Stimulation method and apparatus
阅读说明:本技术 刺激方法和设备 (Stimulation method and apparatus ) 是由 巴德里·阿穆图尔 于 2018-05-04 设计创作,主要内容包括:本方法和设备可以提供具有改善耐受性的改善功效。所述方法和设备可被配置为改变刺激,这可以降低受试者的神经适应并提供改善的响应。可以将声刺激作为音调来递送,这可使所述刺激对于接受所述刺激的所述受试者更容易接受。所述刺激可以包括变化的刺激,以减少对所述刺激的神经适应。可以通过改变占空比、频率或波形形状中的一个或多个来改变所述刺激。所述波形可以包括多个单独的脉冲,其中所述波形在多个脉冲之间变化。声刺激可与电刺激相结合。装置可包括多个传感器以确定所述受试者的所述响应。(The present methods and apparatus can provide improved efficacy with improved tolerability. The methods and devices may be configured to alter stimulation, which may reduce neural adaptation in a subject and provide improved response. Acoustic stimulation may be delivered as tones, which may make the stimulation more acceptable to the subject receiving the stimulation. The stimulus may include a changing stimulus to reduce a neural adaptation to the stimulus. The stimulus may be varied by varying one or more of the duty cycle, frequency, or waveform shape. The waveform may comprise a plurality of individual pulses, wherein the waveform varies between the plurality of pulses. Acoustic stimulation may be combined with electrical stimulation. The device may comprise a plurality of sensors to determine said response of said subject.)
1. An apparatus for treating a subject, the apparatus comprising:
an actuator configured to provide vibration and sound stimulation to the subject's skin in an area including underlying sensory nerve fibers and subcutaneous tissue; and
a processor coupled with the actuator, the processor configured with instructions to vibrate the skin and underlying subcutaneous tissue and neural structures of the subject.
2. The apparatus of claim 1, wherein the processor is configured with instructions to deliver a plurality of vibratory pulses to the subject, the plurality of pulses comprising frequencies corresponding to harmonics of a pitch.
3. The apparatus of claim 2, wherein the frequency is in the range of about 20Hz to about 20,000 Hz.
4. The device of claim 2, wherein the processor is configured to stimulate the ear with a plurality of frequencies corresponding to a pitch frequency.
5. The device of claim 1, wherein the processor is configured with instructions to automatically deliver the vibrational and acoustic stimuli based on real-time sensor measurements.
6. The device of claim 1, further comprising a stimulation electrode to deliver electrical stimulation to the subject.
7. The device of claim 1, further comprising a stimulation electrode that delivers electrical stimulation to the skin of the subject in a region comprising underlying sensory nerve fibers and subcutaneous tissue, and optionally wherein the actuator is located in proximity to the electrode so as to stimulate the region with mechanical vibration and electrical stimulation.
8. The device of claim 1, further comprising a drug delivery mechanism configured to release a drug in conjunction with the vibrational and acoustic stimulation.
9. A non-transitory computer-readable medium comprising machine-executable code that, upon execution by one or more processors, implements a method for treating a subject, the method comprising:
positioning an actuator to provide vibration and acoustic stimulation to the subject's skin in an area including underlying sensory nerve fibers and subcutaneous tissue; and
generating instructions to the actuator to vibrate the skin and underlying subcutaneous tissue and neural structures of the subject.
10. The method of claim 9, wherein the instructions comprise delivering a plurality of vibratory pulses to the subject, the plurality of pulses comprising frequencies corresponding to harmonics of a pitch.
11. The method of claim 10, wherein the frequency is in the range of about 20Hz to about 20,000 Hz.
12. The method of claim 10, wherein the one or more processors are configured to stimulate the ear with a plurality of frequencies corresponding to a pitch frequency.
13. The method of claim 9, wherein the instructions are generated based at least in part on real-time sensor measurements.
14. The method of claim 9, wherein the method further comprises delivering electrical stimulation to the subject using stimulation electrodes.
15. The method of claim 9, wherein the method further comprises delivering electrical stimulation to the skin of the subject in a region comprising underlying sensory nerve fibers and subcutaneous tissue using a stimulation electrode, and optionally wherein the actuator is located in proximity to the electrode so as to stimulate the region with mechanical vibration and electrical stimulation.
16. The method of claim 9, wherein the method further comprises delivering a drug in conjunction with the vibrational and acoustic stimulation.
17. A method for treating a subject, comprising:
positioning an actuator to provide vibration and acoustic stimulation to the subject's skin in an area including underlying sensory nerve fibers and subcutaneous tissue; and
generating, with the aid of one or more processors, instructions to the actuators to vibrate the skin of the subject and underlying subcutaneous tissue and neural structures.
18. The method of claim 17, wherein the instructions comprise delivering a plurality of vibratory pulses to the subject, the plurality of pulses comprising frequencies corresponding to harmonics of a pitch.
19. The method of claim 10, wherein the frequency is in the range of about 20Hz to about 20,000 Hz.
20. The method of claim 10, wherein the one or more processors are configured to stimulate the ear with a plurality of frequencies corresponding to a pitch frequency.
21. The method of claim 17, wherein the instructions are generated based at least in part on real-time sensor measurements.
22. The method of claim 17, further comprising delivering electrical stimulation to the subject using stimulation electrodes.
23. The method of claim 17, further comprising delivering electrical stimulation to the skin of the subject in a region comprising underlying sensory nerve fibers and subcutaneous tissue using a stimulation electrode, and optionally wherein the actuator is located in proximity to the electrode so as to stimulate the region with mechanical vibration and electrical stimulation.
24. The method of claim 17, further comprising delivering a drug in conjunction with the vibrational and acoustic stimulation.
Background
In at least some instances, existing methods and devices for providing ear nerve stimulation to a patient may not be ideal. Although vibration methods have been proposed, in at least some cases, users may not tolerate such nerve stimulation well, which may result in less than ideal compliance and therapeutic effect. Moreover, existing methods may be less ideally suited for determining treatment parameters for treating a subject, such as a human patient. Moreover, work in connection with the present disclosure suggests that the nervous system may adapt to stimulation, and existing methods and devices may be less ideally suited to address neural adaptation that may reduce treatment efficacy.
Disclosure of Invention
The present methods and apparatus can provide improved efficacy with improved tolerability and reduced device related adverse effects. The device may be non-invasive, such as a wearable apparatus. The methods and devices may be configured to alter stimulation, which may reduce neural adaptation in a subject and provide improved response. The apparatus and method of the present invention can be placed at various locations on the body to vibrationally stimulate underlying neural structures. Multiple locations may be determined according to a particular therapy or drug. For example, the location may include a location corresponding to a chinese acupoint according to traditional chinese medicine, such as a limb and a plurality of other peripheral locations. In another example, the device is placed near a pinna location. For pinna applications, the vibratory stimulus may be delivered in a manner consistent with certain perceptions of pitch (pitch) and pleasing consonant combinations of pitch, which may make the stimulus more acceptable to the subject receiving the stimulus. The stimulus may include a changing stimulus to reduce a neural adaptation to the stimulus. The stimulus may be varied by varying one or more of the duty cycle, frequency, amplitude, waveform shape, or any combination of the above. The waveform may comprise a plurality of individual shaking pulses, wherein the waveform varies between the plurality of pulses. Mechanical vibratory stimulation may be combined with electrical stimulation to treat the target nerve with vibration and mechanical stimulation. The device may comprise a plurality of sensors to determine the response of the subject, and feedback from the sensors may be used to adjust the treatment.
In one aspect of the invention, a device for treating a subject is provided. The apparatus comprises: an actuator to provide vibration and acoustic stimulation to the skin of the subject in an area including underlying sensory nerve fibers and subcutaneous tissue, and a processor coupled with the actuator, the processor configured with instructions to vibrate the skin of the subject and underlying subcutaneous tissue and nerve structures.
In some embodiments, the processor is configured with instructions to deliver a plurality of vibratory pulses to the subject, the plurality of pulses comprising frequencies corresponding to harmonics of a pitch. In some cases, the frequency is in a range of about 20Hz (hertz) to about 20,000 hertz.
In some embodiments, the processor is configured with instructions to automatically deliver the vibrational and acoustic stimuli based on real-time sensor measurements. In some embodiments, the device further comprises a stimulation electrode that delivers electrical stimulation to the subject. In some embodiments, the device further comprises a stimulation electrode that delivers electrical stimulation to the skin of the subject in a region comprising underlying sensory nerve fibers and subcutaneous tissue, and optionally wherein the actuator is located in proximity to the electrode so as to stimulate the region with mechanical vibration and electrical stimulation. In some embodiments, the device further comprises a drug delivery mechanism configured to release a drug in conjunction with the vibrational and acoustic stimulation.
In another aspect, a non-transitory computer-readable medium comprising machine-executable code that, upon execution by one or more processors, implements a method for treating a subject is provided. The method comprises the following steps: positioning the actuator to provide vibration and sound stimulation to the skin of the subject in an area including underlying sensory nerve fibers and subcutaneous tissue; and generating instructions to the actuator to vibrate the skin of the subject and underlying subcutaneous tissue and neural structures.
In some embodiments, the instructions include delivering a plurality of vibratory pulses to the subject, the plurality of pulses including frequencies corresponding to harmonics of a pitch. In some cases, the frequency is in the range of about 20Hz to about 20,000 Hz. In some cases, the one or more processors are configured to stimulate the ear with a plurality of frequencies corresponding to pitch frequencies.
In some embodiments, the instructions are generated based at least in part on real-time sensor measurements. In some embodiments, the method further comprises delivering electrical stimulation to the subject using the stimulation electrode. In some embodiments, the method further comprises delivering electrical stimulation to the skin of the subject in a region comprising underlying sensory nerve fibers and subcutaneous tissue using a stimulation electrode, and optionally wherein the actuator is located in proximity to the electrode so as to stimulate the region with mechanical vibration and electrical stimulation. In some embodiments, the method further comprises delivering a drug in conjunction with the vibrational and acoustic stimulation.
In a related, but independent aspect, a method for treating a subject is provided. The method comprises the following steps: positioning the actuator to provide vibration and sound stimulation to the skin of the subject in an area including lower sensory nerve fibers and subcutaneous tissue; and generating, with the aid of one or more processors, instructions to the actuators to vibrate the subject's skin and underlying subcutaneous tissue and neural structures.
In some embodiments, the instructions include delivering a plurality of vibratory pulses to the subject, the plurality of pulses including frequencies corresponding to harmonics of a pitch. In some cases, the frequency is in the range of about 20Hz to about 20,000 Hz. In some cases, the one or more processors are configured to stimulate the ear with a plurality of frequencies corresponding to pitch frequencies.
In some embodiments, the instructions are generated based at least in part on real-time sensor measurements. In some embodiments, the method further comprises delivering an electrical stimulator to the subject using the stimulation electrode. In some embodiments, the method further comprises delivering electrical stimulation to the skin of the subject in a region comprising underlying sensory nerve fibers and subcutaneous tissue using a stimulation electrode, and optionally wherein the actuator is located in proximity to the electrode so as to stimulate the region with mechanical vibration and electrical stimulation. In some embodiments, the method further comprises delivering a drug in conjunction with the vibrational and acoustic stimulation.
Additional aspects and advantages of the present disclosure will become readily apparent to those skilled in this art from the following detailed description, wherein only illustrative embodiments of the present disclosure are shown and described. As will be realized, the disclosure is capable of other and different embodiments and its several details are capable of modifications in various, readily understood aspects all without departing from the disclosure. Accordingly, the drawings and description are to be regarded as illustrative in nature, and not as restrictive.
Is incorporated by reference
All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.
Drawings
The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:
FIG. 1 is a cross-sectional view of an external ear canal and pinna adapted for combination according to some embodiments;
FIG. 2A is a graphical representation of sensory inputs from the concha and external auditory canal to spinal nerves C2 and C3 and
FIG. 2B is a diagram of brainstem nuclei involved in sensory information processing for a combined trigeminal nerve according to some embodiments;
FIG. 3A illustrates sensory inputs from the pinna, concha and external auditory canal to C2, C3 and
FIG. 3B illustrates a brainstem nucleus similar to that shown in FIG. 2B, suitable for combination according to some embodiments;
fig. 4A illustrates a pinna stimulation device according to some embodiments;
figure 4B illustrates a lower posterior portion of an ear according to some embodiments;
fig. 5A illustrates a pinna stimulation device including an ear canal portion and a behind-the-ear portion, according to some embodiments;
fig. 5B illustrates a pinna stimulation device wherein the retroauricular assembly includes a pod, according to some embodiments;
fig. 6A illustrates waveforms of acoustic stimulation according to some embodiments;
FIG. 6B shows the duty cycle of the waveform as in FIG. 6A;
fig. 7 illustrates an implantable pellet configured to provide acoustic stimulation, in accordance with some embodiments;
FIG. 8 illustrates a circuit of an ear stimulation device that provides ear stimulation according to some embodiments; and
FIG. 9 illustrates a digital processing device according to some embodiments.
Detailed Description
The presently disclosed methods and devices can be configured in a variety of ways and are well suited for combination with a variety of types of therapies. For example, the presently disclosed methods and devices may be combined with existing defibrillators to provide improved therapeutic benefits. The methods and apparatus disclosed herein are well suited for combination with remote cloud-based servers and analytics, which can be used to deliver therapy to a subject. Although reference is made to therapy, the device may be configured to provide a number of additional or alternative benefits to the user, such as stimulation or relaxation.
Unless defined otherwise, all technical terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. As used in this specification and the appended claims, the singular forms "a," "an," and "the" include plural referents unless the context clearly dictates otherwise. Any reference to "or" herein is included.
For example, the device may be applied to multiple locations on the body in a non-invasive manner. In some cases, the plurality of locations may be selected according to the location of the peripheral nerve. The geometry or form factor of the device may vary depending on the different locations where it is placed. For example, a device worn around the wrist or arm may have a different size or geometry than a device worn around the ear. However, it should be understood that the method of providing the stimulus or function may be substantially the same between devices placed at different locations. Different treatment tables may be provided that include parameters corresponding to devices placed at different locations. In some embodiments, the device may be placed around the pinna location.
Fig. 1-3B illustrate known ear anatomies and paths suitable for incorporation according to embodiments disclosed herein and are described in Harper and Sauerland, U.S. patent publication No. US2015/0141879 entitled "Device, System and Method for reducing headcanal paper".
Fig. 1 is a cross-sectional view through the
FIG. 2A is a graphical representation of sensory input from the concha and external auditory canal to spinal nerves C2 and C3 and
Fig. 2B is a diagram of brainstem nuclei involved in processing of trigeminal sensory information. The major sensory nucleus (or major sensory nucleus) of the
Fig. 3A and 3B show sensory inputs from the auricle, concha, and external auditory meatus to C2, C3, and
Table 1: therapy and device combinations
Table 1 illustrates attributes of the methods and apparatus disclosed herein, according to some embodiments. The user device may comprise a user-wearable device configured to fit comfortably on the ear of a human subject with a suitable form factor. Alternatively or in combination, the user device may include form factors suitable for other locations (e.g., limbs) of the human subject. For example, the user device may have a form factor such as a wrist band, arm band/patch to be placed in a location other than the pinna location. The device may be configured to provide a combination of mechanical vibration and electrical stimulation to the skin. The apparatus may be configured to provide a combination of vibration and acoustic stimulation. The apparatus typically includes an acoustic vibration actuator and may include one or more electrodes for combination therapy. In some cases, the device may also include a drug delivery feature. Alternatively, the device may be operatively coupled to a drug delivery assembly, such as an electronically controlled drug-releasing skin patch or an implantable drug delivery assembly, to deliver a pre-programmed drug infusion to a desired site. The device may be configured with a stimulation pattern to provide neural stimulation as described herein. The stimulation location may be one or more of a plurality of locations on the ear of the subject as described herein. As described herein, stimulation may be delivered to the ear and other locations of a subject. The apparatus may comprise a user interface and may for example comprise an on/off switch. An application of a mobile device coupled to the wearable device may be provided to the user interface.
The responsiveness of the treatment may be monitored by sensors on the device. In some cases, one or more sensors for detecting treatment responsiveness are provided on the device. Alternatively or additionally, one or more sensors for detecting physiological conditions may be located at a location remote from the device. The sensors may be located on or near the subject, and the collected sensor measurements may be transmitted to an apparatus or processor in communication with the device.
While the sensor may be configured in a variety of ways, in many embodiments the sensor and associated circuitry is configured to determine and detect, for example, Atrial Fibrillation (AF), bradycardia, tachycardia, Heart Rate Variability (HRV), and other cardiac function determinations. The device may use various types of sensors. For example, the device may include an electrical sensor for determining an Electrocardiogram (ECG) signal of the subject. Alternatively or in combination, additional sensors, such as accelerometers, may be provided to determine the subject's movement pattern and direction. The device may include a sensor, such as a pulse oximeter, that measures tissue oxygenation. As noted above, the electrical sensor may be located on the device or at a human location remote from the device.
The device may be configured to automatically provide a therapeutic dose to the subject, for example, using a therapy table/library stored locally on the device. The treatment may be dose adjusted to provide a sufficient amount of stimulation to provide a therapeutic benefit. The therapy table or library may be local on the device or remotely accessed by the apparatus. In some cases, the therapies stored in the therapy table/library may include predetermined parameters such as mechanical vibration stimulation location, duration, stimulation pattern, size, frequency, vibration duty cycle, pitch or tone of acoustic stimulation, various parameters of electrical stimulation, or drug delivery. In some cases, the therapy table may also include a selection of multi-modal or single-modal, vibrational modes (e.g., single-sided vibrational mode, double-sided vibrational mode), or various other modes. Such parameters may be adjusted by a user via a user worn device or a user computing device, preset by the system, or automatically updated or loaded from a source (e.g., a cloud-based server). Alternatively or additionally, the amount of treatment may be increased or decreased as needed, corresponding to real-time feedback. The device or system may automatically adjust the dosage in substantially real time based on physiological inputs. Physiological input may be obtained through analysis of one or more sensor measurements and/or manual user input. Multiple parameters of the treatment dosage may be adjusted until the physiological input reaches a pre-programmed setting.
The user-worn device may be configured to be easy to use and provide an acceptable experience for the subject. For example, the device may be configured to play music in combination with a therapy. Alternatively or in combination, the apparatus may be configured to provide acoustic vibration therapy corresponding to a particular pitch (note) or harmonic of a pitch (note) as described herein, thereby making the acoustic stimulus more acceptable to the subject.
In some cases, the device may be configured with active or passive ambient noise cancellation functionality, which may be beneficial to the subject. The device may be configured to provide noise cancellation of audible and non-audible sound frequencies.
The device may communicate with an external computing device such that one or more functions of the device may be controlled via the external computing device. The external computing device may be a mobile device (e.g., a smartphone, a tablet, a pager, a Personal Digital Assistant (PDA)), a computer (e.g., a laptop, a desktop, a server, or any other type of device.
The user-worn device may include wireless communication circuitry that allows the user-worn device to communicate with other devices, such as the mobile devices described herein. The user device may communicate with an application on a watch, smartphone, or other mobile device. In some cases, the user-worn device may communicate with other sensors or devices remote from the user-worn device. The user device may communicate with a remote server, such as a cloud-based server, and the user device may include components of a cloud-based platform as described herein. The cloud-based platform may be configured to provide remote access. In some embodiments, for example, the user-worn device may be remotely accessible. The wireless communication circuit may enable short-range or long-range wireless communication. Examples of wireless communication may include, but are not limited to, WiFi, 3G, 4G, LTE, radio frequency, bluetooth, infrared, or any other type of communication.
The user-worn device may be configured to provide an appropriate dosage to the subject. For example, the parameters may be programmed using other processor instructions residing on software or a device. The parameters of the device may be adjusted to provide the appropriate treatment. A number of parameters of the dose that may be adjusted may include, for example, the location of the mechanical vibratory stimulation, duration, stimulation pattern, size, frequency, vibration duty cycle, various parameters of the electrical stimulation, or drug delivery. The range of parameters may vary during therapy and may be within the acceptable ranges described herein. The stimulation pattern may include the pitch of the harmonics (notes) and may be adjusted during treatment to reduce adaptation of neurons and nerves to the stimulation pattern. The dose can be adjusted to fit the subject, and can be determined based on the subject's response to the therapy. The device may be configured to operate at points (vibration frequency and intensity) characterized by certain functional responses reflected on the primary heart rate and heart rate dynamics as well as skin resistance (galvanic skin determination) and/or pupil diameter changes provided by neural therapy, for example, with therapy downloaded to the device.
The user-worn device may be configured to perform a physiological measurement of the subject and may include appropriate sensors and circuitry known to those of ordinary skill in the art to measure one or more of heart rate, heart rate variability, sleep quality, blood oxygen saturation, and respiration, for example.
The user-worn device may be configured to treat a variety of indications, including, but not limited to, cardiovascular diseases such as myocardial infarction, heart failure, atherosclerosis, neurological conditions such as stroke, alzheimer's disease, inflammation, and inflammatory conditions such as arthritis, crohn's disease, and pain.
User-worn devices are well suited for combination therapies. The device may include electrodes and circuitry for combination therapy with acoustic, mechanical vibration, and electrical pinna stimulation. The device may be configured to provide acoustic or electrical pinna stimulation in combination with a wearable defibrillator (e.g., a commercially available wearable defibrillator vest such as from Zoll Medical Corporation). For example, a user-worn device may be configured to provide pinna stimulation in combination with implantable ECG electrodes. For example, the user-worn device may be combined with a drug therapy.
The user-worn device may be configured to provide stimulation to both ears, with a similar device placed in a second ear of the subject. The user-worn device may be configured to provide the combined stimulus to other peripheral locations as described elsewhere herein.
Fig. 4A illustrates a pinna stimulation device according to some embodiments; the
The
The
The
One or
Figure 4B illustrates a
FIG. 5A shows a pinna stimulation device including an ear canal portion and a posterior portion of an ear; the
Each of the
While the
Fig. 5B illustrates a
Fig. 6A illustrates a stimulation waveform for controlling a vibration stimulation, according to some embodiments. For example, the stimulation waveform may include a ramp up and a ramp down. Alternatively or in combination, the stimulation waveform may comprise an approximately sinusoidal waveform or a pulsed signal. For example, the stimulation waveform may include a voltage and/or current to the actuator, or a current to the electrode.
Fig. 6B shows the duty cycle of the stimulation waveform. Typically, the duty cycle corresponds to the amount of time that the actuator or electrode is activated (e.g., turned on) divided by the amount of time that the actuator or electrode is turned off.
For example, the stimulation waveform may include a varying frequency or frequencies. The frequencies may be in the audible range, such as 20Hz to about 20,000Hz, which includes frequencies corresponding to at least harmonics of the pitch (note). Pitch may generally refer to the perceived order of sound on a scale related to frequency. A particular pitch relates to the location of a single sound in a range or scale. Pitch and tone may be related in that tone represents the "quality" of the sound, such as the sharpness or fullness of the sound. The note is a named pitch. For example, western music typically refers to a pitch of 440Hz as "a" (more specifically, a 4). In some cases, the acoustic stimulus may include harmonic acoustic characteristics. The harmonic sound characteristic may include a plurality of sound frequencies, with higher sound frequencies being approximately integer multiples of the lowest sound frequency (or fundamental frequency). Work in relation to the embodiments shows that altering the waveform can reduce the adaptation of the nerve to stimulation. The stimulation may be varied in a number of ways, for example, the waveform may comprise a plurality of individual waves spaced at intervals between each pulse. The amount of time may correspond to the frequency of the pitch (note) as described herein.
The frequency of pitch may correspond to piano key frequencies known to those of ordinary skill in the art, for example, as described in the Wikipedia website (en.
Table 2: piano key note
The stimulus waveform may be a waveform of a mechanical vibration stimulus. The electrical signal for electrical stimulation may or may not be synchronized with the mechanical vibration waveform. As previously mentioned, the device may provide a single-sided vibration mode, a double-sided vibration mode, or a combination of both. When the unilateral vibration mode is selected, the stimulus waveforms provided to the left and right ears are synchronized, and when the bilateral vibration mode is selected, the stimulus waveforms provided to the left and right ears are rhythmic left and right patterns.
Fig. 7 shows an implantable
Fig. 8 illustrates circuitry of a
The processor may comprise a commercially available processor known to those of ordinary skill in the art and may include one or more of a number of components as described herein, such as a time, analog-to-digital converter, digital-to-analog converter, and memory. The processor may comprise a gate array such as a programmable gate array or an application specific integrated circuit. The processor may include a memory as described herein. The memory may include treatment parameters corresponding to the pinna stimulation treatment described herein. The treatment parameters may include parameters of a treatment table having instructions to deliver and change auricle stimulation as described herein.
For example, the
The processor may be coupled to a Heart Rate (HR) sensor to determine the heart rate of the subject, e.g., in response to a known R peak of the heart rate. The processor may include instructions to determine the heart rate in response to the amplified electrical signals from the
The
For example, the
Although fig. 6 illustrates a
The
Digital processing device
Fig. 9 illustrates a
In some embodiments, the platforms, systems, media and methods described herein include digital processing devices or uses thereof. In further embodiments, the digital processing device includes one or more hardware Central Processing Units (CPUs) or general purpose graphics processing units (gpgpcpus) that perform device functions. In still further embodiments, the digital processing apparatus further comprises an operating system configured to execute the executable instructions. In some embodiments, the digital processing device is optionally connected to a computer network. In a further embodiment, the digital processing device is optionally connected to the internet so that it accesses the world wide web. In still further embodiments, the digital processing device is optionally connected to a cloud computing infrastructure. In other embodiments, the digital processing device is optionally connected to an intranet. In other embodiments, the digital processing device is optionally connected to a data storage device.
Suitable digital processing devices include, by way of non-limiting example, server computers, desktop computers, laptop computers, notebook computers, sub-notebook computers, netbook computers, notepad computers, set-top computers, media streaming devices, handheld computers, internet devices, mobile smart phones, tablet computers, personal digital assistants, video game consoles, and vehicles in accordance with the description herein. Those skilled in the art will recognize that many smart phones are suitable for use with the system described herein. Those skilled in the art will also recognize that alternative televisions, video players, and digital music players with alternative computer network connections are suitable for use with the system described herein. Suitable tablet computers include tablet computers having booklets, tablets and convertible configurations known to those skilled in the art.
In some implementations, the digital processing apparatus includes an operating system configured to execute executable instructions. An operating system is, for example, software containing programs and data that manages the hardware of the device and provides services for the execution of application programs. Those skilled in the art will recognize that suitable server operating systems include, by way of non-limiting example, FreeBSD, OpenBSD, NetBSD, Linux, and the like,
Mac OS XWindowsAndthose skilled in the art will recognize that suitable personal computer operating systems include, by way of non-limiting example Mac OSAnd UNIX-like operating systems such asIn some implementations, the operating system is provided by cloud computing. Those skilled in the art will also recognize that suitable mobile smartphone operating systems include, by way of non-limiting example, a mobile smartphone operating system OS、Research InBlackBerry WindowsOS、WindowsOS、Andthose skilled in the art will also recognize that suitable media streaming device operating systems include Apple, by way of non-limiting exampleGoogleGoogleAmazonAndthose skilled in the art will also recognize that suitable video gaming machine operating systems include, by way of non-limiting example XboxMicrosoft Xbox One、 WiiAndin some embodiments, the device comprises a storage and/or memory device. The storage and/or memory means are one or more physical devices for temporarily or permanently storing data or programs. In some embodiments, the device is a volatile memory and requires power to maintain the stored information. In some embodiments, the device is a non-volatile memory and retains stored information when the digital processing device is not powered. In a further embodiment, the non-volatile memory comprises flash memory. In some embodiments, the non-volatile memory comprises Dynamic Random Access Memory (DRAM). In some embodiments, the non-volatile memory includes Ferroelectric Random Access Memory (FRAM). In some embodiments, the non-volatile memory includes phase change random access memory (PRAM). In other embodiments, the device is a storage device including, by way of non-limiting example, a CD-ROM, a DVD, a flash memory device, a magnetic disk drive, a magnetic tape drive, an optical disk drive, and a cloud-based computing memory. In further embodiments, the storage and/or memory device is a combination of devices such as those disclosed herein.
In some embodiments, the digital processing device includes a display that delivers visual information to the user. In some embodiments, the display is a Cathode Ray Tube (CRT). In some embodiments, the display is a Liquid Crystal Display (LCD). In a further embodiment, the display is a thin film transistor liquid crystal display (TFT-LCD). In some embodiments, the display is an Organic Light Emitting Diode (OLED) display. In various further embodiments, on the OLED display is a passive matrix OLED (pmoled) or active matrix OLED (amoled) display. In some embodiments, the display is a plasma display. In other embodiments, the display is a video projector. In still further embodiments, the display is a combination of devices such as those disclosed herein.
In some embodiments, the digital processing device includes an input device that receives information from a user. In some embodiments, the input device is a keyboard. In some embodiments, the input device is a pointing device, including, by way of non-limiting example, a mouse, a trackball, a trackpad, a joystick, a game controller, or a stylus. In some implementations, the input device is a touch screen or a multi-touch screen. In other embodiments, the input device is a microphone that captures voice or other sound input. In other embodiments, the input device is a camera or other sensor for capturing motion or visual input. In further embodiments, the input device is a Kinect, Leap Motion, or the like. In still further embodiments, the input device is a combination of devices such as those disclosed herein.
Referring to fig. 9, in certain embodiments, an exemplary
With continued reference to FIG. 9, CPU905 may execute a series of machine-readable instructions, which may be embodied in a program or software. The instructions may be stored in a storage location, such as
With continued reference to fig. 9, the
With continued reference to FIG. 9,
The methods as described herein may be implemented by way of machine (e.g., computer processor) executable code stored on an electronic storage location of the
Non-transitory computer-readable storage medium
In some embodiments, the platforms, systems, media, and methods disclosed herein include one or more non-transitory computer-readable storage media programmed with a program comprising instructions executable by an operating system of an optional networked digital processing device. In a further embodiment, the computer readable storage medium is a tangible component of a digital processing apparatus. In yet another embodiment, the computer readable storage medium is optionally removable from the digital processing apparatus. In some embodiments, the computer-readable storage medium includes, by way of non-limiting example, flash memory devices, solid state memory, and the like. In some cases, programs and instructions are encoded on media permanently, substantially permanently, semi-permanently, or non-temporarily.
Computer program
In some embodiments, the platforms, systems, media and methods disclosed herein comprise at least one computer program or use thereof. The computer program includes a series of instructions executable in the CPU of the digital processing apparatus, which are written to perform specified tasks. Computer readable instructions may be implemented as program modules, such as functions, objects, Application Programming Interfaces (APIs), data structures, etc., that perform particular tasks or implement particular abstract data types. Based on the disclosure provided herein, one of ordinary skill in the art will recognize that computer programs may be written in various versions of various languages.
The functionality of the computer readable instructions may be combined or distributed as desired in various environments. In some embodiments, a computer program includes a sequence of instructions. In some embodiments, a computer program includes a plurality of sequences of instructions. In some embodiments, the computer program is provided from one location. In other embodiments, the computer program is provided from a plurality of locations. In various embodiments, the computer program includes one or more software modules. In various embodiments, the computer program includes, in part or in whole, one or more web applications, one or more mobile applications, one or more standalone applications, one or more web browser plug-ins, extensions, add-ons, or a combination thereof.
Web application
In some implementations, the computer program includes a web application. In light of the disclosure provided herein, one skilled in the art will recognize that, in various embodiments, web applications use one or more software frameworks and one or more database systems. In some embodiments, based on a signal such asNET or Ruby on Rails (RoR) software framework creates web applications. In some embodiments, the web application utilizes one or more database systems including, by way of non-limiting example, a relational database system, a non-relational numberDatabase systems, object-oriented database systems, relational database systems, and XML database systems. In further embodiments, suitable relational database systems include, by way of non-limiting example
An SQL server, And Oracle. Those skilled in the art will also recognize that, in various embodiments, web applications are written in one or more versions of one or more languages. The web application may be written in one or more markup languages, presentation definition languages, client-side scripting languages, server-side coding languages, database query languages, or a combination thereof. In some implementations, the web application is written in some way in a markup language such as hypertext markup language (HTML), extensible hypertext markup language (XHTML), or extensible markup language (XML). In some implementations, the web application is written in a representation definition language such as Cascading Style Sheets (CSS) to some extent. In some embodiments, web applications are implemented to some extent using, for example, asynchronous Javascript and XML (AJAX),Action script, Javascript orIs written in the client scripting language of (1). In some embodiments, the web application is implemented to some extent using a software application such as Active Server Pages (ASPs),Perl、JavaServer Pages(JSP) A hypertext preprocessor (PHP),Ruby、Tcl、Smalltalk、Or Groovy's server-side coding language. In some implementations, the web application is written to some extent in a database query language, such as the Structured Query Language (SQL). In some embodiments, the web application integrates a web application such asLotusThe enterprise server product of (1). In some implementations, the web application includes a media player element. In various further embodiments, the media player component utilizes one or more of a number of suitable multimedia technologies, including, by way ofmobile application program
In some embodiments, the computer program includes a mobile application program provided to the mobile digital processing device. In some embodiments, the mobile application is provided to the mobile digital processing device at the time of its manufacture. In other embodiments, the mobile application is provided to the mobile digital processing device via a computer network as described herein.
In view of the disclosure provided herein, mobile applications are created by techniques known to those skilled in the art using hardware, language, and development environments known to those skilled in the art. Those skilled in the art will recognize that mobile applications are written in a variety of languages. Non-limiting examples of suitable programming languages include C, C + +, C #, Objective-C, JavaTM、Javascript、Pascal、Object Pascal、PythonTMNet, WML and XHTML/HTML with or without CSS or a combination thereof.
Suitable mobile application development environments are available from a variety of sources. By way of non-limiting example, commercially available development environments include AirplaySDK, alchemiO, AlcheMo,Celsius, Bedrop, FlashLite,. NET Compact frame, Rhomobile and WorkLight mobile platforms. Other development environments are available for free, including Lazarus, mobilflex, MoSync, and Phonegap, as non-limiting examples. In addition, mobile device manufacturers distribute software development kits that include, by way of non-limiting example, iPhone and IPad (iOS) SDK, AndroidTMSDK、SDK、BREW SDK、
OS SDK, Symbian SDK, webOS SDK andMobileSDK。those skilled in the art will recognize that a number of business forums may be used to distribute mobile applications, including, by way of non-limiting example,
App Store、Play、Chrome WebStore、app World, App Store for Palm devices, App Catalog for webOS,Marketplace for Mobile, used forOvi Store, of the plant,Apps andDSi Shop。standalone application
In some embodiments, the computer program comprises a stand-alone application that is a program that runs as a stand-alone computer process, rather than an add-on to an existing process, e.g., rather than a plug-in. Those skilled in the art will recognize that stand-alone applications are often compiled. A compiler is a computer program that converts source code written in a programming language into binary object code, such as assembly language or machine code. By way of non-limiting example, suitable compiled programming languages include C, C + +, Objective-C, COBOL, Delphi, Eiffel,
Lisp、Visual Basic and vb. Compilation is typically performed, at least in part, to create an executable program. In some embodiments, a computer programThe program includes one or more executable compiled applications.Web browser plug-in
In some implementations, the computer program includes a web browser plug-in (e.g., extension, etc.). In computing, a plug-in is one or more software components that add specific functionality to a larger software application. Manufacturers of software applications support plug-ins to enable third party developers to create functionality for extended applications, support easy addition of new functionality, and reduce the size of applications. When supported, the plug-in allows the functionality of the software application to be customized. For example, plug-ins are commonly used in web browsers to play videos, generate interactivity, scan for viruses, and display specific file types. Those skilled in the art will be familiar with several web browser plug-ins, including
Player、And in some implementations, the toolbar includes one or more web browser extensions, add-ons, or add-ons. In some embodiments, the toolbar includes one or more explorer bars, toolbars, or desktop bars.In view of the disclosure provided herein, one skilled in the art will recognize that a variety of plug-in frameworks may be used to develop plug-ins in a variety of programming languages, including, by way of non-limiting example, C + +, Delphi, Java, for exampleTM、PHP、PythonTMNet or a combination thereof.
Web browsers (also known as Internet browsers) are software applications designed for use with network-connected digital processing devices for retrieval, presentation, and navigationInformation resources on the world wide web. By way of non-limiting example, suitable web browsers includeInternet
Chrome、OperaAnd KDE Konqueror. In some implementations, the web browser is a mobile web browser. Mobile web browsers (also known as microbrowsers, and wireless browsers) are designed for use with mobile digital processing devices, including by way of non-limiting example mobile digital processing device handheld computers, tablet computers, netbook computers, sub-notebook computers, smart phones, music players, Personal Digital Assistants (PDAs), and handheld video game systems. By way of non-limiting example, suitable mobile web browsers includeBrowser, RIMA browser,Blazer、A browser,for mobile、InternetMobile、Basic Web、Browser, OperaMobile andPSPTMa browser.Software module
In some embodiments, the platforms, systems, media and methods disclosed herein include software, servers and/or database modules or uses thereof. In view of the disclosure provided herein, software modules are created by techniques known to those skilled in the art using machines, software, and languages known to those skilled in the art. The software modules disclosed herein are implemented in a variety of ways. In various embodiments, a software module comprises a file, a code segment, a programming object, a programming structure, or a combination thereof. In further various embodiments, a software module includes a plurality of files, a plurality of pieces of code, a plurality of programming objects, a plurality of programming structures, or a combination thereof. In various embodiments, the one or more software modules include, by way of non-limiting example, a web application, a mobile application, and a standalone application. In some embodiments, the software modules are in one computer program or application. In other embodiments, the software modules are in more than one computer program or application. In some embodiments, the software module is hosted on one machine. In other embodiments, the software module is hosted on more than one machine. In further embodiments, the software module is hosted on a cloud computing platform. In some implementations, the software modules are hosted on one or more machines in one location. In other embodiments, the software module is hosted on a machine in one or more of more than one location.
Database with a plurality of databases
In some embodiments, the platforms, systems, media, and methods disclosed herein include one or more databases or uses thereof. In view of the disclosure provided herein, one skilled in the art will recognize that a variety of databases are suitable for storing and retrieving therapy information or user-specific information. In various embodiments, suitable databases include, by way of non-limiting example, relational databases, non-relational databases, object-oriented databases, object databases, entity-relational model databases, relational databases, and XML databases. Other non-limiting examples include SQL, PostgreSQL, MySQL, Oracle, DB2, and Sybase. In some embodiments, the database is internet-based. In a further embodiment, the database is web-based. In still further embodiments, the database is cloud computing based. In other embodiments, the database is based on one or more local computer storage devices.
The disclosed methods and apparatus are suitable for combination with previous treatment methods. The acoustic pinna stimulation device may include one or more electrodes and sensing circuitry to deliver electrical stimulation for treatment, as described in U.S. application serial No. 11/749,500 entitled "Systems for Stimulating Neural targets" published as US 2008/0288016, filed on 16.5.2007, the entire disclosure of which is incorporated herein by reference.
The
While preferred embodiments of the present invention have been shown and described herein, it will be readily understood by those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.
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