Magnetic core for medical procedures

Information

  • Patent Grant
  • 10617884
  • Patent Number
    10,617,884
  • Date Filed
    Wednesday, February 21, 2018
    6 years ago
  • Date Issued
    Tuesday, April 14, 2020
    4 years ago
Abstract
The inventive technique includes a system, method and device for treating a patient. The device includes a magnetic device having a core created by a binder process having a relatively low temperature. The device further includes a conductor in electrical communication with the core.
Description
BACKGROUND

A number of medical ailments are treated or treatable and/or diagnosed through the application of a magnetic field to an afflicted portion of a patient's body. Neurons and muscle cells are a form of biological circuitry that carry electrical signals and respond to electromagnetic stimuli. When an ordinary conductive wire loop is passed through a magnetic field or is in the presence of a changing magnetic field, an electric current is induced in the wire.


The same principle holds true for conductive biological tissue. When a changing magnetic field is applied to a portion of the body, neurons may be depolarized and stimulated. Muscles associated with the stimulated neurons can contract as though the neurons were firing by normal causes.


A nerve cell or neuron can be stimulated in a number of ways, including transcutaneously via transcranial magnetic stimulation (TMS), for example. TMS uses a rapidly changing magnetic field to induce a current on a nerve cell, without having to cut or penetrate the skin. The nerve is said to “fire” when a membrane potential within the nerve rises with respect to its normal negative ambient level of approximately −90 millivolts, depending on the type of nerve and local pH of the surrounding tissue.


The use of magnetic stimulation is very effective in rehabilitating injured or paralyzed muscle groups. Apart from stimulation of large muscle groups such as the thigh or the abdomen, experimentation has been performed in cardiac stimulation as well. In this context, magnetic stimulation of the heart may prove to be superior to CPR or electrical stimulation, because both of those methods undesirably apply gross stimulation to the entire heart all at once.


Another area in which magnetic stimulation is proving effective is treatment of the spine. The spinal cord is difficult to access directly because vertebrae surround it. Magnetic stimulation may be used to block the transmission of pain via nerves in the back, e.g., those responsible for lower back pain.


Magnetic stimulation also has proven effective in stimulating regions of the brain, which is composed predominantly of neurological tissue. One area of particular interest is the treatment of depression. It is believed that more than 28 million people in the United States alone suffer from some type of neuropsychiatric disorder. These include conditions such as depression, schizophrenia, mania, obsessive-compulsive disorder, panic disorders, and others. Depression is the “common cold” of psychiatric disorders, believed to affect 19 million people in the United States and possibly 340 million people worldwide.


Modern medicine offers depression patients a number of treatment options, including several classes of anti-depressant medications (e.g., SSRI's, MAOI's and tricyclics), lithium, and electroconvulsive therapy (ECT). Yet many patients remain without satisfactory relief from the symptoms of depression. To date, ECT remains an effective therapy for resistant depression; however, many patients will not undergo the procedure because of its severe side effects.


Recently, repetitive transcranial magnetic stimulation (rTMS) has been shown to have significant anti-depressant effects for patients that do not respond to the traditional methods. The principle behind rTMS is to apply a subconvulsive stimulation to the prefrontal cortex in a repetitive manner, causing a depolarization of cortical neuron membranes. The membranes are depolarized by the induction of small electric fields in excess of 1 V/cm that are the result of a rapidly changing magnetic field applied non-invasively.


Creation of the magnetic field has been varied. Certain techniques describe the use of a coil to create the necessary magnetic field. Other techniques contemplate the use of a high saturation level magnetic core material, like vanadium permendur. Use of the magnetic core material, as compared to the coil or so-called “air” core solution, has been shown to increase the efficiency of the TMS process. For example, as discussed with reference to U.S. Pat. No. 5,725,471, using a magnetic core instead of just a coil increases the efficiency of the TMS process by creating a larger, more focused magnetic field with the same or lesser input power requirements.


This advance has allowed a more cost effective solution that uses existing 120 volt power without complicated and a costly power supplies. Also, because of the need for the same or lesser power inputs, the magnetic core significantly reduces the undesirable heating that was associated with the coil solution and created a safety risk for patients. For example, magnetic core devices in comparison to coil-only devices reduce the magnetic reluctance path by a factor of two. This reluctance reduction translates into a reduction of required current to generate the same magnetic field by the same factor, and thus provides a fourfold reduction in required power.


The ferromagnetic core alternatives typically are fabricated by laminating layers of silicon steel or similar ferromagnetic metal together to form the core structure. The layers may be constructed by stacking cut-out shapes or by winding a ribbon of material onto a mandrel followed by further machining and processing to attain the desired core geometry.


While solutions fabricated using these ferromagnetic cores offered a marked improvement over their coil-only counterparts, the ferromagnetic cores also suffer from certain complexities in their construction and limitations in their geometry. Specifically, the stacked layer construction method does not provide optimal alignment of the metal crystal structure with the magnetic flux lines and also requires a controlled lamination process to guarantee minimal eddy current losses. The wound ribbon construction method typically results in a core with arc-shaped or C-shaped structure having a certain radius and span. The dimensions and geometry of these ferromagnetic cores are selected to ensure desired depth of penetration, magnetic field shape and appropriate magnetic field magnitude at certain locations within the patient's anatomy.


The ferromagnetic core's construction method involves a complex and meticulous construction process that increased both the complexity and cost of the core. For example, because ferromagnetic material is electrically conductive, eddy currents are established in the material when it is exposed to a rapidly varying magnetic field. These eddy currents not only heat the core material through resistive heating, but they also produce an opposing magnetic field that diminishes the primary magnetic field. To prevent these losses the eddy current pathways are broken by fabricating the core from very thin layers or sheets of ferromagnetic material that are electrically isolated from each other.


The sheets typically are individually varnished or otherwise coated to provide insulation between the sheets, thus preventing current from circulating between sheets and resulting in reduced eddy current losses. Also, the sheets are oriented parallel to the magnetic field to assure low reluctance.


The wound core fabrication process begins by winding a long thin ribbon of saturable ferromagnetic material, such as vanadium permendur or silicon steel, on a mandrel to create the desired radius, thickness and depth of the core. Each side of the ribbon typically is coated with a thin insulative coating to electrically isolate it. Once the ribbon has been wound on the mandrel to the desired dimensions, it is removed from the mandrel and dipped in epoxy to fix its position. Once the epoxy has cured, a sector of the toroidal core is cut with a band saw and removed, thus forming the desired arc-shape. Because the cutting process may reduce the electrical isolation of adjacent laminations, each cut is finely ground so that it is smooth, and then a deep acid etch is performed. The deep etch is performed by dipping each of the cut ends in an acid bath. This removes any ferromagnetic material that may be shorting the laminations. Following the deep etch, the faces are coated to prevent oxidation and to maintain the shape and structural integrity of the core. The manufacturing process of cutting, coating, aligning, attaching and laminating the layers makes for a complex and costly manufacturing process. Also, these considerations make it difficult to change or customize the shape of the core structure.


Winding a coil of insulated wire around the ferromagnetic core to deliver the current needed to create the magnetic field also is a complex and detailed process. A typical inductance for a core of this type is about 15-20 microHenries. Each pass of the winding around the core must be made at precise intervals on the core structure. In the simplest configuration, each core has only one winding, although typically the core may be wound multiple times.


While the present ferromagnetic core shape and composition work well, and certainly better than the coil-only approach, it should be appreciated that other core compositions and core shapes may work equally well under other circumstances.


SUMMARY

The inventive technique include a system, method and device for treating a patient. The device includes a magnetic device having a core created by a binder process having a relatively low temperature. The device further includes a conductor in electrical communication with the core.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1A illustrates an example core shape and configuration;



FIG. 1B illustrates another example core shape and configuration;



FIG. 2A illustrates another example core shape and configuration;



FIG. 2B illustrates another example core shape and configuration;



FIG. 3A illustrates another example core shape and configuration;



FIG. 3B illustrates another example core shape and configuration;



FIG. 4 illustrates another example core shape and configuration;



FIG. 5 illustrates another example core shape and configuration;



FIG. 6 illustrates another example core shape and configuration;



FIG. 7 illustrates another example core shape and configuration;



FIG. 8 illustrates another example core shape and configuration;



FIG. 9 illustrates another example core shape and configuration;



FIG. 10 illustrates another example core shape and configuration;



FIG. 11 illustrates another example core shape and configuration;



FIG. 12 illustrates another example core shape and configuration;



FIG. 13 illustrates another example core shape and configuration;



FIG. 14 is a flow diagram of a method for treating a patient;



FIG. 15 is a block diagram of a system for treating a patient; and



FIG. 16 is a flow diagram of a method for manufacturing a magnetic core for treating a patient.





DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

In one embodiment of the invention, a distributed gap core structure is contemplated, for example an air gap core structure. It should be appreciated that the air gap core refers to the internal structure of a magnetic core, while the “air core” discussed in the Background of the Invention section refers to a winding without any magnetic core. One type of distributed air gap core structure is created by dispersing powdered ferromagnetic particles in a matrix of insulating material. It should be appreciated that the invention is not limited to an ferromagnetic powder core, but various embodiments may include any gap core structure. The gap core structure may be any structure where one or more conductive particles are insulated (or nearly so) from each other.


The use of distributed gap core structures, like powdered ferromagnetic core materials reduces the complex manufacturing and corresponding cost burden inherent in the laminated structures. In addition, because of the insulating material that separates the ferromagnetic particles in the core material, the core is less conductive, and as a result eddy current losses are minimal. More specifically, the non-conductive gaps may prohibit the flow of current from one ferromagnetic particle to the next, and thus reduce overall current flow in the core. Because eddy currents result from the conductive flow of current in magnetic materials like the core, reducing the conductive flow serves to reduce the eddy currents. As a result of the reduced eddy currents, the distributed gap core structure produces even less heat than its counterpart ferromagnetic core structures.


Therefore, higher power and current levels may be used to drive coils fabricated with a distributed gap core without concern for heating that may be excessive for a patient undergoing treatment. Moreover, these higher power levels may be achieved without the need for sophisticated cooling systems, typical of the “air” core solutions. In addition, these higher current drive levels may drive the distributed gap cores closer to their saturation level to obtain greater magnetic field strength, without concern for consequent undesirable heating. In fact, in some embodiments, heating due to resistive losses in the windings may be greater than heat generated within the distributed gap core material. In other words, the heating characteristics of the windings may provide the only real heating concerns for patient use.


Reducing eddy current losses and the concomitant reduction in heat generation permits operation of the magnetic core at proportionally higher duty cycles. From a medical application perspective, relatively greater and more intense therapy may be achieved, which may be beneficial for certain applications. In addition to its inherent reduced temperature, the core may additionally be enclosed in a structure that further enhances its thermal performance. For example, by potting the core into a shell heat may be directed to a desirable surface for radiation to the surrounding air. Such a surface may, for example, be located away from surfaces that touch a patient or the operator.


Air spaces and thermal insulation also may be added between the windings or other heat generating materials to insulate them from surfaces that may come in contact with a patient, for example. Typically these surfaces must be kept at or below 41.5 degrees Celsius in order to comply with medical device standards, well known to those skilled in the art.


It also should be appreciated that the reduced current flow and eddy current loss gained with the distributed gap core structure is not found in the cores created by a sintering process. This is due, in part, because the sintering process operates to place the insulated iron powder particles back into electrical conductivity with one another, and thus promote current flow and increased eddy current losses.


The insulative material may be any material that offers a different level of permeability and inductance as compared to the ferromagnetic particles. By introducing an insulative gap, the magnetic flux path is increased, thus reducing the permeability and the inductance of the core material. It may be desirable to have a core with a permeability of greater than 1. Moreover, because the distributed gap reduces eddy currents, there are fewer flux distortions. This relatively greater isotropic structure provides for a more uniformly distributed flux and facilitates more complex and sophisticated core structures.


The ferromagnetic powder used to make the core may be made of particles that are less than 0.05 inch in diameter. Although it should be appreciated that the particles may be of any size in the contemplated embodiments, it should be appreciated that the specific particle dimension is related to the frequency at which the core is to operate. For example, if the core is to be pulsed at a higher frequency, it may be desirable to use particles with a smaller dimension. The ferromagnetic particles may vary in size and may not be spherical but rather irregular in shape. In any event, it should be appreciated that specific particle size may be selected to reduce losses resulting from eddy currents and hysteresis losses within individual particles.


Also, although the invention is not limited to any particular formation, it should be appreciated that individual ferromagnetic particles may be formulated from iron, iron alloys and amalgams of other conductive or partially conductive materials. Also, the material composition of the particles may include non-ferrous metals such as copper, brass, aluminum and alloying elements such as carbon, silicon, nickel and chromium formulated to create the desired crystal structure and desired magnetic characteristics. Saturation, permeability and B-H curve characteristics vary depend on this selected formulation. In addition, the ferromagnetic particles may be coated with a non-conductive resin to, among other things, prevent oxidation while being stored before the coated particles are formed into the desired structure in the core manufacturing process.


The contemplated embodiments include a method for manufacturing a magnetic core device, for example a powdered ferromagnetic core device. The method includes selecting certain powdered ferromagnetic materials. The materials are then mixed and compressed to form the core. The powder may be pressed into a mold having the final form of the core. Alternatively, blocks of compressed material can be manufactured and subsequently machined to the desired geometry. Also, separate molded or machined component pieces may be mechanically assembled into the final core geometry using cement, heating or bonding by other mechanical means. The ferromagnetic powder core may be produced by any of several processes. For example, stream of molten iron may be atomized by a high pressure water jet.


The ferromagnetic particles may be coated with any appropriate substance. For example, the ferromagnetic particles may be coated with an insulative substance, like alkali metal silicate, for example. The insulative substance provides insulation between each of the particles in the core, and thus creates the distributed gap core. In one embodiment, an aqueous alkali metal silicate solution is used containing up to 39% by weight solids of K2O and SiO2, and up to 54% by weight solids of Na2O and SiO2. A wetting agent or surfactant, like alkyl phenoxyl polyethoxy ethanol for example, may be added to facilitate uniform coating of the particles.


The appropriate substances are mixed and may be surface-dried at the same time. A thin coating of an adherent resin may be applied to the ferromagnetic particles. Such resins may include polyimides, fluorocarbons and acrylics. The resin permits the particles to remain flexible and thus capable of withstanding high temperatures without decomposing into conducting residues.


To form the core, the powder is compressed. The compression may be approximately in the range of 25 to 100 tons per square inch. A form may be used to create the desired shape. The pressed components may be annealed, for example, at 500 to 600 degrees Celsius to relieve the stresses and reduce the hysteresis losses.


If ferromagnetic powder is to be used for the magnetic core in such an application, the particles may be insulated from one another, for example, with between 1% to 3% spacing between particles. Although this is just one example. When raw ferromagnetic powder is compressed up to 100 tons per square inch and not sintered, the density remains 1% or 2% below the true density of solid iron, because of residual crevices or interstices which remain empty or are filled with lower density resin. As a result, the ferromagnetic powder may be compressed to about 90% of theoretical density or better in order to have a distributed insulation-containing air gap less than 3% in each of the three orthogonal directions, one of which is that of the flux path. In any of the embodiments, the magnetic core may be a composition that allows the core to saturate at 0.5 Tesla or greater, for example.


During the manufacturing process, the individual ferromagnetic particles in the powder may be mixed with a binding material, for example phenolic or epoxy. The ferromagnetic powder may then be pressed into its final shape. Next, a baking or heating process may be implemented to cure the core material. After the core has been cured, the ferromagnetic particles may be separated by air or insulative binding material which effectively results in a distributed gap. As a result, the gap is distributed throughout the core.


The novel device and techniques may be used for many purposes including the treatment of patients with medical conditions. This applicability will be discussed in the context of TMS in order to provide greater understanding. However, it should be appreciated that techniques have applicability beyond TMS also are contemplated by the invention.


In just one embodiment, a method of treating a patient by creating a magnetic field using a magnetic device having a non-linear core is contemplated. As will be discussed with reference to FIGS. 1-13, the core may assume a number of different and various shapes and sizes. The shapes and sizes may vary with the particular area of the patient's anatomy that needs treatment, as well as the external area of the patient on which the magnet may be placed. For example, in just one embodiment, the core may have a U-shaped structure that facilitates placing the core in close proximity to a patient's head for the purpose of treating the brain with pulsed magnetic fields for the treatment of depression. This may be accomplished, for example, by stimulating tissue (e.g., brain tissue), nerves and/or muscle, for example, from an area relatively proximate to the cutaneous surface and the area of treatment.


Also, the core used to treat the patient may be a gap distributed core and more specifically an ferromagnetic powder core. As discussed, the embodiments are not limited to any compositions, but contemplate any material composition that effectively creates a distributed gap core structure. Also, the embodiments contemplate any type of core structures, including ferromagnetic, where the shape of the core structure has a non-arc shaped structure. For example, the embodiments contemplate the use of a non-sintered core material. Also, other embodiments contemplate a non-linear shaped ferromagnetic powder core.


The magnetic field passing through the core may be applied to the patient for the purpose of treating or diagnosing the patient. The embodiments are not limited to a specific level or intensity of the magnetic field, but instead contemplate any field strength, focus and duration necessary to treat or diagnose the desired patient.


A novel system may include a magnetic field generating device created using a powdered ferromagnetic core, a circuit in electrical communication with the magnetic core, and being drive by a power source in electrical communication with the circuit.


A power source may be provided in order for the core to generate the requisite magnetic field. The power source may be in electrical communication with the windings wrapped around a portion of the core. The power source may be created to provide a substantially constant power or substantially constant current source. For example, the power source may provide a substantially constant power or substantially constant current source to a capacitor, which then discharges to the core to create the magnetic field.


The power source may operate on an alternating current input voltage in the range of 85 volts to 264 volts. In this way, the inventive device may operate using power typically available in residential and commercial settings.


Finally, the embodiments contemplate a method for treating depression. As part of the method a patient is selected who suffering from a depressive disorder. The patient's brain is then magnetically stimulated using a transcranial magnetic stimulator with a magnetic core. The core may be a ferromagnetic core having a U-shaped structure and/or a distributed gap core structure having any core shape and structure.


It should be appreciated that the use of ferromagnetic powder core makes more feasible many possible core geometries. In fact, the distributed gap core (e.g., ferromagnetic powder core) manufacturing process, allows the core's geometry to have an array of possibilities. The precise shape and size of the core's geometry may be made to vary depending upon various factors. For example, although not an exclusive list of considerations, the following may be considered in deciding upon the size and geometry of the core: the use of the core, the available mounting area and volume, the allowable radiation, the limitations on windings, the operating temperature, and how the core will be mounted. Consequently, a core's geometrical shape can take any form, including a cylinder, bobbin, toroid, a non-toroid or several other possible shapes.


In addition, it also should be appreciated that the ferromagnetic powder manufacturing process facilitates construction of the core as multiple components or pieces. Multi-piece ferromagnetic powder cores, each piece made of similar or different magnetic material, may be used for extremely complex shapes or larger core constructions. These individual pieces, of different or similar permeabilities, may be brought together by gluing and/or any other attachment techniques well known to those skilled in the art. This is facilitated, in part, due to the ease of manufacturing and core shaping provided by the powder core process.


In addition, the powder core manufacturing process also facilitates the use of other materials to shape the magnetic field provided by the core structure. For example, it may be desirable to deflect or redirect a certain portion of the created magnetic field away from certain parts of the anatomy. For example, for brain stimulation, it may be desirable to protect the trigeminal nerve from being stimulated and causing discomfort to the patient. This may be accomplished using any number of techniques.


One example technique locates a conductor on a treatment area relative to the protected area. The conductor may act to reduce stimulation of a cutaneous-proximate area on the patient. This may be accomplished by modifying an electric or magnetic field created by the transcutaneous stimulation. Also, it may be accomplished via modification of the electric field through modification of the magnetic flux created by the transcutaneous stimulation.



FIGS. 1 through 13 provide various examples of core shapes and configurations that are facilitated by the contemplated embodiments. It should be appreciated, however, that FIGS. 1 through 13 are not provided in order to detail every possible shape and configuration contemplated by the invention. Instead, the figures merely provide certain examples to aid in an understanding of just a few of the contemplated embodiments.


Generally, it may be noted that the magnetic cores shown in FIGS. 1 through 13 essentially comprise three sections. Although the cores may not have to be separately constructed in three of such sections, describing their shape as such facilitates further discussion of the shape, and thus is not meant to be limiting in any way.



FIG. 1 will be used to discuss the features of the core. As shown in FIG. 1, a core 100 includes a first section 101, a second section 102 and a third section 103. In the context of FIG. 1 which is a squared off U-shape, second section 102 serves as a bridge connecting first section 101 and third section 103, which serve as the posts or poles for the U-shape. First section 101 is joined with second section 102 at a right angle. Similarly, third section 103 is joined with second section 102 at a right angle. It should be appreciated that these sections may be fabricated as one complete pressed part, or they could be individually pressed and later assembled to form the U-shape.


As shown in FIGS. 2 through 13, various other shapes and configurations that may be modifications or minor alterations are depicted in FIG. 1. For example, as shown in FIG. 2, either ends of the first, second and/or third sections may be angled or chamfered. Such angles or chamfering may be accomplished using any such value, for example using an angle of 45 degrees. Such modifications to the shape of the pole face are used by those skilled in the art to redirect and optimize the spatial distribution of the magnetic field for the intended application. Also, the angled sections may be arc-shaped as shown in FIG. 3.


The angles may be made to both the cornered ends of the core as shown in FIG. 2, or on just one of the cornered ends of the core as shown in FIG. 13. Similarly, the angles may be made at the opposite ends with respect to the cornered ends, as shown in FIG. 5. Alternatively, the angles depicted in FIG. 5 may be arc-shaped or smoothed, as shown in FIGS. 4 and 6. Also, the first and third sections may be L-shaped as shown in FIG. 7 with a linear second section, or as shown in FIG. 8 with an arc-shaped second section.


As shown in FIG. 9, the magnetic core may be arc-shaped core having a wire wound around any portion of its axis. Alternatively, as shown in FIGS. 10 and 11, the core may be a linear-shaped structure having perpendicular or chamfered ends with respect to its main axis. In both cases, a wire may be wound around any portion of its axis. The wound wire may be a single strand and or multiple strands in parallel electrically. The wire may include a metal sheet of conductive material with or without insulation, and or an extruded magnet wire with or without insulation. Also, as shown in FIG. 12, the core may have more than 2 poles with windings around one or more of the poles.


It should be appreciated that the construction, size and shape of the core may be made to be dependent upon how the windings will be installed on the core component. For example, certain embodiments contemplate windings that are wound directly around and/or on the core. Also, other embodiments may include windings that are wound on a sleeve or bobbin that is slipped over a portion of the core, or are wound on a mandrel, potted and removed for subsequent assembly onto the core. It should be appreciated that certain embodiments may include a combination of the these approaches. A channel may be cut into the face of the pole in order to allow windings or wire to be installed. For example, a shorted turn may be inserted into the channel and connected together outside of the channel.


The wire used for the windings may be insulated to prevent closely wound, adjacent turns from shorting out. In the context of directly wound windings, the wire may be of such a gauge as to prevent the core from cutting through the insulation, for example with sharp surfaces or edges. Therefore, to accommodate such directly wound cores, the core may have a smooth winding surface, or in some cases may provide a corner radius to accommodate the turns.


The bobbin may be a structure that includes a single bobbin or multiple bobbins. The bobbin may provide insulation properties with respect to the rest of the core, as well as providing operation and safety capabilities. The wire may be wound around the pole faces of the core. Where wire is wound around two or more poles, the number of turns of the winding may be equal between both poles. Also, the wire may be wound around a central point of the core, instead of or in addition to being wound around the pole faces of the core. Where wound around both, the number of turns of the winding around the pole faces may be a fraction of the number of turns around the central point of the core.


Again, it should be appreciated that fabrication of a core by pressing ferromagnetic powder into a mold allows a diverse range of core shapes and therefore more varied winding solutions. For example, in one embodiment of a distributed gap core a bobbin may be more readily used to accurately prefabricate and position the winding on the core.



FIGS. 1B, 2B and 3B illustrate how one or more wires may be wound around at least a portion of the magnetic core. As shown in FIGS. 1B, 2B and 3B, the windings may be wound around the first and third sections of the core. Such a winding may be a single winding wound around the first and third sections, or two or more individual windings each wound around the first and third sections. Alternatively, as shown in FIGS. 1A, 2A and 3A, the winding may be wound around the second section of the core. Again, the core winding may be a single winding or multiple windings.



FIG. 14 is a flow diagram of a method for treating a patient. As shown in FIG. 14, in 1401 a magnetic field is created using a distributed gap core magnetic device. In 1402, the magnetic device is placed proximate to a cutaneous area on the patient, for example, in proximity to the patient's head. In 1403, a portion of the patient's anatomy that is desired to be treated (e.g., brain) is stimulated. In 1404, the magnetic field is applied to the patient. In 1405, the patient is treated, for example for depression, incontinence, and weight control, with the magnetic field. Other types of conditions also may be treated using these techniques. These may include, but are not limited to, treating the peripheral nervous system, rehabilitating the patient's muscle.


It also should be appreciated that the described techniques further may be used to directly diagnose a patient's condition. Also, the techniques may be used to diagnose a response to drugs or other therapy and/or to quantify effectiveness of such therapies. In just one of many possible examples, pharmaceuticals may have effects (i.e., direct or secondary) on the performance of the central nervous system. These effects may be observed by providing stimulation (e.g., TMS) and observing evoked potentials, motor response, conduction velocities or other responses, just to name a few of the many contemplated observed effects. Changes in response may be used to quantify performance or to determine optimal dosing, for example.


In addition, many pathologies may be diagnosed using the described techniques an investigative tool to observe neurological response. Such pathologies include, but are not limited to, degenerative diseases, extent of traumatic injury, progression of diseases, systemic deficiencies, and congenital anomalies (e.g., tinnitus). A partial list of such conditions is provided here for the purposes of further understanding. However, the scope of the described embodiments are not limited to this list. These include assessment or measuring effect of pharmaceuticals, including anti-convulsives, Alzheimer's medications, anti-psychotics, pain medications, anti-anxiety, hypnotics (sedatives), analgesics (central), ADHD medications and, anesthetics. Just a few of the contemplated diagnostic applications include compromised motor function, degenerative diseases (e.g., Alzheimer's, Parkinson's, Amyotrophic Lateral Sclerosis), multiple sclerosis, diabetic neuropathy, chronic demyelinating neuropathy, acute demyelinating neuropathy, epilepsy, vitamin B12 deficiency (e.g., pernicious anemia), vitamin E deficiency, neurosarcoidosis, tinnitus, and stroke rehabilitation.


Other disorders may also be treated with the described techniques including treating a patient such as a human suffering from major depressive disorder, epilepsy, schizophrenia, Parkinson's disease, Tourette's syndrome, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Alzheimer's disease, attention deficit/hyperactivity disorder, obesity, bipolar disorder/mania, anxiety disorders (panic disorder with and without agoraphobia, social phobia also known as social anxiety disorder, acute stress disorder, generalized anxiety disorder), post-traumatic stress disorder (one of the anxiety disorders in DSM), obsessive compulsive disorder (one of the anxiety disorders in DSM), pain (migraine, trigeminal neuralgia) (also: chronic pain disorders, including neuropathic pain, e.g., pain due to diabetic neuropathy, post-herpetic neuralgia, and idiopathic pain disorders, e.g., fibromyalgia, regional myofascial pain syndromes), rehabilitation following stroke (neuro plasticity induction), tinnitus, stimulation of implanted neurons to facilitate integration, substance-related disorders (dependence and abuse and withdrawal diagnoses for alcohol, cocaine, amphetamine, caffeine, nicotine, cannabis), spinal cord injury & regeneration/rehabilitation, head injury, sleep deprivation reversal, primary sleep disorders (primary insomnia, primary hypersomnia, circadian rhythm sleep disorder), cognitive enhancements, dementias, premenstrual dysphoric disorder (PMS), drug delivery systems (changing the cell membrane permeability to a drug), induction of protein synthesis (induction of transcription and translation), stuttering, aphasia, dysphagia, essential tremor, or eating disorders (bulimia, anorexia, binge eating).


The method further may include determining so-called “motor threshold” of the patient. More specifically, the magnetic device may be moved over a particular area until some indication of positioning is provided. For example, in the context of magnetic stimulation of the brain, the magnetic device may be moved over the patient's head until the patient's thumb moves or twitches indicating a motor threshold point. This motor threshold determination may be at a similar or different frequency, for example, using a stimulation frequency rate of 1 Hz.


From this point, the magnetic device may be moved to a desired treatment location. For example, for TMS treatment of the brain, the magnetic device may located approximately 5 centimeters anteriorly from motor threshold point. During TMS treatment, in some embodiments, the stimulator output may be set to approximately 110% of relaxed motor threshold with perhaps a repetition rate of approximately 10 Hz.



FIG. 15 is a block diagram of a system for treating a patient. As shown in FIG. 15, a system 1500 for treating a patient includes a magnetic field generating device 1501. Magnetic field generating device 1501 may have a distributed gap core structure. Also, a circuit 1502 is in electrical communication with the magnetic field generating device.


The circuit may be act as a switch to pulse the magnetic field generating device in such a way to treat the desired condition. In this way, the magnetic field may be applied to the patient in cycles intermittently. The exact stimulation frequency or frequency in which the magnet is pulsed may be varied depending upon the particular application (e.g., size of magnet and area of stimulation). For example, in just some embodiments, it may be desirable to stimulate for a five second period, followed by rest for a five second period and then repeat stimulation continuously for another five seconds. While they are being stimulated, it is desirable to have the muscle groups continuously excited. This requirement dictates the necessity of continuing to pulse the cores at a repetition rate of 15 Hz. Because of the large currents involved during any given firing of the core, it is necessary to make the cores as efficient as possible. It is desirable to focus the magnetic field into the region targeted for stimulus to the exclusion of surrounding regions. The specially designed cores offered by this invention realize that focusability.


In addition, a power source 1503 may be in electrical communication with the circuit. The power source may provide direct current (dc) or alternating current (ac) power. Also, the power levels may be consistent with those available in residential and commercial settings.



FIG. 16 is a flow diagram of a method for manufacturing a magnetic core for treating a patient. As shown in FIG. 16, in 1601, ferromagnetic particles are selected with an insulated coating. In 1601, the ferromagnetic particles are mixed and in 1602, the ferromagnetic particles are formed into a core structure. In 1604, a conductor (e.g., wire) is wound around the core structure. In 1605, a power source is connected to the core structure.


Although not shown for the purposes of brevity, it should be appreciated that similar winding configurations may be applied to any of the possible core shapes, illustrated in the figures or otherwise. The description herein with regard to the shapes and winding configurations of the core have been provided to facilitate the discussion and understanding of the many possible shapes and configuration that are within the scope of the contemplated embodiments. Similarly, it should be appreciated that these shapes and configurations are equally applicable to any type of magnetic core used for treating and/or diagnosing a patient, including but not limited to pressed powder, sintered, tape wound, and coil only or “air” core structures.


It is to be understood that the foregoing illustrative embodiments have been provided merely for the purpose of explanation and are in no way to be construed as limiting of the invention. Words used herein are words of description and illustration, rather than words of limitation. In addition, the advantages and objectives described herein may not be realized by each and every embodiment practicing the present invention. Further, although the invention has been described herein with reference to particular structure, materials and/or embodiments, the invention is not intended to be limited to the particulars disclosed herein. Rather, the invention extends to all functionally equivalent structures, methods and uses, such as are within the scope of the appended claims.


For example, although a great deal of the discussion was based on the use of a pressed powder distributed gap core structure, it should be appreciated that the contemplated embodiments include the use of any core structure, including “air core,” non-sintered, and other ferromagnetic core structures for example. Moreover, although certain core shapes and configurations have been described herein, it should be appreciated that the shapes are provided merely to provide an understanding of the many core shapes contemplated by the embodiments.


In addition, although the disclosure addresses the treatment of patients, it should be appreciated that techniques described herein also contemplate patient diagnosis. In fact, where the disclosure refers to the treatment of patients for certain conditions, the techniques equally apply to the monitoring and diagnosis of patients for the same or similar conditions.


Those skilled in the art, having the benefit of the teachings of this specification, may affect numerous modifications thereto and changes may be made without departing from the scope and spirit of the invention.

Claims
  • 1. A method for manufacturing a magnetic core for a magnetic field generating device configured for use in transcranial magnetic stimulation (TMS), the method comprising: determining a frequency to pulse the magnetic field generating device for performing TMS;selecting a dimension of ferromagnetic particles based on the frequency;mixing the ferromagnetic particles with a non-conductive material;forming the mixture of the ferromagnetic particles and the non-conductive material into a non-linear core structure; andcompressing the mixture of the ferromagnetic particles and the non-conductive material using a binder process to create the magnetic core so that the magnetic core comprises a matrix of non-conductive gaps.
  • 2. The method of claim 1, wherein a smaller dimension is selected for the ferromagnetic particles when the magnetic field generating device is configured to be pulsed at higher frequencies as compared to the dimension of the ferromagnetic particles that are selected when the magnetic field generating device is configured to be pulsed at lower frequencies.
  • 3. The method of claim 1, further comprising: selecting the dimension of the ferromagnetic particles to reduce at least one of losses resulting from eddy currents or hysteresis losses within the ferromagnetic particles.
  • 4. The method of claim 1, wherein the ferromagnetic particles are compressed during the binder process in a range of 25 to 100 tons per square inch to create the magnetic core.
  • 5. The method of claim 1, wherein the ferromagnetic particles are less than 0.05 inch in diameter.
  • 6. The method of claim 1, wherein a winding is wound around an exterior surface of the magnetic core.
  • 7. A device for transcranial magnetic stimulation (TMS), the device comprising: a magnetic field generating device comprising a winding and a magnetic core, the magnetic core comprising a combination of ferromagnetic particles and an insulative binding material;a circuit in electrical communication with the magnetic field generating device, the circuit configured to pulse the magnetic field generating device at a frequency to perform TMS; anda power source in electrical communication with the circuit;wherein the ferromagnetic particles have a dimension that is selected based on a frequency at which the circuit is configured to pulse the magnetic field generating device to perform TMS.
  • 8. The device of claim 7, wherein the ferromagnetic particles have a smaller dimension when the magnetic field generating device is configured to be pulsed at higher frequencies as compared to the dimension of the ferromagnetic particles when the magnetic field generating device is configured to be pulsed at lower frequencies.
  • 9. The device of claim 7, wherein the dimension of the ferromagnetic particles is selected to reduce at least one of losses resulting from eddy currents or hysteresis losses within the ferromagnetic particles.
  • 10. The device of claim 7, wherein the magnetic core is created by compressing the ferromagnetic particles to approximately 100 tons per square inch during a binder process.
  • 11. The device of claim 7, wherein the magnetic core comprises a distributed gap core structure comprising a matrix of non-conductive gaps, and wherein the winding is wound around an exterior surface of the magnetic core.
  • 12. A method of manufacturing a magnetic core for treating a patient, comprising: selecting one or more ferromagnetic particles;mixing the one or more ferromagnetic particles with a non-conductive material;forming the mixture of the one or more ferromagnetic particles and the non-conductive material into a non-linear core structure suitable for use in transcranial magnetic stimulation (TMS), wherein the non-linear core structure is formed for placement of at least one pole face in proximity to the patient for applying a magnetic field to a target anatomy; andcompressing the mixture of the one or more ferromagnetic particles and the non-conductive material in a range of 25 to 100 tons per square inch using a binder process to create the magnetic core.
  • 13. The method of claim 12, wherein the binder process comprises at least one of the following: thermally set having a relatively low temperature, pressure or chemical.
  • 14. The method of claim 12, wherein the mixture of the one or more ferromagnetic particles and the non-conductive material is compressed to approximately 100 tons per square inch using the binder process to create the magnetic core.
  • 15. The method of claim 12, wherein the magnetic core has a permeability of greater than 1.
  • 16. A device for treating a patient as part of a transcranial magnetic stimulation (TMS) procedure, comprising: a magnetic field generating device comprising a winding and a core, the core created by a binder process, wherein the core comprises ferromagnetic particles that are combined with an insulative binding material such that the ferromagnetic particles are substantially insulated from each other, wherein the core has a non-linear core structure comprising two pole faces, and wherein the core is formed for placement of at least one pole face in proximity to the patient for applying a magnetic field to a target anatomy of the patient during TMS;a circuit in electrical communication with the winding of the magnetic field generating device, the circuit configured to pulse the winding at a frequency to perform TMS; anda power source in electrical communication with the circuit.
  • 17. The device of claim 16, wherein the binder process comprises at least one of the following processes: thermally set, pressure and chemical.
  • 18. The device of claim 16, wherein the core has a permeability of greater than 1, and wherein the ferromagnetic particles of the core are compressed to about 90% of theoretical density or greater.
  • 19. The device of claim 16, wherein the core comprises a distributed gap core structure comprising a matrix of non-conductive gaps.
  • 20. The device of claim 16, wherein the ferromagnetic particles are formed into a non-linear core structure, and wherein the core includes at least one of the following: iron, nickel, cobalt, and rare earth materials.
CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No. 14/982,739, filed Dec. 29, 2015, which is a continuation of U.S. patent application Ser. No. 12/479,076, filed Jun. 5, 2009 entitled “Magnetic Core for Medical Procedures,” now U.S. Pat. No. 9,308,386 issued on Apr. 12, 2016, which is a division of U.S. patent application Ser. No. 11/325,660, filed Jan. 4, 2006 entitled “Magnetic Core for Medical Procedures,” now U.S. Pat. No. 7,560,058 issued on Jul. 14, 2009, which is a continuation of U.S. patent application Ser. No. 11/191,106, filed Jul. 27, 2005 entitled “Magnetic Core for Medical Treatment,” now U.S. Pat. No. 7,824,324 issued on Nov. 2, 2010, and also a continuation of U.S. patent application Ser. No. 11/213,415, filed Aug. 26, 2005 entitled “Magnetic Core for Medical Treatment,” now U.S. Pat. No. 7,963,903 issued on Jun. 21, 2011. This application is also related to U.S. patent application Ser. No. 12/479,069, filed Jun. 5, 2009 entitled “Magnetic Core for Medical Procedures,” now U.S. Pat. No. 8,657,731 issued on Feb. 25, 2014, which is also a division of U.S. patent application Ser. No. 11/325,660, filed on Jan. 4, 2006 entitled “Magnetic Core for Medical Procedures,” now U.S. Pat. No. 7,560,058 issued on Jul. 14, 2009. Each of these applications is herein incorporated by reference in its entirety.

US Referenced Citations (159)
Number Name Date Kind
3197678 Primas Jul 1965 A
3658051 Maclean Apr 1972 A
3683923 Anderson Aug 1972 A
3848331 Pavlik et al. Nov 1974 A
4022701 Sawa et al. May 1977 A
4156882 Delagi et al. May 1979 A
4473074 Vassiliadis Sep 1984 A
4601753 Soileau et al. Jul 1986 A
4601765 Soileau et al. Jul 1986 A
4638798 Shelden et al. Jan 1987 A
4678616 Kawashima Jul 1987 A
4712558 Kidd et al. Dec 1987 A
4994015 Cadwell Feb 1991 A
4995395 Ilmoniemi et al. Feb 1991 A
5063011 Rutz et al. Nov 1991 A
5078674 Cadwell Jan 1992 A
5097833 Campos Mar 1992 A
5116304 Cadwell May 1992 A
5154723 Kubota et al. Oct 1992 A
5160447 Ishikawa et al. Nov 1992 A
5178757 Corney Jan 1993 A
5211896 Ward et al. May 1993 A
5254123 Bushey Oct 1993 A
5268140 Rutz et al. Dec 1993 A
5268438 Carson et al. Dec 1993 A
5299569 Wernicke et al. Apr 1994 A
5370117 Mclaurin, Jr. Dec 1994 A
5543174 Rutz Aug 1996 A
5566681 Manwaring et al. Oct 1996 A
5591373 Ward et al. Jan 1997 A
5655534 Ilmoniemi Aug 1997 A
5707334 Young Jan 1998 A
5725471 Davey et al. Mar 1998 A
5769778 Abrams et al. Jun 1998 A
5812301 Nakamura Sep 1998 A
5813970 Abrams et al. Sep 1998 A
5820623 Ng Oct 1998 A
5828770 Leis et al. Oct 1998 A
5855582 Gildenberg Jan 1999 A
5898253 El-Antably et al. Apr 1999 A
5923417 Leis Jul 1999 A
6002251 Sun Dec 1999 A
6057373 Fogel May 2000 A
6061644 Leis May 2000 A
6066084 Edrich et al. May 2000 A
6074385 Klopotek Jun 2000 A
6086525 Davey et al. Jul 2000 A
6117066 Abrams et al. Sep 2000 A
6132361 Epstein et al. Oct 2000 A
6155966 Parker Dec 2000 A
6169963 Markov Jan 2001 B1
6179769 Ishikawa et al. Jan 2001 B1
6179771 Mueller Jan 2001 B1
6198958 Ives et al. Mar 2001 B1
6205356 Holcomb Mar 2001 B1
6210317 Bonlie Apr 2001 B1
6253109 Gielen Jun 2001 B1
6256531 Ilmoniemi et al. Jul 2001 B1
6266556 Ives et al. Jul 2001 B1
6279579 Riaziat et al. Aug 2001 B1
6288785 Frantz et al. Sep 2001 B1
6355049 Gill Mar 2002 B1
6366814 Boveja et al. Apr 2002 B1
6389318 Zarinetchi et al. May 2002 B1
6402678 Fischell et al. Jun 2002 B1
6413263 Lobdill et al. Jul 2002 B1
6418345 Tepper et al. Jul 2002 B1
6425852 Epstein et al. Jul 2002 B1
6463328 John Oct 2002 B1
6477410 Henley et al. Nov 2002 B1
6480743 Kirkpatrick et al. Nov 2002 B1
6484059 Gielen Nov 2002 B2
6488617 Katz Dec 2002 B1
6497648 Rey Dec 2002 B1
6500110 Davey et al. Dec 2002 B1
6503187 Ilmoniemi et al. Jan 2003 B1
6516213 Nevo Feb 2003 B1
6516288 Bagne Feb 2003 B2
6537197 Ruohonen et al. Mar 2003 B1
6551233 Perreault et al. Apr 2003 B2
6553326 Kirsch et al. Apr 2003 B1
6560490 Grill et al. May 2003 B2
6567702 Nekhendzy et al. May 2003 B1
6571123 Ives et al. May 2003 B2
6572528 Rohan et al. Jun 2003 B2
6618614 Chance Sep 2003 B1
6625563 Kirsch et al. Sep 2003 B2
6629935 Miller et al. Oct 2003 B1
6641520 Bailey et al. Nov 2003 B2
6663556 Barker Dec 2003 B2
6827681 Tanner et al. Dec 2004 B2
6849040 Ruohonen et al. Feb 2005 B2
6954060 Edel Oct 2005 B1
6978179 Flagg et al. Dec 2005 B1
7367935 Mechlenburg et al. May 2008 B2
7367936 Myers et al. May 2008 B2
7407478 Zangen et al. Aug 2008 B2
7560058 Riehl et al. Jul 2009 B2
7824324 Riehl et al. Nov 2010 B2
8246529 Riehl et al. Aug 2012 B2
9308386 Riehl et al. Apr 2016 B2
9931518 Riehl Apr 2018 B2
20010002441 Boveja May 2001 A1
20010012912 Feucht Aug 2001 A1
20010016977 Moro et al. Aug 2001 A1
20010018547 Mechlenburg et al. Aug 2001 A1
20010031906 Ishikawa et al. Oct 2001 A1
20020013612 Whitehurst Jan 2002 A1
20020014280 Moro Feb 2002 A1
20020087201 Firlik et al. Jul 2002 A1
20020091419 Firlik et al. Jul 2002 A1
20020097125 Davey Jul 2002 A1
20020103515 Davey et al. Aug 2002 A1
20020123780 Grill et al. Sep 2002 A1
20020160436 Markov et al. Oct 2002 A1
20020169355 Rohan et al. Nov 2002 A1
20030004392 Tanner et al. Jan 2003 A1
20030023159 Tanner Jan 2003 A1
20030028072 Fischell et al. Feb 2003 A1
20030050527 Fox et al. Mar 2003 A1
20030065243 Tanner Apr 2003 A1
20030073899 Ruohonen et al. Apr 2003 A1
20030074032 Gliner Apr 2003 A1
20030077448 Ueta et al. Apr 2003 A1
20030082507 Stypulkowski May 2003 A1
20030087264 Kaplitt et al. May 2003 A1
20030088274 Gliner et al. May 2003 A1
20030097161 Firlik et al. May 2003 A1
20030125786 Gliner et al. Jul 2003 A1
20030130706 Sheffield et al. Jul 2003 A1
20030195588 Fischell et al. Oct 2003 A1
20030204135 Bystritsky Oct 2003 A1
20040010177 Rohan et al. Jan 2004 A1
20040019370 Gliner et al. Jan 2004 A1
20040051279 Grant et al. Mar 2004 A1
20040077921 Becker et al. Apr 2004 A1
20040077923 Frimerman et al. Apr 2004 A1
20040122281 Fischell et al. Jun 2004 A1
20040127942 Yomtov et al. Jul 2004 A1
20040138524 Ueda et al. Jul 2004 A1
20040138550 Hartlep et al. Jul 2004 A1
20040143300 Rogers Jul 2004 A1
20040153129 Pless et al. Aug 2004 A1
20040167592 Grove et al. Aug 2004 A1
20040172012 Otsuka et al. Sep 2004 A1
20040193001 Miller Sep 2004 A1
20040193002 Tanner et al. Sep 2004 A1
20040204625 Riehl et al. Oct 2004 A1
20050021104 Dilorenzo Jan 2005 A1
20050124848 Holzner Jun 2005 A1
20050212162 Aisenbrey Sep 2005 A1
20050216071 Devlin et al. Sep 2005 A1
20050228209 Schneider et al. Oct 2005 A1
20050234286 Riehl et al. Oct 2005 A1
20050256539 George et al. Nov 2005 A1
20060052687 Ruohonen Mar 2006 A1
20060113696 Aisenbrey Jun 2006 A1
20060199992 Eisenberg et al. Sep 2006 A1
20090240096 Riehl et al. Sep 2009 A1
Foreign Referenced Citations (60)
Number Date Country
0977216 Feb 2000 EP
0998958 May 2000 EP
1145738 Oct 2001 EP
1273320 Jan 2003 EP
S60-1816 Jan 1985 JP
61-112310 May 1986 JP
62-43113 Feb 1987 JP
01-220407 Sep 1989 JP
6-41376 Feb 1994 JP
10-41119 Feb 1998 JP
11-144971 May 1999 JP
11-354359 Dec 1999 JP
2000-100617 Apr 2000 JP
2000-504785 Apr 2000 JP
2000-504966 Apr 2000 JP
2001-293098 Oct 2001 JP
2001-526947 Dec 2001 JP
2002-015912 Jan 2002 JP
2003-180649 Jul 2003 JP
2003-303711 Oct 2003 JP
2004-237050 Aug 2004 JP
2004-253434 Sep 2004 JP
2004-288437 Oct 2004 JP
2005-095591 Apr 2005 JP
2005-171275 Jun 2005 JP
2230533 Jun 2004 RU
2235527 Sep 2004 RU
2235528 Sep 2004 RU
2235529 Sep 2004 RU
2248821 Mar 2005 RU
WO 1997030810 Aug 1997 WO
WO 1998006342 Feb 1998 WO
WO 1999033516 Jul 1999 WO
WO 1999064884 Dec 1999 WO
WO 2000074777 Dec 2000 WO
WO 2001012236 Feb 2001 WO
WO 2001028622 Apr 2001 WO
WO 2001097906 Dec 2001 WO
WO 2002009811 Feb 2002 WO
WO 2002031604 Apr 2002 WO
WO 2002032504 Apr 2002 WO
WO 2002072194 Sep 2002 WO
WO 2002085449 Oct 2002 WO
WO 2002085454 Oct 2002 WO
WO 2002089902 Nov 2002 WO
WO 2002094997 Nov 2002 WO
WO 2003035163 May 2003 WO
WO 2003039468 May 2003 WO
WO 2003082405 Oct 2003 WO
WO 2003084605 Oct 2003 WO
WO 2003085546 Oct 2003 WO
WO 2003090604 Nov 2003 WO
WO 2003098268 Nov 2003 WO
WO 2004006750 Jan 2004 WO
WO 2004082759 Sep 2004 WO
WO 2004100765 Nov 2004 WO
WO 2005000401 Jan 2005 WO
WO 2005065768 Jul 2005 WO
WO 2005067610 Jul 2005 WO
2008-070001 Jun 2008 WO
Non-Patent Literature Citations (29)
Entry
Awiszus et al., “Characterization of Paired-Pulse Transcranial Magnetic Stimulation Conditions Yielding Intracortical Inhibition of 1-Wave Facilitation using a Threshold Paradigm”, Experimental Brain Research, vol. 129, No. 2, Nov. 1999, pp. 317-324.
Baudewig et al., “Functional MRI of Cortical Activations Induced by Transcranial Magnetic Stimulation (TMS)”, Brain Imaging-Neuro Report, Nov. 16, 2001, vol. 12, No. 16,2001, pp. 3543-3548.
Bohning et al., “A Combined TMS/fMRI Study of Intensity-Dependant TMS over Motor Cortex”, Society of Biological Psychiatry, vol. 45, No. 4, Feb. 1999, pp. 385-394.
Bohning et al., “A TMS Coil Positioning/Holding System for MR Image-Guided TMS Inter Leaved with fMRI”, Clinical Neurophysiology, Nov. 2003, vol. 114, No. 11, 2003, pp. 2210-2219.
Bohning et al., “BOLD-fMRI Response to Single-Pulse Transcranial Magnetic Stimulation (TMS)”, Journal of Magnetic Resonance Imaging, vol. 11, No. 6, Jun. 2000, pp. 569-574.
Garcia-Toro et al., “Modest Adjunctive Benefit with Transcranial Magnetic Stimulation in Medication-Resistant Depression”, Journal of Affective Disorders, vol. 64, No. 2-3, May 2001, pp. 271-275.
George et al., “A Controlled Trial of Daily Left Prefrontal Cortex TMS for Treating Depression”, Society of Biological Psychiatry, vol. 48, No. 10, Nov. 15, 2000, pp. 962-970.
George, Marks., “New Methods of Minimally Invasive Brain Modulation as Therapies in Psychiatry:TMS, MST, VNS and DBS”, Chinese Medical Journal, Aug. 2002, vol. 65, No. 8, Sep. 2002, pp. 349-350.
Grafman, Jordan, “TMS as a Primary Brain Mapping Tool”, Transcranial Magnetic Stimulation in Neuropsychiatry, First Edition, American Psychiatric Press, 2000, pp. 115-140.
Greene APA Meeting, “Electromagnetic Stimulation Relieves Depression”, May 17, 1999, 3 pages.
Hess et al., “Magnetic Stimulation of the Human Brain: Influence of Size and Shape of the Stimulating Coil”, Motor Disturbances II, May 1990, pp. 31-42.
Iramina et al., “Effects of Transcranial Magnetic Stimulation on EEG Activity”, IEEE transactions on Magnetics, vol. 38, No. 5, Sep. 2002, pp. 3347-3349.
Lisanby et al., “Sham TMS: Intracerebral Measurement of the Induced Electrical Field and the Induction of Motor-Evoked Potentials”, Society of Biological Psychiatry, vol. 49, No. 1, Mar. 2001, pp. 460-463.
Lisanby, Sarah H., “Magnetic Seizure Therapy of Major Depression”, Archives of General Psychiatry, Mar. 2001, vol. 58, No. 3, Mar. 2001, pp. 303-307.
Lisanby, Sarah H., “Safety and Feasibility of Magnetic Seizure Therapy (MST) in Major Depression: Randomized Within-Subject Comparison with Electroconvulsive Therapy”, Neuropsychopharmacology, New York State Psychiatric Institute, vol. 28, No. 10, Jul. 2003, pp. 1852-1865.
Lisanby, Sarah H., “Update on Magnetic Seizure Therapy: A Novel Form of Convulsive Therapy”, The Journal of ECT, vol. 18, No. 4, Dec. 2002, pp. pp. 182-188.
Loo et al., “Transcranial Magnetic Stimulation (TMS) in Controlled Treatment Studies: Are Some “Sham” Forms Active?”,Society of Biological Psychiatry, vol. 47, No. 4, Feb. 15, 2000, pp. 325-331.
Lorberbaum, J. P., “Safety Concerns of TMS”, Transcranial Magnetic Stimulation in Neuropsychiatry, First Edition, American Psychiatric Press, 2000, pp. 141-161.
Nahas et al., “Left Prefrontal Transcranial Magnetic Stimulation (TMS) Treatment of Depression in Bipolar Affective Disorder: A Pilot Study of Acute Safety and Efficacy”, Bipolar Disorders, vol. 5, No. 1, Feb. 2003.
Nahas et al., “Safety and Feasibility of Repetitive Transcranial Magnetic Stimulation in the Treatment of Anxious Depression in Pregnancy: A Case Report”, The Journal of Clinical sychiatry , vol. 60, No. 1, Jan. 1999, pp. 50-52.
Nahas et al., “Unilateral Left Prefrontal Transcranial Magnetic Stimulation (TMS) Produces Intensity-Dependent Bilateral Effects as Measured by Interleaved BOLD FMRI”, Society of Biological Psychiatry, vol. 50, No. 9, Nov. 1, 2001, pp. 712-720.
Pascual-Leone, et al., “Rapid-Rate Transcranial Magnetic Stimulation of Left Dorsolateral Prefrontal Cortex in Drug-Resistant Depression”, The Lancet, vol. 348, No. 9022, Jul. 27, 1996, pp. 233-237.
Pridmore, Saxby, “Rapid Transcranial Magnetic Stimulation and Normalization of the Dexamethasone Suppression Test”, Psychiatry and Clinical Neurosciences, vol. 53, No. 1, Feb. 1999, pp. 33-37.
Roth et al., “A Coil Design for Transcranial Magnetic Stimulation of Deep Brain Regions”, Journal of Clinical Neurophysiology, vol. 19, No. 4, Aug. 2002, pp. 361-370.
Ruohonen, Jarmo, “Electroencephalography Combined with TMS”, BioMag Laboratory, Helsinki University Central Hospital, Available at http://www.biomag.helsinki.fi/tms/TMSEEG.html , Oct. 6, 1999, 22 pages.
Sommer et al., “Increased Transcranial Magnetic Motor Threshold after ECT”, European Archives of Psychiatry and Clinical Neuroscience, vol. 252, No. 5, Oct. 2002, pp. 250-252.
Terrace et al., “The Cognitive Effects of Electroconvulsive Shock and Magnetic SeizureTherapy in Rhesus Monkeys”, Society for Neuroscience, vol. 27, No. 1, 2001, pp. 1418.
Trivedi, Madhukar H., “Treatment-Resistant Depression: New Therapies on the Horizon”, Annals of Clinical Psychiatry, vol. 15, No. 1, Mar. 2003, pp. 59-70.
Wassermann, E.M., “Repetitive Transcranial Magnetic Stimulation: An Introduction and Overview”, CNS Spectrums, The International Journal of Neuropsychiatric Medicine, vol. 2, No. 1, Jan. 1997, pp. 21-25.
Related Publications (1)
Number Date Country
20180178026 A1 Jun 2018 US
Divisions (1)
Number Date Country
Parent 11325660 Jan 2006 US
Child 12479076 US
Continuations (4)
Number Date Country
Parent 14982739 Dec 2015 US
Child 15901853 US
Parent 12479076 Jun 2009 US
Child 14982739 US
Parent 11191106 Jul 2005 US
Child 11325660 US
Parent 11213415 Aug 2005 US
Child 11191106 US