Assembly and method for spatially selectively changing a nerve activity in a target volume

Abstract

The invention relates to an assembly (100) for spatially selectively changing a nerve activity in a target volume (103) by means of an electrical manipulation field that can be spatially selectively generated, wherein the assembly (100) for generating the manipulation field has a magnetic coil (121, 122, 123), an electrode (130), and a control unit (110). The invention further relates to a corresponding method and a measurement method.

Description

[0001] Arrangement and method for spatially selective modification of nerve activity in a target volume

[0002] The invention relates to an arrangement for spatially selectively changing nerve activity in a target volume by means of a spatially selectively generateable electrical manipulation field.

[0003] The invention further relates to a method for spatially selectively changing nerve activity in a target volume by means of a spatially selectively generated electric field.

[0004] The invention further relates to a measuring method.

[0005] Such arrangements and methods are known and are used, for example, in medicine. They can be used to specifically manipulate nerves, for example to stimulate or inhibit them. A change in nerve activity can therefore be understood in particular as the stimulation or inhibition of a nerve or axon, in particular of an excitation conduction of a nerve or axon. Inhibition of a nerve can be understood in particular as the nerve being put into a state in which no further conduction takes place. In this case, for example, no motor stimuli and / or pain stimuli are conducted through the nerve. The inhibition of a nerve can therefore be used, for example, to eliminate pain in an area supplied by the nerve.

[0006] A nerve or nerve activity, for the purposes of this invention, can be understood to mean any neuron or any neuronal activity. Nerves, for the purposes of this invention, are in particular directed arrangements of nerve fibers (axons). Nerve activity, for the purposes of this invention, is in particular any transmission of nerve signals (action potentials) along these nerve fibers. In particular, for the purposes of this application, any of the processes generally referred to as nerve activity can be a transmission of nerve signals along the nerve fibers. Nerve activity can be determined in particular by the transmission properties of nerve fibers, in particular nerve pathways. Any change in nerve activity, for the purposes of this application, can be a change in the transmission properties of nerve fibers, in particular of nerve pathways with a predetermined transmission direction. This can, for example, lead to an inhibition of nerve conduction.

[0007] A nerve can generally be understood as any nerve tissue, in particular nerve fibers (tracts) of the spinal cord, nerve cell bodies in the spinal cord (nuclei), or fiber tracts in the brain (e.g., white matter). Which of the arrangements or methods described within the scope of this invention can be used effectively only with a subselection of the aforementioned neurons, nerve tissue, or nerve pathways is known to those skilled in the art.

[0008] The change in nerve activity occurs by means of an electric field, the manipulation field.

[0009] The change in nerve activity occurs in a target volume. The target volume defines the location where nerve activity is to be changed and, depending on the application, can contain, for example, a specific nerve or a section of that nerve. The target volume can also contain multiple nerves.

[0010] The invention relates to an arrangement for spatially selectively modifying nerve activity in a target volume by means of a spatially selectively generated electrical manipulation field. The manipulation field can, in particular, also be described as being selectively generated in a vectorial and / or spatially directed and / or temporally specific manner.

[0011] In the context of this invention, spatially selective generation or modification of a location-dependent property in a target volume means that locations or regions in the target volume can be variably selected or specified at which the property is generated or modified in a desired manner. In particular, this concerns the vectorial and / or spatially directed alignment of the electrical manipulation field along one or more nerve pathways in the target volume whose nerve activity, in particular conduction properties, are to be influenced.

[0012] Thus, according to the invention, the change in nerve activity in the target volume occurs spatially selectively. One or more locations or sub-regions in the target volume can therefore be specified at or in which the nerve activity is changed in a specified manner. A spatially selective change in nerve activity in the target volume can therefore be understood in particular to mean that the nerve activity is changed only or in any case in the target volume. This can also be understood in particular to mean that the nerve activity is changed only or in any case in a sub-region of the target volume, for example in a section of a nerve contained in the target volume or only or in any case in one of several nerves contained in the target volume.

[0013] Thus, this can be understood in particular to mean that only or at least the conduction properties of nerve pathways of one or more predetermined spatial orientations are changed. Analogously, the manipulation field can be generated spatially selectively in the target volume. Therefore, one or more locations or sub-areas can be specified in the target volume at or in which the electrical manipulation field can be generated in a desired manner. For example, the desired manner can consist of specifying location-dependent field strengths, field directions, frequencies, and / or other field properties.

[0014] The properties of the manipulation field, for example its electric field strength, frequency and / or direction generally determine the effects on nerve cells, particularly nerve pathways, and also whether a nerve is stimulated or inhibited. At manipulation field frequencies below the maximum discharge frequency of a nerve fiber, stimulation occurs if the amplitude is sufficient. This stimulation can be painful. The time during which no action potential can be generated is called the refractory period and is on the order of a few milliseconds, depending on the type of nerve fiber. At frequencies beyond the maximum discharge frequency, not every stimulation pulse is followed by an action potential. Furthermore, the conduction properties of the nerve are changed by the manipulation field.This can manifest itself as increased excitability (facilitation) or inhibition. In the maximum variant, a conduction block for any incoming nerve signals occurs, depending on the type of fiber, frequency, amplitude, direction and / or waveform of the alternating field, among other things. A change in the conduction properties is not necessarily accompanied by the creation of new action potentials / nerve signals like a stimulation; rather, the type and manner of signal transmission along the nerve pathway is influenced. The manipulation field can be defined in terms of its parameters, for example amplitude, frequency, direction, temporal and / or spatial progression, distribution pattern and alignment, particularly along nerve pathways.

[0015] The object of the invention is to improve the performance characteristics of the arrangements and methods mentioned at the outset.

[0016] To achieve the stated object, the features of claim 1 are provided according to the invention. In particular, to achieve the stated object, in arrangements of the type described above, the invention proposes that the arrangement for generating the field comprise a magnetic coil, an electrode, and a control unit.

[0017] The arrangement can therefore have exactly one or more magnetic coils and / or exactly one or more electrodes. In the following, the arrangement is generally described using a magnetic coil and an electrode. Depending on the specific design of the arrangement and the functions to be implemented, the description may also include multiple magnetic coils and / or multiple electrodes. Depending on the requirements, the electrode can be a surface electrode and / or a needle electrode.

[0018] Two different methods can be used to generate the manipulation field. First, a magnetic field can be generated using the magnetic coil, whose temporal changes lead to the induction of an electric field. Second, an electric field can be generated directly using the electrode. For this purpose, the magnetic coil and the electrode can be connected to the control unit, preferably by cable, and controlled by the control unit.

[0019] In an advantageous embodiment, it can be provided that the change in nerve activity is a change in the conduction properties of nerve fibers, in particular directed nerve pathways.

[0020] A nerve pathway can, for example, be characterized by comprising more than one nerve fiber. The directed nerve pathways consist, for example, of a directed arrangement of nerve fibers (axons). The manipulation field can be directed, in particular, along one or more nerve pathways.

[0021] The invention is therefore applicable to directed nerve pathways composed of axons. In contrast to other arrangements, devices, and / or methods whose purpose is to elicit new nerve action potentials by stimulating, for example, a cell body present, for example, in the gray matter of the brain, the aim of the invention is to alter the conduction of excitation following the elicitation of a nerve action potential.

[0022] In addition, it can be provided that the change in nerve activity is a suppression of the transmission of nerve signals.

[0023] For example, this can lead to inhibition and / or inhibition of nerve conduction.

[0024] Alternatively or additionally, it can be provided that the change in nerve activity is one within a defined effective range.

[0025] This effective range can also be referred to as the inhibition range, particularly in the case of inhibition.

[0026] Alternatively or additionally, it may be provided that the change in nerve activity is caused by a change in conduction properties.

[0027] In an advantageous embodiment, it can be provided that the control unit is designed to jointly control the magnetic coil and the electrode in such a way that respective electric fields generated by the magnetic coil and the electrode in the target volume are superimposed to form the manipulation field.

[0028] In this way, the aforementioned options for generating the manipulation field - the magnetic coil and the electrode - can be advantageously combined with one another. An electric field induced by the magnetic coil typically reaches deeper into the target volume than an electric field generated by the electrode. With the help of several magnetic coils and / or several electrodes, several electric fields can be induced and / or generated, which can overlap to form the manipulation field. This can lead to constructive and / or destructive interference. For example, the magnitude and / or direction of a vector of an electric field strength can be changed and / or adjusted.

[0029] The control of the magnetic coil and the electrode can be pulsed and / or synchronous.

[0030] Depending on the requirements of the manipulation field, this can be advantageously designed by appropriately controlling the magnetic coil and / or the electrode. In particular, the magnetic coil and / or the electrode can be controlled simultaneously within a time interval.

[0031] In an advantageous embodiment, the manipulation field can have a higher frequency than the maximum discharge frequency of nerves in the target volume whose activity, in particular their conduction properties, is altered. Preferably, the aforementioned nerves are directed nerve pathways. In particular, the manipulation field can be generated as a pulsed field and / or alternating field, wherein it has a higher frequency than the maximum discharge frequency of the nerve pathways in the target volume.

[0032] The maximum discharge frequency results, among other things, from the refractory period of the respective cell types.

[0033] Alternatively or additionally, it can be provided that the manipulation field induces nerve inhibition in a predetermined inhibition area of ​​the target volume.

[0034] The aforementioned advantages of a manipulation field that can be generated spatially selectively, in particular vectorially selectively and / or spatially directed, can thus be used to bring about nerve inhibition in a predetermined inhibition region of the target volume. For example, the position, shape and / or size of the inhibition region can be predetermined. This can occur, for example, depending on the location of the nerves. The location of the nerves and / or the inhibition region can be generally known or determined in each individual case. In this way, individual nerves in individual sections can be specifically inhibited. Other nerves located in the target volume but outside the inhibition region can remain unaffected, or at least not be inhibited.These statements apply in particular to a general inhibition and / or general change in the conduction properties of nerve pathways of a given orientation within a general effective area. For example, the conduction properties of individual nerve pathways in individual sections of the target volume can be influenced in a differentiated manner. Other nerve pathways located within the target volume, particularly outside of an effective area, for example, with a different orientation, can remain deliberately unaffected, or at least their conduction properties cannot be influenced.

[0035] In an advantageous embodiment, it can be provided that a predetermined sub-region of the manipulation field which leaves the nerve activity unchanged is generated by compensating for the electric field generated by the magnetic coil by means of the electric field generated by the electrode. The inhibition region and the sub-region which leaves the nerve activity unchanged are therefore disjoint sub-regions of the manipulation field. Thus, portions of nerve pathways with changed and unchanged conduction properties in the target volume are also disjoint portions of the nerve pathways in the target volume. This corresponds to disjoint sub-regions of the manipulation field, in particular for nerve pathways with a predetermined or existing orientation. The compensation can in particular relate to and / or influence the course, distribution patterns such as gradients, the amplitude and / or the orientation of the manipulation field along the nerve pathways.

[0036] The sub-area that leaves the nerve activity, in particular the conduction properties of nerve pathways, unchanged is preferably located closer to the magnetic coil and / or the electrode than the inhibition area. The distances to be compared can, in particular, refer to the respective location of a respective area that is closest to the other area.

[0037] Unchanged nerve activity, particularly unchanged conduction properties, can be understood to mean that the nerve activity of the nerve in question does not change noticeably for the patient. For example, an electric field occupying a comparatively large volume of the target volume can be induced by the magnetic coil. The electric field generated by the electrode can compensate for the electric field generated by the magnetic coil in partial areas of the target volume.

[0038] In an advantageous embodiment, it can be provided that the electric field generated by the magnetic coil can be at least partially compensated by the electric field generated by the electrode.

[0039] The magnetic coil and the electrode are therefore arranged in such a way that they can each generate an electric field or the electric field in the target volume. This can, for example, create the conditions for generating the aforementioned partial area that leaves nerve activity unchanged. At least partial compensation of the electric field generated or induced by the magnetic coil can be understood, in particular, as reducing the magnitude of the electric field strength of this electric field.

[0040] In an advantageous embodiment, it can be provided that the control unit is designed to control the magnetic coil and the electrode in such a way that the activity of a nerve located in a fixed orientation to the arrangement and / or the target volume can be spatially selectively changed.

[0041] Alternatively or additionally, it may be provided that the

[0042] The control unit is configured to control the magnetic coil and the electrode in such a way that the conduction properties of one or more nerve pathways located in a fixed orientation relative to the arrangement and / or the target volume can be spatially selectively changed.

[0043] Thus, information about the orientation of a nerve relative to the arrangement and / or the target volume can be used to specifically change the activity, in particular the conduction properties, of the nerve. From the information about the orientation, a control leading to a desired change in activity can be derived and implemented via the magnetic coil and the electrode. The information about the orientation of the nerve can be derived, for example, from the arrangement being in a fixed orientation relative to, for example, an extremity containing the nerve and the nerve being in a known orientation relative to the extremity.

[0044] In an advantageous embodiment, it can be provided that the control unit is configured to adapt a field strength, a frequency and / or a waveform of the electric field generated by the electrode and / or by the magnetic coil.

[0045] Thus, the electrical fields that overlap to form the manipulation field can be specifically influenced to create a manipulation field that meets specific requirements. The manipulation field can be constructed relatively complexly, and the target volume can encompass, for example, both inhibition areas and areas of unaffected nerve activity, or both effective areas with altered conduction properties and areas with unaffected conduction properties.

[0046] In an advantageous embodiment, it can be provided that several electrodes and / or magnetic coils are formed to generate the manipulation field.

[0047] Depending on the desired complexity of the manipulation field, for example in position, extent, shape and electric field strength, several electrodes and / or magnetic coils can be used to generate the manipulation field.

[0048] Additionally, it can be provided that the orientation of the manipulation field can be spatially selectively adjusted using the plurality of electrodes and / or magnetic coils. This can, in particular, involve an orientation of the manipulation field along a nerve and / or a nerve pathway.

[0049] The manipulation field can thus be tailored even more specifically to the nerve or nerve segment to be inhibited and / or the nerve pathway to be influenced.

[0050] In an advantageous embodiment, a data storage device can be configured in which a location-dependent, and in particular orientation-dependent and / or provided with orientation information, target activity map is stored for the target volume, and the control unit is configured to control the magnetic coil and the electrode in such a way that the nerve activity altered by the manipulation field replicates the target activity map. This applies accordingly if a target specification in the sense of altered nerve conduction properties is present.

[0051] For the target volume, a location-dependent

[0052] A target activity map can be specified which depicts the desired target activity at different locations in the target volume. The desired target activity can be understood in particular as the desired nerve activity present after the change in nerve activity by the manipulation field. The target activity can also be understood as a desired change in the conduction properties or as changed conduction properties. The target activity map can include appropriately selected parameters which represent the changed conduction properties. For example, the change to be made in nerve activity can be derived from the nerve activity present at the start and the target activity. The changes to be made in the conduction properties can be derived accordingly from the conduction properties present at the start and the intended target parameters of the conduction properties.The magnetic coil and the electrode can be controlled such that the nerve activity altered by the manipulation field replicates the target activity map or exhibits the target activity. The target activity can, for example, correspond to neuroinhibition. Depending on the desired target activity, it is possible that nerve activity present at the beginning is irrelevant for determining the desired change in nerve activity. This applies accordingly if the target activity is to be achieved through altered conduction properties or represents such.

[0053] In an advantageous embodiment, it can be provided that a data memory is formed in which a location-dependent target field map is stored for the target volume and that the control unit is set up to control the magnetic coil and the electrode in such a way that the manipulation field simulates the target field map. The data memory can in particular be the one already mentioned or a separate data memory. A target field map can therefore be specified instead of or in addition to the target activity map. If the target field is already known, calculation steps for calculating a target field from the target activity can be omitted. The target field map can also initially be calculated from a target activity map or from a known or already determined necessary change in nerve activity.The replication of the target field map by the manipulation field can particularly affect the local distribution, amplitude, spatial orientation and / or the suitability for changing the nerve activity and / or conduction properties.

[0054] In an advantageous embodiment, it can be provided that the control unit has a first control electronics for controlling the magnetic coil, a second control electronics for controlling the electrode and a controller with which the control signal generated by the control electronics can be or is modifiable.

[0055] The magnetic coil and the electrode can thus have separate control electronics, each connected to the controller, and controlled by this interconnection in the desired manner. For this purpose, the control unit can be connected to the controller and control it, or it can contain the controller. The modification of the control signal can, in particular, relate to the coordination of the control signal with regard to its temporal sequence.

[0056] In an advantageous embodiment, it can be provided that the control unit is set up so that in a first period of time a constant field is applied by means of the electrode and in a second period of time an alternating field is applied by means of the electrode.

[0057] The first period can include and / or be the period during which the manipulation field builds up to a desired electrical field strength. The second period can include and / or be the period during which neuroinhibition occurs. Instead of neuroinhibition, generally altered conduction properties may be present.

[0058] The electrode can therefore have control electronics that enable the generation of a direct field and an alternating field. The control unit can be configured to control the electrode in a corresponding manner and to alternate between the direct field and the alternating field over time. For example, when using the arrangement, it may be necessary to generate a direct field with the electrode while the manipulation field is being built up until neuroinhibition and / or a defined change in the conduction properties is achieved, in particular to compensate for the electric field generated or induced by the magnetic coil, in order to avoid neurostimulation, which may be associated with pain.Switching the electrode from the direct current field to an alternating current field can, for example, occur in a later phase of the construction of the manipulation field if, for example, neurostimulation is no longer expected to complete the manipulation field due to a certain electrical field strength or frequency being exceeded.

[0059] In an advantageous embodiment, the arrangement may comprise a support to which the magnetic coil is attached. Alternatively or additionally, the arrangement may comprise a support to which the electrode is attached. It is also possible for the magnetic coil and the electrode to be attached to the same support.

[0060] In this way, the solenoid and / or electrode can be securely attached. The solenoid and / or electrode can also be held in a specific orientation to establish known positions and orientations of the solenoid and / or electrode. These positions and orientations can then be used to determine the necessary activation of the solenoid and / or electrode that leads to the creation of the manipulation field.

[0061] Additionally, the carrier may be a cuff. Alternatively or additionally, the carrier may be flat and / or flexible. Alternatively or additionally, the carrier may be designed as an implant.

[0062] The shape and material properties of the carrier can thus be determined more precisely. If the carrier is designed as a cuff, reproducible positions of the magnetic coil and / or the electrode can be determined by always applying the cuff in the same way, so that the desired manipulation field can be generated in a reproducible manner. If the carrier is designed as an implant, the arrangement can be implanted. The arrangement can therefore be placed closer to the area in which the nerve activity, in particular the conduction properties, is to be changed. The arrangement can also be used for long-term action on a nerve. This can be done, for example, as part of long-term therapy. The arrangement can therefore be used for the treatment of neurological diseases.In an advantageous embodiment, it can be provided that a distance between the electrode and the target volume is smaller than a distance between the magnetic coil and the target volume.

[0063] The electrode and the magnetic coil can thus advantageously be arranged in a space-saving manner, whereby an electric field induced by the magnetic coil can be at a greater distance from the magnetic coil than the electric field generated by the electrode. The electrode can therefore be used, for example, to compensate for the electric field induced by the magnetic coil in the target volume, preferably in an outer region of the target volume.

[0064] In an advantageous embodiment, it can be provided that the magnetic coil and the electrode each have the same, preferably lateral, distance from the target volume, in particular from a center point and / or a center axis of the target volume.

[0065] The distance may be a lateral distance. In the case of a cuff-shaped arrangement, this may, for example, be understood to mean the distance from a central axis of the cuff and / or from an outer side of the cuff.

[0066] The distance to the target volume can in particular be the distance to a center point and / or a central axis of the target volume.

[0067] The distance can therefore be defined more precisely. A more precise

[0068] Definition of the geometric relationships is advantageous for the creation of a defined manipulation field.

[0069] In an advantageous embodiment, it can be provided that a grounding electrode is provided which is separate from the electrode.

[0070] This allows an electrical current generated by the electrode to be diverted. For example, the electrode and the ground electrode can be placed on a patient.

[0071] In addition, it can be provided that the grounding electrode is arranged at a distance from the or a base body of the arrangement which determines the position of the magnetic coil and / or the electrode.

[0072] For example, the arrangement can be designed with a cuff as the base body, with the cuff being placed around a patient's extremity. The grounding electrode can then be attached to the patient at a distance from the cuff, for example in the form of an adhesive electrode.

[0073] In an advantageous embodiment, it can be provided that a signal from a nerve can be derived by means of the electrode.

[0074] The electrode can, for example, be one of several electrodes if the array has multiple electrodes. In particular, it can be a needle electrode. This makes it possible to analyze the state of the nerve. For example, an inhibition state of the nerve can be detected. This also makes it possible to implement a feedback loop that can detect whether the manipulation field leads to the desired change in nerve activity. For example, when using the array in anesthesia, it can be checked whether a desired degree of neuroinhibition, e.g. to eliminate pain, has been achieved. This can be shown to a user, for example, to enable them to manually adjust the manipulation field or perform other manual measures.

[0075] In addition, it can be provided that the control unit is designed to control the magnetic coil and the electrode in dependence on the signal from the nerve.

[0076] For example, during the formation of the feedback loop described above, the manipulation field can be adjusted if it does not yet or no longer lead to the desired change in neural activity. For example, when using the device in anesthesia, it can be registered that a desired degree of neuroinhibition is not or no longer achieved, and the manipulation field can be readjusted accordingly. The registration and / or readjustment can preferably be automated.

[0077] In an advantageous embodiment, it can be provided that the control unit has an input for a signal from a sensor.

[0078] The arrangement can therefore comprise and / or be connected to a sensor. The sensor can be used, for example, to determine a patient's condition and transmit it to the control unit.

[0079] Alternatively or additionally, it can be provided that the control unit has an output for a signal from the control unit.

[0080] The control unit can thus control other components in addition to the solenoid coil and / or the electrode. For example, the control unit can control the controller(s) mentioned above. The control unit can also output information for documentation purposes.

[0081] In addition, it can be provided that the sensor can be applied to a patient's body.

[0082] The sensor can therefore, for example, be glued onto the surface of a patient’s skin.

[0083] In addition, it can be provided that the control unit is designed to control the magnetic coil and / or the electrode depending on the signal from the sensor.

[0084] Thus, a state detected by the sensor can be used, for example, to detect a change in state, such as the removal or reduction of neuroinhibition. For example, the manipulation field can be readjusted in response, preferably automatically. Control can be achieved, particularly with regard to the parameters of the manipulation field, by superimposing the electric fields generated in the target volume by the magnetic coil and the electrode.

[0085] In an advantageous embodiment, the arrangement can be provided with a heating element and / or cooling element that can be controlled by the control unit for modifying nerve activity in the target volume. Alternatively or additionally, the arrangement can be provided with a heating element and / or cooling element that can be controlled by the control unit for modifying the conduction properties of nerve pathways in the target volume.

[0086] The term heating element is to be understood broadly in the sense of this application and also includes devices for targeted, spatially limited temperature changes, such as devices emitting electromagnetic radiation, for example for temperature changes by means of radio frequency pulses, (IR) lasers, and / or microwaves.

[0087] In addition, it can be provided that the heating element and / or cooling element can be applied to a patient's body.

[0088] Alternatively or additionally, it can be provided that the heating element and / or cooling element and / or their respective control is adapted to the properties of the manipulation field.

[0089] Thus, nerve activity in the target volume can be altered by temperature stimuli. This can be used, for example, as a control mechanism to determine whether neuroinhibition is present. It is also possible, for example, to influence a nerve or its conduction properties using multiple mechanisms, such as the manipulation field and a temperature stimulus, and to advantageously coordinate these effects.

[0090] In an advantageous embodiment, it can be provided that the magnetic coil has a cylindrical, helical and / or spiral basic shape.

[0091] The solenoid coil can therefore be designed in a variety of ways depending on the specific requirements. Several differently designed solenoid coils can also be provided and / or can work together.

[0092] Alternatively or additionally, the electrode may be provided with recesses to prevent eddy currents.

[0093] This allows for the reduction and / or prevention of interference with the electrode caused by a magnetic field generated by the magnetic coil and / or interference with the manipulation field. The recesses can be slots, for example.

[0094] In an advantageous embodiment, it can be provided that several magnetic coils and / or several electrodes are arranged in such a way that they maintain defined distances and / or positions from one another.

[0095] The defined distances can therefore be incorporated into calculations for the control of the magnetic coils and / or electrodes required to generate a desired manipulation field. The manipulation field can therefore be generated even more precisely and, for example, replicate a desired manipulation field even more accurately.

[0096] The magnetic coils and / or electrodes can each be of the same type.

[0097] The magnetic coils and / or electrodes can therefore, for example, each have identical geometries. This simplifies the arrangement and calculations for controlling the magnetic coils and / or electrodes.

[0098] In addition, it can be provided that a distance of a magnetic coil to a next magnetic coil is smaller than a diameter of the magnetic coil.

[0099] The magnetic coils can therefore be arranged close together. This can reduce the size of the assembly.

[0100] Alternatively or additionally, it can be provided that a distance from one electrode to a next electrode is greater than a diameter, preferably greater than twice a diameter, of the electrode.

[0101] The electrodes can therefore maintain greater relative distances from each other than the magnetic coils. The manipulation field can thus be designed even more broadly.

[0102] In an advantageous embodiment, it can be provided that a test electrode is arranged which can be applied to a surface of a patient's body, by means of which test electrode a test signal is applied to the nerve, the activity and / or conduction properties of which are spatially selectively changed, in a first section, and a response signal is measured with a further electrode attached to the patient's body in a second section of the nerve which is separated from the first section by the electrode.

[0103] The arrangement can therefore comprise at least two additional electrodes, namely the test electrode and the further electrode . These electrodes do not have to be involved in generating the manipulation field . Several test electrodes and / or further electrodes can also be provided . The test electrode and / or further electrodes can be designed as bipolar electrodes . The electrodes can be applied to or on a surface of a patient's body, for example, can be adhesively bonded to the skin . In particular, one or more needle electrodes can be used here .

[0104] The first and second sections can, for example, be two sections of a patient's extremity. If, after the test signal has been applied by the test electrode in the first section, no response signal is measured by the further electrode in the second section, it can be assumed, for example, that neuroinhibition is caused by the manipulation field. The status of neuroinhibition can therefore be checked using the arrangement. This information can, for example, be given to a user so that they can decide on the necessary measures. The user can, for example, change the position of the magnetic coil and / or the electrode and thus the manipulation field.

[0105] A response signal is to be understood in the sense of a detection of a signal by the additional electrode, whereby interim stimulus processing, for example in the central nervous system, is not necessary. The additional electrode can therefore, for example, measure the signal emitted by the test electrode to the nerve in the first section on the same nerve, but in the second section. The first and second sections are separated by the electrode of the arrangement. The electrode refers to the electrode inserted at the beginning and intended to generate the manipulation field.

[0106] For example, a nerve can be stimulated, particularly with just one pair of electrodes, and after the stimulus has been processed in the central nervous system, a response can be measured in the same nerve, particularly with the same pair of electrodes (H-reflex). In this way, the entire nerve path between the stimulation site and a patient's spinal cord can be tested.

[0107] If the arrangement comprises several electrodes intended to generate the manipulation field, one of these electrodes can be considered the electrode. If the test electrode in the first section and the further electrode in the second section are separated from each other by all the electrodes in the arrangement generating the manipulation field, the exact position of the boundary between the sections can be seen at any of the electrodes.

[0108] Additionally, it can be provided that the response signal is automatically evaluated and, depending on the evaluation result, a control signal of the magnetic coil and / or the electrode is changed. This serves, in particular, to specifically adjust the parameters of the manipulation field.

[0109] In this way, in the event of insufficient neuroinhibition, the manipulation field can be readjusted by changing the magnetic coil's control signal in order to restore neuroinhibition as quickly as possible. This can be supported by automated evaluation and / or readjustment. In principle, automated or automatable steps can be replaced by a corresponding output to a user, such as an anesthesiologist. The user can then manually decide on the measures to be taken and execute them.

[0110] In an advantageous embodiment, it can be provided that a magnetoimpedance tomography method can be carried out by means of the magnetic coil and a further magnetic coil and that an impedance of a material of the body is determined by means of the magnetoimpedance tomography method.

[0111] Alternatively or additionally, it can be provided that an electrical impedance tomography method can be carried out by means of the electrode and a further electrode and that an impedance of a material of the body is determined by means of the electrical impedance tomography method.

[0112] Thus, additional diagnostics, particularly imaging ones, can be carried out with the arrangement.

[0113] In addition, it can be provided that the location of a nerve is determined from the determined impedance.

[0114] It can therefore provide information about the location of a

[0115] Nerve and used in calculations of the manipulation field and / or the signals used to generate the

[0116] The manipulation field can be used to control the magnetic coil and / or electrode. In particular, the alignment of a nerve or nerves can also be determined.

[0117] Alternatively or additionally, it can be provided that a state of neuroinhibition is determined from the determined impedance and, depending on the determined state, the manipulation field is changed and / or a valve and / or a pump is controlled.

[0118] The additional diagnostics can therefore be used to test neuroinhibition. If the test reveals that neuroinhibition is not occurring as desired, for example, if it has diminished, the manipulation field can be changed. It is also possible to provide a valve and / or a pump, such as a syringe pump, by means of which, for example, an anesthetic can be administered to the patient. This allows conventional anesthesia procedures to be applied as quickly as possible in the event of inadequate neuroinhibition, for example, to avoid the patient perceiving pain or to interrupt it as quickly as possible.

[0119] Analogously, a state with regard to conduction properties can be determined from the determined impedance or a conclusion can be drawn about these and the additional diagnostics can be used to test the conduction properties of nerve pathways.

[0120] Alternatively or additionally, to achieve the stated object, the invention provides the features of the subordinate claim directed to a method for spatially selectively modifying nerve activity in a target volume by means of a spatially selectively generated electrical manipulation field. In particular, to achieve the stated object, in methods of the type described above, the invention proposes that the manipulation field be generated by means of a magnetic coil and an electrode.

[0121] The manipulation field is thus generated jointly by the magnetic coil, in particular by induction, and the electrode. The advantages of the method according to the invention are therefore analogous to those of the arrangement according to the invention. The method according to the invention can therefore have advantages analogous to the arrangement according to the invention. The advantages and explanations already described for the arrangement according to the invention therefore apply analogously to the method according to the invention. For example, the method according to the invention can also use exactly one magnetic coil or several magnetic coils and exactly one electrode or several electrodes. In the following, the method is mostly described using a magnetic coil and one electrode. Depending on the specific design of the method and the functions to be implemented, several magnetic coils and / or several electrodes are also included in the description.

[0122] In an advantageous embodiment, it can be provided that the change in nerve activity is and / or is caused by a change in the transmission properties of nerve fibers, in particular of directed nerve pathways, preferably a suppression of the transmission of nerve signals and / or in a defined effective range.

[0123] Thus, by means of the method according to the invention, the conduction properties of directed nerve pathways can be influenced accordingly, as already described in the course of the description of the device. The device-related descriptions and advantages apply accordingly to the method according to the invention.

[0124] In an advantageous embodiment, it can be provided that the change in nerve activity is a stimulation or inhibition of a secondary conduction of a nerve, nerve cell body, network of nerve cells and / or a neuroinhibition.

[0125] As already explained with regard to the arrangement, nerve activity can thus be modified in a variety of ways. For example, the method according to the invention can be used in anesthesia or neurology.

[0126] In an advantageous embodiment, it can be provided that the manipulation field has a higher frequency than the maximum discharge frequency of nerves whose activity is changed, in particular of directed nerve pathways, in the target volume (103).

[0127] In an advantageous embodiment, the magnetic coil and / or the electrode can be controlled simultaneously by a control unit at a time interval. The control can be pulsed and / or synchronous.

[0128] Thus, the advantages of an analog arrangement already described can also be used in the process.

[0129] In an advantageous embodiment, it can be provided that the magnetic coil and / or the electrode are controlled in such a way that a deviation of the manipulation field from a predetermined target field is minimized.

[0130] Thus, the advantages of an analog arrangement already described can also be used in the process.

[0131] For example, the target field, particularly as a target field map, can be retrieved from a data storage device. In the method, the magnetic coil and the electrode can be controlled such that the manipulation field replicates the target field, particularly the target field map. Depending on the number and arrangement of the magnetic coil and the electrode, it is possible that the target field or the target field map is not accessible. Replication can therefore be achieved by minimizing the deviation of the manipulation field from the target field or the target field map.

[0132] Alternatively or additionally, it can be provided that the magnetic coil and / or the electrode are controlled in such a way that a deviation of the electric field strength of the manipulation field from a predetermined electric target field strength is minimized.

[0133] In an analogous manner, the electric field strength can be used to plan and define the manipulation field.

[0134] In this case, it can additionally be provided that the target field and / or the target field strength is only specified in a partial volume of the target volume.

[0135] The partial volume can, for example, be an area occupied by the nerve whose activity is to be changed.

[0136] In an advantageous embodiment, it can be provided that the nerve activity of several nerves located in the target volume is selectively changed.

[0137] If multiple nerves are present in the target volume, the manipulation field can be generated in such a way that individual nerves can be selectively influenced. For example, one nerve can be inhibited while another remains unaffected. Additionally, the nerve activity of the nerves can be altered in different ways.

[0138] For example, of several nerves in the target volume, one nerve can be inhibited while another nerve is stimulated.

[0139] In an advantageous embodiment, it can be provided that an electric field is generated in the target volume by means of the magnetic coil, which electric field is completely or at least partially compensated in at least a partial volume of the target volume by an electric field generated by the electrode.

[0140] Thus, the method can realize the advantages of an analog arrangement. At least partial compensation of the electric field generated or induced by the magnetic coil can also be understood here in particular as meaning that the magnitude of the electric field strength of this electric field is reduced.

[0141] In an advantageous embodiment, it can be provided that the manipulation field has a higher electric field strength in an inner partial volume of the target volume than in an outer partial volume of the target volume.

[0142] For example, neuroinhibition can occur in the inner sub-volume, while nerves in the outer sub-volume can remain unaffected.

[0143] In addition, it can be provided that the outer partial volume completely surrounds the inner partial volume at least in two dimensions.

[0144] For example, the inner sub-volume can be approximately cylindrical and / or the outer sub-volume can be approximately hollow and cylindrical. In an advantageous embodiment, it can be provided that the manipulation field in one or the inner sub-volume of the target volume has an electric field strength of more than 50 V / m. In this case, it can be provided that the manipulation field in one or the inner sub-volume of the target volume has an electric field strength of more than 100 V / m.

[0145] The manipulation field can therefore have sufficient electric field strengths for neuroinhibition.

[0146] In an advantageous embodiment, it can be provided that in a first period of time a constant field is applied by means of the electrode and in a second period of time an alternating field is applied by means of the electrode.

[0147] The first period can include and / or be the period during which the manipulation field builds up to a desired electrical field strength. The second period can include and / or be the period during which neuroinhibition occurs.

[0148] Analogous to the arrangement described above, the method can therefore offer the advantages of avoiding neurostimulation during the construction of the manipulation field.

[0149] In an advantageous embodiment, it can be provided that a test electrode is arranged on the surface of a patient's body, by means of which test electrode a test signal is applied in a first section to the nerve whose activity is spatially selectively changed, and that a response signal is measured by a further electrode attached to the patient's body in a second section of the nerve separated from the first section by the electrode. The method can therefore realize the advantages of an analog arrangement with regard to monitoring the state of neuroinhibition. The test electrode and the further electrode can therefore be bipolar electrodes, for example. Several test electrodes and / or further electrodes can also be provided.

[0150] In addition, it can be provided that the test electrode is arranged at a distance from the electrode.

[0151] The test electrode can therefore advantageously be placed as a separate electrode.

[0152] Alternatively or additionally, it can be provided that the response signal is automatically evaluated and a control signal of the magnetic coil is changed depending on an evaluation result.

[0153] It is therefore possible, upon detection of a decreasing neuroinhibition, to change the manipulation field in such a way that the neuroinhibition is restored.

[0154] In an advantageous embodiment, it can be provided that a magnetoimpedance tomography method is carried out by means of the magnetic coil and at least one further magnetic coil and that an impedance of a material of the body is determined by means of the magnetoimpedance tomography method.

[0155] Alternatively or additionally, it can be provided that an electrical impedance tomography method is carried out by means of the electrode and a further electrode and that an impedance of a material of the body is determined by means of the electrical impedance tomography method

[0156] Thus, additional diagnostics, particularly imaging ones, can be performed within the scope of the procedure. In addition, the location of a nerve can be determined from the determined impedance.

[0157] It can therefore provide information about the location of a

[0158] Nerve and used in calculations of the manipulation field and / or the signals used to generate the

[0159] The manipulation field requires the control of the magnetic coil and / or the electrode.

[0160] Alternatively or additionally, it can be provided that a state of neuroinhibition is determined from the determined impedance and, depending on the determined state, the manipulation field is changed and / or a valve and / or a pump is controlled.

[0161] Thus, the method can realize the advantages of an analog arrangement with regard to monitoring the state of neuroinhibition and, in particular, automatic intervention.

[0162] In an advantageous embodiment, it can be provided that a neuroinhibition or the state of a neuroinhibition is monitored and that, depending on the monitored state, the manipulation field is changed and / or a valve and / or a pump is controlled.

[0163] Thus, the method can realize the advantages of an analog arrangement with regard to monitoring the state of neuroinhibition and, in particular, automatic intervention.

[0164] In an advantageous embodiment, it can be provided that the activity and / or the change in the activity of a nerve which is subject to the spatially selective change in nerve activity in the target volume and / or a tissue property of the patient's body is measured, preferably at a distance from the target volume, and that depending on the determined activity and / or change in the activity and / or the tissue property, the magnetic coil and / or the electrode are controlled in order to change the manipulation field.

[0165] Thus, the method can realize the advantages of an analog arrangement with regard to monitoring the state of neuroinhibition and, in particular, automatic intervention.

[0166] Alternatively or additionally, the features of the independent claim directed to a measuring method are provided according to the invention to achieve the stated object. In particular, to achieve the stated object, in measuring methods of the type described above, the invention proposes that a method according to the invention be applied and that a response behavior of the body be measured.

[0167] The body's response can be understood, in particular, as a change in nerve activity and / or a change in a neurologically measurable parameter, such as a second nerve conduction. Thus, the method can be used, for example, for diagnosis. It may be necessary for the user to independently derive the diagnosis from the measured response, particularly with the aid of additional data. It is also possible to verify the result of a method used as part of a therapy directly during the therapy.

[0168] Furthermore, in an arrangement according to the invention, it is proposed that the magnetic coil and the electrode be arranged and configured, and the control unit be configured, in such a way that a method according to the invention can be carried out with them. Thus, the described advantages of methods according to the invention can be utilized with arrangements according to the invention.

[0169] The invention will now be described in more detail with reference to exemplary embodiments, but is not limited to the exemplary embodiments. Further exemplary embodiments result from combining the features of one or more claims with one another and / or with one or more features of the exemplary embodiments.

[0170] It shows :

[0171] Fig. 1 is a schematic representation of an arrangement according to the invention,

[0172] Fig. 2 is a schematic representation of a further arrangement according to the invention,

[0173] Fig. 3 is a schematic representation of a further arrangement according to the invention,

[0174] Fig. 4 is a schematic representation of a further arrangement according to the invention,

[0175] Fig. 5 is a schematic representation of a further arrangement according to the invention,

[0176] Fig. 6 is a schematic representation of a further arrangement according to the invention,

[0177] Fig. 7 is a schematic representation of a further arrangement according to the invention,

[0178] Fig. 8 is a schematic representation of a further arrangement according to the invention,

[0179] Fig. 9 is a schematic representation of a further arrangement according to the invention, Fig. 10 is a schematic representation of a further arrangement according to the invention,

[0180] Fig. 11 is a schematic representation of a further arrangement according to the invention,

[0181] Fig. 12 is a schematic representation of another arrangement according to the invention,

[0182] Fig. 13 schematic representations of magnetic coils which can be used in an arrangement according to the invention,

[0183] Fig. 14 schematic representations of possible arrangements of magnetic coils in an arrangement according to the invention

[0184] Fig. 15 is a schematic representation of an electrode which can be used in an arrangement according to the invention,

[0185] Fig. 16 is a schematic representation of a possible arrangement of magnetic coils and electrodes in an arrangement according to the invention.

[0186] The figures show various exemplary embodiments of the invention. The exemplary embodiments are therefore described together. Components and functional units that are functionally and / or structurally similar or identical to the preceding exemplary embodiments are designated by the same reference numerals and are not described separately again.

[0187] Figure 1 shows an inventive embodiment of an arrangement 100 for the spatially selective modification of nerve activity in a target volume 103 by means of a spatially selectively generated electrical manipulation field. The modification of nerve activity can be a modification of the conduction properties of the nerve in question, in particular of one or more nerve pathways. This can, for example, involve suppression and / or inhibition and / or facilitation of a nerve conduction along the nerve pathways with a defined orientation. A nerve fiber 101 runs through the target volume 103. The target volume 103 can take on different shapes and sizes as required. Within the target volume 103, nerve activity is spatially selectively modified, for example that of nerve fiber 101.The arrangement 100 lies on a body 106 of a patient not shown in detail, namely on the surface 107 of the body 106 of the patient.

[0188] The arrangement 100 has a magnetic coil 121, an electrode 130 and a control unit 110 for generating the manipulation field. The arrangement 100 can have exactly one or more magnetic coils 121, for example in the form of one of the magnetic coils 121, 122, 123 shown in Fig. 13 and / or as one of the magnetic coil arrangements 120 shown in Fig. 14, and / or exactly one or more electrodes 130, for example in the form of the electrode 130 shown in Fig. 15. In the exemplary embodiment shown, the arrangement 100 has two electrodes 130, one of the electrodes 130 functioning as a ground electrode 131. This is therefore a ground electrode 131 that is separate from the one electrode 130.

[0189] The control unit 110 is configured to control the magnetic coil 121 and the electrodes 130 jointly, in a pulsed and synchronous manner, such that the respective electric fields generated by the magnetic coil 121 and the electrodes 130 in the target volume 103 are superimposed to form the manipulation field. The manipulation field brings about nerve inhibition in a predetermined inhibition region 104 of the target volume 103. This nerve inhibition is a neuroinhibition of the nerve fiber 101. A predetermined sub-region 105 of the manipulation field, which leaves the nerve activity unchanged and through which, for example, another nerve fiber 101 (not shown in detail) can run, is generated by compensating for the electric field generated by the magnetic coil 121 by means of the electric field generated by the electrodes 130.The electric field generated by the magnetic coil 121 can be at least partially compensated by the electric field generated by the electrodes 130.

[0190] The control unit 110 is configured to control the magnetic coil 121 and the electrodes 130 in such a way that the activity of a nerve, here in the form of the nerve fiber 101, located in a fixed orientation to the arrangement 100 and the target volume 103 can be spatially selectively changed.

[0191] The control unit 110 is further configured to adapt a field strength, a frequency and a waveform of the electric field generated by the electrodes 130 and the magnetic coil 121.

[0192] To generate the manipulation field, a plurality of electrodes 130 are provided, as already described. Instead of the magnetic coil 121, a plurality of magnetic coils 121 can be provided, as already described. Using these electrodes 130 and the magnetic coil 121, the orientation of the manipulation field along a nerve, here in the form of nerve fiber 101, can be spatially selectively adjusted.

[0193] The arrangement 100 also includes a data memory (not shown in detail) which is here integrated into the control unit 110. The data memory can also be designed separately. A location-dependent target activity map for the target volume 103 is stored in the data memory. The control unit 110 is configured to control the magnetic coil 121 and the electrodes 130 such that the nerve activity changed by the manipulation field replicates the target activity map. The arrangement 100 also includes a further data memory (not shown in detail) which is also integrated into the control unit 110 and which can also be designed separately and, in another embodiment, can be identical to the data memory described above. A location-dependent target field map for the target volume 103 is stored in this data memory.The control unit 110 is configured to control the magnetic coil 121 and the electrodes 130 such that the manipulation field replicates the target field map.

[0194] The control unit 110 further comprises a first control electronics unit (not shown in detail) for controlling the magnetic coil 121, a second control electronics unit for controlling the electrodes 130 and a controller with which the control signal generated by the control electronics unit can be modified.

[0195] The control unit 110 is configured to apply a direct field by means of the electrodes 130 in a first period of time during a build-up of the manipulation field up to a desired electric field strength, and to apply an alternating field by means of the electrodes 130 in a second period of time during which neuroinhibition occurs.

[0196] The magnetic coil 121 and the electrodes 130 each have the same lateral distance from the target volume 103. This can be the lateral distance from a center point and / or a central axis of the target volume 103.

[0197] The embodiment shown in Figure 2 differs from the preceding embodiment at least in that, instead of a single magnetic coil 121, a magnetic coil arrangement 120 is provided, which consists of several magnetic coils 121. Furthermore, the arrangement 100 is spaced from the surface 107 of the body 106 of the patient (not shown in detail).

[0198] The embodiment shown in Figure 3 differs from the preceding embodiment at least in that an external control input 111 is provided for control unit 110. Control instructions can be transmitted to control unit 110 via external control input 111.

[0199] The embodiment shown in Figure 4 differs from the preceding embodiment at least in that the magnetic coil arrangement 120 maintains a greater distance from the target volume 103 than the electrodes 130. In other words, the distance between the electrodes 130 and the target volume 103 is smaller than the distance between the magnetic coil 121, here as part of the magnetic coil arrangement 120, and the target volume 103.

[0200] The embodiment shown in Figure 5 differs from the preceding embodiment at least in that a base body 151 of the arrangement 100 comprises the control unit 110, one of the electrodes 130 and the magnetic coil arrangement 120. The base body 151 is grounded via an earth 134. Furthermore, a further electrode 130 of the arrangement 100 is provided as a ground electrode 131 and is grounded via a further earth 134. Therefore, a ground electrode 131 separate from the electrode 130 is provided, wherein this ground electrode 131 is arranged at a distance from a base body 151 of the arrangement 100, which determines the position of the magnetic coil 121, here as part of the magnetic coil arrangement 120, and of the electrode 130.

[0201] The embodiment shown in Figure 6 differs from the preceding embodiment at least in that, instead of a nerve fiber 101, a nerve tissue 102 of the central nervous system runs through the target volume 103, the nerve activity of which is spatially selectively altered. The embodiment shown in Figure 7 differs from the preceding embodiment at least in that a signal from a nerve, here in the form of the nerve fiber 101, can be derived by means of the electrodes 130. This is made clear by the direction of the arrows. The control unit 110 is configured to control the magnetic coil 121, here as part of the magnetic coil arrangement 120, and the electrodes 130 as a function of the signal from the nerve, here in the form of the nerve fiber 101.

[0202] The embodiment shown in Figure 8 differs from the preceding embodiment at least in that the control unit 110 has an output 142 for a signal from the control unit 110.

[0203] The embodiment shown in Figure 9 differs from the preceding embodiment at least in that the control unit 110 has an input 143 for a signal from a sensor 140, wherein the sensor 140 can be applied to a body 106, namely its surface 107, of a patient, and wherein the control unit 110 is configured to control the magnetic coil 121, here as part of the magnetic coil arrangement 120, and the electrodes 130 depending on the signal from the sensor.

[0204] The embodiment shown in Figure 10 differs from the preceding embodiment at least in that the arrangement 100 has a heating and cooling element 141 which can be controlled by the control unit 110 and applied to the body 106, namely its surface 107, of the patient, in order to change the nerve activity in the target volume 103. The heating and cooling element 141 influences the target volume 103 via heat conduction through the body 106 of the patient 107. The heating and cooling element 141 can be flexibly positioned depending on requirements. The embodiment shown in Figure 11 differs from the preceding embodiment at least in that the arrangement 100 has a carrier 150 to which the magnetic coil 121, here as part of the magnetic coil arrangement 120, and the electrodes 130 are attached, wherein the carrier 150 is a cuff and is flat and flexible.In an embodiment not shown, the carrier 150 can be designed as an implant.

[0205] The embodiment shown in Figure 12 differs from the preceding embodiment at least in that no carrier 150 is provided, but rather the electrodes and the magnetic coils 121 of the magnetic coil arrangement 120 are designed separately and can be applied individually.In this exemplary embodiment, a test electrode 135 which can be applied to the surface 107 of the patient's body 106 is also arranged, by means of which test electrode 135 a test signal is applied to the nerve, here in the form of the nerve fiber 101, in a first section 137, and wherein a further electrode 136 attached to the patient's body 106 measures a response signal in a second section 138 of the nerve, here in the form of the nerve fiber 101, which is separated from the first section 137 by the electrodes 130 which are involved in generating the manipulation field, wherein the response signal is automatically evaluated and a control signal of the magnetic coil 121, here as part of the magnetic coil arrangement 120, is changed depending on an evaluation result.

[0206] In addition, a magnetoimpedance tomography method can be carried out using the magnetic coil 121 and a further magnetic coil 121, each here as part of the magnetic coil arrangement 120, and an electrical impedance tomography method can be carried out using the electrode 130 and a further electrode 130. The impedance of a material of the body 106 is determined using the magnetoimpedance tomography method and the electrical impedance tomography method. The location of a nerve, here in the form of the nerve fiber 101, is determined from the determined impedance. A state of neuroinhibition is determined from the determined impedance, and depending on the determined state, the manipulation field is changed and / or a valve (not shown in detail) is controlled.

[0207] Figure 13 shows a schematic representation of a selection of possible basic shapes for the magnetic coil 121. The magnetic coil 121 can therefore have a cylindrical, helical, and / or spiral basic shape. A spiral-shaped magnetic coil 122 and a helical magnetic coil 123 are shown.

[0208] Figure 14 shows a schematic representation of possible arrangements of the magnetic coils 122, 123 from Figure 13 in a respective magnetic coil arrangement 120. In this case, several identical magnetic coils 122, 123 are arranged such that they maintain defined distances and positions from one another. In this case, the distance between one magnetic coil 122, 123 and the next magnetic coil 122, 123 is smaller than the diameter of the magnetic coil 122, 123.

[0209] Figure 15 shows a schematic representation of a possible embodiment of the electrode 130. This electrode 130 can also be used as a grounding electrode 131. The illustrated electrode 130 has a centrally located electrical connection 132. The illustrated electrode 130 also has slot-shaped recesses 133 to prevent eddy currents.

[0210] Figure 16 shows a schematic representation of a possible magnetic coil arrangement 120, which consists of spiral-shaped magnetic coils 121, 122 and is interspersed with electrodes 130. The electrodes 130 are smaller than the magnetic coils 121, 122. Similar to what is shown in Figure 14, several identical magnetic coils 121, 122 are arranged such that they maintain defined distances and positions from one another. In this case, the distance between one magnetic coil 121, 122 and the next magnetic coil 121, 122 is smaller than the diameter of the magnetic coil 121, 122. In addition, a plurality of similar electrodes 130 are arranged in such a way that they maintain defined distances and positions from one another, wherein a distance from one electrode 130 to a next electrode 130 is greater than a diameter, even greater than twice the diameter of the electrode 130.

[0211] With the illustrated arrangements 100, a method according to the invention for spatially selectively changing nerve activity in a target volume 103 by means of a spatially selectively generated electrical manipulation field can be carried out, wherein the manipulation field is generated by means of a magnetic coil 121 and an electrode 130. The manipulation field can be generated by a plurality of magnetic coils 121, for example in a magnetic coil arrangement 120 and a plurality of electrodes 130. The aspects described as advantageous embodiments of the method can be carried out with at least one of the illustrated arrangements 100.

[0212] Here, the change in nerve activity is a change in the conduction properties and / or is attributable to these. In particular, the change in nerve activity is a stimulation, inhibition, or facilitation of a nerve's conduction, particularly along nerve pathways with a defined orientation. This can also generally refer to neuroinhibition.

[0213] In the method, the magnetic coil 121 and the electrodes 130 are pulsed by a control unit 110 and synchronously controlled at a time interval. In the method, the magnetic coil 121 and the electrodes 130 are controlled in such a way that a deviation of the manipulation field and the electric field strength of the manipulation field from a predetermined target field and from a predetermined electric target field strength is minimized, wherein the target field and the target field strength are only predetermined in a partial volume of the target volume 103.

[0214] In the method, the nerve activity of several nerves located in the target volume 103, here in the form of the nerve fiber 101 shown, located in the inhibition region 104, and a further nerve fiber, not shown in more detail, located in the partial region 105 that leaves the nerve activity unchanged, is selectively changed, wherein the nerve activity of the nerves, here in the form of the aforementioned nerve fibers 101, is changed in different ways.

[0215] In the method, an electric field is generated in the target volume 103 by means of the magnetic coil 121, which electric field is completely or at least partially compensated in at least one partial volume of the target volume 103, which corresponds to the partial area 105 leaving the nerve activity unchanged, by an electric field generated by the electrodes 130.

[0216] In the method, the manipulation field in an inner sub-volume, which corresponds to the inhibition region 104, of the target volume 103 has a higher electric field strength than in an outer sub-volume, which corresponds to the sub-region 105 of the target volume 103 that leaves the nerve activity unchanged. The outer sub-volume can completely surround the inner sub-volume at least in two dimensions. The manipulation field in the inner sub-volume of the target volume 103 has an electric field strength of more than 50 V / m, even more than 100 V / m. In the method, in a first period of time, while the manipulation field is being built up to a desired electric field strength, a direct field is applied by means of the electrodes 130, and in a second period of time, in which neuroinhibition occurs, an alternating field is applied by means of the electrodes 130.

[0217] In the method, the nerve activity and / or conduction properties of nerve pathways in the target volume 103 are modified, in particular coordinated with the properties of the manipulation field, by means of a heating element and / or cooling element that can be controlled by the control unit 110 and preferably applied to a patient's body 106. For example, a heat stimulus can be delivered to a nerve, in particular a nerve pathway, in the target volume 103 before, during, and / or after the application of the manipulation field.

[0218] In the method, a test electrode 135 is arranged on the surface 107 of a patient's body 106 at a distance from the electrode 130, by means of which test electrode 135 a test signal is applied to the nerve whose activity is spatially selectively changed, in this case the nerve fiber 101, in a first section 137. Furthermore, a further electrode 136 attached to the patient's body 106 is used to measure a response signal in a second section 136 of the nerve, in this case the nerve fiber 101, which is separated from the first section 137 by the electrodes 130, wherein the response signal is automatically evaluated and a control signal of the magnetic coil 121, in this case the magnetic coil arrangement 120, is changed depending on an evaluation result.

[0219] In the method, a magnetoimpedance tomography method is carried out by means of the magnetic coil 121 and at least one further magnetic coil 121, here in each case the magnetic coil arrangement 120, and an electrical impedance tomography method is carried out by means of the electrode 130 and a further electrode 130. Furthermore, an impedance of a material of the body 106 is determined by means of the magnetoimpedance tomography method and the electrical impedance tomography method. In this case, a location of a nerve, here the nerve fiber 101, is determined from the determined impedance. Furthermore, a state of neuroinhibition is determined from the determined impedance and, depending on the determined state, the manipulation field is changed and a valve (not shown in detail) is controlled.

[0220] In the method, a neuroinhibition or the state of a neuroinhibition is monitored, and the manipulation field is changed depending on the monitored state. It is also possible that a valve and / or a pump (not shown in detail) are controlled depending on the monitored state.

[0221] In the method, the activity and the change in the activity of a nerve which is subject to the spatially selective change in the nerve activity in the target volume 103, here the nerve fiber 101, and a tissue property of the body 106 of the patient at a distance from the target volume 103 are measured and, depending on the determined activity and the determined change in the activity and the determined tissue property, the magnetic coil 121, here as part of the magnetic coil arrangement 120, and the electrode 130 are controlled in order to change the manipulation field.

[0222] Furthermore, a measuring method according to the invention can be carried out with the arrangement 100 of at least one exemplary embodiment, wherein a method according to the invention is applied and a response behavior of the body is measured.

[0223] In the arrangement 100 s shown in at least one exemplary embodiment, the magnetic coil 121, for example as part of the magnetic coil arrangement 120, and the electrode 130 are arranged and designed and the control unit 110 is set up in such a way that a method or measuring method according to the invention can be carried out with them.

[0224] Thus, an arrangement 100 for spatially selectively modifying nerve activity in a target volume 103 by means of a spatially selectively generated electrical manipulation field is proposed. The arrangement 100 for generating the manipulation field comprises a magnetic coil 121, 122, 123, an electrode 130, and a control unit 110. Furthermore, a corresponding method and a measurement method are proposed.

[0225] List of reference symbols

[0226] 100 arrangement

[0227] 101 nerve fibers

[0228] 102 Nerve tissue

[0229] 103 Target volume

[0230] 104 Inhibition area

[0231] 105 part of the nerve activity that leaves unchanged

[0232] 106 bodies

[0233] 107 Surface

[0234] 110 Control unit

[0235] 111 external control input

[0236] 120 magnetic coil arrangement

[0237] 121 Solenoid coil

[0238] 122 spiral magnetic coil

[0239] 123 helical magnetic coil

[0240] 130 Electrode

[0241] 131 Earthing electrode

[0242] 132 electrical connection

[0243] 133 Recess

[0244] 134 Grounding

[0245] 135 Test electrode

[0246] 136 Electrode

[0247] 137 first section

[0248] 138 second section

[0249] 140 sensors

[0250] 141 Heating and cooling element

[0251] 142 Exit

[0252] 143 Entrance

[0253] 150 carriers

[0254] 151 basic bodies

Claims

Claims 1. Arrangement (100) for spatially selectively changing a nerve activity in a target volume (103) by means of a spatially selectively generateable electrical manipulation field, characterized in that the arrangement (100) for generating the manipulation field has a magnetic coil (121, 122, 123), an electrode (130) and a control unit (110).

2. Arrangement (100) according to the preceding claim, characterized in that the change in nerve activity is a change in the conduction properties of nerve fibers, in particular directed nerve pathways, preferably a suppression of the conduction of nerve signals and / or in a defined effective range, and / or is caused by such a change.

3. Arrangement (100) according to one of the preceding claims, characterized in that the control unit (110) is designed to control the magnetic coil (121, 122, 123) and the electrode (130) together, preferably in a pulsed and / or synchronous manner, such that respective electric fields generated by the magnetic coil (121, 122, 123) and the electrode (130) are superimposed in the target volume (103) to form the manipulation field.

4. Arrangement (100) according to one of the preceding claims, characterized in that the manipulation field has a higher frequency than the maximum discharge frequency of nerves whose activity is changed, in particular of the directed nerve pathways, in the target volume (103) and / or brings about nerve inhibition in a predetermined inhibition region (104) of the target volume (103).

5. Arrangement (100) according to one of the preceding claims, characterized in that a predetermined partial area (105) of the manipulation field, which leaves the nerve activity, in particular the conduction properties of nerve pathways, unchanged, is generated by compensating the electric field generated by the magnetic coil (121, 122, 123), in particular with regard to its spatial and / or temporal course, its amplitude and / or orientation along nerve pathways, by means of the electric field generated by the electrode (130).

6. Arrangement (100) according to one of the preceding claims, characterized in that the electric field generated by the magnetic coil (121, 122, 123) can be at least partially compensated by the electric field generated by the electrode (130), in particular with regard to amplitude, distribution pattern and orientation.

7. Arrangement (100) according to one of the preceding claims, characterized in that the control unit (110) is configured to control the magnetic coil (121, 122, 123) and the electrode (130) in such a way that the activity and / or conduction properties of a nerve / nerve pathway located in a fixed orientation to the arrangement (100) and / or the target volume (103) can be spatially selectively changed.

8. Arrangement (100) according to one of the preceding claims, characterized in that the control unit (110) is configured to adapt a field strength, a frequency and / or a waveform of the electric field generated by the electrode (130) and / or by the magnetic coil (121, 122, 123).

9. Arrangement (100) according to one of the preceding claims, characterized in that for generating the Manipulation field is formed with a plurality of electrodes (130, 131) and / or magnetic coils (121, 122, 123), in particular with which an orientation of the manipulation field, in particular along a nerve and / or a nerve tract, can be spatially selectively adjusted.

10. Arrangement (100) according to one of the preceding claims, characterized in that a data memory is formed in which a location-dependent target activity map is stored for the target volume (103), and in that the control unit (110) is configured to control the magnetic coil (121, 122, 123) and the electrode (130) in such a way that the nerve activity changed by the manipulation field replicates the target activity map.

11. Arrangement (100) according to one of the preceding claims, characterized in that a data memory is formed in which a location-dependent target field map is stored for the target volume (103) and that the control unit (110) is set up to control the magnetic coil (121, 122, 123) and the electrode (130) in such a way that the manipulation field simulates the target field map, in particular with regard to local distribution, amplitude, spatial orientation and / or a suitability for changing the nerve activity and / or conduction properties.

12. Arrangement (100) according to one of the preceding claims, characterized in that the control unit (110) has a first control electronics for controlling the magnetic coil (121, 122, 123), a second control electronics for controlling the electrode (130) and a controller with which the control signal generated by the control electronics is modified, in particular in its temporal sequence coordinated.

13. Arrangement (100) according to one of the preceding claims, characterized in that the control unit (110) is configured such that in a first period of time, in particular during a build-up of the manipulation field up to a desired electrical field strength, a direct field is applied by means of the electrode (130) and in a second period of time, preferably in which neuroinhibition takes place, an alternating field is applied by means of the electrode (130).

14. Arrangement (100) according to one of the preceding claims, characterized in that the arrangement (100) has a carrier (150) to which the magnetic coil (121, 122, 123) and / or the electrode (130) is fastened, in particular wherein the carrier (150) is a cuff and / or is flat and / or flexible and / or is designed as an implant.

15. Arrangement (100) according to one of the preceding claims, characterized in that a distance between the electrode (130) and the target volume (103) is smaller than a distance between the magnetic coil (121, 122, 123) and the target volume (103).

16. Arrangement (100) according to one of the preceding claims, characterized in that the magnetic coil (121, 122, 123) and the electrode (130) each have an equal, preferably lateral, distance from the target volume (103), in particular from a center point and / or a center axis of the target volume (103).

17. Arrangement (100) according to one of the preceding claims, characterized in that a to the electrode (130) separate grounding electrode (131) is provided, in particular wherein this grounding electrode (131) is arranged at a distance from the or a base body (151) of the arrangement which determines the position of the magnetic coil (121, 122, 123) and / or the electrode (130).

18. Arrangement (100) according to one of the preceding claims, characterized in that a signal of a nerve can be derived by means of the electrode (130), in particular wherein the control unit (110) is designed to control the magnetic coil (121, 122, 123) and the electrode (130) depending on the signal of the nerve.

19. Arrangement (100) according to one of the preceding claims, characterized in that the control unit (110) has an input (143) for a signal from a sensor (140) and / or an output (142) for a signal from the control unit (110), in particular wherein the sensor (140) can be applied to a body (106) of a patient and / or wherein the control unit (110) is configured to control the magnetic coil (121, 122, 123) and / or the electrode (130) as a function of the signal from the sensor (140), in particular with regard to parameters of the manipulation field as a superposition of the electrical fields generated in the target volume (103) by the magnetic coil (121, 122, 123) and the electrode (130).

20. Arrangement (100) according to one of the preceding claims, characterized in that the arrangement (100) has a heating element and / or cooling element which can be controlled by the control unit (110) and can preferably be applied to a body (106) of a patient, for changing the nerve activity and / or the conduction properties of nerve pathways in the target volume (103), in particular matched to the properties of the manipulation field.

21. Arrangement (100) according to one of the preceding claims, characterized in that the magnetic coil (121, 122, 123) has a cylindrical, helical and / or spiral basic shape and / or that the electrode (130) has recesses (133), in particular slots, to avoid eddy currents.

22. Arrangement (100) according to one of the preceding claims, characterized in that a plurality of preferably similar magnetic coils (121, 122, 123) and / or a plurality of preferably similar electrodes (130, 131) are arranged such that they maintain defined distances and / or positions from one another, in particular wherein a distance of a magnetic coil (121, 122, 123) to a next magnetic coil (121, 122, 123) is smaller than a diameter of the magnetic coil (121, 122, 123) and / or wherein a distance of an electrode (130, 131) to a next electrode (130, 131) is greater than a diameter, preferably greater than twice a diameter, of the electrode (130, 131).

23. Arrangement (100) according to one of the preceding claims, characterized in that a test electrode (135) is arranged which can be applied to a surface (107) of a body (106) of a patient, by means of which test electrode a test signal is applied to the nerve, the activity and / or conduction properties of which are / are spatially selectively changed, in a first section (137), and wherein a response signal is measured with a further electrode (136) attached to the body (106) of the patient in a second section (138) of the nerve, separated from the first section (137) by the electrode (130), in particular wherein the response signal is automatically evaluated and, depending on an evaluation result, a control signal of the magnetic coil (121, 122, 123) and / or the electrode is changed, in particular in order to specifically adapt parameters of the manipulation field.

24. Arrangement (100) according to one of the preceding claims, characterized in that a magnetoimpedance tomography method can be carried out by means of the magnetic coil (121, 122, 123) and a further magnetic coil (121, 122, 123) and / or an electrical impedance tomography method can be carried out by means of the electrode (130) and a further electrode (130, 131), and in that an impedance of a material of the body (106) is determined by means of the magnetoimpedance tomography method and / or the electrical impedance tomography method, in particular wherein a location of a nerve is determined from the determined impedance or wherein a state of neuroinhibition is determined from the determined impedance, and the manipulation field is changed and / or a valve is controlled depending on the determined state.

25. A method for spatially selectively changing nerve activity in a target volume (103) by means of a spatially selectively generateable electrical manipulation field, characterized in that the manipulation field is generated by means of a magnetic coil (121, 122, 123) and an electrode (130).

26. Method according to the preceding claim, characterized in that the change in nerve activity is a change in the conduction properties of nerve fibers, in particular of directed nerve pathways, preferably a suppression of a conduction of nerve signals and / or in a defined effective area, and / or is caused by such a change.

27. Method according to one of the preceding method claims, characterized in that the change in nerve activity is a stimulation or inhibition of a stimulus transmission of a nerve, nerve cell body, network of nerve cells and / or a neuroinhibition.

28. Method according to one of the preceding method claims, characterized in that the manipulation field has a higher frequency than the maximum discharge frequency of nerves whose activity is changed, in particular of directed nerve pathways, in the target volume (103).

29. Method according to one of the preceding method claims, characterized in that the magnetic coil (121, 122, 123) and / or the electrode (130) are controlled by a control unit (110), preferably in a pulsed manner and / or synchronously in a time interval.

30. Method according to one of the preceding method claims, characterized in that the magnetic coil (121, 122, 123) and / or the electrode (130) are controlled in such a way that a deviation of the manipulation field and / or the electric field strength of the manipulation field from a predetermined target field and / or from a predetermined electric target field strength is minimized, in particular wherein the target field and / or the target field strength is predetermined only in a partial volume of the target volume (103).

31. Method according to one of the preceding method claims, characterized in that the nerve activity of a plurality of nerves located in the target volume (103) is selectively changed, in particular wherein the nerve activity of the nerves is changed in different ways.

32. Method according to one of the preceding method claims, characterized in that an electric field is generated in the target volume (103) by means of the magnetic coil (121, 122, 123), which electric field is completely or at least partially compensated in at least a partial volume of the target volume (103) by an electric field generated by the electrode (130).

33. Method according to one of the preceding method claims, characterized in that the manipulation field has a higher electric field strength in an inner partial volume of the target volume (103) than in an outer partial volume of the target volume (103), in particular wherein the outer partial volume completely surrounds the inner partial volume at least in two dimensions.

34. Method according to one of the preceding method claims, characterized in that the manipulation field in one or the inner partial volume of the target volume (103) has an electric field strength of more than 50 V / m, in particular more than 100 V / m.

35. Method according to one of the preceding method claims, characterized in that in a first period of time, in particular during a build-up of the manipulation field up to a desired electric field strength, a direct field is applied by means of the electrode (130) and in a second period of time, preferably in which neuroinhibition takes place, an alternating field is applied by means of the electrode (130).

36. Method according to one of the preceding method claims, characterized in that by means of a heating element which can be controlled by the control unit (110) and can preferably be applied to a body (106) of a patient and / or cooling element, the nerve activity and / or conduction properties of nerve pathways in the target volume (103) are changed, in particular in a manner adapted to the properties of the manipulation field.

37. Method according to one of the preceding method claims, characterized in that a test electrode (135) is arranged on the surface (107) of a body (106) of a patient, preferably arranged at a distance from the electrode (130), by means of which test electrode a test signal is applied to the nerve, the activity of which is spatially selectively changed, in a first section (137), and in that a response signal is measured with a further electrode (130) attached to the body (106) of the patient in a second section (138) of the nerve, separated from the first section (137) by the electrode (130), in particular wherein the response signal is automatically evaluated and a control signal of the magnetic coil (121, 122, 123) is changed depending on an evaluation result.

38. Method according to one of the preceding method claims, characterized in that by means of the magnetic coil (121, 122, 123) and at least one further magnetic coil (121, 122, 123) a magnetoimpedance tomography method and / or by means of the electrode (130) and a further electrode (130, 131) an electrical impedance tomography method is carried out and that by means of the magnetoimpedance tomography method and / or the electrical impedance tomography method an impedance of a material of the body (106) is determined, in particular wherein a location of a nerve is determined from the determined impedance or wherein a state of neuroinhibition is determined from the determined impedance and depending on the determined state the Manipulation field is changed and / or a valve is controlled.

39. Method according to one of the preceding method claims, characterized in that one or the state of a neuroinhibition is monitored and wherein, depending on the monitored state, the manipulation field is changed and / or a valve and / or a pump is controlled.

40. Method according to one of the preceding method claims, characterized in that the activity and / or the change in the activity of a nerve which is subject to the spatially selective change in the nerve activity in the target volume (103) and / or a tissue property of the patient's body is measured, preferably at a distance from the target volume (103), and that depending on the determined activity and / or change in the activity and / or the tissue property, the magnetic coil (121, 122, 123) and / or the electrode (130) are controlled to change the manipulation field.

41. A measuring method, wherein a method according to any one of claims 25 to 40 is applied and wherein a response behavior of the body (106) is measured.

42. Arrangement (100) according to one of claims 1 to 24, wherein the magnetic coil (121, 122, 123) and the electrode (130) are arranged and designed and the control unit (110) is set up so that a method according to one of claims 25 to 40 can be carried out with them.

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