This invention is directed to electrophysiological testing and, more particularly, to a device that facilitates physical and electrical connection of one or more electrophysiological testing wires.
A multitude of electrophysiological tests are currently available for medical professionals to perform on subjects in order to analyze the electrical processes of the body, including, but not limited to, electroencephalography (EEG), electromyography (EMG), nerve conduction studies (NCS), evoked potentials (EP), transcutaneous electrical nerve stimulation (TENS), Holter monitoring, and electrocardiography (ECG/EKG). Such electrophysiological tests are currently performed via a multitude of expensive, bulky, time consuming devices with limited mobility. This time consumption and limited mobility hinders the medical professional's ability to perform such electrophysiological tests quickly, or in a multitude of locations and on a variety of subjects, including, but not limited to, non-ambulatory subjects. Medical professionals must either own or otherwise have access to a variety of testing devices, all of which must be maintained. In addition, there are a variety of tests which could provide more comprehensive results if performed over a length of time or at a location that is infeasible for the medical professional to accommodate due to limited availability of exam room space or the physical presence of the medical professional. For example, a subject who may be experiencing intermittent seizure activity may not manifest said seizure activity during a standard test performed in the office of a medical professional, and a lengthy, portable, recorded test would offer higher testing yield. An example for the need of expedited test performance would be a critical subject with a head injury that may be suffering from prolonged seizures. The current expensive, bulky equipment is unable to be stored in areas that are easily accessible in critical care scenarios. A smaller, more portable unit with time saving setup procedures and on demand viewing potential would allow for expedited test setup and performance times, which could dramatically improve the quality of care in a critical care scenario.
A system must be provided which will allow a medical professional to perform electrophysiological testing faster and in a variety of locations without the inconvenience or risk involved with transporting expensive, bulky devices or without extensive and timely setup procedures. This system should allow the medical professional to perform a multitude of electrophysiological tests with one small, portable, time efficient, affordable device. This system should also make the results of the electrophysiological tests available to medical professional in a multitude of locations and in real time.
One object of the present disclosure is to provide a portable apparatus for receiving and processing electrophysiological signals from a patient related to a plurality of different electrophysiological tests.
One embodiment relates to an apparatus for use in association with a portable computing device in performing a plurality of different electrophysiological tests on a patient. The apparatus may include a body including a receiver for connecting to and receiving at least a portion of the portable computing device, and a controller for receiving a plurality of electrophysiological signals from the patient and for processing and transferring said electrophysiological signals to the portable computing device. The body may further include a central shell with at least one opening for allowing access to a keyboard or touch interface of the portable computing device when the portable computing device is received by and connected to said body. In addition, the apparatus may include means for accessing at least one tactile button on the portable computing device. For example, the means may comprise an aperture in the body for directly accessing the tactile button, or an actuatable portion of the body for actuating the tactile button.
In one aspect, the body may include a first portion on a first side of the central shell and a second portion on a second side of the central shell, wherein the first portion includes the controller. Each of the first and second portions may include a recessed grip adapted to allow a user to hold the body and the portable computing device.
In another aspect, the controller may be adapted to be powered by the portable computing device.
The apparatus may include a connector port adapted to receive the plurality of electrophysiological signals from the patient via a plurality of different configurations of electrodes and further adapted to transmit said signals to the controller for processing. The body may further include at least one port for direct electrical communication with an input port associated with the portable computing device.
Another object of the present disclosure is to provide an apparatus for use in connecting wires or other electrophysiological signal transmitters to a patient's head in specific locations for use in an electrophysiological test associated with the head.
One embodiment relates to an apparatus for use in locating and attaching electrophysiological signal transmitters to a head of a patient, said electrophysiological signal transmitters adapted to receive electrophysiological signals from the patient and transmit said signals to a system for processing said signals. The apparatus may include a plurality of bands for positioning on the head of the patient, said bands adapted for linear proportionate elongation, and a plurality of connectors for connecting the electrophysiological signal transmitters to the plurality of bands and for maintaining contact between the transmitters and the head of the patient.
In one aspect, at least one of the plurality of connectors is adapted to connect a first of the plurality of bands to a second of the plurality of bands. In another aspect, at least one of the plurality of bands includes markings thereon for measuring a distance from a predetermined point.
The plurality of bands may comprise a vertical band adapted for placement along a central portion of the head from front to back and a plurality of lateral bands adapted for placement over the head from side to side. The plurality of bands may further include a circumferential band adapted to substantially surround a circumference of the head. In addition, the apparatus may include a primary positioning element for attachment to and location of the plurality of bands, said primary positioning element including a nose support and Nasion location element. The primary positioning element may further include an Inion location element.
In one aspect, the vertical band and the plurality of lateral bands may form an integrated, unitary element.
In another aspect, the connectors may comprise a plurality of slots for slidably receiving at least one of the plurality of bands, and at least one receiver for receiving at least one of the electrophysiological signal transmitters. The connectors may further include at least two layers connected by a hinge, said hinge adapted for opening the at least two layers for placing at least one of the plurality of bands within at least one of the plurality of slots. In a further aspect, the connectors may include a controller for amplifying the electrophysiological signals and wirelessly transmitting said signals.
In another embodiment of the present invention, a method is disclosed for configuring one of a plurality of wiring harnesses attached to a patient, said wiring harnesses including a plurality of electrodes for use in conducting one of a plurality of different electrophysiological tests on the patient, each of said wiring harnesses including an internal code specific to one of the plurality of different tests. The method may include providing an electronic testing system adapted for connecting to each of the plurality of different wiring harnesses, said electronic testing system for receiving and processing electrophysiological signals from the patient. In addition, the method may include identifying a first of the wiring harnesses connected to the electronic testing system by a first internal code associated with the first wiring harness, and identifying a fist map of a plurality of electrode locations associated with conducting a first electrophysiological test with the first wiring harness, said first map accessible by the electronic testing system. Further, the method may include prompting a user to identify each of the plurality of electrodes of the first wiring harness corresponding to the electrode locations. The system may be adapted for receiving an input from the user identifying each of the plurality of electrodes of the first wiring harness, and mapping each of the plurality of electrodes of the first wiring harness to each of the electrode locations of the first map.
In the illustrated embodiment,
The device 10 may be adapted to connect with one or more wires used for performing a medical test, which may include electrophysiological test wires 22. For example, the left outrigger 16 may comprise various peripheral equipment ports 18 for the interaction between the device 10 and numerous proprietary peripheral equipment, as well as a connector port 20 that allows for the interaction between the device 10 and the electrophysiological test wires 22. The output signals from these wires may be delivered through circuitry in the left outrigger 16, and may be processed for display on a mobile computing device 26 (such as by direct connection 36, via wires, or wirelessly). As shown in
Any of these ports 18,20 may include one or more magnets 21 for maintaining contact between the test wires 22 and the port or ports 18, 20. As can be seen in the illustrated embodiment, any of the ports 18, 20 may include an asymmetrical configuration, at least along one axis, such that proper connection for communication between a head connector 23 and a port 18, 20 may occur only under a single orientation of the head connector.
With further reference to
The centralized shell 12 has a slot that allows the mobile computing device 26 to slide in and fit securely within the enclosure. In addition, the centralized shell 12 includes a window 28 which allows access to the keyboard and track pad of the mobile computing device 26 in order for the user to have full access to the mobile computing device 26 while secured in the centralized shell 12. On the topside of the right outrigger 14 is a cut out 30 that allows access to a plunge button 32 that may actuate the power on/off switch of the mobile computing device 26 to be controlled while the mobile computing device 26 is securely locked inside the centralized shell 12.
As can be seen in
With reference to
The system 50 may be plugged in and powered via a 110 V outlet, or may be unplugged and run on battery power from the mobile computing device 26. The power supply 52 may output a voltage (e.g. 20V DC) to the mobile computing device 26. In one aspect, the mobile computing device may be a Lenovo Thinkpad, and may run a software program, such as ElectroTek Control Software, wherein the software program may be adapted to store, display, and transmit data collected from the system 50. Communication between the mobile computing device 26 and the system 50 may be accomplished via a port, such as a USB 2.0 port (500 mA max). The custom hardware of the system 50 may be powered via the USB 2.0 port. In addition, communication between the system 50 and the software on the mobile computing device 26 may be accomplished over the USB 2.0 port.
In one embodiment, the system 50 may include a plurality of circuit boards, which may include a digital board, an analog board, and a connector board. The system 50 may include a USB 2.0 bridge 54, which may be adapted to function as a translator between the mobile computing device 26 and a master embedded controller 56 of the system. The USB 2.0 bridge 54 may run the entire USB 2.0 protocol stack and may contain an internal data buffer. This bridge 54 may further allow USB communication (including overhead) to occur in parallel with other activities of the master embedded controller 56. In addition, the bridge 54 may be adapted to power down the system 50 in the event that the mobile computing device 26 issues a USB Suspend command, which has special low power draw requirements via the PWREN signal.
An isolation barrier may be provided in the system as a means of providing Means of Patient Protection (MOPP). The isolation barrier may include a plurality of elements, and may include one or more of air gaps and creepage distances, solid insulation, and isolation hardware that may provide two times MOPP. In one aspect, the isolation barrier may include a transformer 60, such as a 1:1 isolation transformer, for powering the system 50. During normal operation (i.e. without the USB Suspend command), the bridge 54 may allow USB voltage (e.g. +5V DC) to flow through a transformer 60.
A power management block 62 may be provided for transforming, conditioning, regulating, and protecting all power for the rest of the system 50. This power is supplied through the transformer 60, and may convert USB bus voltage to the various voltages needed for the system. In one aspect, the power management block may include ferrite power filters, and various protection features, which may include fuses and/or over-current protection.
In another aspect of the isolation barrier 58, the bridge 54 may translate communication (such as USB communication) to an embedded system protocol, such as UART, which flows across the isolation barrier through an isolation driver 64. This protocol may allow for communication across the isolation barrier, which may take the form of magnetic, capacitive, optical coupling technology, or any other technology for communicating across the isolation barrier.
With further reference to the master embedded controller 56, this element may function as the “brain” or controller for the overall system 50. The master embedded controller 56 may comprise a microcontroller, a microprocessor, DSP, FPGA, CPLD or other programmable logic, a custom ASIC, or similar embedded device and associated hardware (which may include an oscillator and program memory. The master embedded controller 56 may be adapted to manage and/or coordinate all activities of the system, including data collection, synchronization, peripheral device communication, event marker detection, etc. In another aspect, the master embedded controller 56 may configure the analog to digital converters 66, 68. In a further aspect, the master embedded controller 56 may be adapted to manage and configure a slave embedded controller 70, which may in turn control secondary tasks such as controlling a multiplexor (MUX) circuit 80. Additionally, the master embedded controller 56 may encapsulate and/or transmit collected data to the computing device 26 via the USB bridge 54 using a custom protocol.
The system 50 may further include a non-volatile memory element 72, which may provide additional memory to be used by the master embedded controller 56 for configuration, data buffering, etc. This memory element 72 is non-volatile, such that it will remember data even when power is not supplied. The non-volatile memory element 72 may communicate with the master embedded controller 56 via an SPI bus.
With further reference to the slave embedded controller 70, this slave controller may comprise a microcontroller, a microprocessor, DSP, FPGA, CPLD, or other programmable logic, a custom ASIC, or similar embedded device and associated hardware, such as an oscillator or program memory. This slave embedded controller 70 may be adapted for addressing delegated activities, such as impedance circuit management, calibration circuit management, and MUX circuit management. The slave embedded controller 70 may communicate with the master embedded controller 56 via an SPI bus. In a further aspect of the present invention, the system 50 may include the USB bridge, the main controller, and slave controller, and or various combinations thereof into a single device.
In addition, the system 50 may include one or more analog to digital converters (ADCs) 66, 68. These analog to digital converters may be adapted to simultaneously sample data for a plurality of channels (e.g. up to 32 channels) at 24 but resolution. The ADCs 66, 68 may be capable of interfacing to both differential and single ended signals. In one aspect, the ADCs 66, 68 may convert analog signals into a digital form that can be read by the main embedded controller 56. In the case of a plurality of ADCs, there may be one master ADC 66, and one or more slave ADCs 68. The master ADC 66 may transmit a synchronization signal to the slave converters to ensure simultaneous sampling. One or more of the ADCs 66, 68 may communication to the main embedded controller 56 via SPI bus. In a further aspect the ADCs may include programmable gain amplifiers that can be configured by the main embedded controller 56 to amplify the signal with various gains. In another aspect, the ADCs may be capable of sampling at various data rates, as configured by the main controller.
In one embodiment, the bridge 54, the master embedded controller 56, the transistor 60, and power management block 62, the ADCs 66, 68, the slave embedded controller 70, and the non-volatile memory element 72 may be included on the digital board.
The system 50 may further include a MUX 80 and/or analog switches. The MUX 80 may comprise a programmable circuit capable of switching the calibration and impedance circuits into and out of various signal paths to test various combinations of sensors and amplifier circuits. In addition, an analog signal conditioning element 82 may be provided. This analog signal conditioning element 82 may comprise stages of analog circuitry adapted to condition bio-physiological signals for sampling by the ADCs 66, 68. The analog signal conditioning element 82 may include one or more buffers, amplifiers, low pass filters, high pass filters, or any other elements capable of manipulating analog signals.
An impedance measurement circuit 84 may be provided as well. This impedance measurement circuit 84 may comprise a voltage controlled current source (VCCS) that may inject a small amount of current into the body of a patient and into circuitry for the interpretation of the electrode/skin impedance of various sensor connections. The impedance measurement circuit 84 may utilize the MUX 80 to switch between sensor combinations.
In addition, a calibration circuit 86 may be provided for calibration purposes. Specifically, the calibration circuit 86 may be adapted to inject a small square wave signal into the front of the analog signal conditioning element 82 via the MUX 80 for the purpose of calibrating and testing all data acquisition hardware. The calibration circuit 86 may utilize the MUX 80 to switch between various analog circuits.
In another aspect of the system 50, an active neutral element 88 may be provided for inversion of a reference signal characteristic of the common mode voltage on the body that is output back to the body with a current limited output that increases the common mode rejection of the system by decreasing common mode noise.
In one embodiment, the MUX 80, the analog signal conditioning element 82, the impedance measurement circuit 84, the calibration circuit 86, and the active neutral element 88 may be provided on the analog board.
In a further aspect, the system 50 may include a patient connection 90, which may comprise a single connection which includes receivers for all applied part signals. One or more differential sensor inputs 92 (e.g. floating sensors) may also be provided in order to accommodate an expanded electrode set, such as additional EEG or EMG channels for a larger data set or artifact removal. Additionally, a cable code 94 may be provided, which may be adapted to identify the type of patient cable that is plugged into the system.
In addition, one or more peripheral connections 96 may be provided for communication between the master embedded controller 56 and one or more peripheral devices , which may include a photic stimulator and/or a handheld nerve stimulator (not pictured). In one aspect, the peripheral connection 96 may be magnetic in nature. An isolation driver 64, such as a UART interface, may be provided to allow for communication across the isolation barrier 58 between the master embedded controller 56 and the peripheral connection 96, such as via one or more control lines. In another aspect, the peripheral connection 96 may not power the peripheral device(s). In this aspect, the power isolation is only used for powering the isolated side of the isolated line driver.
In a further aspect of the system 50, an event marker connection 98 is provided. The event marker connection 98 may comprise a magnetic connection that interfaces to a hand held pendant switch (not shown) used as an event marker. The event marker may be a single pole single throw (SPST) switch that may also have an LED, powered from the isolation transformer. The event marker may be utilized to mark a specific point in time where an event may have occurred. Events may include seizures, artifact / noise or physiologic abnormalities.
In one embodiment, the patient connection 90, the differential sensor inputs 92, the cable code 94, the peripheral connections 96, and the event marker connection 98 may be provided on the connector board.
At various positions throughout the system 50, one or more electrostatic discharge (ESD) protection elements 99 may be provided to protect against ESD discharges, in order to prevent damage to internal circuitry, such as per IEC 60601 regulations.
As can be seen in
In the illustrated embodiment,
In one aspect, the primary alignment band 102 may include three main functional elements. The first is the nose support and Nasion (Nz) location module 104. This module may rest on and/or be formed around the bridge of the nose and may include of a soft, pliable element comprising a material such as, but not limited to, silicon, gel or foam. The nose support and Nasion (Nz) location module 104 may include a grommet insert on a backside (i.e. towards the bridge of the nose when worn) that allows for attachment of an alignment/support band or apparatus. The Nasion (Nz) is located between the eyes on the bridge of the nose. The nose support may establish the center point for the Nasion (Nz) location and allow an anchor point for the alignment band, which then helps guide the remainder of the band placements.
A second functional element of the primary alignment band 102 is the tension module and Inion (Iz) location device 106. This device allows the primary alignment band 102 to increase or decrease its circumference without removing the band from the head. In one aspect, the tension module and Inion (Iz) location device 106 may comprise a sliding adjustable clip with external characteristics including a plastic, rubber, foam or metal housing. For example, the sliding adjustable clip may include a dial crank for adjusting the relative position of each of two side elements associated with the tension module and Inion location device. In another aspect, the tension module and Inion (Iz) location device 106 may have a grommet insert, such as on the backside (i.e. towards the head when worn), that allows for the attachment of an alignment/support strap or apparatus. Once in place, the nose support and Nasion (Nz) location module 104 and the tension module and Inion (Iz) location device 106 may establish the primary locations (Nz & Iz) for an electroencephalograph (EEG) utilizing industry standard electrode placement systems.
A third functional element of the primary alignment band 102 is the presence of one or more sliding anchors 108, which may be located along the primary alignment band 102. These sliding anchors 108 allow for the attachment of alignment/support bands or apparatuses to the primary alignment band 102.
As illustrated in
The head apparatus 100 may further include a central vertical band 114, as shown in
As shown in
Any of the above bands and straps may intersect with one another and may be connected at their intersections by utilizing a connector 124 as described in further detail below and in
In an alternate embodiment, as illustrated in
The central and lateral band system 122 may comprise a pliable material with linear/proportionate stretching capabilities such as, but not limited to, silicon, elastic or polypropylene. The central and lateral band system 122 may include markings 112 for accurate measurement of the head, and said markings may be embedded in the bands. These markings may follow appropriate electrode spacing requirements for various standard electrode spacing systems such as, but not limited to, the International 10/20 system.
In addition, a vertical tab 126 may be provided on top of the connector 124. This vertical tab 126 may serve as a way to handle the connector and reposition it on a patient if necessary. The vertical tab 126 also serves as a way to close the connector on itself, such as by providing a point of leverage for articulating a hinge 134, as outlined below.
In addition, one or more horizontal slots 128 may be located on the sides of the connector 124. The horizontal slots 128 may be formed by articulating the three layers 125a, 125b, 125c, of the connector 124 to close on themselves. The various bands associated with the head apparatus 100 can pass through the horizontal slots 128, which allow the connector 124 to slide along the straps in order to get proper placement of the electrophysiological wires.
In another aspect of the connector 124, one or more receivers such as wire slots 130 may be located along the bottom of the connector 124. The wire slots 130 allow for various electrophysiological wires to move in and out of the connector 124, while the connector maintains a flat connection with the surface of the head. The wire slots 130 allow for an electrophysiological wire, which may be glued to the head, to slip in and out of the wire slot 130 without having to remove the straps or bands. In this way, the configuration and placement locations of the headgear may remain constant even in the event of wires being added or taken away.
In a further aspect of the connector 124 as illustrated in
The connector 124 may also be provided with one or more snap connections 136. The snap connection 136 may assist in securing two of the three layers 125a, 125b, 125c, with respect to one another. In the illustrated embodiment, the snap connection 136 may include a folding flap associated with a first layer 125a, which may at least partially overlap a portion of the second layer 125b, thereby securing the first layer 125a to the second layer 125b. Similarly, a second snap connection 136 may be provided for securing the second layer 125b to the third layer 125c.
As can be more clearly seen in
The connector 124 may additionally include a controller and/or other internal electronics adapted for the acquisition and amplification of electrophysiological signals from the body. Additionally, the connector 124 may include electronics to support a wireless transfer of the amplified data to the mobile computing device 26.
In a further embodiment of the present invention, a process is disclosed for the configuration of a system for performing an electrophysiological test on a patient. This process may be adapted to configure a series of electrodes, such as those associated with a wiring harness for use in association with the device 10 of the present invention. For example, the system may be adapted to configure the electrodes associated with a head apparatus 100 of the present invention, for use with the portable device 10, in order to perform an electroencephalogram (EEG).
As illustrated in
The software may have access to an electrode placement diagram specific to the particular test to be run. In addition, said software may include a prompt to a user to begin configuration and/or placement of the wiring harness and/or the wires or electrodes associated therewith according to the electrode placement diagram. In one aspect, the electrodes associated with the wiring harness may be attached to the patient via the harness, as illustrated in step 202. For example, this may involve attaching the head apparatus 100 to a patient. The process 200 may include the step of accessing a configure electrodes module 204. This configure electrodes module 204 may prompt the user by signaling a given electrode on the electrode placement diagram, such as by flashing light associated with or representative of a given electrode, as noted in step 206. Upon receiving said prompt regarding a given electrode on the electrode placement diagram, the user may identify the corresponding electrode or electrode location on the wiring harness, as indicated at step 208. This may involve the user manually manipulating the electrode, such as by tapping, pressing and holding, or squeezing the corresponding electrode (or an actuator such as a button associated therewith) associated with the wiring harness. Upon the user identifying the corresponding electrode associated with the wiring harness, the configure electrodes module may auto-configure the identified electrode as corresponding to the electrode from the electrode placement diagram within the software system, as shown in step 210. This series of steps, including the prompting the user with an electrode on the electrode placement diagram, identification by the user of a corresponding electrode on the wiring harness, and auto-configuration of said identified electrode on the wiring harness may be repeated until all electrodes associated with the wiring harness have been auto-configured, as indicated at step 212.
An impedance check of the electrodes associated with the wiring harness may be completed, as indicated at step 214. This may be completed after all electrodes have been auto-configured within the system, or may be completed individually as a given electrode is auto-configured. This impedance check step 214 may lead to an indication step 216, that one or all of the electrodes have been configured and the software application is properly receiving data signals from the electrodes associated with the wiring harness. In one aspect, this indication step 216 may be in the form of a visual or audible cue.
The foregoing descriptions of several embodiments made according to the disclosure of certain inventive principles herein are presented for purposes of illustration and description. The embodiments described are not intended to be exhaustive or to limit the invention to the precise form disclosed and, in fact, any combination of the components of the disclosed embodiments is contemplated. Modifications or variations are possible in light of the above teachings. The embodiments described were chosen to provide the best illustration of the principles of the invention and its practical applications to thereby enable one of ordinary skill in the art to utilize the invention in various embodiments and with various modifications as are suited to the particular use contemplated. All such modifications and variations are within the scope of the invention when interpreted in accordance with the breadth to which it is fairly, legally, and equitably entitled.
This application claims priority to U.S. Provisional Patent Application No. 61/981,488, filed Apr. 18, 2014, the disclosure of which is incorporated herein by reference.
Filing Document | Filing Date | Country | Kind |
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PCT/US15/26605 | 4/20/2015 | WO | 00 |
Number | Date | Country | |
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61981488 | Apr 2014 | US |