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INVENTION
Patent of the Russian Federation RU2157260
ELECTROPHYSICAL METHOD OF RECONSTRUCTING THE FUNCTION OF THE OPTICAL ANALYZER
The name of the inventor: Korotkikh Sergey Alexandrovich; Kublanov Vladimir Semenovich; Gaziyeva Gulnara Irekovna
The name of the patent holder: Korotkikh Sergey Alexandrovich; Kublanov Vladimir Semenovich; Gaziyeva Gulnara Irekovna
Address for correspondence: 623400, Sverdlovsk Region, Kamensk-Uralsky, ul. Dobrolyubova 10, ap. 42, Kublanova VS
Date of commencement of the patent: 1999.08.02
The invention relates to neuro-ophthalmology and is intended for the treatment of degenerative eye diseases and severe forms of optic atrophy. The electrostimulation of the visual analyzer is performed through an electrode applied to the eyelids. Before the electrostimulation of the visual analyzer, correction of the cerebral circulation regulation system is performed by a percutaneous action on the ganglion of the sympathetic nervous system (upper cervical and stellate) of the sympathetic nervous system by a rotating electric current pulse field, which is formed in the space between the left and right ganglia by means of two multielement electrodes, Consisting of Q partial galvanically isolated conductive elements performing the functions of cathodes and two anodes that are placed in the projection of ganglia, and when generating electric current pulses, the partial elements of the multielement electrodes are switched according to the program, the action is paused, the blocking zone Ganglion activity, with the frequency, duration and amplitude of the impulses set individually for each patient, so as to provide numbness in the earlobe. At the end of the treatment cycle, consisting of several procedures of exposure and pauses between them, evaluate the status of the function of the visual analyzer. Next, the electrostimulation of the visual analyzer is performed through an electrode superimposed on the eyelids by a rotating field of electrical pulses in the space between this electrode, which serves as the anode function, and the partial elements of the multielement electrodes, so as to form "packets" of Q pulses. Therapeutic procedures in the correction of the cerebral circulation and the electrostimulation of the visual analyzer are continued until they achieve an improvement in the function of the visual analyzer. If it is necessary to further improve the function of the visual analyzer, the therapeutic procedures are repeated. The method allows to effectively treat diseases of the visual analyzer of vascular genesis.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, viz., Neurophthalmology, and can be used to treat degenerative eye diseases and severe forms of optic nerve atrophy caused by autonomic disorders and diseases of vascular genesis.
The analogs of the proposed method are various variants of the electrophysical method of treating eye diseases.
Thus, with certain eye diseases (atrophy of the optic nerve, corneal opacity, iridocyclitis, central retinal vein thrombosis, retinal sclerotic central dystrophy, etc.) is prescribed [1]:
Electrophoresis of specially selected medications to the eye through a special tray or intranasally, for example, lidase, aloe, papain, chymotrypsin;
Ultrasound to the eye through a special tray;
Magnetotherapy on the eye by a rotating magnetic field;
Laser therapy;
Therapy with an electric field of ultrahigh frequency.
In [2] in the treatment of vegetative disorders, which are the cause of eye diseases, it is recommended to use hormonal, cytostatic therapy. In some cases - plasmapheresis.
The closest analogue of the proposed invention is the electrophysical method of treating partial optic nerve atrophy by electrostimulating the visual analyzer with rectangular electric current pulses through an electrode superimposed on the eyelids, with biotropic parameters of current pulses being recommended within the following limits: amplitude from 25 to 800 μA, duration from 5 to 15 ms, the repetition frequency is from 30 to 40 Hz in burst mode for 5 pulses per burst. The packets follow in 1 second, while they are combined in a series of 15 to 30 seconds each: during the electrostimulation, 8 to 10 bursts are delivered with an interval between the series of 1 to 2 minutes [3].
The parameters of electrostimulation with this method of treatment are selected individually for each patient depending on the threshold of electrical sensitivity and electrolibility of his visual system, and also on the nature of electrical phosphene - the elementary visual sensation that occurs when an electric current is applied to any part of the visual analyzer.
It is known that the work of the visual analyzer is determined by the optical system of the eye, the perception and processing of signals by the retina and the central sections of the visual system. In general, the system of cerebral circulation participates in the organization of the mechanisms of functioning of these processes and its functioning depends on the functioning of the elements of the retina, which is part of the brain and is formed during embryonic development due to protrusion of the base of the diencephalon, axons of ganglion cells of the retina that form the optic nerve, But also the visual tract, which ensures the interaction of the retina with various parts of the cerebral cortex [4].
A disadvantage of the known electrophysical method of treating partial atrophy of the visual analyzer is that electrical impulses act directly on only one link of the system providing the functioning of the visual analyzer, namely the optic nerve. This limits the capabilities of the method.
The essence of the proposed invention lies in the fact that in a known electrophysical method of restoring the function of the visual analyzer before electrostimulation of the visual analyzer through an electrode applied to the eyelids, correction of the cerebral circulation regulation system is performed. It is known that the system of cerebral circulation is a complex biophysical structure, the control of which is provided by neurogenic, humoral, metabolic and myogenic regulatory contours, which are in dynamic interaction. Their activity is aimed at providing physical homeostasis, determined by the balance of the process of water filtration from the blood into the brain tissue under the influence of hydrostatic pressure in the arterial part of the capillary and its absorption in the venous capillary section under the influence of the oncotic pressure of the blood plasma, and the chemical homeostasis of the internal environment of the brain. There is a certain hierarchy and co-ordination of regulatory contours. With artificial suppression of activity, individual mechanisms of regulation change the role of each of them in the system of cerebral circulation. The most important executive link of the neurogenic mechanism in the process of regulation of cerebral circulation is efferent innervation of the walls in cerebral vessels of various calibres: from the main arteries to microvessels. This innervation is provided mainly by means of sympathetic constrictor influence on cerebral vessels, and the leading role in this process belongs to the effects on the superior cervical and stellate ganglia [5].
The blocking of the activity of these ganglia is produced by a rotating field of electrical pulses formed by a multielement cathode consisting of Q conductive isolated partial elements and a single-element anode. In this case, the value of the current density of the electric impulses in the impact zone is different, so that the maximum value of the current density falls on the zones of the ganglia of the sympathetic nervous system located in the neck (upper cervical and stellate) regions, in the projection of which the anode is placed. For this, the area of all the partial elements of the multielement cathode must be larger than the anode area. Rotation in the space of the action of the field of electric pulses is provided due to the alternate inclusion in accordance with the prescribed law of one of the Q partial elements of the multi-element cathode. To block the activity of the ganglia of the sympathetic nervous system located in the neck (upper cervical and stellate), the values of the biotropic parameters of the current pulses (amplitude, duration and frequency) are set individually for each patient. The time of ganglion blocking is chosen so that the mechanisms of the regulation system can react to this disturbance. The time after removal of the blockage until the next mode of blocking the ganglia should be sufficient to allow the mechanisms of the regulation system to respond to this disturbance. Multiple repetition of these procedures provides correction of the cerebral circulation system [6].
The electrostimulation of the visual analyzer is also performed by the rotating field of electrical pulses, the electrodes being applied to the eyelids perform the functions of the anode, and the functions of the cathodes, as in the correction of the cerebral circulation regulation system, the procedure described above, are the partial elements of the multielement electrodes.
In Fig. 1 shows the block diagram of the device in which the proposed electrophysical method for restoring the function of the visual analyzer is realized.
Here are presented: two multichannel 1 and 2 electrodes, a driver of 3 pulses of electric current, a regulator of 4 biotropic parameters of these pulses, zones 5 and 6 in the neck region in the projection of which the ganglia of the sympathetic nervous system (upper cervical and stellate), anodes 7 and 8 , Switches 9 and 10, a software device 11, a and two single electrodes 12 and 13 superimposed on the eyelids.
From the first output of the shaper 3, electric current pulses are applied to the multi-element electrodes 1 and 2, each of which consists of Q partial galvanically isolated conductive elements. Anodes 7 and 8 are structurally combined with multi-element electrodes 1 and 2: in each multi-element electrode, the central partial element serves as the anode function, the rest - the cathode. Anodes 7 and 8 are installed in the projection of the left or right zones of the sympathetic nervous system ganglia located in the neck (upper cervical and stellate) regions when multi-element electrodes 1 and 2 are installed on the patient's neck. The areas of each of the partial elements of the multi-element electrodes 1 and 2 and the anodes 7 and 8 are generally equal: the total area of the partial elements is always larger than the area of these anodes. The program device 11 generates a switching algorithm for the switches 9 and 10 through which the electric current pulses are applied to the multi-element electrodes 1 and 2 and the anodes 7 and 8: if an anode 7 is used that is structurally aligned with the multi-element electrode 1, then the cathode functions fulfill the partial elements of the multi-element electrode 2 , Which are switched by the switch 10 (in Figure 1, the anode 7 and the partial elements of the multi-element electrode 2 are of a dark color); If an anode 8 is used that is structurally combined with a multi-element electrode 2, then the cathode functions perform the partial elements of the multi-element electrode 1 which are switched by the switch 9. In this case, a rotating field is formed in the space between the anode 7 (or 8) and the corresponding multi-element electrode 2 (or 1) Electric pulses: the pulses are grouped into "packs", the number of pulses in the "burst" is equal to the number of partial elements Q of the multi-element electrodes 1 and 2. The software device 11 and the switches 9 and 10 provide switching of the partial elements of the multielement electrodes 1 and 2 according to one of the most common in nature Laws of changing the physical fields of the Earth, and anodes 7 and 8. When switching partial elements, the direction of the momentum vector changes, and the current density of these pulses per unit volume has a maximum value in the zone of the anode that is included in the current-forming chain. To block the activity of the corresponding branch of the sympathetic nervous system, set the values of the biotropic parameters of the impulses in order to cause numbness in the earlobe. If it is necessary to change the blocking of the activity of the other branch of the sympathetic nervous system, then, upon the command of the program device 11, a switch 10 switches on the partial elements of the multi-element electrode 1 and connects the anode 8 or the switch 9 which switches the partial elements of the multi-element electrode 2 and connects the anode 7. Upon the command from the program device 11, the switches 9 and 10 disconnect from the multi-element electrodes 1 and 2 and the anodes 7 and 8 the shaper 3 of the electric current pulses: a pause is formed in the electrophysical action on the cervical ganglia.
The single electrodes 12 and 13 perform the functions of the anode and they are used in the electrostimulation of the visual analyzer by the rotating field of electrical pulses, for the formation of which, and as in the correction of the cerebral circulation regulation system, the procedure described above, use the partial elements of multielement electrodes 1 and 2 Cathodes, the driver 3 of the electric current pulses, the controller 4 of the biotropic parameters of these pulses, the switches 9 and 10, and the software device 11. The single electrodes 12 and 13 are applied to the eyelids and from the second output of the driver 3, pulses of electric current are applied to the single electrode 12, Output of the shaper 3 - by a single electrode 13; The biotropic parameters of these pulses are set by the regulator 4, and the law of the alternation of pulses and their formation in the packs at the output of the shaper 3 in this mode is set in the program device 11.
In Fig. 2 - time sequence of the treatment process. Here, OZAA is an evaluation of the function of the visual analyzer, B shg is the effect on the ganglion of the sympathetic nervous system, P sh is the pause between the effects on the ganglion, B is the electrostimulation of the visual analyzer.
Before the treatment, the function of the visual analyzer is evaluated by one of the known methods (for example, the acuity and field of vision, the electric sensitivity of the retina and the electrical lability of the optic nerve, produce computerized campimetry). The course of treatment consists of several procedures, each of which provides alternation of "impact" cycles, when during a time t 1, impulses of electric current on the ganglion of the sympathetic nervous system, and "pause", when during the time t 2, the effect is stopped. These procedures are performed daily or every other day K times. After several procedures and at the end of the course of treatment, the evaluation of the function of the visual analyzer is repeated by one of the methods mentioned above. Further, the electrostimulation of the visual analyzer is performed by pulses of electric current through electrodes applied to the eyelids, and after it the evaluation of the function of the visual analyzer is repeated by one of the methods indicated above. If the improvement in the function of the visual analyzer as a result of the treatment is not enough, then after the break, the course of treatment is repeated.
Examples of the treatment of vision with the proposed electrophysical method are as follows: Examples 1 and 2 show the results of restoration of the function of the visual analyzer after correction of the cerebral circulation system, in Examples 3 and 4 - after electrostimulation by the rotating field of electric pulses through an electrode superimposed on the eyelids, in Example 5 - after correction And electrical stimulation.
Example 1. Patient P., age 70, diagnosis: macular degeneration, dry form of the right and left eyes.
1 course of treatment of 7 procedures was performed by the sympathetic nervous system corrector for the electropulse "SIMPATOKOR" in which a rotating electric pulse field is formed to correct the system of cerebral circulation regulation with the following values of the biotropic parameters: the electric pulse repetition rate is 5 to 70 Hz, the current amplitude is up to 35 mA , The pulse duration is 50 - 500 μs, the number of pulses in the "burst" is 12.
After treatment:
The visual acuity of the right eye improved by 0.1, the left eye did not change;
The field of vision of the right and left eyes increased by 15 ° ;
The number of registered absolute cattle decreased on the right eye from 15 to 7, on the left - from 25 to 23, the number of registered relative cattle decreased on the right eye from 20 to 15, on the left - from 10 to 8;
The threshold of electrical sensitivity of the retina of the right eye decreased from 500 μA to 300 μA, and the left sensitivity from 600 μA to 300 μA;
The threshold of electrical lability of the optic nerve of the right and left eyes increased from 20 to 25 Hz.
Example 2. Patient M., 39 years old, diagnosis: descending atrophy of the optic nerves of the right and left eyes.
1 course of treatment of 7 procedures was performed by the sympathetic nervous system corrector for the electropulse "SIMPATOKOR" in which a rotating electric pulse field is formed to correct the system of cerebral circulation regulation with the following values of the biotropic parameters: the electric pulse repetition rate is 5 to 70 Hz, the current amplitude is up to 35 mA , The pulse duration is 50-500 μs, the number of pulses in the "burst" is 12.
After treatment:
The visual acuity of the right and left eyes did not change;
The field of vision of the right eye increased by 55 ° , the left - by 90 ° ;
The threshold of electrical sensitivity of the retina of the right and left eyes decreased from 200 μA to 100 μA;
The threshold of electrical lability of the optic nerve of the right eye increased from 5 to 15 Hz, and the left eye increased from 5 to 20 Hz.
Example 3. Patient K., 79 years old, diagnosis: myopic disease of the right and left eyes.
1 course of treatment was performed from 10 procedures by a sympathetic nervous system activity corrector with the electroimpulse "SIMPATOKOR" in which a rotating field of electrical pulses with the following values of biotropic parameters is formed for the electrostimulation of the visual analyzer through an electrode applied on the eyelids with the following values: the pulse repetition rate is 20-50 Hz, The current amplitude is up to 1000 μA, the pulse duration is 1-12 ms, the number of pulses in the "burst" is 12.
After treatment:
The visual acuity of the right and left eyes improved from 0.05 to 0.08 (with correction before and after treatment: - 14 o );
The field of vision of the right eye increased by 30 ° left - by 25 ° ;
The threshold of electrical sensitivity of the retina of the right and left eyes decreased from 999 μA to 700 μA;
The threshold of electrical lability of the optic nerve of the right eye increased from 10 to 20 Hz, and the left eye increased from 10 to 15 Hz.
Example 4. Patient S., 18 years old, diagnosis: myopia of 3rd degree of right and left eye, display syndrome.
1 course of treatment of 9 procedures was performed by a sympathetic nervous system corrector for the electroimpulse "SIMPATOKOR" in which a rotating field of electrical pulses with the following values of biotropic parameters is formed for electrostimulation of the visual analyzer through an electrode applied on the eyelids with the following values: the pulse repetition rate is 20-50 Hz, The current amplitude is up to 1000 μA, the pulse duration is 1-12 ms, the number of pulses in the "burst" is 12.
After treatment:
Visual acuity of the right eye 1.0 with correction 4.5 o (before treatment: 6.0 o ), visual acuity of the left eye 1.0 with correction 4.5 o (before treatment: 5.5 o ), the visual acuity of the right and left eyes remained unchanged;
The field of vision of the right and left eyes increased by 15 ° ;
The threshold of electric sensitivity of the retina of the right eye decreased from 110 μA to 100 μA, the left one - from 140 to 100 μA;
The threshold of electrical lability of the optic nerve of the right eye increased from 25 to 30 Hz, and the left eye did not change.
Example 5. Patient O., 12 years old, diagnosis: grade I myopia and amblyopia of degree II of the right eye, myopia of the third degree and amblyopia of the fourth degree of the left eye.
1 course of treatment with the device "SIMPATOKOR" was conducted: in the mode of correction of the system of cerebral circulation - 10 procedures, in the electrostimulation mode - 4 procedures. Biotropic parameters of electrical pulses were set to the same as in Examples 1 to 4.
After treatment:
The visual acuity of the right eye improved from 0.5 to 0.6, the left eye 0.01 to 0.06;
The field of vision of the right and left eyes increased by 20 ° ;
The threshold of electrical sensitivity of the retina of the right and left eyes decreased from 300 μA to 150 μA;
The threshold of electrical lability of the optic nerve of the right and left eye increased from 15 to 25 Hz.
Analysis of the results of treatment of eye diseases by the proposed method of electrophysical restoration of the function of the visual analyzer, conducted during 1998-1999 in the Sverdlovsk Regional Clinical Psychoneurological Hospital of War Veterans, showed that after treatment:
Visual acuity improved to 0.4 depending on the severity and the limitation period of the disease;
The field of view is expanded from 10 ° to 90 ° ;
Thresholds of electrical sensitivity of the retina and electrical lability of the optic nerve are close to normal;
Absolute scotomas decrease in area, relative scotomas decrease or disappear.
Compared with known non-invasive methods, the proposed electrophysical method of restoring the function of the visual analyzer allows treating not only the effects of optic nerve atrophy, but also other diseases of vascular genesis, which significantly increases the efficiency of the therapeutic process.
USED BOOKS
1. AA Ushakov, "Guide to Practical Physiotherapy," Moscow, ANMI, 1996, 267 p.
2. "Vegetative disorders: a clinic, diagnostics, treatment", edited by A.M. Veyna, M., Medical News Agency, 1998, 752 p.
3. E.B. Kompaneets, V.V. Petrovsky, S.I. Dzhindzhikhashvili "A method of treating partial optic nerve atrophy", author's certificate 1531267.
4. "The Physiology of Man", edited by R. Schmidt, G. Tevs, in three volumes, O.-J. Grüsser, W. Grüsser-Cornels "Sight", Volume 1, Moscow, Mir, 1996, p. 235-276.
5. Yu.O. Moskalenko "Brain circulation", in the collection "Heart and Vascular Diseases", Volume 1, edited by EI. Chazova, M., Medicine, 1992, p. 114-124.
6. AL Azin, V.S. Kublanov "Electrophysical method of treatment of headache", patent 2131274. Compiled by S.A. Short.
CLAIM
The electrophysical method of restoring the function of the visual analyzer by electrostimulating the visual analyzer through an electrode superimposed on the eyelids, characterized in that before the electrostimulation of the visual analyzer, a correction of the cerebral circulation regulation system is performed by a percutaneous action on the upper cervical and stellate ganglion of the sympathetic nervous system by a rotating electric pulse field that forms In the space between the left and right ganglia by means of two multi-element electrodes consisting of several partial galvanically isolated conductive elements performing cathode functions and two anodes that are placed in the projection of the ganglia, and when generating electric current pulses, the partial elements of the multielement electrodes are switched , In the action, a pause is formed, then the ganglion activity blocking zone is switched, while the frequency, duration and amplitude of the pulses are set individually for each patient so as to provide numbness in the earlobe; After the treatment cycle, consisting of several procedures of exposure and pauses between them, evaluate the status of the function of the visual analyzer; Further, the electrostimulation of the visual analyzer is performed through an electrode applied to the eyelids by a rotating electric pulse field which is formed in the space between this electrode which serves as an anode and the partial elements of the multi-element electrodes; Treatment procedures in the correction of the cerebral circulation and electrostimulation of the visual analyzer continue until they achieve an improvement in the function of the visual analyzer; If additional visualization function needs to be improved, the treatment procedures are repeated.
print version
Date of publication 06.01.2007gg
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