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外2012经颅磁刺激机器人系统的设计与评价。
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IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 59, NO. 3, MARCH 2012 805 Design and Evaluation of a Robotic System for Transcranial Magnetic Stimulation Lucile Zorn, Pierre Renaud*, Bernard Bayle, Laurent Goffin, Cyrille Leboss e, Michel de Mathelin, and Jack Foucher Abstract—Transcranial magnetic stimulation is a noninvasive brain stimulation technique. It is based on current induction in the brain with a stimulation coil emitting a strong varying magnetic field. Its development is currently limited by the lack of accuracy and repeatability of manual coil positioning. A dedicated robotic system is proposed in this paper. Contrary to previous approaches in the field, a custom design is introduced to maximize the safety of the subject. Furthermore, the control of the force applied by the coil on the subject’s head is implemented. The architecture is original and its experimental evaluation demonstrates its interest: the compensation of the head motion is combined with the force control to ensure accuracy and safety during the stimulation. Index Terms—Force control, medical robotics, robot design and control, transcranial magnetic stimulation (TMS). I. INTRODUCTION T RANSCRANIAL magnetic stimulation (TMS) is a nonin- vasive method to deliver electric stimulation to the cortex. The stimulation results from a rapidly changing magnetic field generated with an external coil (see Fig. 1) that goes through the skull and induces electric currents in the brain. TMS has been used in clinical and neurological studies for more than 25 years [1]. More recently, single pulse and repetitive TMS have been applied in clinical research for the treatment of neu- rological and psychiatric diseases. The efficiency of TMS has been demonstrated in the case of depression [2], [3]. Its ef- fect on several other pathologies, such as compulsive obsessive disorders, schizophrenia, or posttraumatic stress disorders, is currently being investigated [4], [5]. This promising technique has been approved in the U.S., Canada, and Israel for patients whose antidepressant medication has failed. However, it is not Manuscript received July 28, 2011; revised October 8, 2011; accepted November 20, 2011. Date of publication December 15, 2011; date of cur- rent version February 17, 2012. This work was supported by the Region Alsace and the Agence Nationale de la Recherche through the EmergenceTec program. Asterisk indicates corresponding author. L. Zorn, B. Bayle, L. Goffin, and M. de Mathelin are with the Labora- toire des Sciences de l’Image, de l’Informatique et de la T el ed etection, CNRS, University of Strasbourg, 67091 Strasbourg, France (e-mail: lucile.zorn@lsiit- cnrs.unistra.fr; bernard.bayle@unistra.fr; laugof@gmail.com; demathelin@ unistra.fr). *P. Renaud is with the Institut National des Sciences Appliqu ees, 67084 Strasbourg, France, and also with the Laboratoire des Sciences de l’Image, de l’Informatique et de la T el ed etection, CNRS, University of Strasbourg, 67091 Strasbourg, France (e-mail: pierre.renaud@insa-strasbourg.fr). C. Leboss e is with Luxscan Technologies, 4384 Ehlerange, Luxembourg (e-mail: cyrille_lebosse@yahoo.fr). J. Foucher is with the Department of Psychiatry, University Hospital of Strasbourg, 67098 Strasbourg, France (e-mail: jack.foucher@laposte.net). Color versions of one or more of the figures in this paper are available online at http://ieeexplore.ieee.org. Digital Object Identifier 10.1109/TBME.2011.2179938 Fig. 1. Top and bottom views of a figure-of-eight stimulation coil. Fig. 2. TMS setup with localizer for navigation. yet widely accepted because its efficiency varies substantially between subjects. The variability is partially due to how the stimulation gesture is performed [6], [7]. Up to now [8], [9], the most accurate method has been to position the coil manually with the help of a navigation software [10], [11]. This tool combines preoperative MR images and peroperative data from an optical localizer (see Fig. 2) in order to display in a graphical interface the actual position of the coil with respect to the subject’s brain. Even with such an assistance, it remains difficult to obtain an accuracy of a few millimeters in a repeatable manner. The main reason is that each procedure lasts more than 30 min with a coil that weighs more than 2 kg. A static positioning system is sometimes used to hold the coil (see Fig. 2). In such a case, it is not possible to follow continuous trajectories nor to compensate for involuntary motions of the subject during the session. Robotic assistance will allow us to evaluate the benefits of TMS in a more adequate manner, certainly leading to a faster development of this technique. The initial positioning of the stimulation coil will be simplified and the coil position will be tracked in presence of subject movements. Some early experi- mental results of robotized TMS have been reported on phan- toms [12] and healthy subjects [13]. They confirm the interest of robotization to improve stimulation accuracy. However, in these studies, the force applied by the robot on the subject’s head is 0018-9294/$26.00 2011 IEEE

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