Abstract:
A method of determining whether an individual has Attention Deficit Hyperactivity Disorder (ADHD) comprising: sampling the peripheral skin temperature of a human subject during a predetermined time interval when the subject is in an inactive state to provide a sampled peripheral skin temperature signal containing noise: modulating said sampled peripheral skin temperature signal containing noise with a known reference signal to produce a modulated signal; inputting said modulated signal and said known reference signal to a lock-in amplifier to produce a sampled peripheral skin temperature signal free of said noise; and analyzing the sampled peripheral skin temperature signal for a pre-selected parameter to determine whether said predetermined parameter has a value indicative of ADHD.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS  
       [0001]    This patent application claims the benefit under 35 USC § 120 of the earlier filing date of U.S. patent application Ser. No. 09/597,610, filed Jun. 20, 2000. 
     
    
     
       FIELD OF THE INVENTION  
         [0002]    This invention relates in general to a technique for diagnosing and treating Attention Deficit Hyperactivity Disorder (ADHD) and more particularly to a technique for modifying a person&#39;s behavior using biofeedback and image modification.  
         BACKGROUND OF THE INVENTION  
         [0003]    ADHD is the most common neurobehavioral disorder of childhood as well as among the most prevalent health conditions affecting school-aged children. Between 4% and 12% of school age children (several millions) are affected. $3 billion is spent annually on behalf of students with ADHD. Moreover, in the general population, 9.2% of males and 2.9% of females are found to have behavior consistent with ADHD. Upwards of 10 million adults may be affected.  
           [0004]    ADHD is a difficult disorder to diagnose. The core symptoms of ADHD in children include inattention, hyperactivity, and impulsivity. ADHD children may experience significant functional problems, such as school difficulties, academic underachievement, poor relationships with family and peers, and low self-esteem. Adults with ADHD often have a history of losing jobs, impulsive actions, substance abuse, and broken marriages. ADHD often goes undiagnosed if not caught at an early age and affects many adults who may not be aware of the condition. ADHD has many look-alike causes (family situations, motivations) and co-morbid conditions (depression, anxiety, learning disabilities).  
           [0005]    Diagnosis of ADHD involves a process of elimination using written and verbal tests. However, there is no one objective, independent valid test for ADHD. Various objective techniques have been proposed but have not yet attained acceptance. These include:  
           [0006]    1. The eye problem called convergence insufficiency was found to be three times more common in children with ADHD than in other children by University of California, San Diego researchers.  
           [0007]    2. Infrared tracking to measure difficult-to-detect movements of children during attention tests combined with functional MRI imaging of the brain were used by psychiatrists at McLean Hospital in Belmont, Mass. to diagnose ADHD in a small group of children ( Nature Medicine,  Vol. 6, No. 4, April 2000, Pages 470-473).  
           [0008]    3. Techniques based on EEG biofeedback for the diagnoses and treatment of ADHD are described by Lubar ( Biofeedback and Self - Regulation,  Vol. 16, No. 3, 1991, Pages 201-225).  
           [0009]    4. U.S. Pat. No. 6,097,980, issued Aug. 1, 2000, inventor Monastra et al, discloses a quantitative electroencephalographic process assessing ADHD.  
           [0010]    5. U.S. Pat. No. 5,913,310, issued Jun. 22, 1999, inventor Brown, discloses a video game for the diagnosis and treatment of ADHD.  
           [0011]    6. U.S. Pat. No. 5,918,603, issued Jul. 6, 1999, inventor Brown, discloses a video game for the diagnosis and treatment of ADHD.  
           [0012]    7. U.S. Pat. No. 5,940,801, issued Aug. 17, 1999, inventor Brown, discloses a microprocessor such as a video game for the diagnosis and treatment of ADHD.  
           [0013]    8. U.S. Pat. No. 5,377,100, issued Dec. 27, 1994, inventors Pope et al., discloses a method of using a video game coupled with brain wave detection to treat patients with ADHD.  
           [0014]    9. Dr. Albert Rizzo of the Integrated Media Systems Center of the University of Southern California has used Virtual Reality techniques for the detection and treatment of ADHD.  
           [0015]    10. U.S. Pat. No. 6,053,739, inventors Stewart et al., discloses a method of using a visual display, colored visual word targets and colored visual response targets to administer an attention performance test.  
           [0016]    11. U.S. Pat. No. 5,377,100, issued Dec. 27, 1994, inventors Patton et al., discloses a system and method of managing the psychological state of an individual using images.  
           [0017]    There are several clinical biofeedback and physiology monitoring systems (e.g. Multi Trace, Bio Integrator). These systems are used by professional clinicians. A clinician monitors a patient&#39;s physiologic changes and accordingly uses different protocols. Some multimedia content (e.g. images, sound) can be used during the session to display a patient&#39;s pattern of physiologic reactivity and to help the patient in his/her task defined by the clinician. A good example is a session designed to help a patient to increase her/his hand temperature. A synthetic animation with the sun rising over the ocean can be used to show the patient&#39;s temperature. When the patient&#39;s temperature increases the sun is rising over the water horizon. When his/her temperature decreases the sun is moving behind the horizon. A clinician can help the patient with verbal instructions. Although skin temperature spectral characteristics have been shown to indicate stress-related changes of peripheral vasomotor activity in normal subjects (See: “Spontaneous skin temperature oscillations in normal human subjects”, by: Shusternan et al., pp. 1173-1181), there has been no disclosure of the use of variations in skin-temperature response to assist in diagnosing ADHD. (See: Biofeedback and Self-Regulation, Vol. 20, No. 4, 1995).  
           [0018]    PCT International Application WO 00/16687, published Mar. 30, 2000, discloses a method and device for determining depth of anesthesia. A pattern of very low frequency oscillations in measured skin temperature is defined and analyzed. The frequency band width of a frequency domain analysis of the oscillatory pattern, or the correlation between simultaneous oscillatory patterns measured at different physical locations, are used separately or fused to obtain an index of depth of anesthesia. There is no disclosure of the use of variations in skin temperature response to assist in diagnosing ADHD.  
           [0019]    As discussed above, the primary method for diagnosing ADHD is the use of a bank of written and verbal assessment instruments designed to assess criteria established by American Medical Association (AMA) as described in the Diagnostic and Statistics manual −IV (DSM-IV) and administered by the school psychologist or other licensed practitioner. In some cases those individuals who meet DSM-IV criteria for ADHD diagnosis are prescribed a drug such as Ritalin. Behavioral observations of the patient while on Ritalin are conducted to assess the impact of prescribed medication.  
           [0020]    U.S. patent application Ser. No. 09/597,610, describes an apparatus and method of determining whether an individual has Attention Deficit Hyperactivity Disorder by analyzing physiologic reactivity patterns (lower average Mrange) when the subject is asked to sit quietly in a low stimulus environment for a short period of time.  
           [0021]    There are many factors, which can contribute to a change in skin temperature variability besides ADHD. The largest potential source of error is stress due to causes other than the sensory deprivation included in the test. Other extraneous causes of reduced peripheral temperature variability (TV) might include disease states, room temperature variation, etc.  
           [0022]    The primary feature of U.S. patent application Ser. No. 09/597,610 is to diagnose subjects with ADHD. There is no attempt made to treat the condition once it has been diagnosed.  
         SUMMARY OF THE INVENTION  
         [0023]    According to the present invention, there is provided a solution to the problems discussed above.  
           [0024]    According to a feature of the present invention, there is provided a method of determining whether an individual has Attention Deficit Hyperactivity Disorder (ADHD) comprising: sampling the peripheral skin temperature of a human subject during a predetermined time interval when the subject is in an inactive state to provide a sampled peripheral skin temperature signal containing noise: modulating said sampled peripheral skin temperature signal containing noise with a known reference signal to produce a modulated signal; inputting said modulated signal and said known reference signal to a lock-in amplifier to produce a sampled peripheral skin temperature signal free of said noise; and analyzing the sampled peripheral skin temperature signal for a pre-selected parameter to determine whether said predetermined parameter has a value indicative of ADHD.  
         Advantageous Effect of the Invention  
         [0025]    The invention has the following advantages.  
           [0026]    1. A technique for diagnosing ADHD is provided which is simple, inexpensive, reliable and provides a level of accuracy improved over the prior art.  
           [0027]    2. A technique for treating ADHD is provided. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0028]    [0028]FIG. 1 is a diagrammatic view illustrating an embodiment of the present invention.  
         [0029]    [0029]FIG. 2 is a perspective view showing in greater detail the embodiment of FIG. 1.  
         [0030]    [0030]FIG. 3 is a block diagram illustrating the function of a Lock-in Amplifier.  
         [0031]    [0031]FIGS. 4 a  and  4   b  are a block diagram of a system incorporating the present invention respectively in diagnosis and treatment modes.  
         [0032]    [0032]FIGS. 5 and 6 are graphical views useful in explaining the present invention.  
         [0033]    [0033]FIG. 7 is a diagrammatic view useful in explaining the present invention.  
         [0034]    [0034]FIG. 8 is a diagrammatic view useful in explaining the present invention.  
         [0035]    [0035]FIGS. 9 a  and  9   b  are a block diagram of a system incorporating the present invention respectively in diagnosis and treatment modes.  
         [0036]    [0036]FIG. 10 is a diagrammatic view useful in explaining the present invention.  
         [0037]    [0037]FIG. 11 a  is an image as it is displayed on a monitor in accordance with the present invention.  
         [0038]    [0038]FIG. 11 b  is an image as it is displayed on a monitor in accordance with the present invention.  
         [0039]    [0039]FIG. 11 c  is an image as it is displayed on a monitor in accordance with the present invention.  
         [0040]    [0040]FIG. 11 d  is an image as it is displayed on a monitor in accordance with the present invention.  
         [0041]    [0041]FIG. 11 e  is an image as it is displayed on a monitor in accordance with the present invention.  
         [0042]    [0042]FIG. 11 f  is an image as it is displayed on a monitor in accordance with the present invention.  
         [0043]    [0043]FIG. 12 is a graphical view useful in explaining the present invention. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0044]    According to the invention, it has been found that a signature of ADHD is hidden in fluctuation of the temperature of the skin as measured at the extremities such as at a fingertip. Biofeedback practitioners have long used measurement of hand temperature to help subjects manage their physiology by controlling blood flow to the extremities.  
         [0045]    It is well known in the art that as person&#39;s stress level increases the blood vessels in the body contract as is evidenced by the fact a person&#39;s blood pressure increases as their level of stress increases. As the blood vessels in the body contract, blood flow is restricted. This is most evident in the extremities such as the fingers, because the blood vessels in the extremities are small and furthest from the heart. A direct result of decreased blood flow to the blood vessels in the extremities is a decrease in the peripheral temperature of the extremities. Conversely, as a person&#39;s stress level decreases and one relax, is the blood vessels also relax and expand causing blood flow to increase. As the blood flow to the vessels in the extremities increases the peripheral temperature of the extremities increases. When a subject with ADHD is subjected to sensory depravation such as being made to look at a blank screen or an obscured image, the lack of stimulation increases their level of anxiety and their stress level increases. As their stress level increases their blood vessels contract and the peripheral temperature of their extremities decreases. Conversely, as the screen or image they are viewing becomes less obscured or more interesting, thus decreasing their sensory depravation, their level of anxiety and stress decreases, thus relaxing the blood vessels, increasing the blood flow and raising the temperature of their peripheral temperature of the extremities.  
         [0046]    As shown in FIG. 1, a subject  10  is sitting on a chair  12  viewing a display device  14  wearing a set of earphones  30  connected via a wire not shown to a sound-generating device. In the embodiment shown the sound may be generated using an external CPU  44 . The subject  10  is at rest in an inactive state viewing the display device  14 . The subject&#39;s  10  skin temperature is measured via a finger temperature sensor module  22  mounted on the subject&#39;s finger on their left hand  15  connected via a wire  40  to an external CPU  44 . In the embodiment shown the temperature sensor module  22  is connected to the external CPU  44 , which can be used as the control and recording device portion.  
         [0047]    Referring to FIG. 2, the analyzer  18  may be a stand-alone device having the temperature sensor module  22  as an integral part. The analyzer  18  has a display  26  (such as an OLED) or may be connected to an external display  14 . The display  14  can be a monitor, television, palm pilot, or any other type of soft display or device with a soft display.  
         [0048]    Referring again to FIG. 1, the subject&#39;s  10  skin temperature is measured by a temperature sensor module  23  mounted on the subject&#39;s right finger  16  connected via a wire to the external CPU  44 . The subject&#39;s  10  temperature may be measured using either the finger tip  15  or the fingertip on the right hand  16  or fingertips on both hands. The external CPU  44  is connected to the display device  14 . The earphone  30  may be used to block out ambient noise, to produce a white noise intended to reduce or eliminate the audio stimulus from the environment during the test or to obscure a sound related to an image shown on the display  14 . The sound generated may be synchronized with what is appearing on the display  14 .  
         [0049]    Referring to FIG. 2, there is shown an illustration of the analyzer  18  comprising temperature sensor modules  22  and  23 , where the subject  10  inserts their left fingertip  15  in groove  17 . The temperature sensor  22  can have an on/off switch  24 , and a display  26 . The temperature sensor module  22  can have an internal power supply, such as a battery  30 , or an external low voltage power supply port  32  for an external low voltage power supply (not shown), such as used for a telephone. The temperature module  22  can be connected to the external CPU  44  via a cable  40  (such as an USB or RS 232 cable), or wireless-transmitting device such as a RF or IR link (not shown). A second temperature sensor module  23  can be connected to the external CPU  44  or the analyzer  18  via a cable  46 . The second temperature sensor module  23  can be used to sample the skin temperature of the right hand. It should be understood that either temperature sensor module might be used on either hand. Analyzer  18  or CPU  44  applies the appropriate transforms to analyze the sampled temperatures and displays the results on the display  14  or  26 . The results from the test can be stored in the CPU&#39;s memory (not shown) and can be transmitted via a transmission link such as the Internet to other locations.  
         [0050]    Now referring to FIG. 3, there is provided a block diagram showing how a signal S (t)  55  which is combined with a much larger noise N (t)  60 , can nevertheless be extracted by a lock-in amplifier if that signal is modulated with a known reference. An example is a light beam modulated by a chopper  65 . The light is then incident on an electronic device  70  and an output electrical signal is collected. That electronic signal contains within it a signal synchronous with the light modulation, but at a level many orders of magnitude weaker than other components in the electronic device output (the Noise). When the output of the electronic device  70  and the reference signal  75  are fed to a lock-in amplifier  50 , the signal can be extracted  80 . Examples of lock-in amplifiers  50  are the Dual Phase Lock-in Amplifier Printed Circuit Model 5105 or the Dual Phase Wide Bandwidth DSP Lock-in Amplifier Model 7280 made by Perkin-Elmer Corp.  
         [0051]    Referring now to FIG. 4 a , analyzer module  18  includes analyzer circuit  100 . The analyzer circuit  100  includes of a temperature sensor  102 , lock-in amplifier  50 , amplifier and signal conditioner  104 , a switch  105  (shown in the diagnosis (D) position), analog to digital converter  106 , digital signal analysis  108 , display  110 , battery  112 , power switch  114  and power conversion and/or regulation  116 . The circuit  100  can include a memory card slot  118  for receiving a memory card, which can provide system upgradability, and removable data export without compromising safety isolation.  
         [0052]    Referring again to FIG. 1, the fingertip temperature is first recorded during an interval when the subject  10  has been asked to sit quietly for a given period of time, nominally about 10 minutes while viewing monitor  14 . The monitor is either blank or the scene appearing on the monitor is obscured or distorted. The time period may be shorter or longer. The temperature data is sampled via a temperature sampling circuit  100  (shown in FIG. 4 a ) at a time interval At creating a list of N temperature samples, which are digitized by D/A  106  and which are stored. The N samples are divided into windows of m samples. The data from each window is then passed through a Fast Fourier Transform (FFT) algorithm in circuit  108  producing 2 m−1  data points spaced equally in frequency space. The values are complex numbers having form  
           FFT ( f   n )= A ( f   n )+ B ( f   n ) i    
         [0053]    where i is the {square root}{square root over (−1)}. The Phase Φ(f n ) can be found from the equation  
               Φ        (     f     n                  )       =       Tan     -   1            (       B        (     f   n     )         A        (     f   n     )         )               (   .00   )                               
 
         [0054]    and the Magnitude M(f n ) from  
           M ( f   n )={square root}{square root over ( B ( f   n ) 2+   A ()} f   n ) 2   (0.0)  
         [0055]    [0055]FIG. 5 graphically illustrates the temperature signal during one window for a normal subject and a person diagnosed with ADHD.  
         [0056]    [0056]FIG. 6 graphically illustrates the magnitude transform for the data corresponding with a subject with ADHD and normal subject. The magnitude spectrum undergoes dramatic changes essentially changing from a hyperbolic curve to a flat response. These graphical illustrations as well as the following can be displayed on display  110  or on some other visual indication device.  
         [0057]    The following is another feature of the present invention:  
         [0058]    Raw Data  
         [0059]    The raw data T i,k (t) is the temperature taken at a fingertip during the baseline period.  
         [0060]    Windows  
         [0061]    The data for each session were divided into a series of windows prior to performing the Fourier Transform operation. Call the window width w. For each window a FFT algorithm calculates the Fourier Transform F(f). The Magnitude and Phase of this transform are defined as given above. The range of magnitude variation during a window is given below where f max  and f min  are the frequencies where the Magnitude is the greatest and the least respectively (note the dc component at frequency zero is excluded).  
           M   range   =[M ( f   max )− M ( f   min )] 
         [0062]    Session Mean and Standard Deviation  
         [0063]    The mean magnitude range for subject i during session k is found from equation 1.0. where m is the number of windows in the session.  
             &lt;     M     i   ,   k       &gt;=         ∑     j   =   1     m          [         M        (     f   max     )       j     -       M        (     f   min     )       j       ]       m             (   1.0   )                               
 
         [0064]    And the corresponding standard deviation is:  
             &lt;     s     i   ,   k       &gt;=           ∑     j   =   1     m            {         [         M        (     f   max     )       j     -       M        (     f   min     )       j       ]     -     &lt;     M     i   ,   k       &gt;     }     2         m   -   1                 (   1.1   )                               
 
         [0065]    Determination Indicator  
         [0066]    Positive diagnostic indicator is established based upon the chart of FIG. 7 by setting a threshold level (e.g., 3) for one of the parameters. Below that limit, the subject has a positive diagnostic indicator for ADHD. Above the limit, the subject has a negative diagnostic indicator for ADHD. This procedure can be improved by taking peripheral temperatures during different times of the day over a period of one or more days. FIG. 8 shows the results taken at different times of the day over a period of two days.  
         [0067]    Referring to FIG. 9 a , with switches  134  and  138  set to the diagnostic mode D, an image source  120  sends a digitized image to a video mixer  122  where it is mixed with varying amounts of obscuration from the video obscuration signal generator  124 . The obscured image&#39;s signal is then fed to monitor  126 . The amount of obscuration is synchronized to a reference supplied by signal generator  95 , which may be any common waveform such as sine wave, square wave, ramp, triangle wave etc. Simultaneously, an audio source  128  may be fed through an audio obscuration generator  130  where it is mixed with audio noise or attenuated in proportion to and in synchronism with the reference signal. Both the visual and auditory stimuli supplied to the subject are modulated by the reference signal from the reference signal generator  95 .  
         [0068]    Referring now to FIGS. 11 a, b, c, d, e,  and  f , the technique previously described can be used to extract a subject&#39;s response to modulated sensory depravation. By changing (FIG. 9 a ) the amount of obscuration of a stimulating image  200   a, b, c, d, e,  and  f  and/or an audio signal, modulation of the subject&#39;s physiology, as measured by variation of his/her peripheral temperature is created.  
         [0069]    Referring to FIG. 4 a , the peripheral temperature as measured by the temperature sensor  102 , or a function derived from the subject&#39;s peripheral temperature, is fed from amplifier and signal conditioner  104  to the lock-in amplifier  50 . The reference signal  75  is fed from the reference signal generator  95  (shown in FIG. 9 a ) to the lock-in amplifier  50  from point A. With switch  105  set in the diagnostic mode D the part of the subject&#39;s physiological response which is synchronous with the reference signal  75  is extracted by circuit  100 , thus detecting a subject response which is directly correlated with the sensory depravation signal and uncontaminated by other physiological responses.  
         [0070]    Now referring to FIG. 10, the results are shown where a small modulation has been added to actual Mrange data for a subject. FIG. 10 shows the original signal (diamonds), the signal with the modulation added (triangles) and the signal that would be extracted (X&#39;s). Even though only a very small extracted signal (right hand axis) of the subject&#39;s temporal variation could be attributed to the sensory depravation it is still detectable. In this example the reference-modulated component is a constant 0.3 units on a signal whose average value is about 5.0 or about 6%.  
         [0071]    Referring to FIG. 1, an image  200   a  shown in FIG. 11 a  is displayed on the screen  14 . As the subject  10  concentrates on the image  200   a  the blood flow to the fingertip  15  and/or  16  increases causing the subject&#39;s  10  peripheral temperature to change.  
         [0072]    Referring to FIG. 4 b , with switch  105  set in the treatment mode T the change in the subject&#39;s peripheral temperature is fed from the amplifier and signal conditioner  104  of circuit  100  at point B to the difference signal amplifier  132  shown in FIG. 9 b . The change in the subject&#39;s peripheral temperature is also fed from the amplifier and signal conditioner  104  through the analog to digital converter  106 , to the digital signal analysis  108  where the result is shown on display  110 .  
         [0073]    Now referring to FIG. 9 b , with switches  134  and  138  set in the treatment mode T the difference signal amplifier  132  compares signal B, which is a measure of the subjects peripheral temperature, to an adjustable reference voltage V ref  ( 131 ) which may be generated internally to  132  or supplied externally. The value of R ef  V ref , is linearly related to the desired peripheral temperature. Suppose, for example, the subject&#39;s peripheral temperature was 72F. If the value V ref  was then set to correspond to a temperature of 90F, the difference amplifier output would then be proportional to the difference between these temperatures (18F).  
         [0074]    The obscuration generators  124  and  130  would be so constructed that the amount of obscuration would be proportional to the size of the difference signal as shown in FIG. 12.  
         [0075]    Now referring to FIG. 12, the obscuration O shown on the ordinate is directly proportional to the difference voltage Δ=V−V ref  shown on the abscissa as indicated by the equation O=k*Δ 
         [0076]    Thus, as the subject&#39;s peripheral temperature approached the reference temperature, the difference signal would also decrease causing a proportional decrease in the obscuration level. When the subject&#39;s temperature reached the reference setting of 90 degrees, the obscuration would vanish and the scene would be clearly visible and the audio clearly heard.  
         [0077]    Referring to FIGS. 9 a  and  9   b , the switch  134  switches the input of the video obscuration signal generator  124  from the reference signal generator  95  to the difference signal amplifier  132 . The image  136  can be the same as the image  200   a  shown in FIG. 11 a . As previously described in FIG. 9 a , the image  136  is modified in relationship to changes in the subject&#39;s  10  peripheral temperature. For example the image  200   a  can be a scene obscured by fog. As the subject concentrates on the image the fog begins to gradually disappear until the scene becomes clear as shown in FIGS. 11 a  through  11   f  and images  200   a  through  200   f  respectively. This technique is used to train the subject  10  to modify his or her behavior. Likewise switch  138  can switch the input of the audio obscuration signal generator  130  from the reference signal generator  95  to the difference signal amplifier  132  causing the audio heard through the earphones  30  to be modified in relationship to the subject&#39;s  10  peripheral temperature. As in the case of the image the sound for example may be made louder or a distortion such as white noise may be reduced so the audio becomes clearer.  
         [0078]    The invention has been described in detail with particular reference to certain preferred embodiments thereof, but it will be understood that variations and modifications can be effected within the spirit and scope of the invention.  
       Parts List  
       [0079]    [0079] 10  human subject  
         [0080]    [0080] 12  chair  
         [0081]    [0081] 14  display  
         [0082]    [0082] 15  left fingertip  
         [0083]    [0083] 16  right fingertip  
         [0084]    [0084] 17  groove  
         [0085]    [0085] 18  analyzer  
         [0086]    [0086] 20  module  
         [0087]    [0087] 22  temperature sensor module  
         [0088]    [0088] 23  temperature sensor module  
         [0089]    [0089] 24  on/off switch  
         [0090]    [0090] 26  display  
         [0091]    [0091] 28  output  
         [0092]    [0092] 30  earphones  
         [0093]    [0093] 31  battery  
         [0094]    [0094] 32  low voltage power supply port  
         [0095]    [0095] 40  cable  
         [0096]    [0096] 44  CPU  
         [0097]    [0097] 45  cable  
         [0098]    [0098] 46  cable  
         [0099]    [0099] 50  lock-in Amplifier  
         [0100]    [0100] 55  signal S(t)  
         [0101]    [0101] 60  noise signal N(t)  
         [0102]    [0102] 65  modulated light beam  
         [0103]    [0103] 70  electrical device  
         [0104]    [0104] 75  reference signal  
         [0105]    [0105] 80  extracted signal f (S (t))  
         [0106]    [0106] 100  circuit  
         [0107]    [0107] 102  temperature sensor  
         [0108]    [0108] 104  signal conditioner  
         [0109]    [0109] 105  switch  
         [0110]    [0110] 106  A/D converter  
         [0111]    [0111] 108  digital signal analysis  
         [0112]    [0112] 110  display  
         [0113]    [0113] 112  battery  
         [0114]    [0114] 114  power switch  
         [0115]    [0115] 116  power conversion and/or regulation  
         [0116]    [0116] 118  memory slot  
         [0117]    [0117] 120  image source  
         [0118]    [0118] 122  video mixer  
         [0119]    [0119] 124  video obscuration generator  
         [0120]    [0120] 126  monitor  
         [0121]    [0121] 128  audio source  
         [0122]    [0122] 130  audio obscuration generator  
         [0123]    [0123] 132  difference signal amplifier  
         [0124]    [0124] 134  switch  
         [0125]    [0125] 136  image  
         [0126]    [0126] 138  switch  
         [0127]    [0127] 200   a  image  
         [0128]    [0128] 200   b  image  
         [0129]    [0129] 200   c  image  
         [0130]    [0130] 200   d  image  
         [0131]    [0131] 200   e  image  
         [0132]    [0132] 200   f  image