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WO2008001155A1 - Procédé et appareil de stimulation et/ou d'inhibition magnétique transcorporelle - Google Patents

Procédé et appareil de stimulation et/ou d'inhibition magnétique transcorporelle Download PDF

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Publication number
WO2008001155A1
WO2008001155A1 PCT/IB2006/002413 IB2006002413W WO2008001155A1 WO 2008001155 A1 WO2008001155 A1 WO 2008001155A1 IB 2006002413 W IB2006002413 W IB 2006002413W WO 2008001155 A1 WO2008001155 A1 WO 2008001155A1
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magnetic field
area
magnetic
brain
resonance imaging
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Alexandre Carpentier
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
    • A61B5/055—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00—Arrangements or instruments for measuring magnetic variables
    • G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/44—Arrangements or instruments for measuring magnetic variables involving magnetic resonance using nuclear magnetic resonance [NMR]
    • G01R33/48—NMR imaging systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N2/00—Magnetotherapy
    • A61N2/004—Magnetotherapy specially adapted for a specific therapy
    • A61N2/006—Magnetotherapy specially adapted for a specific therapy for magnetic stimulation of nerve tissue
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00—Arrangements or instruments for measuring magnetic variables
    • G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/44—Arrangements or instruments for measuring magnetic variables involving magnetic resonance using nuclear magnetic resonance [NMR]
    • G01R33/48—NMR imaging systems
    • G01R33/4806—Functional imaging of brain activation
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00—Arrangements or instruments for measuring magnetic variables
    • G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/44—Arrangements or instruments for measuring magnetic variables involving magnetic resonance using nuclear magnetic resonance [NMR]
    • G01R33/48—NMR imaging systems
    • G01R33/4808—Multimodal MR, e.g. MR combined with positron emission tomography [PET], MR combined with ultrasound or MR combined with computed tomography [CT]
    • G01R33/4814—MR combined with ultrasound

Definitions

  • the invention relates to an apparatus and a method for transbody, in particular transcranial, magnetic stimulation and/or inhibition by inducing magnetic fields, especially a focalized or diffused three dimensional (3D in the following) gradient magnetic field in a certain area of the human or animal body and specifically of the human brain.
  • the invention also relates to a magnetic resonance imaging (MRI in the following) apparatus and method, a computer program and a data storage medium.
  • MRI magnetic resonance imaging
  • the invention also relates to different advantageous uses of such transbody magnetic field stimulation and/or inhibition, in particular for localizing and mapping particular functions of biological tissue for example by stimulation or inhibition of brain areas, for evaluating the concentration of molecules or drugs in specific areas of the human body and for delivering magnetic field sensitive particles or drugs to a particular area in the human body.
  • TMS transcranial magnetic stimulation
  • EP 1 269 913 A1 describes a method for transcranial magnetic stimulation and inhibition, which advantageously allows to check in advance, which effect an actual resection of a certain spot of the brain would have.
  • MR-image magnetic resonance image
  • a MR-image of the brain of a patient to be examined is taken. Based on this image, a simulation model of the surface of the brain is generated, which is important as the sensorial, motor, visual, auditory and olfactory functions of the patient are being controlled by areas on the surface of the brain.
  • a stimulation device such as for example a coil for generating a local magnetic field, is then arranged relative to the surface of the head of the patient, such that the magnetic field generated by the coil is focused on the surface of an area of the brain, said area being in practice determined on said model.
  • certain areas of the brain are stimulated or inhibited and the reaction of the patient upon this stimulation/inhibition is measured in a suitable way, which depends on the type of reaction to be measured.
  • a patient receiving stimulation signals induced by TMS is to state in which area of the field of vision the stimulation signal generates a flash or which area of the field of vision can no longer be perceived due to an inhibiting signal.
  • mapping of the visual cortex i.e. to assign the fields of vision of the eyes to individual structures on the visual cortex.
  • sensors on the skin of the patient may be used to measure muscular activity.
  • the exact position in the brain, where stimulation or inhibition took place is not measured according to this known method. Based on the simulation model and several assumptions on the magnetic properties of the skull and the brain of the patient it is only estimated that operating the stimulation device in a certain position and with certain parameters would generate a magnetic field in a certain spot of the brain.
  • the known techniques have several disadvantages.
  • the anatomical MR- image acquisition leads to diffraction/distortion errors so that the theoretical point of the magnetic stimulation as planned might not correspond exactly to the effective location of stimulation and it is not possible to realize this error, which is estimated to be in the order of about 5 mm.
  • the co-registration between the magnetic stimulation device and the patient's head has normally at least a 1.5 mm minimal error and is often around 10mm in clinical routine, due to the approximation error of the head position.
  • a proposal to resolve this last point is to have an MRI compatible coil marked with MRI-visible fiducials in order to know exactly where the coil is on the head surface based on morphological images and then to extrapolate the location of the field convergent point within the brain.
  • Coils in the shape of an 8 or a 0 are the most common devices for such purpose and are in fact the only ones used in clinical routine, while other magnetic stimulator devices exist, especially devices with multiple coils.
  • Other systems propose multi-channel (or multi coil) stimulation devices somehow arranged in a helmet.
  • DE 199 14 762 A1 describes a coil arrangement comprising a plurality of individual coils for TMS fixed on a helmet-like structure. As each TMS-coil is individually controllable, it is possible to trigger a magnetic stimulation at various locations in the brain of a patient by means of corresponding activation of the individual coils.
  • the helmet-like structure also provides a radio-frequency head antenna for use in so called “functional magnetic resonance imaging” (commonly abbreviated as "fMRI").
  • fMRI functional magnetic resonance imaging
  • Position markers are allocated to each individual coil, each of said markers comprising a substance that is detectable by magnetic resonance imaging.
  • the coil arrangement described in DE 199 14 762 A1 allows that an MR-image is taken, in which the position of the coils for - A -
  • transcranial magnetic stimulation is shown, thus linking the position of the TMS-coils to the brain.
  • this technique partilally solves the problem of the co-registration error, it does not solve the problem of the diffraction/distortion error of the MRI anatomical acquisition, of the diffraction/distortion error of the magnetic field used for the stimulation and of the error due to movements of the head of the patient.
  • PET Positron Emission Tomography
  • functional MRI both of which allowing only an indirect appreciation of the brain activity since they can only record blood oxygenation and vessel dilatation, which are supposed to be modified with delay after a neuronal activity.
  • a small conventional coil with a figure- eight-conductor configuration is placed near the location of interest - for example somewhat above the skull in the region of the frontal eye area - and a sequence of short magnetic pulses with a magnitude of approximately 1 ,5 Tesla is applied by feeding current pulses into the coil.
  • the neuronal response of the brain is acquired using PET with delay and low spatial resolution (15mm). If the location of simulation is the region of the frontal eye area, the response to this stimulation is acquired at the primary visual cortex using PET. In this way, findings concerning the spatial and temporary interconnectedness of brain functions (the so-called "connectivity”) can be obtained.
  • the described specific TMS coil arrangement must be positioned at the desired location. If the stimulation location is to be modified, this requires a new positioning of the TMS coil arrangement. Moreover, since the field distribution of the magnetic field is predetermined by the geometry of the coil, additional TMS coil arrangements must be provided if stimulation with other field profiles is to take place.
  • DCS direct cortical stimulation
  • disadvantages like field heterogeneity errors, MRI acquisition diffraction/distortion errors, diffraction phenomena due to MRI rooms having insufficient magnetic shielding, magnetic stimulation field diffraction/distortion errors, co-registration errors, targeting errors, head movement errors, indirect representation of brain reaction (poor blood flow spatial resolution) and delay control (poor temporal resolution) of brain reaction.
  • a stimulating or inhibiting magnetic field was actually created with a high spatial resolution (preferably less than 1 mm) and a high temporal resolution (preferably less than 0.05 sec) and with no step errors.
  • a further object of the invention is to provide a method and an apparatus for magnetic stimulation in any place of the human body, and in concomitant multiple loci.
  • the invention proposes first a method for transbody, in particular transcranial, magnetic stimulation and/or inhibition in a certain area of a body, in particular a certain area of a brain, by generating temporarily at least one first magnetic field in at least one area of the body, in particular of the brain, said first magnetic field being locally restricted, wherein said first magnetic field is created within a second magnetic field, said second magnetic field being a constant magnetic field, in particular the constant magnetic field B 0 of a magnetic resonance imaging apparatus.
  • the advantage of temporarily creating said first magnetic field within a constant field is that once the first field stops, an electronic spin relaxation occurs, which can be recorded by an RF-antenna just as "normal" relaxation images
  • the invention proposes to create said first magnetic field for a certain period of time (which, depending on the purpose of the field, can be very short, like 0.05 seconds) and that immediately after this period a magnetic resonance image of the relaxation signals produced by the tissue of said at least one area of the body, in particular of said brain, is taken.
  • This allows for the first time to exactly locate the area, in which the magnetic field was indeed created, by actually measuring signals created by the tissue after switching off the locally restricted magnetic field, whereas in the prior art this location is only mathematically determined based on assumptions of the magnetic properties of the brain and the skull, which may in practice vary from patient to patient.
  • the accuracy of the targeting can be controlled and any diffusion, diffraction and co-registration errors can be corrected.
  • the first magnetic field can be an undulating field having a frequency of about 0.1 to 100 MHz.
  • the first magnetic field is a gradient magnetic field, preferably having a three dimensional gradual variation in terms of frequency and/or intensity.
  • a gradient magnetic field is a field in which frequency, orientation and/or intensity change(s) across the Cartesian space.
  • the gradient field is performed most of the time at a supra clinical level to induce a physiological tissue reaction, while regular MRI always stays infra clinical, so that no tissue function is affected.
  • the technical advantage of creating a gradient stimulation is that relaxation recording can be performed and coded in the Cartesian space. There are no relaxation images if there is no constant field. Actual brain or body stimulation is performed without such constant magnetic field, so that nothing can be recorded just after the stimulation.
  • the least one locally restricted magnetic field may be repeated depending on the effect which shall be achieved (i.e. inhibition or stimulation), for example with a repetition frequency of about 0.1 to 100 Hz, and preferably of 0.5 to 20 Hz. It has turned out that by applying such local magnetic fields of suitable strength - e.g. in the order of 0.5
  • said at least one first magnetic field may consist in an undulated magnetic stimulation with specific frequencies (fjMs) chosen on the basis of the frequency of the precession movement of a certain type of atoms or molecules of interest in said second magnetic field, allowing obtaining relaxation signals of said atoms or molecules of interest.
  • fjMs specific frequencies
  • the method of the invention can also be used to concentrate magnetic field sensible particles in said at least one area, in which the first magnetic field is generated, an may be performed such that an activating energy is generated in said at least one area, in particular by directing and concentrating electromagnetic or ultrasonic waves in said area in order to activate or increase various activities of said particles (biochemical activity, thrombosis activity, thermal activity, ionisation activity, photonic activity, acoustic activity etc.).
  • the invention also proposes a method for non-invasively identifying, which particular area of a brain fulfils a certain function, comprising the steps of: a) creating at least one locally restricted magnetic field within the constant magnetic field of a magnetic resonance imaging apparatus, b) determining the location of the creation of said at least one locally restricted magnetic field in said brain by magnetic resonance imaging, c) determining, which function is performed by the area of the brain, in which said at least one locally restricted magnetic was created.
  • the invention furthermore concerns an apparatus for transbody, in particular transcranial, magnetic stimulation and/or inhibition in a certain area of a body, in particular a certain area of a brain, comprising means for creating temporarily at least one first magnetic field in at least one area of the body, in particular of the brain, said first magnetic field being a locally restricted field, said apparatus further comprising means for generating a second magnetic field such that said first magnetic field is created within said second magnetic field, said second magnetic field being a constant magnetic field, in particular the constant magnetic field Bo of a magnetic resonance imaging apparatus.
  • said apparatus comprises means, in particular a magnetic resonance imaging apparatus, for recording a relaxation signal produced in said area after the temporary generation of said at least one first magnetic field.
  • the means for generating at least one first magnetic field are designed such that said first magnetic field is a gradient magnetic field, preferably with a three dimensional gradual variation in terms of frequency, orientation and/or intensity.
  • the invention also proposes a magnetic resonance imaging method for imaging at least one area of a human or animal body comprising the steps of temporarily stimulating the at least one area of a human or animal body with a first magnetic field and recording at least one relaxation signal after, preferably immediately after canceling said first magnetic field, wherein said first magnetic field is generated within an independent constant magnetic field.
  • the invention proposes a magnetic resonance imaging apparatus for imaging at least one area of a human or animal body comprising first magnetic field generation means for temporarily stimulating the at least one area of a human or animal body, second magnetic field generation means for generating an independent constant magnetic field, wherein at least one magnetic field generated by the first magnetic field generation means is within said independent constant magnetic field, and relaxation signal recording means.
  • Fig. 1 is a schematic diagram showing a principle idea of the invention.
  • Fig. 2 is a schematic diagram showing different modes of carrying out the invention.
  • Fig. 3 is a schematic drawing of an apparatus for carrying out the invention.
  • Fig. 1 schematically visualizes a basic idea of the invention: first, a locally restricted magnetic gradient field, hereinafter simply referred to as "gTMS pulse", is generated for a certain period of time in a certain area of a body, for example an area in the human brain.
  • gTMS is an abbreviation for gradient transbody magnetic stimulation.
  • the field cannot only stimulate but also inhibit tissue functions.
  • gTMS stands for both, stimulation and inhibition.
  • T1 and T2 relaxation signals are acquired, T1 and T2 being well known in the art of MRI.
  • a magnetic gradient field of high frequency as commonly used in MRI can be applied to said area, said gradient field having the same excitation geographical parameters as said at least one locally restricted magnetic field. This enhances the relaxation signals that could be obtained from said area and allows even more precise location of the actual area in which the magnetic field indeed was created.
  • said gTMS can be performed such that more than one magnetic field is generated at the same time in different areas of the body, said magnetic fields having optionally the same or different characteristics in said different areas. For example, different areas in the brain can be activated while others are inhibited, which is very informative in studying neuronal networks.
  • the method according to the invention can be carried out such that a) at least one first magnetic field for a restricted period of time with a first intensity in an area of the body is created, b) the location of the creation of said at least one first magnetic field in said area by magnetic resonance imaging is determined, c) said determined location of creation with the location of a preselected area in said body is compared, d) if said determined location and said location of said preselected area do not match, said at least one first magnetic field is created in a different location for a restricted period of time with said first intensity and the steps b) to d) are repeated until said determined location and said location of said preselected area do match, e) said at least one first magnetic field is created in the location of said preselected area with a second intensity, wherein said second intensity is higher than said first intensity.
  • the preselected area can be selected on the basis of a magnetic resonance image.
  • the invention allows that if the generation of said first magnetic field in said area shows an undesired effect, another first magnetic field is generated in said area having a reversing effect.
  • a certain area in the human brain shows an undesired effect like an epileptic seizure
  • in inhibiting magnetic field can be created in said area.
  • Fig. 2 shows different modes of carrying out the method according to the invention.
  • "ct” stands for clinical threshold and marks the line indicating the intensity of the gTMS pulse, above which tissue function is affected.
  • Fig. 2a shows a mode of carrying out the method, which can be called a "safety mode".
  • gTMS pulses are generated with an intensity below said clinical threshold. This allows to visualize the exact area where the magnetic field was created via the recorded relaxation signals.
  • the gTMS pulses and the acquisition of the T1/T2 signals are carried out in a repetitive fashion.
  • the intensity of the gTMS pulse can be set inferior to 90% of resting motor threshold. This safety mode avoids non-clinical effective stimulation, reduces the epileptic risk and increases the safety of the system.
  • said first magnetic field can be generated with a second intensity being higher than the first intensity to affect the tissue function in said area.
  • This can be done in a "single shot mode" (shown in Fig. 2b) consisting in one stimulating/inhibiting pulse within the predefined desired area and/or in a repetitive mode (shown in Figs. 2c and 2d) consisting in a train of repetitive pulses within the predefined desired area.
  • a single shot transcranial magnetic stimulation can activate neuronal activity informative for brain mapping.
  • the magnetic field can comprise a train of repetitive pulses within said area with a frequency preferably between 0.1 and 100 Hz to affect the tissue function. Said pulses may have a duration between 0 and 1 seconds, preferably between 0.03 and
  • Fig. 2c shows a "repetitive slow mode", in which gTMS pulses are repeated with a frequency between about 0.5 and 2 Hz
  • Fig. 2d shows a “repetitive fast mode”, in which gTMS pulses are repeated with a frequency between about 2 and 20 Hz.
  • the first magnetic field may also be generated for a time of several minutes up to several hours within said area (schematically shown in Fig. 2e), which allows to deliver and accumulate magnetic field sensible particles (drugs, nanoparticles, liposomes etc.) in a desired area of the body.
  • the magnetic field can be static or oscillatory in its orientation, which may increase diffusion of the particles.
  • An additional focused magnetic field or a radiofrequency or an ultrasonic signal can activate said particles (e.g. by heating them up) in order to generate their biological activity in the desired area.
  • Fig. 3 schematically shows a MRI apparatus for imaging at least one area of a human or animal body comprising means for generating the independent constant magnetic field (commonly referred to as "Bo field"), which are integrated in the so called "MRI-doughnut".
  • the MRI apparatus further comprises relaxation signal recording means comprising in particular an MRI-RF-antenna for picking up T1 and T2 relaxation signals.
  • the apparatus has also magnetic field generation means for temporarily generating within said constant magnetic field Bo a locally restricted magnetic field, namely the gTMS pulse mentioned above, wherein the term “pulse” is not meant to indicate only a short period of time.
  • the magnetic field can be used to accumulate particles and can thus last rather long.
  • the means for creating said gTMS pulse are provided in form of several coils (magnetic field generators) arranged in a three-dimensional structure, which can be placed close to the body of a patient to be examined.
  • the magnetic field generators are arranged in a helmet like structure, in which also the MRI-RF-antenna is integrated.
  • FIG. 3 also shows schematically the head of a patient to be examined, resting on an MRI-bed.
  • a magnetic resonance imaging method for imaging at least one area of a human or animal body can be performed by temporarily stimulating the at least one area of a human or animal body with a first magnetic field within said constant magnetic field and recording at least one relaxation signal after, preferably immediately after canceling said first magnetic field.
  • the gTMS coils are advantageously designed to facilitate generation of said first magnetic field in a repetitive fashion comprising a train of repetitive pulses within said area to affect the tissue function, and are in particular designed to allow creating said at least one locally restricted magnetic field with at least a first intensity and a second intensity, said second intensity being higher than said first intensity.
  • the gTMS coils are designed to facilitate generation of a magnetic field which causes in said area a radio frequency excitation like a usual magnetic resonance imaging radio frequency antenna and/or a gradient magnetic field like a usual magnetic resonance imaging gradient field of a magnetic resonance imaging gradient coils antenna.
  • the apparatus advantageously can comprise numerous means for automatically controlling certain functions of the apparatus, such as means for automatically determining the location of the generation of said at least one first magnetic field in said area based on magnetic resonance imaging, - means for automatically comparing said determined location of the generation of said at least one first magnetic field with a preselected area in said body, means for automatically repositioning the location of the generation of said at least one first magnetic field based on the comparison with said preselected area analysis means for automatically determining the exact location, in which the first magnetic field was generated based on data obtained by said relaxation signal recording means at a first time T1 and at a second time T2.
  • means for automatically determining the location of the generation of said at least one first magnetic field in said area based on magnetic resonance imaging - means for automatically comparing said determined location of the generation of said at least one first magnetic field with a preselected area in said body, means for automatically repositioning the location of the generation of said at least one first magnetic field based on the comparison with said preselected area analysis means for automatically determining the exact
  • the apparatus may have a control unit with a neuronavigation software stored thereon and a program to control the multiple magnetic field generators.
  • the apparatus can be used for non-invasively identifying, which particular area of a brain fulfils a certain function, if it further comprises means for sensing functional reactions upon stimulation or inhibition of said brain by said at least one locally restricted magnetic field.
  • the apparatus can also be used to record a relaxation signal in a spectroscopic sequence fashion for collecting spectroscopic data of biological components, especially concentrations of molecules or drugs and optionally their variation within said area.
  • the apparatus can be used for preplanning neurosurgery.
  • the apparatus can also be used for accumulating magnetic field sensible particles, preferably drugs, nanoparticles, and/or liposomes in a desired area of the body.
  • the methods and the apparatus described herein can be commercially used in a wide variety of non-therapeutic treatments and examinations of the human body, for example in commercially testing and developing new drugs and brain stimulating devices.
  • the methods and apparatus disclosed herein can also be used for magnetic drug targeting and accumulating magnetizable drugs in certain areas of the body, for example the brain, for treating certain malfunctions of the brain by stimulating or inhibiting certain brain areas and other therapeutic purposes.

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Abstract

La présente invention concerne un appareil et un procédé de stimulation et/ou d'inhibition magnétique transcorporelle, notamment transcrânienne. Ce procédé consiste à induire des champs magnétiques, en particulier un champ magnétique à gradient tridimensionnel focalisé ou diffus dans une certaine zone du corps humain ou animal, plus spécialement le cerveau humain. Cette invention concerne également un appareil et un procédé d'imagerie par résonance magnétique, un programme informatique et un support de stockage de données. Elle concerne aussi un appareil comprenant des moyens pour produire provisoirement au moins un premier champ magnétique dans au moins une première zone du corps, en particulier le cerveau, lequel premier champ magnétique est un champ localement limité, ainsi que des moyens pour produire un second champ magnétique de manière que le premier champ magnétique soit créé dans le second champ magnétique, lequel second champ magnétique est un champ magnétique constant, en particulier le champ magnétique constant B0 d'un appareil d'imagerie par résonance magnétique.
PCT/IB2006/002413 2006-06-26 2006-06-26 Procédé et appareil de stimulation et/ou d'inhibition magnétique transcorporelle Ceased WO2008001155A1 (fr)

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Cited By (4)

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WO2009000478A1 (fr) * 2007-06-22 2008-12-31 Carl Zeiss Meditec Ag Dispositif de transport
EP2223719A1 (fr) * 2009-02-27 2010-09-01 Koninklijke Philips Electronics N.V. Appareil thérapeutique pour traiter un sujet utilisant des nanoparticules magnétiques
EP2324882A4 (fr) * 2008-08-13 2013-11-27 Starlab Barcelona Sl Procédé et système de stimulation crânienne multisite
WO2014195580A1 (fr) * 2013-06-03 2014-12-11 Nexstim Oy Dispositif de bobine mtms avec enroulements de bobine se chevauchant

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Cited By (6)

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Publication number Priority date Publication date Assignee Title
WO2009000478A1 (fr) * 2007-06-22 2008-12-31 Carl Zeiss Meditec Ag Dispositif de transport
EP2324882A4 (fr) * 2008-08-13 2013-11-27 Starlab Barcelona Sl Procédé et système de stimulation crânienne multisite
EP2223719A1 (fr) * 2009-02-27 2010-09-01 Koninklijke Philips Electronics N.V. Appareil thérapeutique pour traiter un sujet utilisant des nanoparticules magnétiques
US9417302B2 (en) 2009-02-27 2016-08-16 Koninklijke Philips N.V. Therapeutic apparatus for treating a subject using magnetic nanoparticles
WO2014195580A1 (fr) * 2013-06-03 2014-12-11 Nexstim Oy Dispositif de bobine mtms avec enroulements de bobine se chevauchant
US10780291B2 (en) 2013-06-03 2020-09-22 Nexstim Oyj mTMS coil device with overlapping coil windings

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