a secure digital (SD) memory card, etc. The processor can access information from a memory that is not physically located within the treatment system 100, such as a server (not shown), and store data in this memory.

[0036] The memory can comprise a computer-readable storage medium or a machine-readable storage medium that holds computer-executable instructions to implement one or more as described herein. For example, the memory can comprise computer-executable instructions or machine-readable instructions that include one or more portions of the procedures described herein. The processor of the treatment system 100 can access from the memory instructions that are executed to operate the processor as described herein. The memory can comprise computer-executable instructions for executing configuration software. For example, the computer-executable instructions can be executed to implement in part and / or in whole one or more of the procedures described herein. Further, the memory may store one or more settings and / or control parameters associated with the treatment system 100, the motion threshold detection device, and / or the user interface for the motion threshold detection device.

[0037] The processor can receive power from a power source and can be configured to distribute and / or control that power to other components of the processing system 100. The power source can be any suitable device for supplying power to the processing system 100.

[0038] The human patient 120 can be positioned within the human patient positioning device 122. The human patient positioning device 122 can be a chair, a reclining chair, a bed, a stool, and / or the like. When performing a treatment, the treatment coil 102 can be positioned such that the head of the human patient is disposed below the treatment coil 102. The treatment coil 102 can be adjusted by the articulating arm 104 and / or the like. The human patient positioning device 122 can include one or more arms, such as the right arm 124a and the left arm 124b shown in FIG. 1. Although not shown in FIG. 1 but described in more detail below, the right arm 124a and / or the left arm 124b of the human patient positioning device 122 can include a motion threshold detection device (e.g., the motion threshold detection device 200 of FIG. 2A). The motion threshold detection device can be permanently or removably attached to the right arm 124a and / or the left arm 124b of the human patient positioning device 122. The motion threshold detection device can be connected to the processor of the treatment system 100, for example, via an electrical connection and / or a wireless connection. In some examples, the motion threshold detection device may include a dedicated display device (not shown), but in other examples, the motion threshold detection device may also use the display device 106 of the treatment system 100.

[0039] The movement threshold detection device can include one or more movement detection sensors, such as an accelerometer, to detect movement of one or more body parts of a human patient 120, such as a finger or a foot, although not limited thereto. The treatment system 100 (e.g., the movement threshold detection device) can be configured to detect movement of a finger of the human patient 120 that is a result of a magnetic pulse generated by the treatment coil 102. For example, the treatment system 100 may use the movement threshold detection device to detect movement of the finger of the human patient 120 within a certain time period after the pulse is generated (e.g., movement that occurs within 0.25 seconds after the generation of the magnetic pulse). The treatment system 100 may ignore movement outside of that time period. Note that the examples presented herein correspond to the movement threshold detection device of the treatment system 100 that detects movement of one or more fingers of the human patient 120. However, the movement threshold detection device may detect movement of other body parts of the human patient 120 (e.g., the foot of the human patient 120), and it should be understood that examples of detecting movement of body parts of the human patient 120 are not limited to detecting movement of only one or more fingers of the human patient 120 (e.g., when treating other disorders such as OCD or PTSD).

[0040] The treatment system 100 can comprise one or more computer software applications stored in the memory of the treatment system and / or executed on a processor. The computer software application can provide a system graphical user interface (GUI) (e.g., a TMS system GUI) on the display device 106. The computer software application can incorporate workflow management to guide the technician through treatment procedures and / or diagnostic procedures and / or to monitor and / or control one or more subsystems of the treatment system 100. For example, the computer software application can control internal system functions, monitor the system state to ensure safe operation, and / or provide the user with graphical means for managing the preparation and / or performance of treatment procedures and / or diagnostic procedures.

[0041] Interaction with a computer software application can be performed via a user interface. In one or more embodiments, the user interface device can be a display device 106, which may be a touch screen display. The display device 106 can include touch-activated images of alphanumeric keys and / or buttons for user interaction with the treatment system 100. The display device 106 can perform graphic displays of system operations, messages, and / or alerts. Interaction buttons, fields, and / or images are displayed via the display device 106 to enable a technician to, for example, input data, start and stop procedures, perform diagnoses, adjust the positioning and / or configuration of the treatment coil 102, adjust the position of one or more sensors, and / or interact with the system functions such as indicating and / or interacting with the like.

[0042] The treatment system 100 can be used for any therapeutic and / or diagnostic procedure. For example, the treatment system can be used for TMS, transcranial direct current stimulation (tDCS), electroencephalogram (EEG) recording, deep brain stimulation (DBS), diagnostic procedures, and / or the like. For example, the treatment system 100 can be used for any therapeutic and / or diagnostic procedure that includes placing electrodes, sensors, probes, and / or the like on the surface of a human patient's head, etc. Although described with reference to a head model, the treatment system 100 can be configured to generate models of any part of a human patient 120, including but not limited to the arm, neck, chest, leg, foot, and / or the like. Exemplary methods of using the treatment system 100 to determine the MT site and / or treatment site of a human patient 120 are described in U.S. Patent No. 7,104,947 and U.S. Patent No. 9,884,200, the contents of which are hereby incorporated by reference in their entirety.

[0043] Furthermore, as described above, the treatment site of human patient 120 may first be determined prior to treatment. In TMS, for example, the treatment site is typically determined based on the patient's MT location, and this MT location itself is determined by moving the coil near a predicted area determined by the patient's anatomical landmarks until a desired motor response (e.g., single contraction of the thumb) is obtained. This process may be referred to as a motor threshold detection procedure and may be part of the TMS treatment procedure (e.g., a preliminary step performed before generating one or more sets of treatment pulse bursts). In addition to detecting the location of the MT site, the treatment system 100 can also be used to detect the power of the pulses required for the neurons at the MT site to depolarize and be stimulated (e.g., until a desired motor response (e.g., single thumb contraction) of human patient 120 is obtained). As will be described in more detail herein, the treatment system 100 can use a motor threshold detection device to determine the MT location and power level of human patient 120.

[0044] After the MT location and the power level of the test pulse are detected, the MT location and the power level can be stored. For example, the MT location can be marked on the human patient's head, e.g., with an ink mark, or the MT location can be stored in the processor of the treatment system. Furthermore, the power level of the test pulse can be stored, for example, in the memory of the treatment system 100. Next, the treatment site can be determined using the MT location. For example, when using a TMS coil for the treatment of depression, the TMS treatment site is determined by moving the coil a predetermined distance along a forward line from the MT location (e.g., the distance is 5 cm) to identify the treatment site of human patient 120.

[0045] FIG. 2A is a perspective view of an exemplary motion threshold detection device 200 attached to a human patient positioning device (e.g., human patient positioning device 122). FIG. 2B is a perspective view of the motion threshold detection device 200 not attached to the human patient positioning device. As described herein, the motion threshold detection device 200 can be configured to be fixedly attached or removably attached to the human patient positioning device. For example, in some examples, the motion threshold detection device 200 can be provided separately from any treatment system (e.g., treatment system 100), can be attached to an existing treatment system, or can be used beside it.

[0046] The motion threshold detection device 200 can be configured to detect movement of one or more fingers (e.g., or other body parts) of a human patient. For example, the motion threshold detection device 200 can include one or more depressible members operatively coupled to the base 204. For example, the motion threshold detection device 200 device can include three depressible members 202a, 202b, 202c, as shown in FIGS. 2A and 2B. However, in other examples, the motion threshold device may include more than three or fewer depressible members. In some examples, the depressible member(s) can be finger paddles. The depressible member can have a rigid surface configured to interface with a body part (e.g., one or more fingers) of a human patient (e.g., human patient 120). For example, the surface of the depressible member can have an ergonomic shape configured to interface with a body part (e.g., one or more fingers) of a human patient. In some examples, the surface of the depressible member has a flat surface. The depressible member can be a finger paddle configured to move in response to movement of a human patient's finger.

[0047] The base 204 includes a fixed rigid surface sized to conform to the palm of a human patient. Optionally, the surface of the base 204 has an ergonomic shape configured to interface with a body part (e.g., palm) of a human patient. In other cases, the surface of the base 204 may have a planar surface. In some examples, the base 204 and the depressible members 202a-c may be arranged relative to each other in an ergonomic configuration such that a human patient can comfortably place a body part (e.g., palm, thumb, index finger, middle finger, ring finger, and little finger) on the motion threshold detection device 200.

[0048] A removable sanitary barrier (not shown) may be placed on the surfaces of the depressible members 202a, 202b, 202c and the base 204 before proceeding with a procedure such as the exemplary procedure 800. The sanitary barrier can be removed from the surfaces of the depressible members 202a, 202b, 202c and the base 204 after completion of the procedure. In some examples, the sanitary barrier can include a three-layer structure that includes a non-woven liner, an adhesive layer configured to temporarily adhere in contact with the surface, and a release liner configured to protect the adhesive layer prior to use of the sanitary barrier. The sanitary barrier may include a tab having a non-stick area that allows for easy peeling from the release liner as well as repositioning and / or removal after use.

[0049] The depressible member can be sized to fit any number of body parts of a human patient. For example, the depressible members 202a, 202b, and 202c can be sized such that the depressible member 202a interfaces with the thumb (i.e., finger 1) of a human patient, the depressible member 202b interfaces with the index finger and middle finger (i.e., fingers 2 and 3) of a human patient, and the depressible member 202c interfaces with the ring finger and little finger (i.e., fingers 4 and 5) of a human patient, and can be arranged around the base 204. In another example, the motion threshold detection device 200 can include five depressible members such that each depressible member is sized to interface with a respective finger of a human patient. In yet another example, the motion threshold detection device 200 can include two depressible members such that one depressible member can be sized to interface with the thumb (i.e., finger 1) of a human patient and another depressible member can be sized to interface with the index finger, middle finger, ring finger, and little finger of a human patient.

[0050] The motion threshold detection device 200 can include a communication port 207 that can interface with a printed circuit board (PCB) of the motion threshold detection device 200 (e.g., PCB 224). The communication port 207 can enable electronic communication between the motion threshold detection device 200 and a controller (e.g., a processor) of a treatment system (e.g., treatment system 100). For example, as further described herein, the communication port 207 can enable the motion threshold detection device 200 to transmit one or more signals indicative of the amount and / or timing of actuation of each of the depressible members 202a-c to a motion threshold detection device user interface and / or a treatment system.

[0051] Figure 2C is a cross-sectional bottom view of the exemplary motion threshold detection device 200 of FIGS. 2A and 2B. FIG. 2D is an exploded assembly view of the exemplary motion threshold detection device 200 of FIGS. 2A, 2B, and 2C. The base 204 of the motion threshold detection device 200 can include an upper housing 210a coupled to a bottom housing 210b. The upper housing 210a can include a surface that interfaces with the palm of a human patient. The upper housing 210a can be shaped to house one or more electronic components of the motion threshold detection device 200. For example, the upper housing 210a can house a printed circuit board (PCB) 224, a portion of a cable 222, and / or a portion of spring arms 214a, 214b, and 214c. The PCB 224 can include one or more communication ports 207 for one or more connectors, such as a connector to a processor of a treatment system (e.g., treatment system 100) and / or a connector to a motion threshold detection device user interface.

[0052] The bottom housing 210b can include a first portion 228a that couples to the upper housing 210a. The bottom housing 210b can include a second portion 228b that extends from a proximal end of the first portion 228a to a distal end of the second portion 228b such that the second portion 228b extends beyond the upper housing 210a. For example, the second portion 228b of the bottom housing 210b can extend from the proximal end of the first portion 228a to the distal end of the second portion 228b such that the second portion 228b encompasses one or more regions of a pushable member, such as pushable members 202a, 202b, 202c.

[0053] In some examples, the distal end of the second portion 228b can include guards such as guards 206a, 206b, and 206c that project upward from the bottom housing 210b. Guards 206a, 206b, and 206c can be rigid members that project upward from the inner surface 229b of the bottom housing 210b. Guards 206a, 206b, and 206c can be configured to prevent an object from contacting one or more of the pushable members 202a, 202b, and 202c and / or a body part (e.g., a finger) disposed on the pushable members 202a, 202b, and 202c during a procedure such as the exemplary procedure 800 described herein. In some examples, the bottom housing 210b can include a guard for each pushable member, and for example, the guard can be disposed in the vicinity (e.g., in front) of the pushable member. For example, guard 206a can be disposed in front of pushable member 202a, guard 206b can be disposed in front of pushable member 202b, and guard 206c can be disposed in front of pushable member 202c.

[0054] The bottom housing 210b can include one or more partition members such as a partition member 208 that projects upward from the bottom housing 210b. The partition member 208 can be a rigid projection, extend upward from the inner surface 229b of the bottom housing 210b, and also extend between two pushable members such as pushable members 202b and 202c. The partition member 208 can be configured to separate two body parts of a human patient disposed on two pushable members such as pushable members 202b and 202. For example, the partition member 208 can separate the index finger and middle finger (i.e., finger 2 and finger 3) of a human patient disposed on pushable member 202b from the ring finger and little finger (i.e., finger 4 and finger 5) of the human patient disposed on pushable member 202c. The partition member 208 can be provided to prevent a body part (e.g., index finger and middle finger) disposed on one pushable member (e.g., pushable member 202b) from inadvertently contacting another pushable member (e.g., pushable member 202c).

[0055] The bottom housing 210b includes a partition member 208 between the depressable members 202b and 202c, but does not include a partition member 208 between the depressable members 202a and 202b. However, examples where the bottom housing 210b includes a partition member 208 between each of the depressable members 202a, 202b, and 202c are contemplated. Further, other examples where the bottom housing 210b includes a partition member 208 between adjacent depressable members but not between other adjacent depressable members are contemplated. Further, other cases where the bottom housing 210b does not include any partition member 208 are contemplated.

[0056] The depressable member may include an upper housing coupled to the bottom housing such that a sensor and a portion of the spring arm are present inside the upper housing and the bottom housing. For example, the depressable member 202a may include an upper housing 220b and a bottom housing 220a that are coupled to each other. The upper housing 220b and the bottom housing 220a can accommodate the sensor 226c and the distal end portion of the spring arm 214a. Further, the depressable member 202b may include an upper housing 218b and a bottom housing 218a that are coupled to each other. The upper housing 218b and the bottom housing 218a can accommodate the sensor 226b and the distal end portion of the spring arm 214b. The depressable member 202c may include an upper housing 216b and a bottom housing 216a that are coupled to each other. The upper housing 216b and the bottom housing 216a can accommodate the sensor 226a and the distal end portion of the spring arm 214c.

[0057] Sensors 226a, 226b, and 226c can be fixed to the distal end portions of respective spring arms, such as spring arms 214a, 214b, and 214c. Each sensor can be configured to detect the movement of a respective pushable member via a respective spring arm. For example, sensor 226a can be configured to detect the movement of pushable member 202c when spring arm 214c moves in direction A, as shown in FIG. 2B. For example, if either or both of the ring finger and little finger (i.e., finger 4 and finger 5) of a human patient move pushable member 202c (e.g., a single contraction), sensor 226a can detect that pushable member 202c has moved, and thus indicate that either or both of the ring finger and little finger have also moved. Similarly, sensor 226b can be configured to detect the movement of pushable member 202b when spring arm 214b moves in direction A, as shown in FIG. 2B. Also, sensor 226c can be configured to detect the movement of pushable member 202a when spring arm 214a moves in direction A, as shown in FIG. 2B.

[0058] Sensors 226a, 226b, and 226c are operatively coupled and can provide information to the PCB 224 via the cable 222. For example, as further described herein, sensors 226a, 226b, and 226c can transmit one or more signals indicating the amount and / or timing of actuation of their respective depressable members 202a-c to the PCB 224. The PCB 224 can include a processor 225 configured to receive signals from the respective sensors 226a, 226b, and 226c. In some examples, the signals can be voltage signals indicating the timing and / or amount of actuation of the respective sensors 226a, 226b, and 226c. The processor 225 can be configured to process these signals and supply signals indicating the amount and / or timing of actuation of the respective depressable members 202a-c to a user interface device and / or a treatment system via the communication port 207. Thus, the user interface device and / or the treatment system can be configured to receive signals indicating the amount and / or timing of actuation of the respective depressable members 202a-c.

[0059] Sensors 226a, 226b, and 226c can include accelerometers, or any other sensors capable of detecting movement of an object. In some examples, the proximal end portion of the spring arm is fixed to the base 204, and the distal end portion of the spring arm is fixed to the respective depressable member. The distal end portion of the spring arm can be fixed to the respective depressable member such that the distal end portion of the spring arm and the respective depressable member are fixed to each other and move in unison when an object (e.g., index finger) contacts and moves the depressable member. Alternatively, or in addition, in some examples, sensors 226a, 226b, and 226c can include passive infrared (PIR) sensors, ultrasonic sensors, tactile switches configured to be actuated by movement of the spring arms 214a, 214b, and 214c, and / or the like.

[0060] The motion threshold detection device 200 can be fixed to an object such as an arm of a human patient positioning device (e.g., the right arm 124a or the left arm 124b of the human patient positioning device 122) via the first portion 228a of the bottom housing 210a. For example, the first portion 228a includes one or more magnets (e.g., neodymium magnets) such as magnets 212a and 212b that are configured to magnetically couple to the object and are disposed on the inner surface 229b of the first portion 228a.

[0061] FIG. 3 is a perspective view of an exemplary armrest base for supporting a motion threshold detection device (e.g., the motion threshold detection device 200). The treatment system (e.g., the treatment system 100) may include the armrest base 300. The armrest base 300 may include a plane 302 coupled to a mounting member 304. In some examples, the outer surface 229a of the first portion 228a of the bottom housing 210a may rest on the plane 302 of the armrest base 300.

[0062] The planar surface 302 of the armrest base 300 can be formed from a metallic material that can be magnetically coupled to the first portion 228a of the bottom housing 210a via one or more magnets such as magnets 212a, 212b. Although two magnets 212a, 212b are shown, the motion threshold detection device 200 may include more or fewer magnets. By magnetically coupling the motion threshold detection device 200 to the planar surface 302 of the armrest base 300, the motion threshold detection device 200 can be easily positioned so as to obtain the best fit and comfort for a human patient. In some examples, the attachment member 304 can be shaped to conform to and couple around a portion of an object such as an arm of a human patient positioning device (e.g., the right arm 124a or the left arm 124b of the human patient positioning device 122). The shape of the attachment member 304 can provide a clamping force such that when the attachment member 304 is expanded outwardly to conform around, for example, an arm of a human patient positioning device, the attachment member 304 can utilize that clamping force to couple to the arm. Thus, the design of the spring-like attachment member 304 can allow for easy attachment and detachment to the arm of the human patient positioning device. Further, the design of the spring-like attachment member 304 can allow the armrest base 300 and the motion threshold detection device to be easily positioned in a preferred position along the length of the arm of the human patient positioning device to obtain the best fit and comfort for the human patient.

[0063] Note that the armrest base 300 can be coupled to an object such as an arm of a human patient positioning device by other means such as adhesives, fasteners, clamps, etc., and is not limited to coupling to the object only by the attachment member 304. Further, it should be understood that the motion threshold detection device 200 can be fixed to or removably coupled to a stationary object by other means (e.g., an adhesive or Velcro (registered trademark) that removably couples the bottom surface 229a of the motion threshold detection device 200 to the surface of an arm of a human positioning device) without using the armrest base 300.

[0064] FIG. 4A is a front perspective view of a user interface device 400 that can be used with a motion threshold detection device (e.g., motion threshold detection device 200). FIG. 4B is a bottom perspective view of the user interface device 400. The motion threshold detection device can be used with a treatment system (e.g., treatment system 100). The user interface device 400 can include a housing 402. The user interface device 400 can include a display device 404, a power on / off button (not shown), a motion threshold detection device port 408, volume buttons 410, and / or a system port 412.

[0065] The motion threshold detection device port 408 can be operably coupled to a motion threshold detection device (e.g., motion threshold detection device 200). Thus, signals of the corresponding motion threshold detection device (e.g., those signals generated by the processor of the motion threshold detection device 200 in response to signals provided by sensors 226a, 226b, and 226c) can be received by the user interface device 400. In response thereto, the user interface device 400 can present, via the display device 404, information indicative of the amount and / or timing of actuation of each pushable member of the motion threshold detection device.

[0066] System port 412 can be coupled to the treatment system. The system port 412 can be configured to receive from the treatment system a signal (e.g., a timing signal) indicative of the timing of a pulse of the magnetic field generated by the treatment coil of the treatment device. In some examples, the signal received from the treatment system can be the drive signal used by the treatment system to generate the magnetic field. For example, in some examples, the signal received from the treatment system can be a square wave signal, where the rising edge of the square wave indicates the start of each pulse and the falling edge indicates the end of each pulse. Alternatively, in some examples, the signal received from the treatment system can be a digital signal. Thus, the user interface device 400 can be configured to determine the timing between the pulse of the magnetic field generated by the treatment coil and the actuation of the depressible member of the motion threshold detection device. Therefore, using the motion threshold detection device port 408 and the system port 412, the user interface device 400 can receive from the motion threshold detection device a signal indicative of the amount and / or timing of the actuation of each depressible member, and at the same time, can receive from the treatment system a signal (e.g., a timing signal) indicative of the timing of a pulse of the magnetic field generated by the treatment coil of the treatment device.

[0067] Furthermore, in some examples, the user interface device 400 can be configured to receive power from the treatment device via the system port 412. Additionally, the user interface device 400 can include an internal power source (not shown) disposed within the housing 402 to power the components of the user interface device 400.

[0068] The user interface device 400 may include a processor (not shown) and a memory (not shown) within the housing 402 of the user interface device 400. The processor can be configured to receive signals from the motion threshold detection device indicating the amount and / or timing of actuation of each depressible member. The process can be configured to receive from the treatment system a signal (e.g., a timing signal) that determines the timing of pulses of the magnetic field generated by the treatment coil of the treatment device (e.g., the timing of test pulses used to determine the MT site prior to treatment). The processor can store these signals in the memory and / or generate one or more user interfaces (UIs) for display on the display device 404.

[0069] The processor of the user interface device 400 can be configured to determine whether the movement of the pushable member of the motion threshold detection device occurred in response to (e.g., simultaneously with) a pulse of the magnetic field generated by the treatment coil of the treatment device (e.g., a motion threshold detection pulse). The processor can be configured to generate a UI indicating whether the movement of the pushable member of the motion threshold detection device occurred in response to (e.g., simultaneously with) a pulse of the magnetic field generated by the treatment coil of the treatment device. Thus, the technician using the user interface device 400 can receive a clear indication as to whether the movement of the user's finger that moved the pushable member occurred in response to the magnetic field pulse or whether it was an unrelated movement of the human patient (e.g., a false positive). Accordingly, the user interface device 400 can distinguish between movement caused by the magnetic field and movement unrelated to the magnetic field (e.g., false positives). Further, although described as being performed by the processor of the user interface device 400, in other examples, the processor of the treatment system and / or the processor of the motion threshold detection device can receive respective signals from the motion threshold detection device and the treatment system and be configured to determine whether the movement of the pushable member of the motion threshold detection device occurred in response to (e.g., was a false positive for) a pulse of the magnetic field generated by the treatment coil of the treatment device.

[0070] The user interface device 400 can provide feedback to a user, such as a technician, indicating the amount and / or timing of actuation of each pushable member of the motion threshold detection device, and can also confirm that the actuation of the pushable member occurred as a result of a pulse of the magnetic field generated by the treatment device. For example, the processor can be configured to generate on the display device a (e.g., illustrated) UI indicating whether the motion threshold detection device detected movement of each pushable member. For example, the processor can be configured to generate on the display device a UI indicating whether the motion threshold detection device detected movement of the pushable member associated with the patient's thumb, and this UI can indicate that the coil is at the motor threshold (MT) site of the human patient. Accordingly, the processor can be configured to generate on the display device 404 a UI that displays information indicating whether the TMS coil is oriented over the MT site and / or whether the TMS coil is pulsed at a level sufficient to depolarize and stimulate the neurons at the MT site.

[0071] The user interface device 400 can include a mounting clip 406 so that the user interface device 400 can be mounted at a fixed position visible to the user. For example, during the exemplary procedure 800, a technician can mount the user interface device 400 to the articulating arm (e.g., articulating arm 104) of the treatment system. Note that the user interface device 400 can be provided within the treatment system since it can display the feedback performed (e.g., those signals provided by sensors 226a, 226b, and 226c) on the display device (e.g., display device 106) of the treatment system.

[0072] Furthermore, in some examples, the user interface device 400 can also be configured to perform one or more tests to ensure that the motion threshold detection device and / or the treatment system are correctly connected and / or functioning properly based on signals received via, for example, the motion threshold detection device port 408 and / or the system port 412. For example, the user interface device 400 (e.g., and / or the treatment system) can be configured to enter a mode (e.g., a demonstration mode), in which mode the treatment system can generate a trigger signal that simulates a magnetic pulse, and / or the motion threshold detection device can be configured to generate a signal that stimulates the movement of one or more depressible members. The user interface device 400 can receive a signal from the trigger signal that simulates a magnetic pulse and determine whether the connection between the user interface device and the treatment system is functioning properly. The user interface device 400 can receive a signal that stimulates the movement of one or more depressible members and determine whether the sensors of the motion threshold detection device are functioning properly. The user interface device 400 can perform either test periodically.

[0073] In some examples, a treatment system (e.g., a processor of the treatment system) can receive an output signal of a motion threshold detection device indicating an amount and / or timing of movement of a depressable member of the motion threshold detection device. The treatment system can receive the signal in addition to, or instead of, a user interface device 400 that receives the output signal of the motion threshold detection device. In such examples, the treatment system can be configured to automatically adjust a level (e.g., a power level) of a subsequent pulse of a magnetic field generated by a treatment coil based on the output signal of the motion threshold detection device indicating the amount and / or timing of movement of the depressable member of the motion threshold detection device. For example, if the output signal indicates that a depressable member associated with the user's thumb has moved but only slightly, the treatment system can increase the power of a subsequent pulse of the treatment coil, for example, for the purpose of increasing movement of the thumb of a human patient (e.g., exceeding a threshold associated with an MT level sufficient for treatment such as TMS).

[0074] Furthermore, in some examples, a treatment system (e.g., treatment system 100) may include a robotic arm configured to move a treatment coil relative to a human patient (e.g., relative to the patient's head). For example, a processor of the treatment system can be configured to control the movement of the treatment coil before, during, or after the MT processor or the treatment procedure itself. An example of a robotic arm for a TMS coil is described in U.S. Patent No. 8,845,508, which is hereby incorporated by reference in its entirety. In examples where the treatment system includes a robotic arm, the treatment system can be configured to automatically adjust the position of the treatment coil prior to the generation of a subsequent magnetic field pulse based on an output signal of a movement threshold detection device indicating the amount and / or timing of movement of a depressible member of the movement threshold detection device that occurred in response to a preceding magnetic field pulse. For example, if the output signal indicates that the patient's middle finger and / or ring finger moved in response to a preceding magnetic pulse, the treatment system can be configured to move the robotic arm with the treatment coil in a direction closer to the MT site of the human patient, for example, in anticipation that the subsequent pulse will singly contract the patient's thumb, and to pulse drive the coil again. In this way, using the movement threshold detection device and the robotic arm, the treatment system can, for example, use the output signal(s) received from the movement threshold detection device to automatically adjust the position of the treatment coil and to search for the user's MT site without requiring a technician to physically move the treatment coil relative to the patient's head.

[0075] In some examples, the user interface device 400 may be incorporated into a treatment system (e.g., treatment system 100) such that, for example, the system includes the treatment system and the motion threshold detection device. In such a case, the output of the motion threshold detection device can be received by the treatment system (e.g., a processor of the treatment system), and the treatment system can be configured to determine whether the movement of the pushable member of the motion threshold detection device occurred (e.g., occurred simultaneously) in response to a pulse of the magnetic field generated by the treatment coil of the treatment device (e.g., the motion threshold detection pulse). Further, the processor of the treatment system can provide feedback to the technician indicating the amount and / or timing of the resulting actuation of each pushable member of the motion threshold detection device and / or confirm that the actuation of the pushable member occurred as a result of a pulse of the magnetic field generated by the treatment device. In such a case, the user interface device 400 can be omitted, for example, because the functions of the user interface device 400 can be performed by the treatment system.

[0076] FIG. 5A is a perspective view of the display device 520 before the treatment system (e.g., treatment system 100) generates a motion threshold pulse. FIG. 5B is a perspective view of the display device 520 after the treatment system generates a motion threshold pulse and the motion threshold detection device (e.g., motion threshold detection device 200) detects the movement of two pushable members (e.g., pushable members 202b, 202c). FIG. 5C is a perspective view of the display device 520 after the treatment system generates a motion threshold pulse and the motion threshold detection device detects the movement of one pushable member (e.g., pushable member 202a). The display device 520 can be an example of the display device 404 of the user interface device 400 and / or the display device 106 of the treatment system 100. Accordingly, the processor of the user interface device 400 and / or the processor of the treatment system 100 can be configured to control the display device 520 for generating the UI depicted in FIGS. 5A-5C.

[0077] The display device 520 can generate a UI including one or more of a plurality of meters such as a status indicator 500, a bar meter, etc. Although described in the case of a bar meter, the display device 520 may be configured to generate a UI including other types of meters (e.g., a line graph, etc.) that present the amount and / or timing status of feedback related to the detected movement of the pushable member of the movement threshold detection device. The illustrated example presents a first bar meter 502a, a second bar meter 502b, and a third bar meter 502c, as well as a movement indicator 506. The status indicator 500 can present the status of the movement threshold detection device during an MT procedure such as the exemplary procedure 800. For example, the status indicator 500 can display an indication that the movement threshold detection device is waiting for a timing signal (e.g., a synchronization signal) of a magnetic pulse from the treatment system. When a timing signal is detected, the status indicator 500 can display an indication that the received data is being processed. Further, in some examples, the status indicator 500 can also display an instruction to the user (e.g., a technician) of the treatment system regarding the current or next step for performing the MT procedure. In some examples, the status indicator 500 can display an indication as to whether the patient's hand has been detected by the movement threshold detection device (e.g., when the movement threshold detection device includes a sensor configured to detect whether a human patient's hand is touching the pushable member).

[0078] The plurality of bar meters can provide feedback related to the detected movement of the pushable member of the motor threshold detection device. For example, referring to the movement threshold detection device 200, the first bar meter 502a can provide feedback regarding the pushable member 202a, the second bar meter 502b can provide feedback regarding the second pushable member 202b, and the third bar meter 502c can provide feedback regarding the third pushable member 202c.

[0079] A plurality of barometers can be overlaid on the reference image 505 displayed on the display device 520. The reference image 505 can be used as a guide for detecting the movement of each body part of a human patient disposed on each pushable member of the motion threshold detection device. For example, the reference image 505 can be an image of a hand, with the first barometer 502a overlaid on the thumb of the hand (i.e., the first finger), the second barometer 502b overlaid on the index finger and middle finger of the hand (i.e., finger 2 and finger 3), and the third barometer 502c overlaid on the ring finger and little finger of the hand (i.e., finger 4 and finger 5).

[0080] As shown here, the display device 520 can be an example of the display device 404 of the user interface device 400 and / or the display device 106 of the treatment system 100. Also, the user interface device can be coupled to the motion threshold detection device (e.g., via the motion threshold detection device port 408), and the processor of the user interface device can be configured to receive from the motion threshold detection device a signal indicating the amount and / or timing of the actuation of each pushable member of the motion threshold detection device. Further, simultaneously, the user interface device can be configured to receive from the treatment device (e.g., via the system port 412) a signal (e.g., a timing signal) indicating the timing of the pulses of the magnetic field generated by the treatment coil of the treatment device. Thus, the user interface device can determine whether the movement of the pushable member of the motion threshold detection device occurred in response to the pulses of the magnetic field generated by the treatment coil of the treatment device (e.g., whether it was a false positive), and in response, can be configured to generate a GUI indicating by a mark that the pushable member moved in response to the pulses of the magnetic field.

[0081] The movement indicator 506 can present an indication of the detected movement of each depressable member. For example, when the movement of a depressable member (e.g., depressable member 202a, 202b, or 202c) is detected, the display device 520 can display a positive indication (e.g., check marks 508b, 510a, or 512a) of each depressable member. Further, when the movement of a depressable member (e.g., depressable member 202a, 202b, or 202c) is not detected, the display device 520 can display a negative indication (e.g., "X" 508a, 510b, 512b) of each depressable member for which movement was not detected.

[0082] In some examples, each of the barometers 502a, 502b, 502c can provide feedback regarding the amount of movement of each pushable member of the connected movement threshold detection device. For example, the display device 520 can brighten the barometer in response to detecting a large amount of movement of each pushable member. In this way, the display device 520 can provide feedback indicating the strength or amount of movement of a human patient (e.g., the strength or movement of a finger monopulse). A processor of a user interface device or treatment system that includes the display device 520 can determine the amount by which to brighten the barometer based on the received signals provided by each sensor of the movement threshold detection device (e.g., sensors 226a, 226b, 226c). For example, the processor of the user interface device or treatment system may determine that the accelerometer data provided by sensor 226c indicates a large movement of pushable member 202c and that the accelerometer data provided by sensor 226b indicates a small movement of pushable member 202b. Thus, the display device 520 can brighten region 514a of barometer 502c and brighten region 514b of barometer 502b, and the brightened region 514a is larger than the brightened region 514b. In some examples, the brightened regions can be displayed with various indicators (e.g., color, texture, etc.). Additionally, in some examples, the display device 520 may display the brightened regions generated in response to magnetic pulses with a fixed indicator, thereby enabling the brightened regions generated in response to one magnetic pulse to be distinguishable from the brightened regions generated in response to another magnetic pulse.

[0083] The display device 520 can display the detected movement of one or more magnetic pulses from the treatment system. For example, referring to FIG. 5B, the processor can detect the movement of the depressible members 202b and 202c during a time window around the received signal from the treatment system indicating that the first magnetic pulse has occurred. In some examples, the time window can be 250 ms after the magnetic pulse occurs. In other examples, the time window can be set to be between 20 ms and 250 ms after the magnetic pulse occurs. In response, the processor can cause the display device 520 to brighten the regions 514a and 514b of the barometers 502b and 502c, respectively. Before generating the second magnetic pulse, the technician can move the position of the treatment coil relative to the human patient to identify, for example, the MT site (e.g., the position where the magnetic pulse causes a single contraction of the human patient's thumb, resulting in movement of the depressible member 202a). Alternatively, or in addition, the technician can increase the force (e.g., strength) of the magnetic field.

[0084] Referring further to FIG. 5B, the processor of the user interface device can receive, from the motion threshold detection device 200, data indicative of the movement of the depressible members 202b and 202c during a time window around the received signal from the treatment system indicating that the second magnetic pulse has occurred. In response, the processor can cause the display device 520 to brighten the regions 516a and 516b of the bar meters 502b and 502c, respectively. Further, to assist the technician, the display device 520 can include both bright regions 516a and 516b indicative of the movement of the depressible members 202b and 202c that occurred in response to the second magnetic pulse, and also bright regions 514a and 514b indicative of the movement of the depressible members 202b and 202c that occurred in response to the preceding magnetic pulse. Thus, since the movement of the depressible members 202b and 202c increased in response to the generation of the second magnetic pulse, the technician can infer that the power level of the second magnetic pulse was greater than that of the first magnetic pulse (e.g., and / or the treatment coil moved towards the MT site). However, since the user indicator device is not detecting movement of the depressible member 202a, the processor is configured not to brighten the bar meter 502a, which indicates that the treatment coil is not positioned over the MT site of the human patient.

[0085] Referring to FIG. 5C, the technician can again move the position of the treatment coil relative to the human patient to cause the treatment system to generate subsequent magnetic pulses. In this way, the motion threshold detection device can generate a signal indicating the movement of the depressable member 202a during a time window around the received signal from the treatment system indicating that a subsequent magnetic pulse has occurred. In response, the processor of the user interface device can brighten the region 518a of the barometer 502a on the display device 520. In some cases, the technician can generate a series of magnetic pulses without repositioning the treatment coil relative to the human patient. By doing so, the technician can confirm the position of the treatment coil relative to the human patient. For example, the technician can generate subsequent magnetic pulses at a higher power level even at the same position. The motion threshold detection device can generate a signal indicating the movement of the depressable member 202a again, and the processor of the user interface device can brighten the region 518b of the barometer 502a on the display device 520. The region 518b can be larger than the region 518a since the subsequent magnetic pulse was generated at a higher power level, and as a result, the motor response of the human patient becomes more prominent (e.g., the single contraction of the thumb becomes larger).

[0086] By brightening the respective barometer regions and displaying the bright regions associated with the detected movement of the depressible member by different magnetic pulses, a technician may be assisted when attempting to place a treatment coil on a human patient to navigate various regions of the human patient's brain. For example, the technician may use the brightened regions to navigate the central sulcus 702 of the cerebral cortex of the human patient's brain 700 (e.g., human patient 120) shown in FIGS. 7A and 7B to identify a specific location on the central sulcus 702, such as region 710 that controls the movement of the patient's thumb, which may be the MT site for the treatment of a specific disorder (e.g., depression, etc.). Further, although FIGS. 5B and 5C show feedback from only a single preceding pulse (e.g., brightened regions 514a and 514b in FIG. 5B, and brightened region 518a in FIG. 5C), in some examples, the display device 520 may be configured to display feedback indicative of the detected movement of the depressible member resulting from a plurality of preceding magnetic pulses.

[0087] FIG. 6 is a block diagram showing an example of a magnetic stimulation system 600. The magnetic stimulation system 600 may be an example of the treatment system 100. The magnetic stimulation system 600 can include a sensor 610, a controller 620, a user interface device 630, a power source 640, and a magnetic stimulation component 650. The magnetic stimulation component 650 may be an example of the treatment coil 102 of the treatment system 100 of FIG. 1.

[0088] The magnetic stimulation component 650 can be configured to generate a pulsed magnetic field 665 for performing magnetic stimulation therapy on a treatment area of a patient, such as a human patient 120. The magnetic stimulation therapy can be, for example, transcranial magnetic stimulation (TMS). TMS can also refer to TMS, repetitive transcranial magnetic stimulation (rTMS), deep TMS (dTMS), cTMS, etc. The magnetic stimulation component 650 can be a treatment coil. The magnetic stimulation component 650 can include a single treatment coil, a plurality of treatment coils, and / or an array of treatment coils. The treatment area can be, for example, a position within the brain 700 determined using the area 710 (e.g., motor threshold site) that controls the movement of the thumb of a human patient on the central sulcus 702 shown in FIGS. 7A and 7B, but is not limited thereto. The magnetic stimulation component 650 may or may not include a core such as a magnetic core (e.g., a ferromagnetic core). The pulsed magnetic field 665 can include test pulses (e.g., used during an MT detection procedure) and / or one or more pulse bursts (e.g., used during a treatment procedure). The pulse burst of the pulsed magnetic field 665 (e.g., each pulse burst) can include one or more pulses.

[0089] Sensor 610 can be configured to generate a signal associated with pulse magnetic field 665. Sensor 210 can be disposed between magnetic stimulation component 650 and the treatment area of the patient. Sensor 610 can be configured to generate a signal (e.g., a signal induced by pulse magnetic field 665) associated with pulse magnetic field 665 of magnetic stimulation component 650. For example, sensor 610 can convert a physical property (e.g., the strength of pulse magnetic field 665) into a corresponding electrical signal (e.g., a current signal or a voltage signal). Thus, sensor 610 can detect and / or measure the physical parameters of the pulse magnetic field and generate a signal associated with the pulse magnetic field using the detected / measured physical parameters. The generated signal can be a voltage signal, a current signal, and / or the like that may be proportional to the change in pulse magnetic field 665. For example, a current proportional to pulse magnetic field 665 can be generated by sensor 610. Sensor 610 can generate a voltage that may be proportional to the magnetic flux density (dB / dt) of pulse magnetic field 665.

[0090] Sensor 610 can include one or more of a conductive coil, a loop (e.g., having a number of turns based on a pulse magnetic field), a Hall sensor, a magnetoresistive material, a Faraday effect sensor, a Kerr effect sensor, a fluxgate sensor, an inductance change element, a nerve tissue response measurement device, an electric field sensor (e.g., within a conductive field), and / or the like. Sensor 610 can be configured to generate a plurality of signals (e.g., a plurality of signals associated with pulse magnetic field 665 generated by magnetic stimulation component 650).

[0091] The controller 620 can be of any type of hardware, software, or a combination thereof. The controller 620 can be configured to control one or more of the components of the magnetic stimulation system 600, such as the sensor 610, the user interface device 630, the power supply 640, and / or the magnetic stimulation component 650, for example, to perform magnetic stimulation therapy. For example, the controller 620 can include a general-purpose processor, a dedicated processor, a conventional processor, a digital signal processor (DSP), multiple microprocessors, one or more microprocessors coupled with a DSP core, a microcontroller, any other type of integrated circuit (IC), a state machine, and / or the like.

[0092] The controller 620 can be coupled to the memory 670 and can be configured to transmit and receive information from the memory 670. The memory 670 can comprise a computer-readable storage medium or a machine-readable storage medium that holds computer-executable instructions for implementing one or more as described herein. For example, the memory 670 can comprise computer-executable instructions or machine-readable instructions that include one or more portions of the procedures described herein. The controller 620 can access the memory for instructions to operate the processor 670 as described herein. The memory 670 can comprise computer-executable instructions for executing configuration software. For example, the computer-executable instructions can be executed by the controller 620 to perform some or all of one or more of the procedures described herein. Further, the memory 670 may store one or more settings and / or control parameters associated with the magnetic stimulation system 600, the motor threshold detection device 690, and / or the user interface device 680.

[0093] The controller 620 can be configured to receive inputs from the user interface device 630 of the magnetic stimulation system 600 and / or from the sensor 610, and, in response to the inputs, can be configured to perform a magnetic stimulation treatment accordingly. For example, the controller 620 can perform signal encoding, data processing, power control, input / output processing, and / or any other function that enables the controller 620 to operate the magnetic stimulation component 650 for magnetic stimulation. The controller 620 can include a drive circuit (not shown) that generates a drive signal for driving (e.g., powering such as pulse driving) the magnetic simulation component 650. In some examples, the drive circuit is separate from the controller 620 and may be electrically coupled to the magnetic stimulation component 650. The controller 620 can be configured to transmit a signal indicating the timing of the magnetic field pulses (e.g., indicating the timing and power of the drive signal used to generate the magnetic field) to the user interface device 680.

[0094] Furthermore, the controller 620 can be configured to change the drive signal provided to the magnetic stimulation component 650 based on the inputs received from the user interface device 630 and / or the sensor 610. The controller 620 can be configured to estimate (e.g., measure) a characteristic associated with the signal generated by the sensor 610 (e.g., associated with one or more peaks of the signal). The controller 620 can estimate a subset of the signal pulses or can estimate the signal continuously. By estimating the characteristics of the signal, the controller 620 can estimate a model of what is occurring in the human patient's brain in response to the pulsed magnetic field.

[0095] Furthermore, the controller 620 can determine whether a failure has occurred based on one or more characteristics of the signals generated by the sensor 610. If it is determined that a failure has occurred, the controller 620 can enter a failure mode. In the failure mode, the controller 620 can pause the magnetic stimulation treatment, cut off the magnetic stimulation component 650, warn the user of the magnetic stimulation system 600, and / or change the current applied to the magnetic stimulation component 650. For example, when the controller 620 enters the failure mode, the controller 620 can adjust the frequency when estimating the characteristics of the generated signals. For example, after a first failure is detected, the controller 620 can check more frequently for the absence of failures. Furthermore, the magnetic stimulation system 600 can include an indicator that can display to the user of the magnetic stimulation system 600 that a failure has occurred. For example, the indicator can be a light source, a speaker, an icon displayed on the user interface 630, and / or the like. Examples of failure detection procedures (s) that can be implemented by the controller 620 are described in U.S. Patent No. 10,183,172, the entire contents of which are incorporated herein by reference in their entirety.

[0096] The user interface device 630 can include any type of interface that allows the user of the magnetic stimulation system 600 to start, adjust, and / or end the magnetic stimulation treatment. For example, the user interface device 630 can be a personal computer (PC), a keyboard, a mouse, a display device such as a touch screen display device, a wireless device, and / or the like that enables an interface between the user and the magnetic stimulation system 600. The user interface device 630 can be an example of the display device 106 of the treatment system 100. Furthermore, in some examples, the controller 620 can be configured to start or adjust any operating settings of the user interface device 680 and / or the motor threshold detection device 690.

[0097] The power source 640 can be any type of power source that supplies sufficient energy for the magnetic stimulation component 650 to generate a pulsed magnetic field 665 for its intended purpose, for example, for TMS, rTMS, MST, or any other type of application. For example, the power source 640 can be a conventional 120VAC or 240VAC main power source.

[0098] The magnetic stimulation system 600 can be coupled to a user interface device 680. The user interface device 680 can be coupled to a motor threshold detection device 690. The motor threshold detection device 690 can be an example of the motor threshold detection device 200. The motor threshold detection device 690 can include a controller 692, one or more sensors 694, and a memory 696.

[0099] The controller 692 can be any type of hardware, software, or combination thereof. The controller 692 can be configured to control one or more of the components of the motor threshold detection device 690. For example, the controller 692 can include a general-purpose processor, a dedicated processor, a conventional processor, a digital signal processor (DSP), multiple microprocessors, one or more microprocessors coupled to a DSP core, a microcontroller, any other type of integrated circuit (IC), a state machine, and / or the like.

[0100] The controller 692 can be configured to couple to the memory 696 and to transmit and receive information from the memory 696. The memory 696 can comprise a computer-readable storage medium or a machine-readable storage medium that holds one or more computer-executable instructions to implement as described herein. For example, the memory 696 can comprise computer-executable instructions or machine-readable instructions that include one or more portions of the procedures described herein. The controller 692 can access from the memory instructions that are executed to operate the processor 696 as described herein. The memory 696 can comprise computer-executable instructions for executing configuration software. For example, the computer-executable instructions can be executed by the controller 692 to implement in part or in whole one or more of the procedures described herein. Further, the memory 696 may store one or more settings and / or control parameters associated with the motion threshold detection device 690.

[0101] The sensor 694 can be an example of sensors 226a, 226b, and 226c. For example, the sensor 694 can comprise an acceleration sensor or any other sensor capable of detecting movement of an object.

[0102] The controller 692 can be configured to detect movement of one or more fingers (e.g., other body parts) of a human patient, for example, by using one or more depressible members (e.g., depressible members 202a, 202b, and 202c). In response to detecting movement of the depressible member, the controller 692 can be configured to transmit one or more signals indicative of the timing and / or amount of movement of the depressible member to, for example, the user interface device 680 and / or the magnetic stimulation system 600. The controller 692 can be configured to detect movement of the depressible member using one or more sensors 664.

[0103] The user interface device 680 may be an example of the motion threshold device user interface 400. The user interface device 680 may include a controller 682, a display 684, and a memory 686. The controller 682 may be any type of hardware, software, or a combination thereof. The controller 682 may be configured to control one or more of the components of the user interface device 680. For example, the controller 682 may include a general-purpose processor, a dedicated processor, a conventional processor, a digital signal processor (DSP), multiple microprocessors, one or more microprocessors coupled with a DSP core, a microcontroller, any other type of integrated circuit (IC), a state machine, and / or the like.

[0104] The controller 682 can be coupled to the memory 686 and configured to transmit and receive information from the memory 686. The memory 686 may comprise a computer-readable storage medium or a machine-readable storage medium that holds one or more computer-executable instructions to be executed as described herein. For example, the memory 686 may comprise computer-executable instructions or machine-readable instructions that include one or more portions of the procedures described herein. The controller 682 can access instructions from the memory to operate the processor 686 as described herein. The memory 686 may comprise computer-executable instructions for executing configuration software. For example, the computer-executable instructions may be executed by the controller 682 to implement in part and / or in whole one or more of the procedures described herein. Further, the memory 686 may sometimes store one or more settings and / or control parameters associated with the user interface device 680.

[0105] The controller 682 can be configured to receive from the motion threshold detection device 690 a signal indicating the timing and / or amount of movement of one or more depressible members of the motion threshold detection device 690. The controller 682 can receive from the magnetic stimulation system 600 a signal indicating the timing and / or power of a pulse of the magnetic field (e.g., indicating the timing and power of a drive signal used to generate the magnetic field). Thus, the controller 682 can be configured to determine whether the movement of the depressible member of the motion threshold detection device 690 occurred (e.g., or was a false positive) in response to a pulse of the magnetic field generated by the magnetic stimulation component 650 of the magnetic stimulation system 600.

[0106] The display device 684 can be an example of the display device 404 and / or the display device 520. The controller 682 can provide feedback to a user, such as a technician, via the display device 684 during the procedure. For example, the controller 682 can be configured to generate, via the display device 684, a display indicating whether the movement of the depressible member of the motion threshold detection device occurred (e.g., or was a false positive) in response to a pulse of the magnetic field generated by the treatment coil of the treatment device.

[0107] In some examples, the user interface device 680 may include a mounting clip (e.g., mounting clip 406) so that the user interface device 680 can be mounted in a fixed position visible to the user. In some examples, the user interface device 680 may be provided as part of the magnetic stimulation system 600, for example, as part of the user interface 630 of the magnetic stimulation system 600. Further, in some examples, the user interface device 680 may be part of the motor threshold detection device 690. Finally, it should be noted that in some examples, any combination of the magnetic stimulation system 600, the user interface device 680, and the motor threshold detection device 690 may be combined to form a single device.

[0108] In some examples, the user interface device 680 may be incorporated into the treatment system 600. In such a case, the output of the motor threshold detection device 690 can be received by the controller 620 of the treatment system 600, and the controller 620 can be configured to determine whether the movement of the pushable member of the motor threshold detection device 690 occurred (e.g., occurred simultaneously) in response to a pulse of the magnetic field generated by the magnetic stimulation component 650. Further, the controller 620 can be configured to provide feedback (e.g., via the user interface 630) to the technician indicating the amount and / or timing of the resulting actuation of each pushable member of the motor threshold detection device, and / or to confirm that the actuation of the pushable member occurred as a result of a pulse of the magnetic field generated by the treatment device. In such a case, the user interface device 680 can be omitted, for example, because the functions of the user interface device 680 can be performed by the treatment system 600.

[0109] Furthermore, although described in connection with controller 682 and / or controller 620, in some examples, an analog circuit (e.g., one including a comparator) may be configured to receive the output of movement threshold detection device 690 and to receive a signal indicating the timing and / or power of a pulse of the magnetic field from magnetic stimulation system 600. This analog circuit may be configured to determine whether movement of the pushable member of movement threshold detection device 690 occurred in response to (e.g., simultaneously with) a pulse of the magnetic field generated by magnetic stimulation component 650.

[0110] In some examples, controller 620 of treatment system 600 can receive an output signal of movement threshold detection device 690 indicating the amount and / or timing of movement of the pushable member of the movement threshold detection device. Controller 620 can receive the signal in addition to, or alternatively to, user interface device 680 that receives the output signal of the movement threshold detection device. In such examples, controller 620 can be configured to automatically adjust the level (e.g., power level) of subsequent pulses of the magnetic field generated by magnetic stimulation component 650 based on the output signal (e.g., feedback from sensor 694) of movement threshold detection device 690 indicating the amount and / or timing of movement of the pushable member of the movement threshold detection device. For example, if the output signal indicates that the pushable member associated with the user's thumb moved but only slightly, controller 620 can increase the power of subsequent pulses of magnetic stimulation component 650, for example, for the purpose of increasing movement of the thumb of a human patient (e.g., exceeding a threshold associated with an MT level sufficient for treatment such as TMS).

[0111] Further, in some examples, the treatment system 600 can include a robotic arm configured to move the magnetic stimulation component 650 relative to a patient (e.g., relative to the patient's head). For example, the controller 620 can be configured to control the movement of the magnetic stimulation component 650 before, during, or after the MT processor or the treatment procedure itself. The controller 620 can be configured to automatically adjust the position of the magnetic stimulation component 650 based on the output signal of the motion threshold detection device 690 indicating the amount and / or timing of movement of the depressable member of the motion threshold detection device generated in response to a preceding pulse of the magnetic field, prior to the generation of a subsequent pulse of the magnetic field. For example, if the output signal indicates that the patient's middle finger and / or ring finger moved in response to a preceding magnetic pulse, the controller 620 can configure the robotic arm to move the magnetic stimulation component 650 in a direction closer to the patient's MT site and re-pulse the coil, for example, expecting the subsequent pulse to singly contract the patient's thumb. In this way, using the feedback from the sensor 692 of the motion threshold detection device 690 and the robotic arm, the controller 620 can use the output signal(s) received from the motion threshold detection device 690 to automatically adjust the position of the magnetic stimulation component 650 and to search for the user's MT site, for example, without requiring the technician to physically move the magnetic stimulation component 650 relative to the patient's head.

[0112] Furthermore, in some examples, the controller 620 can be configured to automatically adjust both the position of the magnetic stimulation component 650 and the power level of the magnetic field pulse using a robotic arm to automate MT site and MT stimulation level processing. For example, the controller 620 can be configured to automatically adjust the position of the magnetic stimulation component 650 using a robotic arm between magnetic pulses of the magnetic stimulation component 650 to automatically determine the MT site. The controller 620 can also automatically adjust the stimulation level of the magnetic stimulation component 650 between magnetic pulses to automatically determine the MT stimulation level of the patient. Further, in such examples, the controller 620 can request and / or receive confirmation from a technician (e.g., via the user interface 630) once the MT site and MT stimulation level are identified.

[0113] In some examples, the controller 682 and / or the controller 620 can be configured to determine whether movement of the depressible member of the motor threshold detection device 690 occurred (e.g., occurred simultaneously) in response to a pulse of the magnetic field generated by the magnetic stimulation component 650, even in situations where the patient has tremors. For example, the controller 682 and / or the controller 620 can measure the periodic movement resulting from tremors prior to the occurrence of a magnetic pulse, for example, to determine the amount and / or timing of any resulting movement, if any, as a result of the pulse of the magnetic field generated by the magnetic stimulation component 650, and subtract the tremor movement from the resulting movement detected by the sensor 694 during the magnetic pulse (e.g., during a time window).

[0114] FIG. 8 is a flowchart of an exemplary procedure 800 for determining the movement of one or more depressible members and generating a graphical user interface (GUI) accordingly. Procedure 800 can be implemented by a controller of the treatment system, such as a processor of treatment system 100, a controller of movement threshold detection device 200, a controller of user interface device 400, a controller 620 of magnetic stimulation system 600, a controller 682 of user interface device 680, and / or a controller 692 of movement threshold detection device 690. The controller can implement procedure 800 to detect the movement of one or more depressible members and to determine whether the movement of the depressible member occurred in response to a pulse of magnetic field. Further, the controller can generate, via a display device (e.g., display device 106, display device 404, display device 520, user interface 630, and / or display device 684), a GUI indicating whether the movement of the depressible member occurred in response to a pulse of magnetic field, for example, to assist a technician in determining the MT location of a human patient.

[0115] The controller can implement procedure 800 in response to a magnetic stimulation device (e.g., treatment coil 102 or magnetic stimulation component 650) that generates a test pulse for determining the movement threshold site of a human patient. Alternatively, or in addition, the controller can also implement procedure 800 periodically.

[0116] Prior to the start of treatment, a human patient can place his or her finger on each depressible member of a movement threshold detection device (e.g., movement threshold detection device 200). A technician can place the magnetic stimulation device, for example, on the head of the human patient. In some examples, to start treatment, the technician can use the treatment system to generate one or more test pulses (i.e., magnetic pulses).

[0117] At 802, the controller can receive signals from the movement threshold detection device for each depressable member. For example, the controller can receive sensor data (e.g., data from one or more of sensors 226a, 226b, 226c) indicating the timing and / or amount of movement of one or more depressable members (e.g., depressable members 202a, 202b, and 202c) of the movement threshold detection device. As described herein, the movement threshold detection device can be configured to generate signals indicating the timing and / or amount of movement of one or more depressable members and transmit those signals to the controller.

[0118] At 804, the controller can be configured to receive signals indicating the timing and / or power level of test pulses (e.g., timing pulses or synchronization pulses) at 804. For example, the treatment system may generate one or more test pulses during the movement threshold detection procedure. The treatment system can transmit a signal indicating the timing of the test pulse to the controller.

[0119] At 806, the controller can be configured to determine whether movement of one or more depressible members occurred within a time window around the test pulse. For example, the controller can compare the timing of the signal received from the movement threshold detection device (at 802) with the timing of the signal received from the magnetic stimulation device (at 804) to determine whether the signal received from the movement threshold detection device occurred substantially simultaneously (e.g., within the time window) with the signal received from the magnetic stimulation device. In this way, the controller can determine whether movement of the depressible member of the movement threshold detection device occurred in response to a pulse of the magnetic field generated by the treatment coil of the treatment device, or whether the movement of the depressible member occurred in response to an unrelated movement of the human patient (e.g., a movement unrelated to the magnetic stimulation device). In some examples, the time window can be configured to be short enough to correspond to the time at which the controller receives signals from the movement threshold detection device and the magnetic stimulation device. For example, in some examples, the time window can be about 0.25 seconds after the magnetic pulse is generated. In other examples, the time window can be set to be between 20 ms and 250 ms after the magnetic pulse is generated. Some patients may react to the sound of the magnetic pulse generated by the treatment system, while other patients may react quickly in anticipation of the pulse. The system must be designed to avoid these false positive movements.

[0120] If the controller determines that the movement of one or more pushable members did not occur within the time window around the test pulse at 806, the controller can ignore the movement and / or determine that the movement was not a valid movement that occurred in response to the magnetic pulse. For example, the controller can generate, at 808, a GUI via the display device indicating that the movement of the pushable member was an invalid movement. Thus, in such an example, the technician can receive confirmation that the movement of the pushable member did not occur in response to the pulse of the magnetic field generated by the magnetic stimulation device (e.g., the movement was a false positive). In this way, the technician knows that the coil is not placed at the MT site of the human patient and can accordingly move the placement of the treatment coil and / or change the strength of the magnetic pulse and then generate another test pulse.

[0121] Furthermore, in some examples, it should be understood that if the controller determines that the movement of one or more pushable members did not occur within the time window around the test pulse at 806, the controller may not need to generate a GUI and the procedure 800 may end. Additionally, in some examples, if the controller determines that the movement of one or more pushable members did not occur within the time window around the test pulse at 806, the controller may be configured to detect (e.g., diagnose) nerve damage and / or neurodegenerative diseases in a human patient. For example, the controller can determine that the patient is at risk of amyotrophic lateral sclerosis (ALS) based on the delay between the magnetic pulse and the time when the pushable member moves (e.g., a small amplitude of the magnetic field, a delayed, asynchronous primary peak with a long excitatory postsynaptic potential (EPSP) rise time of a reduced amplitude).

[0122] If the controller determines that the movement of one or more depressible members occurred within a time window around the test pulse at 806, the controller can generate, at 810, a GUI (e.g., by a mark) indicating the movement of at least one depressible member via a display device. For example, if a magnetic pulse occurs at time t = 0, the time window can be configured such that the controller ignores the movement if it occurs within the first time range (e.g., 20 ms) after the occurrence of the magnetic pulse (e.g., between t = 0 and t = 20 ms), the controller can detect the movement if it occurs within the time window between the first time range and the second time range (e.g., between 20 ms and 250 ms), and the controller can ignore the movement if it occurs beyond the second time range (e.g., 250 ms) after the occurrence of the magnetic pulse.

[0123] The controller can generate, via a display device, a GUI indicating that the movement of the depressible member was caused by a pulse of the magnetic field generated by the magnetic stimulation device at 810. Alternatively, or in addition, the controller can also generate, via a display device, a GUI indicating that the magnetic stimulation device is placed at the MT site of the patient. In some examples, the controller can generate, via a display device, a GUI indicating the direction in which the magnetic stimulation device should be moved so that the magnetic stimulation device is placed at the MT site and / or the treatment site of the human patient. Further, in some cases, the controller can generate, via a display device, a GUI indicating which depressible member moved and / or the amount of movement of the depressible member by a mark. Examples of GUIs that can be generated by the controller at 810 can be those depicted in FIGS. 5A - 5C, but the procedure 800 is not limited to only these GUIs.

[0124] Thus, using procedure 800 may assist a technician in identifying the proper location of a magnetic stimulation device for treating a human patient. For example, using procedure 800 may assist a technician in identifying a user's MT site and / or treatment site. If the controller detects invalid movement at 806 and 808, the technician may repeat procedure 800 until the technician places the magnetic stimulation device at the MT site. Finally, as shown here, in some examples, the MT site may be a site that elicits a specific response by the human patient, such as a single twitch of the thumb of a human patient. After the MT site is detected, the technician can use that MT site to determine the treatment site. For example, when using a TMS coil to treat depression, the treatment site can be determined by moving the magnetic stimulation device a predetermined distance (e.g., the distance is 5 cm) along a line forward from the MT site to identify the patient's treatment site.

[0125] Finally, although described in the context of the GUI, in some cases the controller can generate notifications via another user interface at 808 and / or 810 (e.g., in addition to, or as an alternative to, generating the GUI). For example, the controller can generate an audible notification via a speaker of the system (e.g., the treatment system may include a speaker). Alternatively, or in addition, the controller can activate one or more light sources (e.g., light emitting diodes) that indicate whether a depressible member has moved in response to a pulse of the magnetic field. In some examples, the movement threshold detection device may include a light source. For example, the light source can be disposed adjacent to or proximate to each depressible member (e.g., the light source may be disposed on or integrated with the depressible member), and the controller can activate the light source (e.g., green or on if the depressible member has moved in response to a pulse of the magnetic field, red or off if the depressible member has not moved in response to a pulse of the magnetic field) to indicate whether the depressible member has moved in response to a pulse of the magnetic field.

[0126] Those skilled in the art will understand that the above and various other configurations of the exemplary TMS devices can be implemented without departing from the scope and spirit of the present disclosure.

Claims

1. A system for detecting movement of a human patient when determining a movement threshold or a position of a treatment site of the human patient during treatment or therapy, the system comprising: a plurality of depressible members, each depressible member being configured to move in response to movement of a finger of the human patient; a plurality of sensors, each depressible member being associated with at least one sensor, each sensor being configured to sense movement of at least one of the plurality of depressible members; a processor configured to: receive a feedback signal from each of the plurality of sensors; receive a signal indicating a time point of generation of a magnetic stimulation pulse; determine that a feedback signal from at least one of the plurality of sensors indicates movement exceeding a threshold within a time window after the time point of generation of the magnetic stimulation pulse; and generate, via a user interface, a notification indicating that at least one of the plurality of depressible members has moved in response to the magnetic stimulation pulse. The system further comprising a processor configured as above. A system comprising the above.

2. The notification indicates an amount of movement of the at least one depressible member that has moved in response to the magnetic stimulation pulse. The system according to claim 1.

3. The notification includes a meter for indicating an amount of movement of the at least one depressible member that has moved in response to the magnetic stimulation pulse. The system according to claim 2.

4. The meter comprises a first indication indicating an amount of movement of the depressible member during a current magnetic stimulation pulse and a second indication indicating an amount of movement of the depressible member during a previously generated magnetic stimulation pulse. The system according to claim 3.

5. The plurality of depressible members includes a first depressible member configured to receive the thumb of the human patient, movement of the first depressible member indicating that the stimulation coil that generated the magnetic stimulation pulse is disposed at the movement threshold site of the human patient. The system according to claim 1.

6. The plurality of depressible members further includes a second depressible member configured to receive the index finger and middle finger of the human patient and a third depressible member configured to receive the ring finger and little finger of the human patient. The system according to claim 5.

7. The plurality of sensors comprises a plurality of accelerometers, The system according to claim 1.

8. A base configured to receive the palm of the human patient's hand, the base being rigidly fixed and configured to remain stable during movement by the fingers of the human patient, further comprising a base, The system according to claim 1.

9. Further comprising a plurality of spring arms, each of the pushable members being associated with at least one spring arm, the spring arms being configured to move the pushable members in response to movement of the fingers of the human patient, The system according to claim 1.

10. Further comprising the user interface device, the user interface device comprising the user interface, The system according to claim 1.

11. The user interface comprises a display device, The system according to claim 10.

12. An electromagnet, A drive circuit electrically coupled to the electromagnet, A second processor configured to control the drive circuit to supply a current to the electromagnet to generate the magnetic stimulation pulse and further comprising, The system according to claim 1.

13. The second processor is further configured to supply the signal indicating the occurrence time of the magnetic stimulation pulse to the processor, The system according to claim 11.

14. A system for detecting movement of one or more body parts of a human patient, the movement occurring in response to a magnetic stimulation pulse, the system comprising A motion detection device, A plurality of pushable members operably coupled to a base member, the plurality of pushable members being configured to move around the base member in response to movement of each body part of the human patient, a plurality of pushable members, A plurality of sensors, each sensor being coupled to a respective one of the plurality of pushable members, and each sensor being configured to detect movement of the respective pushable member, a plurality of sensors including a motion detection device, A processor, Receiving sensor data associated with one or more detected movements of the plurality of pushable members, Receiving a signal indicating the occurrence time of the magnetic stimulation pulse, determine that the sensor data indicates movement of the one or more pushable members within a time window associated with the time of occurrence of the magnetic stimulation pulse, generate a notification indicating that at least one of the pushable members has moved in response to the magnetic stimulation pulse a processor configured to comprise a system.

15. The processor is included in the motion detection device, The system according to claim 13.

16. The processor is included in a treatment device comprising a stimulation coil configured to generate the magnetic stimulation pulse, The system according to claim 13.

17. The processor is included in a user interface device comprising a display device, and the processor is configured to generate the notification via the display device, The system according to claim 13.

18. The notification indicates the amount of movement of the at least one pushable member that has moved in response to the magnetic stimulation pulse, The system according to claim 13.

19. The notification includes a meter for indicating the amount of movement of the at least one pushable member that has moved in response to the magnetic stimulation pulse, The system according to claim 17.

20. The meter comprises a first mark indicating the amount of movement of the pushable member during the current magnetic stimulation pulse and a second mark indicating the amount of movement of the pushable member during a previously generated magnetic stimulation pulse, The system according to claim 18.

21. The plurality of pushable members comprises a first pushable member configured to receive the thumb of the human patient, and movement of the first pushable member indicates that the stimulation coil that generated the magnetic stimulation pulse is disposed at the motor threshold site of the human patient, The system according to claim 13.

22. The plurality of pushable members further comprises a second pushable member configured to receive the index finger and middle finger of the human patient and a third pushable member configured to receive the ring finger and little finger of the human patient, The system according to claim 20.

23. The plurality of sensors comprises a plurality of accelerometers, The system according to claim 13.

24. A plurality of spring arms, each of the depressible members being associated with at least one spring arm, the spring arms being configured to move the depressible members in response to movement of a finger or thumb of the human patient, further comprising a plurality of spring arms. The system according to claim 13.

25. A system for detecting movement of a human patient when determining a movement threshold site or treatment site of the human patient, the system comprising: A depressible member configured to move in response to movement by the human patient; A processor, Receiving a feedback signal indicating the timing of movement of the depressible member, Receiving a signal indicating the timing of generation of a magnetic stimulation pulse, Determining that movement of the depressible member has occurred in response to the magnetic stimulation pulse, Generating, via a user interface, a notification indicating that the depressible member has moved in response to the magnetic stimulation pulse A processor configured as such A system comprising.

26. A sensor associated with the depressible member, the sensor further comprising a sensor configured to sense movement of the depressible member. The system according to claim 24.

27. Further comprising a treatment coil configured to generate the magnetic stimulation pulse. The system according to claim 24.

28. A display device, the notification being a graphical user interface (GUI) generated via the display device, further comprising a display device. The system according to claim 24.

29. The notification is an audible notification. The system according to claim 24.

30. At least one light source, the notification further comprising at least one light source including lighting of the light source. The system according to claim 24.

31. The notification indicates that the treatment coil is disposed at the movement threshold site of the human patient. The system according to claim 24.

32. The notification indicates a direction in which the treatment coil should be moved so that the treatment coil is disposed at the movement threshold site or treatment site of the patient. The system according to claim 24.

33. The notification indicates the amount of movement of the depressible member. The system according to claim 24.

34. A plurality of depressible members configured to move in response to movement by the human patient, each depressible member being configured to move in response to movement of a different finger or thumb of the human patient, further comprising a plurality of depressible members, The processor is configured to determine whether each of the plurality of depressible members has moved in response to the magnetic stimulation pulse, and the notification indicates which of the plurality of depressible members has moved in response to the magnetic stimulation pulse. The system according to claim 24.

35. Further comprising a plurality of sensors, each depressible member being associated with at least one sensor, each sensor being configured to sense movement of at least one of the plurality of depressible members. The system according to claim 33.

36. A treatment coil configured to generate the magnetic stimulation pulse, A display device, wherein the notification is a graphical user interface (GUI) generated via the display device, and a display device Further comprising The system according to claim 34.

37. A method for detecting movement of a human patient when determining a motor threshold site or treatment site of the human patient during treatment or procedure, the method comprising: Receiving a feedback signal from each of a plurality of sensors, each of the plurality of sensors being associated with a depressible member of a plurality of depressible members, each sensor being configured to sense movement of at least one of the plurality of depressible members; Receiving a signal indicating a time point of generation of the magnetic stimulation pulse; Determining that the feedback signal from at least one of the plurality of sensors indicates movement exceeding a threshold within a time window after the time point of generation of the magnetic stimulation pulse; Generating, via a user interface, a notification indicating that at least one of the plurality of depressible members has moved in response to the magnetic stimulation pulse Including methods.

38. Each depressible member is configured to move in response to movement of a finger or thumb of the human patient. The method according to claim 36.

39. The notification indicates the amount of movement of the at least one depressable member that moved in response to the magnetic stimulation pulse. The method according to claim 36.

40. The notification includes a meter for indicating the amount of movement of the at least one depressable member that moved in response to the magnetic stimulation pulse. The method according to claim 38.

41. The meter includes a first mark indicating the amount of movement of the depressable member during the current magnetic stimulation pulse and a second mark indicating the amount of movement of the depressable member during a previously generated magnetic stimulation pulse. The method according to claim 39.

42. A method for detecting movement of a human patient when determining a motor threshold site or a treatment site of the human patient, the method comprising: receiving a feedback signal indicating the timing of movement of a depressable member, the depressable member being configured to move in response to movement by the human patient; receiving a signal indicating the time of occurrence of a magnetic stimulation pulse; determining that movement of the depressable member occurred in response to the magnetic stimulation pulse; and generating, via a user interface, a notification indicating that the depressable member moved in response to the magnetic stimulation pulse. A method comprising the above steps.

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