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rTMSATHARMONICSOFBIOLOGICAL Publicationnumber WO2013152354A2

SIGNALS Publicationtype Application
WO2013152354A2 Application
PCT/US2013/035642
number
ABSTRACT Publicationdate Oct10,2013
Filingdate Apr8,2013
RepetitiveTranscranialMagneticStimulation(rTMS)is Prioritydate Apr6,2012
administeredatapulseratethatisequaltooraharmonicofa Alsopublishedas CA2867770A1,US9308385,
biologicalmetricofapatient.Thepurposeistoprovidefrequency US20130267760,US20160220837
couplingamongdifferentorgans(e.g.,heart,brain,breathing,and Inventors YiJin
gastrointestinalmovement)throughrhythmicentrainment.The
Applicant NewportBrainResearchLaboratory
specificharmonicchosenistheoneclosesttoadesiredEEG
Inc.
frequency.ThedesiredEEGfrequencyischosenbasedonthe
cognitiveelementorsymptomthatistargeted. ExportCitation BiBTeX,EndNote,RefMan
Referencedby(1),Classifications(8),LegalEvents(9)
ExternalLinks:Patentscope,Espacenet

DESCRIPTION(OCRtextmaycontainerrors)
CLAIMS(OCRtextmaycontainerrors)
rTMSATHARMONICSOFBIOLOGICALSIGNALS

CROSSREFERENCETORELATEDAPPLICATIONSThe CLAIMSWeclaim:
presentapplicationclaimspriorityunder35U.S.C.119(e)toU.S.
1.Amethodofmodulatingabrainactivityofamammalwhich
ProvisionalApplicationNo.61/621,423,filedonApril6,2012,the comprisessubjectingthemammaltorepetitivetranscranial
disclosureofwhichisincorporatedhereinbyreferenceinits magneticstimulation(rTMS)atafrequencyofabiologicalmetric,
entirety.
oranharmonicorsubharmonicofsaidbiologicalmetric,fora
FIELDOFTHEINVENTION timesufficienttomodulatesaidbrainactivitywhereinan
improvementinaphysiologicalconditionoraneuropsychiatric
Thepresentinventionrelatestomethodsofmodulatingbrain conditionisachieved.
activitywithrepetitivetranscranialmagneticstimulation(rTMS)
whereintherTMSisadministeredatafrequencyofabiological
metricoraharmonicofabiologicalmetric. 2.Themethodofclaim1whereinthebiologicalmetricisheart
rate,respiratoryrate,gastrointestinalmovementrate,oranEEG
BACKGROUNDOFTHEINVENTION
frequency.
TranscranialmagneticstimulationandrTMShavebeenusedto
treatmanypsychologicalandmedicaldisorderssuchasmajor
depressivedisorder,Parkinson'sdisease,Alzheimer'sdisease, 3.Themethodofclaim1whereinthebrainactivityisadesired
autismspectrumdisorder(ASD),schizophreniaandothers. EEGbandandtherTMSfrequencyisequalto,oranharmonicor
Recently,JinandPhillips,inUSPatentPublication2009/0082690, subharmonicof,anonEEGbiologicalmetricthatisclosesttothe
havedisclosedatreatmentprotocolusingrTMSwheretheoutput targetedfrequencyinthedesiredEEGband.
ofthemagneticfieldisadjustedbasedonapatient'sEEGintrinsic
frequenciesinanattempttoalterthepatient'sintrinsicEEG
frequencies.
4.Themethodofclaim3whereinthenonEEGbiologicalmetricis
SUMMARYOFTHEINVENTION heartrate,respiratoryrateorgastrointestinalmovementrate
(peristalsis).
Briefly,inaccordancewiththepresentinventionthebrainactivity
ofamammalismodulatedbysubjectingthemammaltorepetitive
transcranialmagneticstimulation(rTMS)atafrequencyofa
biologicalmetric,oraharmonic(includingsubharmonics)ofthe 5.Themethodofclaim1whereinthephysicalconditionis
biologicalmetricforatimesufficienttomodulatethebrainactivity concentration,sleep,alertness,memory,bloodpressure,stress,
ofthemammal.Animprovementinaphysiologicalcondition, libido,speech,motorfunction,physicalperformance,cognitive
psychologicalcondition,oraneuropsychiatricconditionexhibited function,intelligence,heightorweight.
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bythemammalisachieved.Thebiologicalmetriccanbeany
biologicalmetricincludingbutnotlimitedtoheartrate,respiratory
rate,gastrointestinalmovementrate,oranEEGfrequency. 6.Themethodofclaim1whereinthementalconditionisAutism
Preferably,thebrainactivitytobemodulatedisadesiredEEG SpectrumDisorder(ASD),Alzheimer'sdisease,ADHD,
band,suchas,forexample,thebrains'alphawaves,andthe schizophrenia,anxiety,depression,coma,Parkinson'sdisease,
rTMSfrequencyisequalto,oraharmonicorsubharmonicof,a substanceabuse,bipolardisorder,asleepdisorder,aneating
nonEEGbiologicalmetricthatisclosesttothetargetedfrequency disorder,tinnitus,traumaticbraininjury,posttraumaticstress
inadesiredEEGbandsuchasforexampletheheartrate,which syndrome,orfibromyalgia.
isasubharmonicofthealphafrequency.Otherbiologicalmetrics
includethepatient'srespiratoryrateandthegastrointestinal
movementrate(rateofperistalsis).OtherEEGfrequenciesinclude
7.Themethodofclaim2whereinthefrequencyisdeltaband(<4
thedeltaband(<4Hz),thethetaband(48Hz),thebetaband(13
Hz),thethetaband(48Hz),thealphaband(813Hz),thebeta
30Hz),thegammaband(40Hz)ortheMuband(813Hz).
band(1330Hz),thegammaband(40Hz)ortheMuband(813
Bymodulatingthebrainactivityofamammal,improvementsin Hz).
physicalconditions,psychologicalconditions,andneuropsychiatric
conditionsareimprovedinanoninvasivemannerandusually
withouttheneedformedications.Physicalconditionsthatcanbe 8.Amethodofmodulatingabrainactivityofapatienthaving
improvedincludepainrelief(painmanagement),bloodpressure, autismspectrumdisorder(ASD)whichcomprisessubjectingthe
stress,libido,motorfunction,physicalperformance,height(in patienttorepetitivetranscranialmagneticstimulation(rTMS)ata
children)orweight.Psychologicalconditionsthatcanbeimproved frequencyofabiologicalmetric,oranharmonicofsaidbiological
includedconcentration/focus,sleep,alertness,memory,speech, metric,foratimesufficienttomodulatesaidbrainactivitywherein
intelligence,andothercognitivefunctions.Neuropsychiatric animprovementinthesymptomsoftheASDisachieved.
conditionsthatcanbeimprovedincludesymptomsofAutism
SpectrumDisorder(ASD),Alzheimer'sdisease,attentiondeficit
hyperactivitydisorder(ADHD),schizophrenia,anxiety,depression,
coma,Parkinson'sdisease,substanceabuse,bipolardisorder,a 9.Themethodofclaim8whereinthebiologicalmetricisthe
sleepdisorder,aneatingdisorder,tinnitus,traumaticbraininjury, patient'srestingheartrate.
posttraumaticstressdisorder(PTSD),orfibromyalgia.

Ofparticularinterestinthepracticeofthepresentinventionare
10.Amethodofmodulatingabrainactivityofapatienthaving
methodsofmodulatingahumanpatient'salphabrainwavesina Alzheimer'sdiseasewhichcomprisessubjectingthepatientto
patientwithASD,chronicpainorAlzheimer'sdisease.TherTMS repetitivetranscranialmagneticstimulation(rTMS)atafrequency
treatmentprotocolwillbeginasadailyregimenof30minutesof ofabiologicalmetric,oranharmonicofsaidbiologicalmetric,for
rTMSsetatafrequencywhichisaharmonicofthepatient'sheart atimesufficienttomodulatesaidbrainactivitywhereinan
ratewhichisclosesttothefrequencyinthealphabrainwave improvementinthesymptomsoftheAlzheimer'sdiseaseis
rangeof813Hz.AsseeninExample1below,ifthepatient's achieved.
heartrateis1.5Hzthenthe6thharmonicwillbesetatreatment
frequencyoftherTMSdeviceat9HzwherehisalphaEEG
frequencymaybeat9.1Hzor8.9Hz.Eachpatientwillvary
11.Themethodofclaim10whereinthebiologicalmetricisthe
dependingonhis/herspecificbiologicalmeasurements.
patient'srestingheartrate.
BRIEFDESCRIPTIONOFTHEDRAWINGSFIG.1shows
coherencebetweenthealphabandandtheheartrate.
12.Amethodofmodulatingabrainactivityofapatienthaving
FIG.2showscoherencebetweenthedeltabandandtheheart
chronicpainwhichcomprisessubjectingthepatienttorepetitive
rate.
transcranialmagneticstimulation(rTMS)atafrequencyofa
DETAILEDDESCRIPTIONOFTHEINVENTION biologicalmetric,oranharmonicofsaidbiologicalmetric,fora
timesufficienttomodulatesaidbrainactivitywhereinan
Theterm"mammal"whenusedhereinincludesanymammal improvementinthesymptomsoftheASDisachieved.
especiallyhumans.Nonhumanmammalsincludenonhuman
primates,zooanimals,companionanimals(dogs,cats),
performancemammalssuchasracehorseandbreedinganimals.
13.Themethodofclaim12whereinthebiologicalmetricisthe
Variousbodilyfunctionsoperateatfrequenciesthatareharmonics
patient'srestingheartrate.
orsubharmonicsofthebrain'sintrinsicfrequency.Forexample,
theheartrateisapproximatelythe6th,7th,8th,or9thsub
harmonicofthebrain'salphafrequencyatawakeandthe2ndor
3rdsubharmonicofdeltaatsleep.Thebreathingrateisgenerallythe5lhsubharmonicofthe
heartbeat.Thegastrointestinalmovementfrequencyisapproximatelythe4thor5thsubharmonicof
thebreathingrate.
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Itisevidentthatitisadvantageousfortheretobecoherencebetweenthepeakfrequencyofa
dominantEEGactivityandthenearesthigherharmonicofabiologicalmetricsuchasforexamplethe
restingheartrate.Invariousdiseasestatescoherenceislowwhileinhealthystatescoherenceis
high.InapreferredembodimentofthepresentinventionthefrequencyofanadministeredrTMS
treatmentischosenaccordingtotheEEGpeakfrequencythathasthehighestcoherencecoefficient
withtheEEG.

FIG.1showsapatient'salphabandEEGpatternintheupperleftportion(top3patterns)witha
correspondingfastFouriertransform(FFT)appearingtotherightofeachpatternshowingfrequency
peaks.Thebottomleftpatternisanelectrocardiogram(ECG)patternofthesamepatientwiththe
correspondinghigherharmonicsappearingtotherightoftheECGpattern.Thecoherencecoefficient
isshowninaboxtotherightsideoftheEEGgraphs.Thehighestcoherencecoefficientofthealpha
peakfrequencywiththe9thharmonicoftheheartratecanbeseenfromthetopEEGpattern(Coh
=0.6).The9thharmonicoftheheartrateis10.52Hzandthisisthepreferredfrequencyforthis
patient'srTMStreatmentforconditionssuchaschronicpain,ASDandAlzheimer'sdisease.

FIG.2showsapatient'sdeltabandEEGpatternintheupperleftportion(top3patterns)witha
correspondingfastFouriertransform(FFT)appearingtotherightofeachpatternshowingfrequency
peaks.Thebottomleftpatternisanelectrocardiogram(ECG)patternofthesamepatientwiththe
correspondinghigherharmonicsappearingtotherightoftheECGpattern.Thecoherencecoefficient
isshowninaboxtotherightsideoftheEEGgraphs.Thehighestcoherencecoefficientofthedelta
bandpeakfrequencywiththe3rdharmonicoftheheartratecanbeseenfromthebottomEEG
pattern(Coh=0.7).The3rdharmonicoftheheartrateis3.69Hzandthisisthepreferredfrequency
forthispatient'srTMStreatmentforconditionssuchasinsomniaandattentiondeficitdisorders.

Adesynchronizedoscillatorysystemamongsttheorgansislessenergyefficient.Thefrequency
couplingamongdifferentorgansdevelopsbyrhythmicentrainmentinordertolowerthetotalenergy
costandincreaseefficiencyofthesystemasawhole.Patientswithvariousmentaldisordersareoften
foundtohavefrequency"decoupling"betweencriticalorgans,suchasheartandbrain.Providing
rTMSatthefrequency(oraharmonicthereof)ofoneofthesebiologicalsignalscanmakeuseofthe
body'snaturalresonancetoinfluencebrainactivityandresynchronizethe
heart/brain/respiratory/gastrooscillation,lowerenergy,andincreaseefficiencyandstability.Thisin
turnwilllessenthesymptomsofthedisorderorimproveaphysicalconditionwhich,inthecaseof
Alzheimer'sdiseaseandASD,resultsinimprovedcognitivefunctionandmotorfunctionassociated
withmovementorspeech.Additionally,inunderdevelopedchildrenrTMStreatmentsaccordingtothe
presentinventionmayincreasetheheightandweightofthetreatedchild.Inanotherembodimentof
thepresentinvention,chronicpainreliefcanbeachievedbyadministeringrTMStoapatientin
chronicpainatafrequencythatisaharmonicofthepatient'sheartratepreferablythe6th10th
harmonicoftheheartrate.

ByprovidingrTMSstimulationtothebrainataharmonicoftheheartbeat,breathingrate,or
gastrointestinalfrequency,entrainmentandtheresonantpropertyofthemammaliansystemwill
graduallyimprovethefrequencycouplingamongorgans.Thebrainistargetedbecauseitisthe
centralcontrolmechanismforallorgansinthebody.Thefrequencychosenispreferablyaharmonic
oftheheartbeatthatisclosesttoaninterestedfrequencythatmaybeassociatedwiththedisorder,
symptom,cognitivecharacteristicorphysicalconditionofinterest.Frequenciesofinterestincludethe
following:

a.Deltabandintrinsicfrequency(<4Hz).Deltawavesarenormallyprevalentininfants,duringslow
wavesleeporduringcontinuousattentiontasksinadults.Inpathologicalconditions,itisoften
associatedwithmetabolicencephalopathyorothertypesdiffusedbrainlesions.Ingeneral,rTMSat
2ndor3rdharmonicofheartbeatareusedtotreatinsomniaandimproveattention.

b.Thetabandintrinsicfrequency(48Hz).Thetawavesarecommonlyfoundinchildrenandduring
periodsofdrowsinessinadults.Itisalsoassociatedwithinhibitionofelicitedresponses.Ithasbeen
observedinpathologicalconditionssuchasfocalsubcorticallesions,metabolicencephalopathy,and
deepmidlinedisorders.Ingeneral,rTMSat4lhor5thharmonicofheartbeatmayhelpcontrol
impulsivebehaviorinautismandmanyothermentaldisorders

c.Alphabandintrinsicfrequency(813Hz).Alphabandisnormallyfoundduringperiodsof
relaxationwhileclosingtheeyes.Physiologicallyitisassociatedwiththeprocessofinhibitioncontrol.
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Lackofalphaactivityisfoundinautism,andothermentaldisorders,suchasanxiety,schizophrenia,
andADHD.ReducedalphafrequencycoherencehasbeenfoundinpatientswithAlzheimer'sdisease.
Excessivealphaactivitymaybeseenincomatoseconditions.Ingeneral,rTMSinthisrangewillhelp
treatautism,reduceanxiety,increaseattention,ortreatschizophreniaandAlzheimer's.

d.Betabandintrinsicfrequency(1330Hz).Betabandisassociatedwithalertness,busyoranxious
thinking.Significantreductionofbetaactivityisoftenfoundinsubjectstreatedwithbenzodiazepines.
rTMSinthisrangewillhelptoincreasealertness.

e.Gammabandintrinsicfrequency(40Hz).Gammaactivitydisplaysduringcrossmodalsensory
processingorshorttermmemorymatchingofrecognizedobjects,sounds,ortactilesensations.A
decreaseingammabandactivitymaybeassociatedwithcognitivedecline,suchasAlzheimer's
disease.rTMSinthisrangeisusedtotreatcognitivedeficitsinAlzheimer'sdiseaseorotherformsof
dementia.f.Muactivity(813Hz).Murhythmhasfrequencyoverlapwithalphawavebut,insteadof
parietaloccipitalregions,itisonlyseeninthesensorymotorcortex.Itreflectsthesynchronousfiring
ofmotorneuronsinreststate.Musuppressionisthoughttoreflectmotormirrorneuronsystems.
DeficitsinMusuppression,andthusinmotorneurons,playaroleinautism.rTMSinthefrequency
bandatthespecificlocationwillhelpnormalizethemirrorneuronstotreatautism.

Inapreferredembodimentofthepresentinvention,anharmonicofapatient'sheartrateisusedto
determinetherTMSfrequencyinapatientwherethealphabrainwavefrequencycannotbe
determinedorwhichispoorlydefined.Anharmonicoftheheartrateischosenwhichmostclosely
correspondstoafrequencywithinthealphabrainwaveintrinsicfrequencyof813Hz.Iftheintrinsic
alphabrainwavefrequencyofanautisticpatientoranAlzheimer'spatientcannotbedeterminedoris
illdefinedthenanharmonicoftheheartrateischosenwhichiswithinthe813Hzrange.Thepatient
isthentreatedwithrTMSatthatharmonicandthepatientismonitoredwithEEGtodeterminewhen
anintrinsicalphabrainwavefrequencyemerges.ThentherTMSfrequencycanbechangedtothis
frequencyifitisdifferentthantheoriginalharmonicused.Forexample,ifanautisticpatienthasa
heartrateof1.5Hzandthepatient'sintrinsicalphabrainwavescannotbedeterminedthentherTMS
treatmentsareinitiallysettothe6thharmonicor9Hz.Thepatientistreatedatthisfrequencyuntilan
intrinsicalphabrainwavefrequencyisestablished.rTMStreatmentsarethencontinuedatthe
intrinsicfrequency.ThefollowingTable1showsexamplesofthepresentinventionwhererTMSis
usedtomodifyalphabrainwaves(intrinsicfrequency813Hz).Table1showstheheartrate,the
heartfrequencyinHzandafrequencyoftherTMStreatment.TypicallytherTMSoutputintensityused
totreatapatientisfrom10%toabout120%ofthemotorthresholdofthepatient.

TABLE1

ThefollowingTable2showsexamplesofthepresentinventionwhererTMSisusedtomodifydelta
brainwaves(intrinsicfrequency<4Hz).Table2showstheheartrate,theheartfrequencyinHzanda
frequencyoftherTMStreatment.TypicallytherTMSpowerusedtotreatapatientisfrom10%to
about120%ofthemotorthresholdofthepatient.

TABLE2

HeartRate(beat/min)HeartRateinHzrTMSFrequncyinHz
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801.332.66

851.422.84

901.53.0

ThefollowingTable3showsexamplesofthepresentinventionwhererTMSisusedtomodifytheta
brainwaves(intrinsicfrequency48Hz).Table3showstheheartrate,theheartfrequencyinHzand
afrequencyoftherTMStreatment.TypicallytherTMSpowerusedtotreatapatientisfrom10%to
about120%ofthemotorthresholdofthepatient.

TABLE3

ThefollowingTable4showsexamplesofthepresentinventionwhererTMSisusedtomodifybeta
brainwaves(intrinsicfrequency1330Hz).Table4showstheheartrate,theheartfrequencyinHz
andafrequencyoftherTMStreatment.TypicallytherTMSpowerusedtotreatapatientisfrom10%
toabout120%ofthemotorthresholdofthepatient.TABLE4

HeartRate(beat/min)HeartRateinHzrTMSFrequncyinHz

(85%ofMotorThreshhold)

500.8320.7

601.032.0

651.0819.44

701.1732.76

751.2525.0

801.3315.96

851.4231.24

901.530.0

ThefollowingTable5showsexamplesofthepresentinventionwhererTMSisusedtomodifygamma
waves(intrinsicfrequency~40Hz).Table5showstheheartrate,theheartfrequencyinHzanda
frequencyoftherTMStreatment.TypicallytherTMSpowerusedtotreatapatientisfrom10%to
about120%ofthemotorthresholdofthepatient.

TABLE5

ThefollowingTable6showsexamplesofthepresentinventionwhererTMSisusedtomodifyMu
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brainwavesofthesensorymotorcortex(intrinsicfrequency813Hz).Table6showstheheartrate,
theheartfrequencyinHzandafrequencyoftherTMStreatment.TypicallytherTMSpowerusedto
treatapatientisfrom10%toabout120%ofthemotorthresholdofthepatient.

TABLE6

Thefollowingexampleillustratesthepracticeofthepresentinventionbutshouldnotbeconstruedas
limitingitsscope.

EXAMPLE1TREATMENTOFAUTISM

A9yearoldboysufferedfromdevelopmentdelayincognitiveandfinemotorfunctions,andhadbeen
diagnosedwithautism.Duringtheinitialinterview,thepatientappearedtobeslowinresponseto
simplequestions,exhibitedalimitedworkingmemoryandhadobviousdifficultyinwritingandother
finemotorfunctions.Thepatientwasreportedtohavefrequentheaddropsandimpropergazing.He
hadbeentreatedwithanticonvulsantsandwastakinganticonvulsantmedications.Thepatient'sEEG
showeddiffusedandleftfrontallobedominantslowwavesat6.3Hzwithoccasionalshortburstsof
alpharhythmintheoccipitalareabutnoclearandconsistentintrinsicalphafrequencycouldbe
identified.SingleleadECGshowedaregularheartbeatat1.5Hz.Takingits6thhigherharmonic,it
wasdecidedtosettherTMSat9.0Hzoverthemidcentralandleftfrontallobe.Followingthefirst2
sessionsofrTMS,thepatientshowedsomedegreeofimprovementwithmorevigilanceand
spontaneouscommunication.Withfurthertreatmentstherewasasignificantreductionoftheslow
wavesinthepatient'sEEGandanincreaseinalpharhythm.Clinically,thefrequencyofseizure
episodesreducedsignificantly.Aftertitratingdowntheanticonvulsantdosageovertime,thepatient
experiencedasignificantimprovementincognitiveandmotorfunctions.

EXAMPLE2PAINRELIEFPAINMANAGEMENT

Anadultmalehadchronicpainforseveralyearsaftergoingthroughmanybacksurgeries.The
patient'sEEGshoweddesynchronizedalphawavesandalowalphawavevalue.SingleleadECG
showedaregularheartbeatat1Hz.Takingits9thhigherharmonic,itwasdecidedtosettherTMSat
9Hzoverthebilateralprefrontallobe.Following3sessionsofrTMS,thepatientshowedasignificant
reductioninpain.TheEEGpatternshowedsignificantimprovementinalphasynchronization.

EXAMPLE3TREATMENTOFALZHEIMER'SDISEASE

Anadultfemale(85yearsold)hadbeendiagnosedwithAlzheimer'sdiseaseforabout15years.The
patient'sEEGshowedalphapeakfrequencybelow8Hzwhichisinthethetabandrange.Singlelead
ECGshowedaregularheartbeatat1.2Hz.Takingits7thhigherharmonic,itwasdecidedtosetthe
rTMSat8.4Hzoverthebilateralprefrontallobe.Following1sessionofrTMS,thepatientshoweda
significantimprovementinshorttermmemoryandworkingmemory.After2weeksofdaily(Monday
Friday)rTMSsessionsthepatientbecamemorecoherentandherMMSEscoreimprovedfrom14
pretreatmentto21posttreatment.TheEEGpatternshowedanalphawavenear8Hz.

Thepresentinventionmaybeembodiedinotherspecificformswithoutdepartingfromitsspiritor
essentialcharacteristics.Thedescribedembodimentsaretobeconsideredinallrespectsonlyas
illustrativeandnotrestrictive.Thescopeoftheinventionis,therefore,indicatedbytheappended
claimsratherthanbytheforegoingdescription.Allchangeswhichcomewithinthemeaningand
rangeofequivalencyoftheclaimsaretobeembracedwithintheirscope.

REFERENCED BY

CitingPatent Filingdate Publicationdate Applicant Title

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 Attentiondeficithyperactivitydisorderobjective
CN104127186A* Jul31,2014 Nov5,2014
evaluationsystem
*Citedbyexaminer

CLASSIFICATIONS

InternationalClassification A61N2/04,A61B5/04
CooperativeClassification A61N2/006,A61N2/004,A61B5/7282,A61B5/7257,A61B5/048,A61B5/0245

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