Principles of Organization and Control of the New Implementation of

the “SYMPATHOCOR-01” Neuro-electrostimulation Device

Vladimir Kublanov, Mikhail Babich and Anton Dolganov

Research Medical and Biological Engineering Centre of High Technologies, Ural Federal University, Mira 19, 620002,

Yekaterinburg, Russian Federation

Keywords: Neuro-electrostimulation, Mobile Device, Device Control, Device Organization, “SYMPATHOCOR-01”

Abstract: The paper describes peculiarities of the organizational and control principles of the new implementation of

the “SYMPATHOCOR-01” device. Necessity of the device division into two blocks, having different

functions, was justified. The specifics of the schematic implementation were mentioned. Advantages of the

wireless connection between two blocks were shown. Particular possibilities and actual implementation of

the control block via Android application for mobile devices were presented. The potential targets for the

neuro-electrostimulation that affect autonomic processes were considered.

1 INTRODUCTION

It is well known that combination of several kinds of

stimulation, each of which provides different types

of physiological reactions of damaged cognitive,

autonomic, motor, sensory and vestibular functions,

achieves the best efficiency in the process of

neurorehabilitation. This is necessary for the specific

attraction of new neuronal resources into the

damaged neural network, which provides

rehabilitated function (Enriquez-Geppert et al.,

2013). This principle has been used for a long time

in the creation of the effective programs for the

physical rehabilitation by means of the

transcutaneous electrical muscle stimulation (Nagai

et al., 2016).

According to modern science concepts, addition

of the physical and cognitive load to the process of

neurorehabilitation can increase the production of

neurotrophic factors and activate the mirror neuron

system (Yuan et al., 2015). The neurotrophic factors

implement the neuroplasticity of the brain

mechanisms. At the same time, mirror neurons are

able to remodel lost functions (Reichardt, 2006).

Devices that are compact, portable and do not

cause discomfort for patients during rehabilitation

procedures are the most promising for the

combination of several kinds of stimulation during

treatment process. At present time, many neuro-

electrostimulation devices that meet these

requirements are designed.

Neuro-electrostimulation devices, which use

low-frequency current pulses with single polarity,

are among the perspectives types of the

neuroelectrostimulation. The duration and frequency

of such devices commensurate with the duration of

nerve pulses and the frequency of their appearance

in neural networks.

The number of corresponding devices decreases

dramatically, if one exclude devices with implanted

electrodes. Non-invasive neuro-electrostimulation

devices, that include multi-electrode systems, have

greater opportunities for activation of the brain

neuroplasticity mechanisms, compared to other

devices, due to the redundancy of the information

generated by their spatially distributed current pulses

fields.

Two original multi-channel portable systems for

non-invasive stimulation of the tongue (PoNS

device) (Danilov and Kublanov, 2014) and the neck

area (“SYMPATHOCOR-01” device) (Kublanov

2008) are fully satisfied of these requirements.

The “SYMPATHOCOR-01” device is included

in the register of medical equipment products of the

Russian Federation and has the Certificate of

correspondence to the requirements of the Safety.

The Manual for its use was approved by the State

Control of the quality, effectiveness and safety of the

medicines and medical equipment Department of the

Russian Ministry of Health.

This article discusses the features new technical

Kublanov V., Babich M. and Dolganov A.

Principles of Organization and Control of the New Implementation of the â

AIJSYMPATHOCOR-01â

I Neuro-electrostimulation Device.

DOI: 10.5220/0006175802760282

implementation of the compact and mobile

“SYMPATHOCOR-01” device. The device is aimed

for application in neurorehabilitation tasks that

imply using of several kinds of stimulation.

2 NEURO-

ELECTROSTIMULATION

TARGETS

The basis of all human mental activity are the

processes in the central nervous system. It should be

noted that the role of the cerebral circulation: mental

performance (attention, memory and perception,

logical thinking) is reduced at the deterioration of

blood supply to the brain. This feature determines

the search for solutions to manage the blood supply

of the brain. Therefore, those physiological

mechanisms of the sympathetic nervous system are

fundamental which allows to control the tone of the

blood vessels of different caliber.

The most important formations that are involved

in the organization of the neuro-electrostimulation

are:

 glossopharyngeal nerve and its branches;

 vagus nerve and its branches;

 the accessory nerve;

 the nerve plexus around the carotid artery;

 the sympathetic trunk structures

o upper cervical node;

o middle cervical node;

o vertebral ganglion;

o stellate ganglion;

 spinal nerves C2-C4 forming the cervical

plexus.

Figure 1 shows the conventional areas of the

nerve structures location in the neck region.

Regulating centers of the vital functions are

placed in the nuclei of the brain stem, midbrain,

pons and the cerebellum, in the autonomic nuclei of

the brain and spinal cord. Many of the mentioned

pathways are located in the neck.

The nervous formations of neck area are closely

associated with brainstem, which have two-side

connections with midbrain, cerebellum, thalamus,

hypothalamus and the large brain cortex. Presence of

these connections provides participation of the neck

nervous formations in analysis of sensory

stimulation, regulation of the muscle tonus,

autonomic and the highest integrative functions

(Netter, 2010).

Figure 1: Conventional areas of the nerve structures

location in the neck: 1 – n. glossopharyngeus; 4 – n.

plexus caroticus externus; 11 – ganglion cervicale

medium; 15 – ganglion stellatum; 21 – ramus

communicans griseus; 22 – ganglion cervicale superius;

23 – n. vagus.

As a stimulation targets can be used:

 the superior cervical ganglia of the

sympathetic nervous system;

 the stellate ganglion;

 other components of the sympathetic trunk;

 the afferent branches of the cervical plexus;

 cranial nerves and their branches (IX, X and

XI pair).

These targets are the conductive paths of the

brain stem nerve structures. Usage of them

significantly extends the capabilities of the neuro-

electrostimulation method (Kublanov and Babich,

2015).

The stimulation of neck nodes of the sympathetic

trunk affects both the vascular tone of arteries of the

brain, and autonomic spinal nucleus. Thus, neuro-

electrostimulation device is able to fully modulate

the autonomic processes and affect motor control

and cognitive functions.

3 ORGANIZATION OF THE

“SYMPATHOCOR-01” DEVICE

The “SYMPATHOCOR-01” is the non-invasive

neuro-electrostimulation device that performs

stimulation by the spatially distributed current pulses

field using two multi-electrode (ME) systems. ME

systems are placed symmetrically on the neck skin,

in projections of the sympathetic nervous system

neck ganglion.

Partial current pulses that flows from partial

cathodes of one ME system to single anode of the

other ME system carry out the stimulation process.

Partial current pulses have the amplitude, ranging

from 0 to 15 mA; the duration, ranging from 15 to

60 us; the modulation frequency from 5 to 150 Hz.

For the neuro-electrostimulation process from 1 to

13 partial cathodes can be involved.

3.1 General Structure

The “SYMPATHOCOR-01” device consists of two

blocks. First block has autonomous power source

(built-in Li-ion battery) and forms the spatially

distributed field of current pulses. The energy

consumption of the first block reaches 47 mA. Time

of the continuous operation reaches 22 hours.

Second block sets characteristics of the spatially

distributed current pulses field, field’s configuration

in the neck area, based on functional state of the

autonomic and central nervous systems of the

patient. Personal computer or mobile device can be

used as the second block.

Fig. 2 presents the block-scheme of the

“SYMPATHOCOR-01” device.

Figure 2: Block-scheme of the “SYMPATHOCOR-01”

device.

The built-in processors control both blocks. The

wireless communication channel provides

connection between two blocks. Each block has a

built-in receiver-transmitter. The Bluetooth Low

Energy technology is used as the wireless

communication channel. The second block

implement virtual block of the characteristics setting

as the graphical user interface accessible to the

doctors.

The wireless communication channel between

two blocks has possibility to perform the

information transfer using unique addresses of the

receiver-transmitters, placed in both blocks.

Therefore, it is possible for one doctor to organize

management of simultaneous neuro-

electrostimulation for group of patients by means of

single second block.

The block-scheme of the

“SYMPATHOCOR-01” organization in case of

simultaneous neuro-electrostimulation of two

patients is shown on Fig. 3.

Figure 3: Block-scheme of the “SYMPATHOCOR-01”

device organisation for two patients.

3.2 The First Block Structure

The division of the “SYMPATHOCOR-01” device

into two blocks, in comparison with older releases,

allowed to exclude user interface used by doctor,

and to simplify the processor installed in the first

block. Simplification of the first block processor

arisen from shifting of particular functions to the

second block. Because of that the first block was

implemented as mobile and compact device with the

following dimensions: 90.0  50.0  18.5 mm. The

general view of the “SYMPATHOCOR-01” device

first block is shown on Fig. 4. Fig. 5 shows general

view of the main printed circuit board (PCB) in the

“SYMPATHOCOR-01” device first block.

8-channel chips of the Analog Devices

ADG5408 multiplexers are the basis for

commutation of the partial cathodes and anodes. In

the present implementation of the neuro-

electrostimulation device, four chips are used. In this

case, it is possible to use in the stimulation process

up to 16 partial cathodes and 16 anodes.

Three bipolar transistors (two BC807 and one

BC817) implement current source of the neuro-

electrostimulation by means of the current mirror.

The built-in 12-bit digital-to-analog converter

generates control voltage of the current source. The

resistor values of the current mirror were selected in

a way that current source generates current with the

amplitude in a range from 0 to 15 mA, with load in

range from 0 to 2 kOhm.

The algorithm of the current pulses field

formation, implemented in the first block processor

is shown on Fig. 6.

Figure 4: General view of the first block.

Figure 5: General view of the first block printed circuit

board.

Figure 6: The algorithm of the field formation.

Change of the current pulses field state is

possible only in certain discrete time points. These

time points are defined by the equation

=





+∗,

(1)

where: ∈, ∈,0, K – the number of

the partial cathodes used in the neuro-

electrostimulation,  – the duration of the partial

pulse, ν – the modulation frequency of the current

pulse field.

The processor performs the following steps for

i-th time point:

 Consequent turning off the previously

connected cathode and turning on the

following cathode in accordance with the

neuro-electrostimulation program;

 Changing of the anodes, in case of the

respective requirements of the neuro-

electrostimulation program or by doctor

command;

 In case of new target values of the amplitude,

the duration, the modulation frequency of the

partial current pulses, set by the second block

of the device, changing of the respective

characteristics in accordance with the

following equations:







targe

, 



i−1

−



targe

<∆



i−1

+∆



i−1

+∆



target



i−1

−∆



i−1

−∆



targe

(2)











targe

, 

i−1

−

targe

<∆



i−1

+∆

,

i−1

+∆

<

target



i−1

−∆

,

i−1

−∆

>

target

=1/

(3)



targe

,τ

i−1

−τ

targe

<∆

i−1

+∆

,τ

i−1

+∆

<τ

target

i−1

−∆

,τ

i−1

−∆

>τ

targe

(4)

where: A – the amplitude of the partial current

pulses, A

target

– the target amplitude of the partial

current pulses, Δ

– the maximum amplitude

increment, T

target

– the target period of the current

pulses, ΔT – the maximum period increment,

target

– the target duration of the partial pulse, Δ

–

the maximum duration increment.

Usage of the constraint to the rate of the

characteristics change allowed preventing pain

feelings during the neuro-electrostimuation process.

3.3 The Second Block Structure

Currently, the second block control program is

implemented as the application for the mobile

devices with the operational system Android 4.2.2

and higher. Fig. 7 shows general view of the

graphical user interface for the application.

The application allows one to control and change

the amplitude, duration and the modulation

frequency of the partial current pulses, to switch the

currently used anode and to change field direction in

real time.

The characteristics of the partial current pulses

can be set by either using the seek bar or through

direct value setting in the corresponding fields, to

the right of seek bar elements. For the amplitude

changes buttons of coarse (‘+1’, ‘-1’) and fine

(‘+0.1’, ‘-0.1’) change were additionally

implemented. This addition allowed preventing pain

feelings caused by unreasonable amplitude increase.

Figure 7: General view of the graphical user interface.

The group of radio buttons are used for switching

of the current anode. The pattern of the radio buttons

placement is similar to the pattern of the partial

electrodes placement of the ME systems.

The filed state can be either ‘Turned off’, or

‘Direct’ or ‘Reverse’. Three corresponding buttons

on the graphical user interface control the field state.

The ‘Reverse’ state changes role of the ME systems.

In present time, two modes of the currently used

anode switch are implemented: ‘Manual’ and

‘Automatic’. In case of manual mode, the doctor

switch currently used anode based on functional

state of the patient. In case of automatic mode,

currently used anode switch in accordance with the

specific neuro-electrostimulation algorithm.

4 RESULTS

In the present time, the efficacy of the

“SYMPATHOCOR-01” device was proven both, for

prenosological state of the pathology development

and for patients treatment, suffering from the

disorders of the cognitive, autonomic, motor, sensor

and vestibular functions. The

“SYMPATHOCOR-01” device is used in more than

200 Russian hospitals (Kublanov et al., 2010). The

device is applied for correction of the following

pathologies:

 migraine;

 neurocirculatory dystonia;

 alcohol and narcotic abstinences;

 hypertonic diseases;

 obliterate atherosclerosis of the lower limbs;

 Raynaud’s disease;

 trigeminal nerve inflammation;

 sensorineural deafness;

 degenerative diseases of vision;

 atrophy of the optical nerve;

 osteochondrosis of the back bone;

 neuropathies of various genesis;

 cephalalgia syndrome;

 hyperhidrosis syndrome;

 syndrome of the orthostatic hyposthenia;

 postural tachycardia;

 vestibular disease;

 vegetative deregulation syndrome;

 epilepsy;

 attention deficit hyperactivity disorder.

New mobile implementation of the

“SYMPATHOCOR-01” device can be used for the

neuro-electrostimulation in combination with

different kinds of the stimulation. This extends the

application of the device for the following

directions:

 treatment of the cognitive disorders caused by

the cranial injuries, strokes, neuroinfections

during the athrophic diseases of the human

brain;

 treatment of the depressive and anxiety

disorders;

 improvement of the senso-motor coordination

and recovery of the autonomic functions for

patients with brain circulation disorders;

 rehabilitation of the military personnel;

 target transport of the drugs in the local areas

of the organism;

 preventative medicine;



recovery of the sportsmen in the training

period and during the competitions in the sport

medicine.

Table 1 presents comparison of electrical and

ergonomic characteristics of the new and old

technical implementations of the

“SYMPATHOCOR-01” device. The standard

laboratory equipment, which includes oscilloscopes

and the power supply, were used for comparison of

the characteristics. A system of resistors, that

connects all cathodes and all anodes at the same

point, was used as an equivalent to biological

material.

Table 1: Comparison of characteristics of the new and old

technical implementations of the “SYMPATHOCOR-01”

device.

Characteristic

Old technical

implementation

New technical

implementation

Number of

partial cathodes

12 13

Number of

partial anodes

1 13

Weight 1.5 kg 200 g

Dimensions,

186x116x60 90x50x18,5

Amplitude of

the partial

pulses

0 - 25 V 0 - 15 mA

Frequency of

the pulse field

modulation, Hz

15 – 100 5 – 150

Length of the

partial pulse, µs

35 – 50 15 – 60

Set of the field’s

parametres

Switchers on the

panel of the

device

Wireless

channel by

means of

Bluetooth Low

Energy

Also device with new technical implementation

is capable of changing program of the neuro-

electrostimulation and conducting procedures on

multiple patients by single second block.

Comparative analysis of the data in table 1 shows

the increase of the possibilities of the device in

neuroreabilitation tasks due to decrease of weight

and device proportions. New implementation of the

device does not cause any discomfort to patient

during the procedures. In addition to that,

application of the wireless channel simplify

combination of the neuro-electrostimulation with

other kinds of stimulation used in the rehabilitation.

The ability to change program of the neuro-

electrostimulation as well as availability of the

multiple partial anodes allows to involve in the

stimulation process not only neck ganglia, but also

influence on the stellate ganglion, the afferent

branches of the cervical plexus, cranial nerves and

their branches as well as other components of the

sympathetic trunk. All in all, abovementioned

improvements significantly enhance possibilities of

the new technical implementations of the

“SYMPATHOCOR-01” device in

neurorehabilitation tasks.

5 CONCLUSIONS

The article describes new technical implementation

of the “SYMPATHOCOR-01” device.

Implementation of the device as the two block

allowed to improve ergonomic characteristics, to

make the device mobile and compact, to realize the

simultaneous stimulation of the patients group by

single doctor. Presented in the article analysis of the

organizational and control principles of the

“SYMPATHOCOR-01” device new implementation

revealed the innovative possibilities in the

neurorehabilitation tasks. Device mobility and

wireless control allow doctors to combine several

kind of stimulation including cognitive and motor

loads and neuro-electrostimulation using

“SYMPATHOCOR-01” device.

The next step of device implementation is

automatic real-time recording of the functional

changes in the central and autonomic nervous

systems. This recording will allow us to improve

informational control of the treatment management

and to increase treatment efficiency.

ACKNOWLEDGMENTS

The work was supported by Act 211 Government of

the Russian Federation, contract № 02.A03.21.0006.

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