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WO2000074777A1 - Stimulation magnetique transcranienne permettant d'ameliorer la vision chez l'homme - Google Patents

Stimulation magnetique transcranienne permettant d'ameliorer la vision chez l'homme Download PDF

Info

Publication number
WO2000074777A1
WO2000074777A1 PCT/EP1999/003836 EP9903836W WO0074777A1 WO 2000074777 A1 WO2000074777 A1 WO 2000074777A1 EP 9903836 W EP9903836 W EP 9903836W WO 0074777 A1 WO0074777 A1 WO 0074777A1
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WO
WIPO (PCT)
Prior art keywords
stimulation
visual
magnetic
brain
subjects
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP1999/003836
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English (en)
Inventor
Bernhard A. Sabel
Janna Gothe
B. U. Meyer
S. Brandt
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Medinova Medical Consulting GmbH
Original Assignee
Medinova Medical Consulting GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Medinova Medical Consulting GmbH filed Critical Medinova Medical Consulting GmbH
Priority to AU45055/99A priority Critical patent/AU4505599A/en
Priority to PCT/EP1999/003836 priority patent/WO2000074777A1/fr
Publication of WO2000074777A1 publication Critical patent/WO2000074777A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N2/00—Magnetotherapy
    • A61N2/02—Magnetotherapy using magnetic fields produced by coils, including single turn loops or electromagnets

Definitions

  • TMS Transcranial Magnetic Stimulation
  • the invention relates to the transcranial magnetic stimulation (TMS) for improving vision of visually impaired or blind people.
  • TMS transcranial magnetic stimulation
  • the invention relates to the use of trans-cranial magnetic stimulation for improving the visual functions of humans and to a process for improving the visual function of humans by transcranial magnetic stimulation.
  • Loss of visual functions is a frequent consequence of brain injury which may be due to different disorders, including trauma, tumor, stroke or perinatal damage. Many patients with brain injury suffer from visual loss due to trauma, stroke, visual defects in early development etc.. This loss of vision is due to loss or impairment of visual system neurons in the brain. An activation of surviving neurons can, as of now, only be achieved by long-term, appropriate training of visual functions. Proper vision is commonly believed to require a highly specific neuronal organization, which is laid down during early development. Despite this specificity in neuronal organization, however, a considerable degree of plasticity exists in the injured visual system, and its activation is an important goal of clinical research. Surviving neurons in partially injured brain areas play the decisive role.
  • U.S. Patent No. 5,441,495 (Libof et al.) describes a method and an apparatus for thera- Illustrated stroke.
  • a controlled, fluctuating, directionally oriented magnetic field is produced parallel to a predetermined axis projecting through the cerebral tissue of the person to be treated. It is described in said document that the applied magnetic field, immediately applied after a stroke, may contribute to maintaining tissue viability and reducing edema by controlling ion electrolyte balance by adjusting the frequency of the fluctuating magnetic field and/or by adjusting the intensity of the applied magnetic field after nulling out the local magnetic field at the region containing the target cerebral tissue.
  • blindness is clinically defined by the inability of the patients to orient themselves in the visual environment without external help, this definition of blindness includes many subjects which still have some, often small, amount of residual vision.
  • partial blindness is a condition which is characterized by some intact sectors of the visual field, with patients being unable to perceive visual stimuli and objects in the remaining visual field sector which vary considerably in size and location.
  • TMS transcranial magnetic stimulation
  • rTMS repetitive transcranial magnetic stimulation
  • TMS may amplify the residual signals that the few surviving neurons in the brain transmit to higher brain areas, such as visual cortex.
  • TMS and particular rTMS was applied to the neocortex, producing markedly improved vision in patients which suffered severe visual impairments.
  • TMS and particularly rTMS comprises a new method to treat visual impairment in patients with visual system disorders.
  • rTMS repetitive transcranial magnetic stimulation
  • Repetitive transcranial magnetic stimulation i. e. the repetitive stimulation of certain parts of the brain by magnetic field pulses through the intact cranium, has recently been developed as a method to stimulate the brain non-invasively to either interfere with normal brain function or, when applied repetitively, to induce visual hallucinations or reduce depression (George et al., 1998).
  • rTMS has not been used to improve functions which have been lost following injury to the brain, such as vision.
  • rTMS surprisingly allows to stimulate areas of residual vision in such a manner that they become more excitable to the reduced visual input and thus increase their functions.
  • the invention related to the use of transcranial magnetic stimulation for improving the visual functions of a human.
  • the invention relates to a process for improving the visual function of a human by transcranial magnetic stimulation, said process comprising the steps of
  • TMS is achieved by holding a magnetic coil to the skull of a patient or a part thereof and inducing magnetic fields onto the cortical areas of interest. While in the present experiment this stimulation was limited to small, localized regions, it is apparent to those skilled in the art that stimulation of larger regions is also possible.
  • TMS When applied to the skull non-invasively, TMS induces an electric current through electromagnetic induction in the brain tissue. In this manner it is possible to stimulate selected areas of the brain without invasive procedures. This can be controlled by applying TMS through a grid, which permits that a selected brain region can be stimulated, recording the behavioral or perceptual response during or after the stimulation.
  • TMS TMS
  • magnetic interference with normal brain function to localized critical structures in the brain which are involved in the function to be studied
  • magnetic enhancement of normal brain function by strengthening endogenous signals.
  • TMS-induced functional enhancement is that of motor cortex stimulation which leads to a visible muscle twitch of the thumb in uninjured patients or the induction of phosphenes in a normal human being when the visual system in stimulated (Meyer et al., 1991).
  • TMS can be used to stimulate visual functions in patients with visual impairments in two ways: Firstly, it elicits photic sensations, called phosphenes, in blind and partially blind subjects, and secondly TMS may be used to improve residual visual perception within blind subjects beyond the period of actual stimulation.
  • a stimulation was carried out by magnetic field pulses through the intact cranium (transcranial magnetic stimulation; TMS). Particularly, more than 2 consecutive stimuli having a frequency of > 1 Hz were provided with a constant inter-stimulus interval (repetitive transcranial magnetic stimulation; rTMS).
  • Magnetic stimulation was delivered from a Dantec MagPro repetitive stimulator (maximum stimulator output: 4 Tesla).
  • a large figure eight coil Magnetic coil transducer MC-B70; coil winding data: inner radius 10 mm, outer radius 50 mm, winding height 6 mm
  • Orientation marks for easy positioning, low click noise level and a trigger button supported clinical use of the instrument.
  • motor- threshold measurements single pulse TMS
  • rTMS bi-phasic current
  • the subjects were blindfolded and seated in a darkened room.
  • the coil was placed laterally from the inion-nasion midline. Stimulation was started with 50% and adjusted until the subject reported phosphenes. The intensity then was tuned more precisely in order to determine the threshold of phosphene perception. The latter was determined both by increasing and decreasing the TMS intensity.
  • Table 2 shows the motor and visual thresholds for healthy subjects using 7 pulses with 15 Hz (0.5 s). Stimulation of visual cortex
  • the blindfolded subjects sat in a darkened room. They wore a cap with a coordinate system (l x l cm). The grid was placed in such a manner that the zero reference point was located above the inion and along the midline of the scull. The stimulator was positioned behind the subjects.
  • TMS During the first part of the stimulation, TMS was applied with 50% of the maximum stimulator output at the grid crosspoints located above visual cortex (5 cm lateral and up to 10 cm superior from the inion. The stimulation intensity corresponded to a factor of 1.25 of the motor threshold (see the above measurements). 7 TMS pulses (15 Hz; 0.5 s; biphasic current) were used. In the case of a higher or lower motor threshold, the stimulus intensity for the visual mapping was increased or decreased (6 subjects), respectively. After each single stimulation over the grid, the subjects had to describe all sensory perceptions they had during the stimulation, including quality, quantity and location. The reports were recorded on tape for subsequent analysis. As soon as any sensory perceptions were noted by the subjects, the corresponding visual threshold was recorded.
  • each subject was stimulated with increasing intensity (5 % over the stimulator output used in the first step of the experiment, at most 55 %) 10 times at different points over the grid at those positions where phosphenes had been noted before.
  • the subjects were then asked to report possible changes in perception, also recorded on tape, which occurred not only during the stimulation but particularly those which occurred after the stimulation was discontinued.
  • Table 3 shows a comparison of motor and visual thresholds (in percent of the stimulator output) in healthy and blind subjects.
  • Table 4 shows data of subjects with enhanced residual vision
  • phosphenes can be elicited in blind subjects, independent of whether or not they had some residual light detection before being entered into the study, i.e. minimal residual visual function in their individual history.
  • TMS-induced visual enhancement are not known at the current time and are not important with respect to the results achieved and reported here. How- ever, those skilled in the art will readily appreciate that visual enhancement by TMS may be similar to those processes which are also involved in long-term potentiation. For example, Pascual-Leone et al. (1998) report that rTMS modulates cortical excitability beyond the duration of the rTMS trains themselves.
  • Patient OO (age: 19 years) was blind since birth with lowest ability for light detectionof highly illuminated light sources.
  • the stimulation (7 TMS pulses; 15 Hz; 0.5 s interpulse interval; biphasic current), he reported an increasing brightness in his contralateral visual field (depending upon the stimulated hemisphere). Variation of stimulation intensity led to an alteration within this perception.
  • the patient noted a stable and increased ability of the orientation and light detection (e. g. he was able to determine the position of shades on the wall for a time beyond the duration of the stimulation).
  • Patient KR Treatment KR:
  • Patient KR was a 57 year old female patient who went blind approximately 36 years before the date of stimulation as a result of a medical practice known as "pneumencepha- lography" that is no longer used today.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Magnetic Treatment Devices (AREA)

Abstract

Cette invention a trait à une stimulation magnétique transcraniènne (TMS) permettant d'améliorer la vision chez l'homme, notamment chez des sujets atteints de déficience visuelle ou de cécité. Elle porte, notamment, sur l'utilisation de la stimulation magnétique transcraniènne visant à améliorer les fonctions visuelles chez l'homme ainsi que sur le procédé correspondant mettant en oeuvre cette technique.
PCT/EP1999/003836 1999-06-02 1999-06-02 Stimulation magnetique transcranienne permettant d'ameliorer la vision chez l'homme Ceased WO2000074777A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU45055/99A AU4505599A (en) 1999-06-02 1999-06-02 Transcranial magnetic stimulation (tms) for improving vision in humans
PCT/EP1999/003836 WO2000074777A1 (fr) 1999-06-02 1999-06-02 Stimulation magnetique transcranienne permettant d'ameliorer la vision chez l'homme

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP1999/003836 WO2000074777A1 (fr) 1999-06-02 1999-06-02 Stimulation magnetique transcranienne permettant d'ameliorer la vision chez l'homme

Publications (1)

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WO2000074777A1 true WO2000074777A1 (fr) 2000-12-14

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Cited By (27)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6926660B2 (en) 2003-03-07 2005-08-09 Neuronetics, Inc. Facilitating treatment via magnetic stimulation
DE102007003565A1 (de) 2007-01-24 2008-07-31 Forschungszentrum Jülich GmbH Vorrichtung zur Reduktion der Synchronisation neuronaler Hirnaktivität sowie dafür geeignete Spule
US7499894B2 (en) 2001-03-13 2009-03-03 Shimon Marom Cerebral programming
WO2009049068A1 (fr) * 2007-10-09 2009-04-16 Neostim, Inc. Affichage de champs magnétiques modélisés
WO2009063435A1 (fr) * 2007-11-14 2009-05-22 Mcgill University Appareil et procédé pour traiter un trouble visuel cortical par utilisation d'une stimulation magnétique transcrânienne
US7560058B2 (en) 2005-07-27 2009-07-14 Neuronetics, Inc. Magnetic core for medical procedures
US7601115B2 (en) 2004-05-24 2009-10-13 Neuronetics, Inc. Seizure therapy method and apparatus
US7651459B2 (en) 2004-01-06 2010-01-26 Neuronetics, Inc. Method and apparatus for coil positioning for TMS studies
US7857746B2 (en) 2004-10-29 2010-12-28 Nueronetics, Inc. System and method to reduce discomfort using nerve stimulation
US8052591B2 (en) 2006-05-05 2011-11-08 The Board Of Trustees Of The Leland Stanford Junior University Trajectory-based deep-brain stereotactic transcranial magnetic stimulation
US8088058B2 (en) 2005-01-20 2012-01-03 Neuronetics, Inc. Articulating arm
US8177702B2 (en) 2004-04-15 2012-05-15 Neuronetics, Inc. Method and apparatus for determining the proximity of a TMS coil to a subject's head
US8267850B2 (en) 2007-11-27 2012-09-18 Cervel Neurotech, Inc. Transcranial magnet stimulation of deep brain targets
JP2012529947A (ja) * 2009-06-17 2012-11-29 ネクスティム オーワイ 磁気刺激デバイスおよび方法
US8506468B2 (en) 2005-05-17 2013-08-13 Neuronetics, Inc. Ferrofluidic cooling and acoustical noise reduction in magnetic stimulators
US8517908B2 (en) 2003-03-07 2013-08-27 Neuronetics, Inc. Reducing discomfort caused by electrical stimulation
US8723628B2 (en) 2009-01-07 2014-05-13 Cervel Neurotech, Inc. Shaped coils for transcranial magnetic stimulation
US8795148B2 (en) 2009-10-26 2014-08-05 Cervel Neurotech, Inc. Sub-motor-threshold stimulation of deep brain targets using transcranial magnetic stimulation
US8845508B2 (en) 2004-04-09 2014-09-30 The Board Of Trustees Of The Leland Stanford Junior University Robotic apparatus for targeting and producing deep, focused transcranial magnetic stimulation
US8956273B2 (en) 2007-08-20 2015-02-17 Cervel Neurotech, Inc. Firing patterns for deep brain transcranial magnetic stimulation
US8956274B2 (en) 2007-08-05 2015-02-17 Cervel Neurotech, Inc. Transcranial magnetic stimulation field shaping
US9352167B2 (en) 2006-05-05 2016-05-31 Rio Grande Neurosciences, Inc. Enhanced spatial summation for deep-brain transcranial magnetic stimulation
US9492679B2 (en) 2010-07-16 2016-11-15 Rio Grande Neurosciences, Inc. Transcranial magnetic stimulation for altering susceptibility of tissue to pharmaceuticals and radiation
US9884200B2 (en) 2008-03-10 2018-02-06 Neuronetics, Inc. Apparatus for coil positioning for TMS studies
CN110975150A (zh) * 2019-12-18 2020-04-10 中国科学院深圳先进技术研究院 一种确定转捩点的方法及相关产品
US10695574B2 (en) 2015-10-21 2020-06-30 University Of Washington Sensory input through non-invasive brain stimulation
JP7620751B1 (ja) 2024-01-12 2025-01-23 ロート製薬株式会社 老視による視覚機能低下を治療、改善、緩和又は予防する方法

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Cited By (51)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7499894B2 (en) 2001-03-13 2009-03-03 Shimon Marom Cerebral programming
US7614996B2 (en) 2003-03-07 2009-11-10 Neuronetics, Inc. Reducing discomfort caused by electrical stimulation
US7153256B2 (en) 2003-03-07 2006-12-26 Neuronetics, Inc. Reducing discomfort caused by electrical stimulation
US7320664B2 (en) 2003-03-07 2008-01-22 Neuronetics, Inc. Reducing discomfort caused by electrical stimulation
US8517908B2 (en) 2003-03-07 2013-08-27 Neuronetics, Inc. Reducing discomfort caused by electrical stimulation
US8864641B2 (en) 2003-03-07 2014-10-21 Neuronetics, Inc. Reducing discomfort caused by electrical stimulation
US10413745B2 (en) 2003-03-07 2019-09-17 Neuronetics, Inc. Reducing discomfort caused by electrical stimulation
US6926660B2 (en) 2003-03-07 2005-08-09 Neuronetics, Inc. Facilitating treatment via magnetic stimulation
US7651459B2 (en) 2004-01-06 2010-01-26 Neuronetics, Inc. Method and apparatus for coil positioning for TMS studies
US8845508B2 (en) 2004-04-09 2014-09-30 The Board Of Trustees Of The Leland Stanford Junior University Robotic apparatus for targeting and producing deep, focused transcranial magnetic stimulation
US9421392B2 (en) 2004-04-15 2016-08-23 Neuronetics, Inc. Method and apparatus for determining the proximity of a TMS coil to a subject's head
US10596385B2 (en) 2004-04-15 2020-03-24 Neuronetics, Inc. Method and apparatus for determining the proximity of a TMS coil to a subject's head
US8177702B2 (en) 2004-04-15 2012-05-15 Neuronetics, Inc. Method and apparatus for determining the proximity of a TMS coil to a subject's head
US9681841B2 (en) 2004-04-15 2017-06-20 Neuronetics, Inc. Method and apparatus for determining the proximity of a TMS coil to a subject's head
US7601115B2 (en) 2004-05-24 2009-10-13 Neuronetics, Inc. Seizure therapy method and apparatus
US7857746B2 (en) 2004-10-29 2010-12-28 Nueronetics, Inc. System and method to reduce discomfort using nerve stimulation
US8088058B2 (en) 2005-01-20 2012-01-03 Neuronetics, Inc. Articulating arm
US10315041B2 (en) 2005-05-17 2019-06-11 Neuronetics, Inc. Ferrofluidic cooling and acoustical noise reduction in magnetic stimulators
US11185710B2 (en) 2005-05-17 2021-11-30 Neuronetics, Inc. Ferrofluidic cooling and acoustical noise reduction in magnetic stimulators
US8506468B2 (en) 2005-05-17 2013-08-13 Neuronetics, Inc. Ferrofluidic cooling and acoustical noise reduction in magnetic stimulators
US7963903B2 (en) 2005-07-27 2011-06-21 Neuronetics, Inc. Magnetic core for medical procedures
US9931518B2 (en) 2005-07-27 2018-04-03 Neuronetics, Inc. Magnetic core for medical procedures
US8246529B2 (en) 2005-07-27 2012-08-21 Neuronetics, Inc. Magnetic core for medical procedures
US7560058B2 (en) 2005-07-27 2009-07-14 Neuronetics, Inc. Magnetic core for medical procedures
US8657731B2 (en) 2005-07-27 2014-02-25 Neuronetics, Inc. Magnetic core for medical procedures
US9308386B2 (en) 2005-07-27 2016-04-12 Neuronetics, Inc. Magnetic core for medical procedures
US10617884B2 (en) 2005-07-27 2020-04-14 Neurontics, Inc. Magnetic core for medical procedures
US9486639B2 (en) 2006-05-05 2016-11-08 The Board Of Trustees Of The Leland Stanford Junior University Trajectory-based deep-brain stereotactic transcranial magnetic stimulation
US9352167B2 (en) 2006-05-05 2016-05-31 Rio Grande Neurosciences, Inc. Enhanced spatial summation for deep-brain transcranial magnetic stimulation
US8052591B2 (en) 2006-05-05 2011-11-08 The Board Of Trustees Of The Leland Stanford Junior University Trajectory-based deep-brain stereotactic transcranial magnetic stimulation
DE102007003565A1 (de) 2007-01-24 2008-07-31 Forschungszentrum Jülich GmbH Vorrichtung zur Reduktion der Synchronisation neuronaler Hirnaktivität sowie dafür geeignete Spule
DE102007003565B4 (de) * 2007-01-24 2012-05-24 Forschungszentrum Jülich GmbH Vorrichtung zur Reduktion der Synchronisation neuronaler Hirnaktivität sowie dafür geeignete Spule
US8956274B2 (en) 2007-08-05 2015-02-17 Cervel Neurotech, Inc. Transcranial magnetic stimulation field shaping
US8956273B2 (en) 2007-08-20 2015-02-17 Cervel Neurotech, Inc. Firing patterns for deep brain transcranial magnetic stimulation
US8265910B2 (en) 2007-10-09 2012-09-11 Cervel Neurotech, Inc. Display of modeled magnetic fields
WO2009049068A1 (fr) * 2007-10-09 2009-04-16 Neostim, Inc. Affichage de champs magnétiques modélisés
WO2009063435A1 (fr) * 2007-11-14 2009-05-22 Mcgill University Appareil et procédé pour traiter un trouble visuel cortical par utilisation d'une stimulation magnétique transcrânienne
US8267850B2 (en) 2007-11-27 2012-09-18 Cervel Neurotech, Inc. Transcranial magnet stimulation of deep brain targets
US8523753B2 (en) 2007-11-27 2013-09-03 Cervel Neurotech, Inc. Transcranial magnet stimulation of deep brain targets
US9884200B2 (en) 2008-03-10 2018-02-06 Neuronetics, Inc. Apparatus for coil positioning for TMS studies
US8723628B2 (en) 2009-01-07 2014-05-13 Cervel Neurotech, Inc. Shaped coils for transcranial magnetic stimulation
US9381374B2 (en) 2009-01-07 2016-07-05 Rio Grande Neurosciences, Inc. Shaped coils for transcranial magnetic stimulation
US9132277B2 (en) 2009-01-07 2015-09-15 Cerval Neurotech, Inc. Shaped coils for transcranial magnetic stimulation
JP2012529947A (ja) * 2009-06-17 2012-11-29 ネクスティム オーワイ 磁気刺激デバイスおよび方法
US8795148B2 (en) 2009-10-26 2014-08-05 Cervel Neurotech, Inc. Sub-motor-threshold stimulation of deep brain targets using transcranial magnetic stimulation
US9492679B2 (en) 2010-07-16 2016-11-15 Rio Grande Neurosciences, Inc. Transcranial magnetic stimulation for altering susceptibility of tissue to pharmaceuticals and radiation
US10695574B2 (en) 2015-10-21 2020-06-30 University Of Washington Sensory input through non-invasive brain stimulation
CN110975150A (zh) * 2019-12-18 2020-04-10 中国科学院深圳先进技术研究院 一种确定转捩点的方法及相关产品
JP7620751B1 (ja) 2024-01-12 2025-01-23 ロート製薬株式会社 老視による視覚機能低下を治療、改善、緩和又は予防する方法
WO2025150430A1 (fr) * 2024-01-12 2025-07-17 Rohto Pharmaceutical Co., Ltd. Méthode de traitement, d'amélioration, d'atténuation ou de prévention de la dégradation de la fonction visuelle due à la presbytie
JP2025109652A (ja) * 2024-01-12 2025-07-25 ロート製薬株式会社 老視による視覚機能低下を治療、改善、緩和又は予防する方法

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