Device for examining a subject and, in particular, determining h

Details Device for examining a subject and, in particular, determining h Device for examining a subject and, in particular, determining h

1997-01-10

1999-11-09

Nasser, Robert L.

Surgery

Diagnostic testing

Detecting brain electric signal

600595, A61B 510

Patent

active

059831286

DESCRIPTION:

BRIEF SUMMARY
The invention concerns a device for examining a subject and, in particular, determining his or her vestibular evoked potentials by stimulation of his or her vestibular system.
By subject there is to be understood any living being provided in particular with a vestibular system, whether the subject is clinically ill, in which case it is a question of a patient, or whether the subject is clinically healthy.
The vestibular system can be considered diagrammatically as a system of accelerometers allowing the central nervous system of a subject to measure the resultant both of gravity and of the accelerations in the three planes defining space.
The vestibular system consists of two functional sub-systems which are distinct but complementary. The first sub-system, termed canal sub-system, comprises the so-called semi-circular canals, which are clearly assigned to the measurement of the angular accelerations of the body. The second sub-system, termed otolithic sub-system, is divided into two parts which provide two complementary functions: the utricular system and the saccular system. The first function provided concerns the analysis of the variations of the gravitational forces linked to gravity, and the second function is measurement of the linear accelerations in the three planes which define space (plane X (sagittal), plane Y (lateral), and plane Z (vertical)), as demonstrated by HIXSON, W. C.,; NIVERI, J. J.; CORRELA, M. J., in their article "Kinematics nomenclature for physiological accelerations with special reference to vestibular applications", Monograph 14, Naval Aerospace Medical Institute, Naval Aerospace Medical Center, Pensacola, Fla., 1966.
Since the vestibular system is to a great extent responsible for the balance of a living being, and in particular of a human, it is necessary to be able to test its functioning specifically, either to verify its integrity or to detect the various pathologies thereof and/or to measure the effects of the vestibular therapies.
Such a test can be carried out by specifically stimulating the vestibular system.
In fact, stimulation of the vestibular system, like that of numerous other parts of the nervous system, generates brain activity waves originating from identifiable regions of the brain, which waves, called evoked potentials, can be picked up in particular at the level of the scalp of an individual.
There are thus visual, auditory or somesthesic evoked potentials, which are used every day in neurology, since their origin is relatively well known. In contrast, very little is known of the origin of the vestibular evoked potentials (VEPs).
The principal reason for this lack of knowledge of the cerebral zones generating VEPs lies in the anatomophysiology of the vestibular system which is controlled by the central nervous system in its sub-cortical part. The so-called "second order" vestibular neurones are already centres of processing and integration of the stimulation issuing from the peripheral vestibular system. These second order neurones are termed polyafferent, since they are linked to a large number of nervous structures, which are involved in the unconscious regulation of the posture. Consequently, it is difficult to determine precisely which are the cortical projection zones of the vestibular system.
Up to now, research carried out on the vestibular system has essentially concerned the vestibular evoked potentials linked to the stimulation of the first subsystem comprising the semicircular canals. This research has been made possible by the perfecting of devices making it possible to rotate the body of a subject. Certain vestibular projection zones involved in the sensations of rotation have thus been able to be shown up by means of such devices.
Although the evoked potentials of canal origin are relatively well documented, in contrast the evoked potentials of otolithic origin (second vestibular sub-system), induced by linear acceleration, are virtually unknown. Up to now, only one experiment has given results. This was carried out by KAST and LANKFORD. It i

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PCT Search Report for PCT/FR95/00931, Oct. 2, 1995 (French and English versions).
Acta Otolaryngol, vol. 102, 1986 Stockh., SE, pp. 175-178; Richard Kast, et al., "Otolithic Evoked Potentials: A New Technique for Vestibular Studies".
Electroencephalography and Clinical Neurophysiology, vol. 80, No. 2, Mar. 1991 Ireland, pp. 140-145; J. Elidan et al. "Short and Middle Latency Vestibular Evoked Responses to Acceleration in Man".
Medical Progress Through Technology, vol. 20, No. 1-2, Jan. 1994; Amsterdam, NL, pp. 31-35; Caupolican Munoz-Gamboa et al., "Human Vestibular Evoked Responses".

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