Method and apparatus for biofeedback
Contents
1. worst cause the most distant or fuzziest LVRI image to be displayed LVRI 5 By adjusting the scaling of linked parameters in sub sequent sessions the technician may vary the degree of progress the subject must make in biofeedback before being rewarded with a clearer LVRI image In begin ning sessions it may be desirable to reward the subject for only having made a small amount of progress in altering a parameter As the subject becomes more skilled the requirements can be adjusted so that more relaxation for example can be achieved for the same level of reward Scaling information is presented on a graphical report so the technician can review the sub ject s attainment during the session and decide on the appropriate scaling for the next session When the session is complete i e the preset session time has elapsed the system produces printed reports and graphs for analysis by the technician and physician These include the values of recorded parameters and LVRI level changes against time in the form both of tables and plotted graphs The technician also has the capability of annotating the reports from the keyboard The annotations and a signature line in accordance with accepted medical record keeping practice appear on the printed reports which are produced on laser printer 45 The result of the session is that the subject has been made to relax and to associate the relaxation with the particular audio visual sequence th2. 30 In a preferred embodiment digital computer 30 is compatible with an International Business Ma chines personal computer running the DOS operating system and preferably containing an Intel 386SX or higher microprocessor A fast microprocessor is re quired for example to process EEG signals which exhibit a high information rate In a preferred embodi ment digital computer 30 includes a hard disk not shown for data storage a keyboard 40 for entering commands a printer 45 preferably a laser printer for printing reports and a high resolution graphic monitor 50 to display command menus and graphs of the sub ject s progress to the biofeedback technician In a pre ferred embodiment keyboard 40 has at least ten func tion keys F1 through F10 An asynchronous serial port of computer 30 is connected to video player 60 whereby the player can be controlled by the computer In a preferred embodiment video player 60 is a laser videodisc player such as the Pioneer Model LD V 8000 and the connection to computer 30 is made with a Pio neer serial cable P N CC 13 The Model LD V 8000 is capable of holding a video image while access to a different portion of the videodisc is being established This eliminates blanking of the display device between selection which is undesirable because it interrupts the concentration of the subject Video player 60 need only 3 343 871 5 be capable of directly and guickly accessing video se guences in arb
3. by depressing the F5 Reports key 1 Graphs Generates a line graph versus time for each modality selected in the Control Screen which correspond to the electrophysiological parame ters being monitored for this subject Report F2 Tables Generates a table of numerical values of each modality at discrete time steps through 15 out the session Report F3 Progress Note Invokes a word processor so the technician can introduce notes into the patient s medical record Report F4 All Reports Causes the system to pro duce all possible output reports for this session Report F10 Return to Main Menu It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing 25 illustrative embodiment and that the present invention may be embodied in other specific forms without de parting from the spirit or essential attributes thereof The present embodiments are therefore to be consid ered in all respects as illustrative and not restrictive The scope of the invention being indicated by the ap pended claims and rather than by the foregoing descrip tion and all changes which come within the meaning and range of the eguivalency of the claims are therefore intended to be embraced therein We claim 1 An apparatus for mediating a biofeedback session with a subject at least one of whose electrophysiologi cal parameters is being measured comprising a means for receiving signals i
4. increase is in response to a weighted combination of said parameters and said audio and visual reality are de creased as said weighted combination indicates that the subject s psychological response has become less desir able 11 The method of claim 10 wherein said increase and said decrease in said reality occurs in discrete steps 12 The method of claim 5 wherein the desired psy chological state is relaxation and further comprising the step of C teaching the subject to perform a motor skill when the subject s psychological response has become more desirable whereby the subject s ability to learn said skill is enhanced by the subject s being in said desired psychological state 13 The method of claim 5 wherein the desired psy chological state is relaxation and further comprising the step of C presenting the subject with material to be learned when the subject s psychological response has be come more desirable whereby the subject s ability to learn said material is enhanced by the subject s being in said desired psychological state 14 The method of claims 12 13 7 or 8 wherein said improvement in said reality occurs in discrete steps 15 An apparatus for conditioning a desired psycho logical response in a subject comprising a means for monitoring at least one of the subject s electrophysiological parameters indicative of his psychological response b means for determining from the values of said monitored para
5. levels are assigned the labels LVRI 1 through LVRI 5 LVRI 1 represents the highest level of reality LVRI 5 represents the lowest level of reality The subject is rewarded for favorable biofeedback response by being shown an audio visual Scene at a higher reality level lower LVRI level The purpose of using differing reality levels is to provide the subject with successive related image targets and to indicate to the subject by nondistracting means that biofeedback is succeeding Because all of the scenes 20 25 30 40 45 50 55 60 65 6 within a cluster are partially degraded versions of the same desirable image the subject recognizes the target scene and anticipates improvement in the display fur ther inspiring his effort at biofeedback Negative feedback can be provided by decreasing the level of reality if the subject s physiological parameters move away from the desired direction The present invention has divided reality levels into discrete steps so that the subject is not presented with a constantly fluc tuating image on which attention or enjoyment would be difficult For example if the size of a viewed object were to change continually based on the subject s gal vanic skin resistance the subject would have no fixed target on which to gaze and would be distracted or disturbed by its incessant movement By dividing the range of responses into discrete quanta the subject is better able to concentrate on t
6. ment The subject may even be placed in a room remote from the computer and other equipment with only a television set to observe This separation is particularly beneficial for subjects who experience anxiety in inter acting with a computer During a first session with a human subject a biofeed back technician explains the techniques that will be employed and explains the protocol and objectives The technician then performs an initial evaluation to cali brate the subject s electrophysiological responses In the initial evaluation the subject is seated in a comfort 50 55 65 able chair with biofeedback electrodes in place and shown a series of different high guality audio visual scene seguences each lasting 90 seconds Electrophysi ological parameter measurements are recorded by the computer and reported in graphic and tabular form to the technician who may select a seguence for viewing during later treatment sessions The technician may also select one or more parameters whose values will be used to control changes in clarity levels in the chosen seguence For a treatment session the technician places elec trodes on the subject and inserts in the videodisc player a disc containing the scene seguence to be used during treatment Of the several seguences that may be present on the disc the particular one to be used can be chosen by the technician from a menu of choices presented on graphic monitor 50 The technician c
7. of physiological potentials for a given subject that can be used in conditioning biofeedback response 3 To monitor and record a subject s progress through one or more biofeedback treatments by storing and reporting data concerning the subject s responses on a digital computer so that the combination of physio logical potentials monitored can be altered to maximize the effectiveness of the treatment 4 To provide a means by which a subject s success in controlling his physiological potentials causes presenta tion of a graded sequence of pleasant scenes of succes sively greater video and audio clarity 5 To combine conventional biofeedback devices with a videodisc to permit the presentation of selected image sequences in arbitrary order as a way of reward ing the subject for positive psychological responses 6 To train the subject through biofeedback to induce self relaxation subsequent to a training session without having to rely on a machine for audio visual response 7 To develop a conditioned response on the part of a subject so that he can induce in himself a desired psy cho neurological state by recalling to memory one or more prestored audio visual scenes SUMMARY OF THE INVENTION Accordingly we have invented a biofeedback system in which the feedback provided to the subject is itself calculated to induce the desired state eliminating the need for the subject to imagine a nonexistent scene The apparatus comprises 1
8. 33 Column 12 delete occurs Claim 18 Line 5 Column 14 mean should read means Claim 18 Line 9 Column 14 an should read and Claim 20 Line 16 Column 14 version should read versions Signed and Sealed this Twenty second Day of November 1994 BRUCE LEHMAN Attesting Officer Commissioner of Patents and Trademarks
9. Silva et al 128 2 1 B 3 916 876 11 1975 Freeman 128 2 1 M 3 942 516 3 1976 Glynn et al 128 21 B 3 967 616 7 1976 Ross 128 1 3 978 847 9 1976 Fehmi et al 128 2 1 4 056 805 11 1977 Brady 340 148 4 140 997 2 1979 Brady 340 148 4 354 505 10 1982 128 732 4 461 301 7 1984 128 630 4 665 926 5 1987 Leuner et al 128 716 4 683 891 8 1987 et al 128 630 4 776 323 10 1988 Spector 128 25 4 823 808 4 1989 Clegg et al 128 773 4 883 067 11 1989 Knispel et al 128 732 BIOFEEDBACK PREAMPLIFIER AND CONVERTER DISPLAY RIGHT SPEAKER presentation to the subject of a series of prestored audio visual seguences of varying levels of clarity resident on a direct access video storage device The seguences are real scenes designed to induce a desired psychological state when viewed As the subject succeeds in altering his physiological parameters the clarity of the pres ented image and sound improve as an indication of success By using the invention the subject develops a conditioned response to the scenes and is able to control his physiological parameters even when away from the apparatus by remembering the audio visual seguences used during treatment 20 Claims 2 Drawing Sheets Mi
10. United States Patent US005343871A 11 Patent Number 5 343 871 Bittman et al 45 Date of Patent Sep 6 1994 54 METHOD AND APPARATUS FOR 4 896 675 1 1990 Ohsuga et al 128 671 BIOFEEDBACK 4 919 143 4 1990 Ayers 128 732 4 928 704 5 1990 Hardt 128 732 75 Inventors Barry B Bittman Meadville Pa 4 932 880 6 1990 Kotick et al sss 128 715 Jeffrey R Cram Nevada City Calif 4 984 158 1 1991 Hillsman 364 413 04 5 024 235 6 1991 Ayers 128 732 73 Assignee Mindscope Incorporated Meadville 5 036 858 8 1991 Carter et 128 732 Pa 5 076 281 12 1991 Gavish 128 721 21 Appl No 850 673 Primary Examiner William E Kamm Assistant Examiner Scott M Getzow 22 Filed Mar 13 1992 Attorney Agent or Firm Webb Ziesenheim Bruening A61B 5 02 Lo8sdon Orkin amp Hanson 1521 U S CL nue 128 732 128 905 57 ABSTRACT 128 670 128 733 uti A method and apparatus for mediating biofeedback 58 Field of Search 128 905 732 670 733 session with a human subject in which measurements of 56 References Cited electrophysiological guantities are used to control the U S PATENT DOCUMENTS 3 837 331 9 1974 Ross eee 128 1C 3 855 998 12 1974 Hidalgo Briceno 128 2 1 B 3 875 930 4 1975
11. a high quality display device preferably a high resolution television screen and high fidelity audio system 2 a playback device capable of playing back realistic prestored audio video sequences quickly and in arbitrary order preferably a laser disc player and 3 a digital computer to monitor bioelectric signals and control the display device and the playback device The apparatus is used in conjunction with a conventional set of biofeedback electrodes and associ ated amplifiers and analog to digital converters The apparatus monitors and records such electro physiological parameters as among others 1 electro myographic EMG signals 2 galvanic skin resistance GSR 3 electroencephalographic EEG signals 4 skin temperature 5 blood pressure BP and 6 heart rate HR or pulse Signals indicative of these parame ters are monitored by a computer capable of displaying 5 10 15 20 25 30 35 40 45 50 55 65 4 prestored audio visual scenes at varying levels of visual and acoustic clarity The scenes themselves are of plea surable images designed to induce relaxation such as views of beaches with rolling surf lush flower gardens a sunset a waterfall and the like As the subject gradu ally attains the desired physiological state the image becomes progressively enhanced The reward to the subject for approaching the desired state is a succes sively clearer image closer view or mo
12. at was displayed Furthermore the sequence itself as a result of the initial evaluation is known to assist the subject in attaining the desired relaxation The technician does not need to coach the subject to conjure up an imagined scene The subject will be able after one or more sessions to in duce himself into a state of relaxation outside of a mod erated biofeedback session by remembering the particu lar audio visual sequence By using the present inven tion the subject develops a conditioned biofeedback response The technician controls the system by interacting with it through a small number of screen displays which are primarily menu driven The complete com puter source code implementing these functions is given in Microfiche Appendix B The Initial Screen simply displays title information stored on videodisc 100 in title sector 109 The Main 15 20 25 35 40 45 50 55 60 65 10 Menu Screen permits the choice of seven functions each of which is invoked by depressing one of the pro grammed function keys F1 through F6 and F10 on computer keyboard 40 The Main Menu Screen func tions are Main Fl Demographics This option invokes an other screen permitting the technician to record bio graphical data including the subject s name and other identifying information for later report generation Main F2 Initial Evaluation This causes the com puter to display to the technician the values of act
13. crofiche Appendix Included 2 Microfiche 111 Pages BIOFEEDBACK APPARATUS 70 81 DIGITAL COMPUTER GRAPHIC MONITOR U S Patent 6 1994 Sheet 1 of 2 5 343 871 BIOFEEDBACK APPARATUS 81 RIGHT SPEAKER 4 E Bs 32 L2 25 dr mo X o e LASER PRINTER BIOFEEDBACK DIGITAL PREAMPLIFIER C AND CONVERTER SEMEN 40 COMPUTER KEYBOARD l GRAPHIC MONITOR 45 U S Patent Sep 6 1994 Sheet 2 2 5 343 871 VIDEODISC V CLUSTER 1107 LVRI 1 LVRI 2 LVRI 3 LVRI 4 LVRI 5 tH 112 113 114 115 Fig 3 3 343 871 1 METHOD AND APPARATUS FOR BIOFEEDBACK Two microfiche appendices are provided Microfiche Appendix A comprises 46 frames on microfiche 1 of 2 Microfiche Appendix B comprises 56 frames on micro fiche 2 of 2 BACKGROUND OF THE INVENTION 1 Field of the Invention This invention relates to a method of mediating a biofeedback session with a human subject in which measurements of certain of the subject s electrophysio logical parameters are used to control the presentation to the subject of a series of prestored audio visual se quences of varying levels of clarity or perspective to provide targets whose viewing induces in the subject a desired psychological state 2 Description of the Prior Art Biofeedback is a process in which electrodes are con nected to a huma
14. ctu ally be used to change LVRI levels and can assign relative weights to their importance Control F4 Scaling Allows setting of baseline levels and ranges for electrophysiological parameters Control F5 Start Stop Begins and ends a biofeed back session and controls recording of parameters and output of reports Control F6 Pause Temporarily halts data recording to allow interruptions such as for adjustment of elec trodes Control F7 Progress Allows toggling between the Control Screen and the Progress Screen The Progress Screen displays to the technician a graphic representa tion of the recorded parameters versus time so the progress of the subject can be monitored Control F10 Main Menu Returns to the Main Menu This option cannot be selected until a session has been halted with the F5 key The following functions are available on the Video Screen which can be invoked from the Main Menu by depressing the F6 Utilities key Video F1 Help Provides documentation of options Video F2 Status Indicates the position of the disc and slide door 3 343 871 11 Video F3 Open Slide Door Opens the disc drawer on video player 60 so videodisc 100 may be inserted or removed therefrom Video F4 Close Slide Door Closes the disc drawer so that the disc can be read and a session can begin 5 Video F10 Return to Main Menu The following functions are available on the Reports Screen which can be invoked from the Main Menu
15. d by the subject to control his rate of respiration Ayers U S Pat Nos 4 919 143 and 5 024 235 teach a sound and light box in addition to graph waveforms as output from a biofeedback system Hardt U S Pat No 4 928 704 teaches combining tone feedback with display of digital data to the subject Hillsman U S Pat No 4 984 158 teaches auditory prompts and use of visual graphs for instructing subjects to use a metered dose inhalation system Carter et al U S Pat No 5 036 858 teaches use of light goggles and headphones to convey beat signals to a subject indicative of how much his brainwave fre quency differs from a desired frequency Gavish U S Pat No 5 076 281 teaches using synthesized sound patterns and optical effects indicative of parameters of biorhythmic activity Freeman U S Pat No 3 916 876 teaches measure ment of muscle tension in two selected muscles while the subject watches electrical meters displaying the tension measurements and other quantities derived from them There is no audio or visual feedback other than meter readings Brady U S Pat Nos 4 056 805 and 4 140 997 disclose a video display comprising a matrix of colored lights that is controlled in response to brainwaves Brady s invention does not comprise a biofeedback system but is directed to conveying a visual indication of a subject s response to sound particularly music Shiga U S Pat No 4 354 505 teaches measurement of the length of time a sub
16. dysfunction TMJ and myofascial syndromes musculoskeletal tension hypertension anxiety and panic disorders asthma dyspepsia and other conditions that can be controlled by reducing muscular tension inducing a state of calm or stabilizing autonomic func tion Biofeedback can be used both for treatment and prevention of such syndromes Biofeedback devices and methods comprising visual displays are known in the prior art Ross U S Pat Nos 3 837 331 and 3 967 616 teach use of a transducing means for exhibiting sensory signal output to the human subject which may include a matrix of num bered lamps slides projected on a screen or an audible chime Hidalgo Briceno U S Pat No 3 855 998 dis closes an entertainment device that monitors electro physiological parameters of a human subject and pres 10 20 25 30 35 40 45 50 55 60 ents audio visual stimulation comprising passages of 65 music flashing lights or projected images intended to place the subject in a desired psychological state The Hidalgo Briceno invention while it receives electrical 2 signals from the subject is not a biofeedback device because the subject is not guided by stimuli to modify his own physiological parameters Cornellier et al U S Pat No 4 683 891 teaches use of a visual display to indicate the values of a subject s physiological parame ters at the point where stress is induced during perfor mance of a goal o
17. each cluster comprising five segments containing related audio visual scenes The scenes are related in that they depict substantially the same subject matter but may differ in such respects as level of audio visual quality viewpoint from which the scenes were photographed or may show one or more objects in differing positions in each scene The objective is to provide a graded sequence of scenes in which each is an improvement on the preceding scene in some respect that is each scene is more real or more desirable than its predecessor Within each cluster therefore the five scenes are re corded at differing levels of reality For example a scene may be made more real to the subject by presenting it in progressively sharper focus beginning with a blurry image and ending with a clear one Alternatively an object may be shown in a begin ning scene at a great distance from the subject and in successive scenes shown coming closer and closer A third method of changing the reality level is to show the object moving within the scene toward a natural goal as the sun setting an airplane landing a climber reach ing the top of a peak a runner approaching the finish line of a race and the like The objective of these se quences is to provide the subject with a audio visual objective that becomes better as the subject improves his physiological parameters A discrete level of reality is known as a Laser Video Reality Index LVRI The five
18. he scenes being pres ented During the use of the present invention the human subject sees and hears only material designed to induce and lead the subject to the desired state No objective indications of progress such as graphs meters flashing lights moving dots or other means used in prior art devices and which 1 cause distraction and 2 do not provide the subject with a desirable mental image for later recall are here employed FIG 3 shows a schematic layout of a typical cluster audio visual scene Cluster 110 comprises five LVRI segments 111 115 in order of reality index from highest LVRI 1 to lowest LVRI 5 The playing time of each LVRI segment is approximately 1 5 minutes If the subject has not progressed during that time the segment is automatically replayed or looped The LVRI segments are created by capturing real Scenes on videotape using high quality commercial television equipment Varying levels of clarity can be achieved by degrading the image during taping as ex plained below After the segments are recorded on videotape acoustic degradation and further video deg radation can be performed in an editing studio When all segments are of appropriate length and LVRI level a master videotape is made from which a videodisc can be produced by known methods The scenes to be recorded on videodisc are chosen so that the audio visual segments themselves both induce the desired psychological state in the subject and
19. is also useful in these applications A number of distinct audio visual sequences can be recorded on a single videodisc and are available for selection by the biofeedback technician controlling the session The software used to control the apparatus of the present invention is listed in source code form in Micro fiche Appendix B It is written in a programming lan guage known as the BOS Protocol Programming Lan guage implemented under the Biomedical Operating System BOS which is available for license from Stu art Enterprises 11330 Southwind Court NE Bain bridge Island Wash 98110 BOS supports popular bio feedback processors comprising electrodes amplifiers and analog to digital converters making it possible to connect the present invention to many types of standard biofeedback equipment BOS and its programming lan guage in which the software of the present invention is written are described in full in the publication BOS Biomedical Operating System User s Manual copyright 1990 published by Stuart Enterprises The invention can be used in the following manner A physician evaluates the subject and determines the pro tocol to be used and the desired physiological objec tives based on which a series of scenes is chosen for presentation to the subject The subject does not see or interact with the system 5 screen The subject is presented only with audio visual imagery so as to keep his attention focused on the treat
20. itrary order on a video storage medium of sufficient capacity to conduct a session of sufficient duration that no reloading is reguired during a biofeed back session which would cause interruption of treat ment The video output of video player 60 is connected to video display 70 which is preferably a large screen television monitor having a resolution of at least 350 horizontal lines The left and right stereophonic audio outputs of video player 60 respectively are connected to left speaker 80 and right speaker 81 In an alternate embodiment speakers 80 and 81 are integrated into a set of headphones worn by subject 11 In a further embodi ment video display 70 is a television set incorporating built in speakers 80 and 81 A manual describing the use of the system in the best mode known to the inventors is reproduced in Micro fiche Appendix A FIG 2 shows the schematic layout of a typical video disc used with the present invention Videodisc 100 comprises eight clusters 101 108 and a title sector 109 The playing time of each of the clusters 101 107 is approximately 7 5 minutes The playing time of cluster 108 is approximately 2 5 minutes The playing time of the title sector is approximately 30 seconds The playing time of the entire videodisc 100 is approximately one hour Videodisc 100 is removably inserted in video player 70 The videodisc contains title information and eight ordered sequences or clusters of information
21. ject has remained in a relaxed state by display ing numerals indicative of the said length Ochs U S Pat No 4 461 301 teaches display of numerical indica tions dependent on the values of monitored electro physiological parameters Leuner et al U S Pat No 4 665 926 teaches a system for measuring a person s 3 343 871 3 relaxation state but in which displayed information is not fed back to the subject but is instead monitored by a technician It is drawback of prior art biofeedback devices and methods that the feedback provided to the subject is merely a display of values of physiological parameters or an indication of how successful the subject has been in achieving his goal They do not provide a target desirable in itself to assist in the attainment of success In fact the prior art devices utilize feedback means that can actually interfere with the desired objective by forcing the subject to concentrate on a wave tracing flashing light or blip on an oscilloscope screen in order to gauge his progress In prior art methods the subject must generally be coaxed by an assistant into imagining a relaxing scene or locale in order to alter his electro physiological responses The following are objects of the present invention 1 To improve the efficacy of biofeedback by elimi nating dependence on stress inducing visual or audio targets on which the subject must concentrate 2 To determine an effective weighted combination
22. ky and 4 varying video color parameters such as hue and tint by adjusting analog controls The analog method of video degradation is preferred because it appears more natural to the subject Audio degradation is accomplished by simulta neously 1 reducing the stereo separation of the left and right audio signals 2 reducing the volume of the sig nals 3 reducing the amplitude of the audio signal at or above selected freguencies clipping and 4 audio panning which varies the extent to which sounds move from the left to right stereo channels and vice versa Table 1 indicates how the first two of these parameters vary by LVRI in a preferred embodiment TABLE 1 Audio Degradation at Different LVRI Levels Reality Stereo Cut at 3 kHz Rolloff at 5 5 kHz Level Separation decibels decibels LVRI1 100 0 0 LVRI2 7596 3 3 LVRI3 5096 6 6 LVRI 4 25 11 12 LVRI 5 0 18 20 Audio distancing another method of obtaining differ ing LVRI levels is accomplished by simultaneously reducing the stereo separation of the left and right audio signals and the overall amplitude of the audio signal Table 2 indicates how these parameters vary by LVRI 3 in a preferred embodiment TABLE 2 Audio Distancing at Different LVRI Levels Reality Stereo Amplitude Reduction Level Separation decibels LVRI 1 10096 0 LVRI2 100 3 LVRI 3 90 6 LVRI4 80 11 LVRI 5 6096 16 An example of the use of video degradation and en hancement is in behavior
23. lity c playback means for retrieving said sequences from said medium d control mean for receiving said signals and con trolling an order of retrieval of said sequences based on said signals and audio visual output means whereby the subject is able to view an hear said sequences 19 The apparatus of claim 18 wherein said control means is a digital computer said digital computer fur ther comprising a computer program 20 The apparatus of claim 19 wherein said computer program is a computer program for controlling a bio feedback session in which at least one of said signals is acquired from a subject and version of an audio visual scene are exhibited to the subject said versions having varying levels of reality said computer program com prising a means for selecting a combination of said signals to be monitored b means for computing a weighted average of said monitored signals means for repeatedly selecting one of said versions for exhibition to the subject based upon said weighted average OR UNITED STATES PATENT AND TRADEMARK OFFICE CERTIFICATE OF CORRECTION 5 343 871 September 6 1994 Barry B Bittman and Jeffrey R Cram PATENT DATED INVENTOR S It is certified that error appears in the above indentified patent and that said Letters Patent is hereby corrected as shown below Claim 8 Line 25 Column 12 steps should read step Claim 9 Line
24. meters when the subject s psycho logical response has become more desirable 3 343 871 13 c means for presenting to the subject a seguence of versions of an audio visual scene said versions exhibiting varying audio and visual reality and d means for controlling said presenting of said se guence so as to display to the subject a scene of increased audio and visual reality when said moni tored parameters indicate that the subject s psycho logical response has become more desirable 16 The apparatus of claim 15 wherein said determin ing means measures a weighted combination of said monitored parameters and said controlling means also displays a scene of decreased audio and visual reality when said monitored parameters indicate that the sub ject s psychological response has become less desirable 17 The apparatus of claim 16 wherein said present ing means further comprises means for increasing and decreasing said reality in discrete steps 18 An apparatus for mediating a biofeedback session with a subject at least one of whose electrophysiologi cal parameters is being measured comprising a means for receiving signals indicative of the mea surements of the parameters b audio visual storage medium comprising at least one cluster wherein each of said clusters comprises 10 20 25 30 35 45 50 55 65 14 a plurality of physically contiguous audio visual sequences progressively degraded in rea
25. modification By gradually exposing a phobic subject to a series of stressful scenar ios the subject can be rewarded via audio visual feed back for generating a desired physiological response the reward consisting of a change in the audio visual template For example an acrophobic individual one who fears heights can be acclimatized to differing ele vations under controlled conditions without actual risk by being shown a sequence of scenes taken at varying heights The method is not restricted to achieving relax ation A rehabilitation patient who is being trained to use certain muscles can be rewarded for exerting stress rather than relaxing An agoraphobe one who fears being out in public can be treated by presenting scenes commencing at home gradually moving outdoors a quiet street an intersection and then a mall or busy city block As the subject relaxes as monitored by the apparatus the jour ney progresses The subject becomes conditioned to associate relaxation with situations that formerly in duced anxiety Similar methods can be used to treat 20 25 30 40 45 8 other phobias such as vertigo reactive anxiety states or panic attacks Reduction of tension has been shown to reduce learn ing time for certain motor skills as typing stenography and repetitive manufacturing activities It also improves Work efficiency and can assist athletes in preparing for competitive sporting events The present invention
26. n subject to monitor electrophysiologi cal parameters such as heart rate electroencephalo graphic signals and galvanic skin resistance These sig nals are converted to a visual or audio display that can been seen and or heard by the subject who attempts to alter the parameters using the display as a guide to his progress If it is desirable to reduce blood pressure for example the display may consist of a bar graph indicat ing the magnitude of the pressure If the subject is suc cessful in lowering his blood pressure he will see the size of the bar diminish and will thus know he is making progress Traditional biofeedback methods employ such mech anisms as analog meters computer generated displays targets shown in cross hairs acoustic tones and audio beat frequencies to indicate to the subject the values of the parameters being monitored Biofeedback is commonly performed by a biofeed back technician who directs the subject verbally to achieve a state of calm by coaching him to develop a mental image of a relaxing scene Unfortunately it can be difficult to relax during such a session because the subject is forced to concentrate on a computer display or audio tone to gauge his progress That is the result or display viewed by the subject is not in itself calming and may actually interfere with the desired objective Biofeedback can be used to treat migraine and tension headaches pain disorders such as temporomandibular joint
27. ndicative of the mea surements of the parameters b audio visual storage means capable of recalling in any order audio visual seguences of acoustically and visually degraded versions of a scene said seguences being prestored in said storage means c control means for receiving said signals and con trolling an order of recall of said seguences based on said signals and d audio visual output means whereby the subject is able to view and hear said seguences 2 The apparatus of claim 1 wherein said audio visual storage means is selected from the group consisting ofa videodisc player and optical digital storage device and a computer with magnetic disk storage 3 The apparatus of claim 1 wherein said audio visual storage means is a videodisc and said audio visual out put means is selected from the group consisting of a television set a computer screen and a television moni tor with associated loudspeakers 4 The apparatus of claim 1 wherein said audio visual 60 storage means is a videodisc said audio visual output means is a television set and said control means is a digital computer 5 A method of conditioning a desired psychological response in a subject comprising the steps of a monitoring at least one of the subject s electro physiological parameters indicative of his psycho logical response and 10 20 35 40 45 50 55 65 12 presenting to subject a seguence of versions of an audio vi
28. ontrols the appara tus by viewing the monitor and entering information through computer keyboard 40 During the session the monitor displays graphically the values of the subject s electrophysiological parameters The technician inter 3 343 871 9 acts with computer 30 through screens that appear on monitor 50 The screens whose content and order is controlled by software in computer 30 provide menu choices that are selected by pressing one of the function keys F1 through F10 The technician may also be asked to enter textual or numeric information through key board 40 The technician may choose the duration of the bio feedback session and the particular set of parameters to be recorded during the session The parameters being recorded are not necessarily all used to control changes in LVRI level The technician may choose for each recorded parameter whether it is to participate in LVRI changes and if so what linear weight will be given to the parameter That is the function used to control LVRI changes is a linear combination weighted average of values of selected recorded pa rameters The parameters that make up this function are called linking parameters For each linking parame ter the technician has the ability to scale the parameter by specifying the range of values from best to worst that the parameter may assume Values near best are associated with the most clear LVRI image LVRI 1 those near
29. riented task A number of prior art biofeedback devices employ purely audio feedback to the subject Silva et al U S Pat No 3 875 930 teaches using a fixed audio signal that decays to silence as an indication that the desired brain wave waveform has been achieved Spector U S Pat No 4 776 323 teaches playing sounds through head phones to induce relaxation in a subject for the purpose of creating a calm state that can then be interrupted by high amplitude noises to cause stress Knispel et al U S Pat No 4 883 067 teaches a method of transforming brainwave activity into musical sound which is fed back to the subject via headphones Numerous prior art devices combine audio and visual feedback Glynn et al U S Pat No 3 942 516 teaches simultaneous monitoring of a plurality of electrophysio logical parameters to produce a single audio visual out put for feedback Fehmi et al U S Pat No 3 978 847 teaches using audio tones and a light that increases in amplitude and stroboscopic frequency as the frequency of the subject s brainwaves increases Clegg et al U S Pat No 4 823 808 teaches a method for treating eating disorders by measuring parameters of the gastrointesti nal tract and providing indications of gastric activity by visual and audio means as by amplifying stomach noises Ohsuga et al U S Pat No 4 896 675 teaches providing graphs of physiological parameters and si multaneously generating a sound pattern to be use
30. sual scene said versions exhibiting varying audio and visual reality wherein said audio and visual reality are increased as said monitored parameters indicate that the subject s psychologi cal response has become more desirable 6 The method of claim 5 further comprising the step of C repeating steps a and b on distinct occasions until said monitored parameters indicate that the subject has become conditioned to exhibit the desired re sponse to said audio visual scene 7 The method of claim 6 wherein the desired psycho logical state is relaxation and further comprising the step of d teaching the subject to perform a motor skill while presenting to the subject said audio visual scene at a time subsequent to the conditioning whereby the subject s ability to learn said skill is enhanced by the subject having been conditioned to enter said desired psychological state 8 The method of claim 6 wherein the desired psycho logical state is relaxation and further comprising the steps of d presenting the subject with material to be learned while presenting to the subject said audio visual scene at a time subsequent to the conditioning whereby the subject s ability to learn said material is enhanced by the subject having been conditioned to enter said desired psychological state 9 The method of claim 5 wherein said audio and visual reality are increased occurs in discrete steps 10 The method of claim 5 wherein at step b said
31. to provide memorable audio visual images that the subject may bring to mind subsequent to the biofeedback ses sion for therapeutic effect Audio visual degradation must be performed in a way that allows the subject to focus his attention on a single scene to avoid distraction or confusion of physio logical response This can be achieved by utilizing one audio visual scenario and successively reducing its qual ity At all times however the goal scene is maintained in view though it may be distant or fuzzy The images representing the scene are presented to the subject in order of increasing clarity to serve as a reward for achieving desired response levels Video degradation to produce different LVRI levels can be accomplished by analog or digital means through 1 defocusing the image 2 eliminating or reducing color 3 zooming by magnifying or demagni fying the image or 4 photographing objects in the scene in varying positions or states In a preferred em bodiment video degradation is performed by analog means as the scenes are being recorded on the videotape from which a videodisc is later made This is done by 1 3 343 871 7 defocusing by moving the focus ring on the video cam era 2 altering the apparent distance to the scene by zooming 3 recording successive scenes in which an object progressively moves toward a goal such as a series of images of the sun setting with attendant color ful illumination of the s
32. ual signals being received by the biofeedback electrodes 115 so the electrodes can be adjusted It also presents the subject with a sequence of audio visual displays so the technician can determine which scene on the video disc produces the most favorable response from the subject Main F3 Screen Selection This permits a choice of the scene sequence to be used for the present biofeed back session among those available on the videodisc that is currently mounted Main F4 Control Screen This screen controls the actual biofeedback session and itself provides eight pro grammed functions discussed below Main FS Reports Screen This invokes a screen to control report generation including selection of report format as discussed below Main F6 Utilities Screen This invokes the Disk Op erating System DOS housekeeping functions such as copying formatting etc Main F10 End This terminates the session The following functions are available on the Control Screen which is invoked from the Main Menu by de pressing the F4 key Control F1 Session Time Allows the technician to set the duration of the session Control F2 Modalities Allows selection of electro physiological parameters to be recorded for this session Control F3 LVRI Link Establishes a relationship between electrophysiological parameters and the reality index progression for this session The technician is able to choose which of the recorded parameters will a
33. vement of an object In this way the subject is able to perform bio feedback without the distraction of prior art feedback indicators which are not themselves relaxation induc ing Subsequent to the treatment the subject is able to induce a relaxed state in himself by recalling the scenes used during treatment BRIEF DESCRIPTION OF THE DRAWINGS FIG 1 shows a block diagram of the apparatus of the present invention FIG 2 shows a layout of clusters of audio visual scenes on a videodisc of the type used in the present invention and FIG 3 shows the internal arrangement of a single cluster of audio visual scenes on tbe videodisc of FIG 2 DETAILED DESCRIPTION OF THE INVENTION Referring now to FIG 1 which shows a block dia gram of the apparatus of the present invention compris ing a biofeedback system 10 Electrodes 15 lead from human subject 11 into the input terminals of preampli fier and converter 20 Preamplifier and converter 20 contains preamplifiers and amplifiers and analog to digital converters to transform analog signals into digi tal outputs indicative of the magnitude of said analog signals Preamplifier and converter devices of this type are well known in the prior art Examples of such de vices are the Autogenics A 8000 the J amp J 1 330 Modu lar System and the SRS Orion 8600 and PRO Series Model 421 The digital output of preamplifier and con verter 20 is connected to an input port of digital com puter
Download Pdf Manuals
Related Search