Systems and methods for assessing tactile perception disorders and motor control abnormalities

Abstract

Materials, systems, and assemblies for the assessment of tactile perception and motor control disorders.

Description

[Background technology]

[0001] Decreased touch sensitivity is commonly attributed to disease, injury, and aging. However, scientific understanding of the underlying neural mechanisms causing these declines is incomplete. Quantitative monitoring of touch sensitivity over time can provide valuable information for research into treatment and disease assessment. Additionally, several diseases and conditions exist that selectively impair the motor system of the nervous system. Tremor and dystonia are several movement disorders / abnormalities that result from disease, injury, and certain prescription medications. A better understanding of tremor and early detection of low-level tremors can improve patient outcomes. Summary of the Invention

[0002] Broadly summarized, systems, devices, and methods for measuring tremor and peripheral nerve sensitivity are disclosed herein. The device may include a housing and an actuator and / or accelerometer accessible from an exterior surface of the housing. The actuator may generate a stimulation signal for a subject's skin surface. A processing circuit may control the actuator to generate the stimulation signal and record responses to the stimulation signal to determine vibrotactile sensitivity. If an accelerometer is used, vibrations generated by the subject may be measured. These and other aspects will become apparent from the detailed description below. In no event, however, should this broad summary be construed to limit claimable subject matter, whether such subject matter is presented in claims in the application as originally filed or in claims amended or otherwise presented during prosecution. [Brief explanation of the drawings]

[0003] [Figure 1] FIG. 1 is an illustration of a system for assessment of tactile perception disorders and motor control abnormalities, in accordance with an illustrative embodiment.

[0004] [Figure 2]FIG. 1 is a diagram of a system including distributed modules for assessment of tactile perception disorders and motor control abnormalities, in accordance with an illustrative embodiment.

[0005] [Figure 3] 1A-1D illustrate an exterior view of an actuator assembly that may be included in a system for the assessment of tactile perception disorders and motor control abnormalities, according to some embodiments.

[0006] [Figure 4] FIG. 1 is a hidden line view of an actuator assembly that may be included in a system for the assessment of tactile perception disorders and motor control abnormalities, according to some embodiments.

[0007] [Figure 5] FIG. 1 is a cutaway view of an actuator assembly according to some embodiments.

[0008] [Figure 6] FIG. 10 is a block diagram illustrating the placement of a mechanically compliant window in contact with an actuator, according to some embodiments.

[0009] [Figure 7] FIG. 10 is a partial block diagram illustrating the placement of an infection barrier on a surface of an actuator assembly, according to some embodiments.

[0010] [Figure 8] FIG. 1 is a block diagram illustrating components of an actuator assembly, according to some embodiments.

[0011] [Figure 9] 1 is a flowchart of a method for measuring tactile vibration perception, according to some embodiments.

[0012] [Figure 10] 1 is a flowchart of a method for detecting a tremor indicative of a neurological disorder, according to some embodiments.

[0013] [Figure 11] FIG. 1 illustrates thresholds for vibration detection for human subjects.

[0014] [Figure 12] FIG. 1 shows measurements taken at different times on a human subject.

[0015] [Figure 13] FIG. 1 illustrates signal flow from vibration capture, according to some embodiments.

[0016] [Figure 14] FIG. 1 illustrates a computing system in which some illustrative embodiments may be implemented. DETAILED DESCRIPTION OF THE INVENTION

[0017] In the following description, reference is made to the accompanying drawings, which form a part of this specification, and in which is shown, by way of illustration, specific embodiments that may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the invention, but it should be understood that other embodiments may be used and that structural, logical, and electrical changes may be made without departing from the scope of the present invention. Therefore, the following description of exemplary embodiments is not to be taken in a limiting sense, and the scope of the present invention is defined by the appended claims.

[0018] Tactile perception disorders and motor control abnormalities can be diagnosed and evaluated in a clinical setting. FIG. 1 is a diagram of a system 100 for assessing tactile perception disorders and motor control abnormalities, according to an exemplary embodiment. As shown in FIG. 1 , a subject 102 can make contact (e.g., by placing a finger) with a device, such as a mechanism of an actuator assembly 106 (e.g., a vibrotactile actuator 104). Under the control of a clinician 108 or using a predetermined testing protocol, a clinician device 110 (e.g., a PC, laptop, tablet, or smartphone, hereafter referred to as a PDA) can communicate via a wired or wireless interface 112 to instruct the actuator assembly 106 to deliver vibrotactile stimuli or stimuli to the skin surface of the subject 102. In some examples, the skin surface includes a fingertip, although embodiments are not limited thereto. The vibrotactile stimuli or stimuli can be a single pulse or a series of stimuli based on a standard benchmark or testing protocol, or based on specific custom instructions or commands from the clinician 108.

[0019] The subject 102 can provide feedback using a feedback device 114 that indicates that the stimulation was perceived. The feedback can be verbal, via computer screen buttons, touch screen buttons, dedicated buttons, a keyboard, etc. The system 100 stores data (test time, stimulation frequency and amplitude, patient feedback, etc.) for analysis. This can be stored in memory as described in connection with FIG. 14 , or in other storage or a combination of other storage, in the cloud 116, at the clinician device 110, or within the actuator assembly 106 itself.

[0020] 2 is a diagram of a system 200 including distributed actuator assemblies 206 for the assessment of tactile perception disorders and motor control abnormalities, according to an exemplary embodiment. A subject 202 may have actuator assemblies 206 distributed along a limb of the subject 202, or on multiple limbs, as shown, or on other skin surfaces or locations. The multiple actuator assemblies 206 communicate with each other or with a clinician device 210 via a wired or wireless interface 212. In some aspects, the multiple actuator assemblies 206 may communicate with each other wirelessly or via a wired connection by a central controller 214, which may additionally include antenna(s) 216, communication circuitry 218, and processing circuitry 220 to control such communications.

[0021] Exemplary Apparatus FIG. 3 illustrates an exterior view of an actuator assembly 106 that may be included in a system for assessing tactile perception and motor control disorders (e.g., system 100 (FIG. 1) or system 200 (FIG. 2)), according to some embodiments. The vibrotactile actuator 104 may be exposed and uncovered as shown, although embodiments are not limited in this respect. A housing 300 may be provided. In embodiments, the actuator 104 is accessible from the exterior of the housing 300 and is configured to generate a stimulation signal (e.g., vibration) to a skin surface of the subject 102 (FIG. 1).

[0022] The housing 300 may include, but is not limited to, an upper part 302 and a lower part 304 bonded together. Materials resistant to cleaning chemicals may be used to construct the housing 300. Such materials may include, but are not limited to, one or more types of thermoplastic materials, such as polypropylene or acrylonitrile butadiene styrene (ABS). The parts (e.g., the upper part 302 and the lower part 304) should be sufficiently bonded to prevent water droplets from forming on the internal electrical components upon moderate spraying of the cleaning solution. A mechanism or device (e.g., an elastic strap or band, or an adhesive not shown in FIG. 3 ) may be provided to immobilize a body part (e.g., a finger, a limb or limb portion, an upper or lower limb, a face, or a head) of the subject 102 so that the associated body part can be provided with or stimulated with a controllable and known baseline normal force on the vibrotactile actuator 104.

[0023] The surface contour of the vibrotactile actuator 104 may be shaped for comfortable, repeatable placement of a finger, hand, or foot. Vibration damping in the form of a ballast, sprung mass, or shock-absorbing mount may be used to isolate the device from ambient vibrations. The contour of the assembly 106 and / or housing 300 may be shaped to fit or conform to the palm of the subject's 102's hand or other body part, for example. The actuator 104 may produce vibrations at the skin surface being stimulated. The vibrations may be perpendicular or nearly perpendicular to the skin surface, although embodiments are not limited thereto. The actuator 104 may produce vibrations of known frequency, amplitude, and phase under control using processing circuitry or other circuitry described later herein. The actuator 104 may include a piezoelectric disk (e.g., available from Steiner & Martins, Inc., Dolan, Florida), a voice coil, an eccentric rotating mass (ERM) actuator (available from Precision Microdrives, London, England), or other types of actuators.

[0024] 4 is a hidden-line diagram of an actuator assembly 106 that may be included in a system for assessing tactile perception disorders and motor control abnormalities, according to some embodiments. As shown in FIG. 4, the circuitry within the actuator assembly 106 may include an amplifier 400 for amplifying signals to or from the vibrotactile actuator, and a normal force sensor 402 for sensing downward force on the vibrotactile actuator 104. The output (e.g., an analog or digital output) of the normal force sensor 402 may be displayed or output to other computing systems of the system 100, as described in more detail later herein. Other circuits and structures may also be included.

[0025] In some examples, gaps and seams in the housing 300 (FIGS. 3 and 4) may be minimized or eliminated to prevent infection, to prevent damage to circuitry within the housing 300, or for other reasons. Gaps and seams may be reduced or eliminated by providing a section within the housing 300 having a mechanically compliant surface that is proximate to the actuator 104 (e.g., in contact with the actuator 104 so that the actuator 104 can move the compliant surface 500). This is shown in FIGS. 5 and 6. FIG. 5 shows a cutaway view of the actuator assembly 106. As shown in FIG. 5, a section of the housing 300 may include the mechanically compliant surface 500. As shown, the mechanically compliant surface 500 may contact the actuator 104.

[0026] In examples, the mechanically compliant surface 500 facilitates the transfer of vibrations between the actuator 104 and the skin surface, finger, etc. of the subject 102. In some examples, the mechanically compliant surface 500 may be created by molding a thermoplastic urethane (TPU) or silicone membrane over the top of the housing 300. In some embodiments, the mechanically compliant surface 500 may surround the seam joining the top piece 302 ( FIG. 3 ) and the bottom piece 304 ( FIG. 3 ) to create an integral gasket.

[0027] In some embodiments, a separate piece of formed compliant material may be used to fit into a recess in the top of housing 300. In some embodiments, a flat piece of compliant material, such as a nitrile material, may be clamped onto the top of actuator 104. A piece of hard material may be used as a piston to transmit vibrations. In this case, a separate mechanically compliant surface 500 may be used to ensure that housing 300 remains resistant to water ingress.

[0028] 6 is a block diagram illustrating the arrangement of a mechanically compliant surface 500, according to some embodiments. As shown, a skin surface (e.g., a fingertip) of a human subject may be presented to the mechanically compliant surface 500 to sense a stimulus signal provided by the actuator 104.

[0029] Additional barriers to the spread of infection may include disposable barriers between the subject and the actuator assembly. In aspects, these sterile barriers may be provided by a sterile distribution system and may be discarded after use. Figure 7 is a partial block diagram illustrating the placement of an infection barrier 700 on a surface of the actuator assembly 106, according to some embodiments. In an example, the infection barrier 700 is positioned adjacent to or at least partially overlapping the mechanically compatible surface 500.

[0030] In addition to the components of the actuator assembly 106 described herein above, the actuator assembly 106 may include other components for providing control, communication, sensing, and other functions. Figure 8 is a block diagram illustrating the components of an actuator assembly, according to some embodiments. In Figure 8, components that have corresponding components in Figures 1-7 are designated using reference numbers that correspond to the reference numbers used in Figures 1-7.

[0031] 8, a device (e.g., actuator assembly 106) includes a housing 300 and an actuator 104 accessible from an exterior surface of housing 300. Actuator assembly 106 further includes a processing circuit 800. Processing circuit 800 may control actuator 104 to generate the stimulation signals described above and may record responses to the stimulation signals. The stimulation signals may be along an axis perpendicular to mechanically compliant surface 500. In some embodiments (e.g., embodiments similar to those shown in FIGS. 3 and 4), mechanically compliant surface 500 is not present, meaning that a patient's finger or other body part may directly contact actuator 104.

[0032] The actuator assembly 106 may further include an accelerometer 802 that measures vibrations. The accelerometer 802 may be a multi-axis accelerometer. The environmental sensor 804 may measure environmental vibrations (such as building vibrations, body vibrations, etc.) or other vibrations that are different from the intended vibrotactile stimulus or the patient's tremor, which may be used to mitigate the environmental vibrations by subtracting the unwanted environmental vibrations from the measured vibrations of the actuator assembly 106. The actuator assembly 106 may further include a displacement sensor 806 that measures the displacement of the mechanically compliant surface 500. The displacement sensor may be a laser displacement sensor. In some embodiments, the displacement sensor may be a Doppler (LD) meter or sensor (e.g., Keyence LK-G5000 series Laser Displacement Sensor available from Keyence, Itasca, Illinois, USA).

[0033] Actuator assembly 106 may further include a memory, as shown and described in more detail herein below with reference to Figure 14. Processing circuit 800 may store data such as vibrations measured by accelerometer 802 or other information including date information, time information, stimulus information (e.g., amplitude, frequency, or phase of the vibration signal), protocol information, subject identification information, and subject response information.

[0034] The actuator assembly 106 may include other sensors and circuits 808, including, for example, temperature and humidity sensors, force sensors, and force control circuitry. Exemplary temperature and humidity sensors may include sensors available from STMicroelectronics (headquartered in Geneva, Switzerland). Exemplary force sensors include FlexiForce sensors (available from TekScan (Boston, MA)) or FX force sensors available from TE Connectivity (headquartered in Schaffhausen, Switzerland). These and other sensor and control systems may be connected via, for example, Universal Serial Bus (USB), I / O, or other protocols. 2 Any suitable bus, such as a C serial bus or an SPI serial bus, may be used to provide analog or digital signals to the processing circuit 800. The force control circuit may control the force applied to the actuator by the subject.

[0035] The actuator assembly 106 may include communications circuitry 810. The communications circuitry 810 may be used to communicate via a wired or wireless interface 112 (FIG. 1) with the cloud 116 (FIG. 1), the clinician device 110 (FIG. 1), other actuator assemblies (e.g., other actuator assemblies of the system 200 (FIG. 2)), remote storage, etc. The communications channel may be used to communicate according to Wi-Fi, cellular, Bluetooth, USB, or other communications standards. Communications may include data streaming or periodic data uploads to or from the actuator assembly 106, software updates and downloads, etc.

[0036] The actuator assembly 106 may include a battery 812, which may be rechargeable, or power may be provided by connection such as through a power jack or USB port. The battery (if present) may be recharged by an internal charging circuit 814 inductively coupled at 816 to an external coil 818.

[0037] Exemplary Methods 1 and 2, systems 100 and 200 can operate in at least two modes. In a first mode, vibrotactile perception is measured by applying vibration (e.g., providing a stimulus signal) to the subject 102 and measuring the perceptual response. In a second mode, the tremor is quantized using a tremor quantization method to detect motor control abnormalities.

[0038] In the first (vibrotactile perception) mode, system 100 (or system 200 in a distributed system embodiment) determines the point at which the patient can detect vibrotactile stimuli emitted from actuator assembly 106 and records the patient's perception. When done over time, changes in the just noticeable difference (JND) threshold of perception can be quantified.

[0039] Such perception can occur in various receptors on the subject's body. There are four main mechanoreceptors found in glabrous (hairless) skin. Each of these mechanoreceptors responds to a unique type of mechanical vibration. As shown in Table 1, each type of mechanoreceptor responds to a different type of mechanical vibration. [Table 1]

[0040] In methods according to at least some embodiments, the processing circuitry 800 may control the actuator 104 (e.g., via commands issued by the clinician device 110) to sweep through various frequency ranges and determine the patient's sensitivity to each vibrotactile frequency range. As measurements are taken over time, researchers can better understand the progression of peripheral neuropathy and how different mechanoreceptors are affected. Also, the effects of drug treatments can be observed. Methods for measuring vibrotactile perception and for detecting tremor are described below.

[0041] 9 shows a flowchart of a method 900 for measuring vibrotactile perception, according to some embodiments. The operations of method 900 may be performed by processing circuit 800 (FIG. 8), by elements of system 100 (FIG. 1) or system 200 (FIG. 2), or by any other processing circuit or computing system.

[0042] The method 900 begins at operation 902, where the processing circuit 800 provides a vibrotactile stimulus to an actuator in physical contact with the subject's skin surface. In some embodiments, the vibrotactile stimulus is a single pulse.

[0043] In other embodiments, the vibrotactile stimulation comprises a train of pulses based on a standard benchmark or protocol. In some embodiments, at least one pulse has a frequency of about 0.4 to 100 Hz to stimulate Merkel's receptors. In some embodiments, at least one pulse has a frequency of about 7 Hz to stimulate Ruffini corpuscles. In some embodiments, at least one pulse has a frequency of about 10 Hz to about 200 Hz to stimulate Meissner's corpuscles. In some embodiments, at least one pulse has a frequency of about 40 Hz to about 800 Hz. In some embodiments, the train of pulses comprises pulses from two or more frequency ranges.

[0044] Method 900 proceeds to operation 904, where processing circuit 800 receives an indication of whether a stimulus was sensed. As described in connection with FIG. 1 , this indication may be provided by feedback device 114 (e.g., via verbal feedback, a computer screen button, a touchscreen button, a dedicated button, a keyboard, etc.). In some embodiments, processing circuit 800 may store the indication in memory. Processing circuit 800 may store other data in memory, whether in the same memory or a different memory, including date information, time information, stimulus information, protocol information, subject identification information, and subject response information, which are described in more detail below with reference to FIG. 14.

[0045] The method 900 proceeds to operation 906, where the processing circuit 800 analyzes the indication to diagnose a neuropathy. In some embodiments, the analyzing may include comparing recorded information over time to detect changes in vibrotactile perception. Analysis is described further below herein.

[0046] In some embodiments, when a distributed system such as system 200 (FIG. 2) is used, method 900 may include processing circuit 800 providing vibrotactile stimulation to multiple actuators that physically contact the subject's skin surface at multiple points. In at least these embodiments, processing circuit 800 may receive instructions from the multiple actuators and compare sensitivity at the multiple points based on the instructions. Processing circuit 800 may provide this information to other elements in system 200, and analysis may be performed in these other elements (e.g., clinician device 110, cloud 116, etc.). In some embodiments, the operations of method 900 may be combined with the operations of method 1000, described below, to both measure vibrotactile perception and detect tremors.

[0047] 10 shows a flowchart of a method 1000 for detecting a tremor indicative of a neuropathy, according to some embodiments. The operations of method 1000 may be performed by processing circuit 800 (FIG. 8) or other elements of actuator assembly 106 (FIG. 1), by elements of system 100 (FIG. 1) or system 200 (FIG. 2), or by any other processing circuit or computing system. In some scenarios where vibrotactile stimuli are not measured, actuator assembly 106 may include an accelerometer but no actuator and may be referred to as an accelerometer assembly.

[0048] Method 1000 begins with operation 1002, in which an accelerometer (e.g., accelerometer 802 (FIG. 8)) is provided in physical contact with an upper or lower limb, finger, hand or foot, face, etc. of a subject (e.g., subject 102 (FIG. 1)). In some embodiments, multiple accelerometers 802 are provided by providing multiple actuator assemblies 206 as shown in system 200 (FIG. 2). In these and other embodiments, multiple accelerometers are provided at multiple points on the subject's limb or finger. If a location-based tremor is suspected, processing circuit 800 can then compare movement indications from the multiple accelerometers to determine where the tremor originates or occurs.

[0049] The method 1000 proceeds to operation 1004 where the processing circuit 800 receives an indication of movement at the accelerometer 802 .

[0050] Method 1000 proceeds to operation 1006, where the processing circuit analyzes the indication to diagnose a neuropathy. In the embodiment illustrated by FIG. 2, multiple indications from multiple actuator assemblies 206 are received and analyzed by processing circuit 800. In some embodiments, processing circuit 800 can compare recorded information over time to detect changes in tremor severity or tremor frequency. In some embodiments, the operations of method 1000 can be combined with the operations of method 900 described herein above to both measure vibrotactile perception and detect tremor.

[0051] Analyses, such as those performed in methods similar to those of methods 900 and 1000, can include correlation of tremor statistics with posture and physical activity, providing diagnostic information for clinicians. For example, processing circuit 800 can record tremor acceleration data and decompose this raw data into frames of data. Processing circuit 800 can analyze each frame for frequency, frequency variability, and intensity. Processing circuit 800 can also perform other statistical analyses, including mean frequency, frequency standard deviation or coefficient of variation, and intensity. For example, a resting tremor can be indicative of Parkinson's disease (frequency between 4 and 8 Hz), and this resting tremor can have a first frequency spectrum that can be analyzed. In Parkinson's disease, the resting tremor temporarily reduces and recurs only during activity (called a recurrent tremor). This can have a distinct frequency spectrum indicative of a recurrent tremor that is different from the frequency spectrum indicative of a resting tremor. Dystonic tremors are irregular and spasmodic, resulting in a frequency spectrum that differs from a consistent Parkinson's tremor. Methods similar to those described herein (particularly with reference to FIG. 10) can provide quantitative data on this behavior to detect frequency spectra indicative of different types of tremor.

[0052] Displacement of the mechanically compliant surface of the actuator assembly described herein can be used to assess movement disorders for physical phenomena other than tremor. For example, a subject 102 (FIG. 1) can be instructed to perform purposeful movements on the actuator assembly 106 (FIG. 1), and various kinematic phenomena such as reaction time, movement accuracy, and velocity and acceleration can be assessed.

[0053] FIG. 11 shows thresholds for vibration detection for a human subject. In a setup similar to that shown in FIGS. 1 and 2, an assessment of tactile perception impairment can be established based on the typical detection thresholds shown in FIG. 11. For example, a human perception threshold is shown by curve 1102. In one example of an experimental setup, subject 102 indicates the presence or absence of a signal during a stimulation test, where the frequency of the stimulation signal and the amount of skin depression caused by such stimulation are shown by curve 1102 (normal or intact human detection threshold). In some stimulation tests, the stimulation signal is present, and in some tests, the signal is absent. For analysis, researchers can quantify the tactile displacement threshold required for a participant to successfully detect the presence of a stimulus at any given vibrotactile frequency. Detection of defects in Meissner's corpuscles or Pacinian corpuscles can be detected by comparing the results to curves 1104 and 1106, respectively.

[0054] 12 shows measurements taken at different times on a human subject. Measurements taken at time T0 are unlikely to indicate disease because sensitivity occurs at a low detection threshold. In contrast, at time T1 (after disease progression), sensitivity may worsen (e.g., a larger skin depression is required for detection to occur). Further later, at time T2, sensitivity decreases further.

[0055] As discussed herein above, it can be important to consider environmental vibrations that are not tremor related, particularly during tremor analysis and diagnosis. According to some embodiments, a system can be provided to detect and consider such environmental vibrations. Figure 13 shows the signal flow from vibration capture, according to some embodiments. The input to the signal processing 1300 is the measured vibration or tremor a xyz In some implementations and test environments, environmental vibrations may occur. For example, some vibration sources are unique to the human body (heart, lungs, intestines, etc.), and systems and methods according to embodiments can identify and account for these vibrations in subsequent analysis. Thus, such environmental vibrations a environment are also provided to signal processing 1300. Other inputs are the time T of the measured vibration, the frequency F of the measured vibration, the displacement d xyz , and other signals.

[0056] A measure of vibration experienced by the patient (a patient ) is the difference between the environmental vibrations (a environment ), and as mentioned above, patient has an associated (x,y,z) reference frame, e.g., based on the direction of gravity and associated environmental vibrations, i.e., a patient =a xyz -a environment Note that this is shown in summation 1302 of Figure 13 (e.g., by subtracting sampled time domain data). In an alternative embodiment, the subtraction can occur in the frequency domain using a Fast Fourier Transform (FFT) of the vibration signal described above according to equation (1). F(a patient )=F(a xyz )-F(a environment ) (1)

[0057] [000139] Signal processing and fusion may be used to process and enhance various signal inputs for signal analysis. An example of this processing and fusion may be signal averaging and application of frequency-specific filters to remove and enhance frequency components of the signal in block 1304. Signal analysis 1308 may include calculating the mean frequency of the tremor (found in block 1306). Variation in tremor frequency and intensity may also be determined. A report may be provided at 1310.

[0058] In some embodiments, the processing circuit 800 may generate a tremor response based on the tremor data acquisition (e.g., as an input to block 1300 above). xyz The processing circuit 800 may calculate the tremor frequency or power (based on the data vs. T). Alternatively, this data may be shown in a graph as discrete data points (a sequence of numbers) occurring at discrete time samples. This sequence of numbers is divided into frames of data. For each frame, the processing circuit 800 can calculate the tremor frequency or power to compare results across frames. Alternatively, the processing circuit 800 can generate a moving filter that moves continuously from t=0 (or n=0) to the end of the data to calculate a sliding average tremor frequency. Techniques for doing this include Fourier, wavelet, or other transform methods. Frame data is compared to data from the same session, or to data from days, months, or years ago, to compare tremor statistics.

[0059] Computing Systems FIG. 14 is a block diagram illustrating a machine in the form of an exemplary computer system 1400, in which a set or sequence of instructions may be executed to cause the machine to perform any one of the methods described herein, according to an exemplary embodiment. In some embodiments, different instantiations of computer system 1400 may be used to implement all or a portion of the functionality of actuator assembly 106 (FIG. 1), clinician device 110, feedback device 114, or other elements of system 100 (FIG. 1). In alternative embodiments, the machine operates as a standalone device or may be connected (e.g., networked) with other machines. In a networked deployment, the machine may operate in either the capacity of a server or a client machine in a server-client network environment, or the machine may function as a peer machine in a peer-to-peer (or distributed) network environment. The machine may be a personal computer (PC), tablet PC, hybrid tablet, set-top box (STB), personal digital assistant (PDA), mobile phone, web appliance, network router, switch or bridge, or any machine capable of executing instructions (sequential or otherwise) that specify actions to be performed by the machine. Further, although only a single machine is shown, the term "machine" may also be interpreted to include any collection of machines that individually or jointly execute a set (or sets) of instructions to perform any one or more of the methodologies described herein.

[0060] The exemplary computer system 1400 includes at least one processor 1402 (e.g., a central processing unit (CPU), a graphics processing unit (GPU), or both, a processor core, a compute node, etc.), a main memory 1404, and a static memory 1406, where the processor 1402, the main memory 1404, and the static memory 1406 communicate with each other via a link 1408 (e.g., a bus). The computer system 1400 may further include a video display unit 1410, an alphanumeric input device 1412 (e.g., a keyboard), and a user interface (UI) navigation device 1414 (e.g., a mouse). In one embodiment, the video display unit 1410, the input device 1412, and the UI navigation device 1414 are incorporated into a touchscreen display. The computer system 1400 may additionally include a storage device 1416 (e.g., a drive unit), a signal generating device 1418 (e.g., a speaker), a network interface device 1420, and one or more sensors (not shown), such as a global positioning system (GPS) sensor, a compass, an accelerometer, or other sensors.

[0061] Storage device 1416 includes non-transitory machine-readable medium 1422 on which one or more sets of data structures and instructions 1424 (e.g., software) embodied in or used by any one or more of the methods or functions described herein are stored. Instructions 1424 may also reside, completely or at least partially, within main memory 1404, static memory 1406, and / or processor 1402 during execution of instructions 1424 by computer system 1400, with main memory 1404, static memory 1406, and processor 1402 also constituting machine-readable media.

[0062] While machine-readable medium 1422 is illustrated as a single medium in the exemplary embodiment, the term "machine-readable medium" can include a single medium or multiple media (e.g., centralized or distributed databases and / or associated caches and servers) that store one or more instructions 1424. The term "machine-readable medium" may also be interpreted to include any tangible medium capable of storing, encoding, or retaining instructions for execution by a machine, or data structures used by or associated with such instructions, that cause the machine to perform any one or more of the methodologies of the present disclosure. Accordingly, the term "machine-readable medium" may be interpreted to include, but is not limited to, solid-state memory, and optical and magnetic media. Specific examples of machine-readable media include, by way of example only, semiconductor memory devices (e.g., electrically programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM)) and flash memory devices, magnetic disks such as internal hard disks and removable disks, magneto-optical disks, and non-volatile memory including, but not limited to, compact disc-read-only memory (CD-ROM) and digital versatile disc-read-only memory (DVD-ROM) disks.

[0063] The instructions 1424 may further be transmitted or received over a communications network 1426 using a transmission medium via a network interface device 1420 using any one of several well-known transfer protocols (e.g., Hypertext Transfer Protocol (HTTP)). Examples of communications networks include local area networks (LANs), wide area networks (WANs), the Internet, cellular networks, plain old telephone service (POTS) networks, and wireless data networks (e.g., Wi-Fi, 3G, and 4G Long Term Evolution (LTE) / LTE-Advanced (LTE-A) or WiMAX networks). The term "transmission medium" may be interpreted to include any non-tangible medium capable of storing, encoding, or carrying instructions for execution by a machine and including digital or analog communications signals or other non-tangible media for facilitating the communication of such software.

[0064] Descriptions of elements in a figure should be understood to apply equally to corresponding elements in other figures unless otherwise indicated. While specific embodiments have been illustrated and described herein, those skilled in the art will recognize that the specific embodiments illustrated and described may be replaced by various alternative and / or equivalent embodiments without departing from the scope of the present disclosure. This application is intended to cover any adaptations or variations of the specific embodiments discussed herein. Accordingly, the present disclosure is intended to be limited only by the claims and equivalents thereof. In addition to the above-described embodiments, the following aspects will be noted. (Appendix 1) A device for measuring peripheral neuropathy, comprising: Housing and an actuator accessible from an exterior surface of the housing and configured to generate a stimulation signal to a skin surface of the subject; A processing circuit, controlling the actuator to generate the stimulus signal; and Recording responses to the stimulus signals a processing circuit configured as follows: An apparatus comprising: (Appendix 2) 2. The device of claim 1, wherein the housing includes a section having a mechanically compatible surface that contacts the actuator. (Appendix 3) 10. The apparatus of claim 1, further comprising an accelerometer for measuring vibrations. (Appendix 4) 4. The device of claim 3, further comprising a memory, wherein the processing circuit is further configured to record vibrations measured by the accelerometer and any of date information, time information, stimulus information, protocol information, subject identification information, and subject response information in the memory. (Appendix 5) 10. The apparatus of claim 1, wherein the stimulation signal includes a vibration signal, and the processing circuitry is configured to record subject response information and stimulation information based on at least one of the amplitude or phase of the vibration signal. (Appendix 6) Housing and an actuator assembly accessible from an exterior surface of the housing, an actuator configured to generate a stimulation signal to a skin surface of the subject; A processing circuit, controlling the actuator to generate the stimulus signal; and Recording responses to the stimulus signals a processing circuit configured as follows: an actuator assembly including: 1. A feedback device comprising: Receives user input, and Providing feedback to clinician devices a feedback device configured to 1. A clinician device comprising: providing a test input to the processing circuitry of the actuator assembly; and receive a response from the feedback device a clinician device configured to A system comprising: (Appendix 7) 7. The system of claim 6, wherein the housing includes a section having a mechanically compatible surface that contacts the actuator. (Appendix 8) 8. The system of claim 7, wherein the stimulation signal is primarily along an axis perpendicular to the mechanically compliant surface. (Appendix 9) 6. The system of claim 5, wherein the stimulation signal includes a vibration signal, and the processing circuitry is configured to record subject response information and stimulation information based on at least one of an amplitude or a phase of the vibration signal. (Appendix 10) 6. The system of claim 5, wherein the stimulus signal has a frequency, amplitude, or phase provided by a test protocol. (Appendix 11) 1. A method for measuring peripheral neuropathy, comprising: providing a vibrotactile stimulus to an actuator in physical contact with a skin surface of the subject; receiving a first indication of whether the vibrotactile stimulus was sensed; and providing a tremor detection assembly; receiving a second indication of whether tremor is present; and analyzing the first indication and the second indication to diagnose a neuropathy; A method comprising: (Appendix 12) 12. The method of claim 11, wherein the vibrotactile stimulation comprises a series of pulses based on a standard benchmark or protocol. (Appendix 13) 13. The method of claim 12, wherein at least one pulse in the series of pulses has a frequency of about 0.4 to 100 Hz to stimulate Merkel receptors, at least one pulse in the series of pulses has a frequency of about 7 Hz to stimulate Ruffini corpuscles, and at least one pulse in the series of pulses has a frequency of about 10 Hz to about 200 Hz to stimulate Meissner corpuscles. (Appendix 14) 14. The method of claim 13, wherein the series of pulses includes pulses from two or more frequency ranges. (Appendix 15) providing the vibrotactile stimuli to a plurality of actuators in physical contact at a plurality of points on the skin surface of the subject; receiving instructions from the plurality of actuators; comparing the sensitivity at the plurality of points based on the instructions; and 12. The method of claim 11, comprising:

Claims

1. 1. A device for diagnosing peripheral neuropathy, comprising: a housing including a mechanically compliant surface; an actuator in contact with the mechanically compliant surface of the housing and configured to deliver a stimulation signal via the mechanically compliant surface to a skin surface in contact with the housing; A processing circuit, controlling the actuator to generate the stimulus signal in response to commands received via a wired or wireless interface; receiving a response to the stimulation signal from a subject; and forming a diagnosis for a neurological disorder based on the received response; a processing circuit configured as follows: Equipped with The apparatus further comprising an accelerometer, wherein the processing circuitry is configured to receive vibration measurements from the accelerometer in response to the stimulus signal.

2. 10. The device of claim 1, further comprising a memory, wherein the processing circuitry is further configured to record in the memory vibration measurements received from the accelerometer and one or more of date information, time information, stimulus information, protocol information, subject identification information, and subject response information associated with the received responses.

3. 10. The device of claim 1, wherein the stimulation signal is a vibration signal, and the processing circuitry is configured to receive stimulation information based on at least one of an amplitude or a phase of the vibration signal.

4. A housing including a mechanically compatible surface; an actuator configured to deliver a stimulation signal to a skin surface in contact with the housing through the mechanically compliant surface of the housing; an accelerometer; an actuator assembly having a processing circuit configured to control the actuator to generate the stimulus signal in response to instructions received via a wired or wireless interface; 1. A feedback device comprising: receiving a response from the subject to the stimulation signal delivered to the skin surface; Providing feedback to clinician devices a feedback device configured to providing a test input to the processing circuitry; and receiving a respective response to each test input from said feedback device; the clinician device configured to Equipped with The system, wherein the processing circuit is configured to receive a response to the stimulus signal from the subject, and the processing circuit is configured to receive vibration measurements from the accelerometer included in the actuator assembly in response to the stimulus signal.

5. The system of claim 4 , wherein the actuator is configured to deliver the stimulation signal primarily along an axis perpendicular to the mechanically compliant surface.

6. 5. The system of claim 4, wherein the stimulation signal comprises a vibration signal, and the processing circuitry is configured to record subject response information and stimulation information based on at least one of an amplitude or a phase of the vibration signal.

7. The system of claim 4 , wherein the stimulus signal has a frequency, amplitude, or phase provided by a test protocol.

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