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NEURO 210 > Clinical Research Techniques > Flashcards

Clinical Research Techniques Flashcards

1
Q

Upper motor neuron

A

Central nervous system. Cell body in the cerebral cortex.

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2
Q

Lower motor neuron

A

Peripheral nervous system. Cell body in the periphery.

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3
Q

Six different neurological exams

A
  1. Mental status.
  2. Cranial nerves.
  3. Motor examination.
  4. Sensory examination.
  5. Cerebellar function.
  6. Deep tendon reflexes.
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4
Q

How are cranial nerves examined?

A

Cranial nerves 2-3 (optic nerve) are examined by stimulating the nerve (via light) to sense an autonomic reaction (pupillary constriction). Failure to respond appropriately to the stimuli is a result of upper motor neuron damage.

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5
Q

How are lower extremity reflexes tested?

A

Patellar, achilles, and plantar reflexes are discussed and are the autonomic responses to stimuli to tendons in the legs.

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6
Q

How do you differentiate between upper or motor neuron injury?

A

Increased reflexive response: upper motor neuron lesion ABOVE level tested.
Decreased reflexive response: lower motor neuron lesion.

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7
Q

Clonus

A

Upper motor neuron injury.

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8
Q

Babinski test

A

Abnormal plantar reflex in which the big toe reflexes upward instead of downward. A positive result shows that clonus is present.

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9
Q

Pathology

A

Form of clinical analysis via dissection post-mortem. Can be used to confirm disease/cancerous cells.

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10
Q

What is the disadvantage of pathology?

A

A sample is required, obtaining which will be fatal for an inflicted patient.

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11
Q

Computerized tomography (CT)

A

X-ray slices through brain to create images that are computerized into an observable figure.

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12
Q

Advantages of CT

A

Cheap and fast, most common technique at hospitals, very good at detecting blood.

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13
Q

Disadvantages of CT

A

Limited resolution.

Can miss presence of acute stroke.

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14
Q

Magnetic resonance imaging

A

Shifts in proton nuclei recorded to form a computerized image. Uses magnets and radio frequency.

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15
Q

Advantages of MRI

A

Very fine details of anatomy.

Can be used to detect specific problems.

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16
Q

Disadvantages of MRI

A

Expensive
Unsuitable for children and special motor care individuals.
Takes 1 hour to complete scan.
Limited availability.

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17
Q

Volume measurement

A

Technique in MRI scans used to quantify damage caused by a particular condition. Differences in neural tissue volume are recorded by comparing before/after images or images between two different patients.

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18
Q

Diffusion-weighted/Perfusion weighted MRI

A

fMRI subtype used to identify acutely ischemic stroke lesions.

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19
Q

Magnetic resonance spectroscopy

A

Provides quantification of specific metabolites or NT in specific region of interest.

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20
Q

Vasculitis

A

Inflammation of vessels.

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21
Q

Angiogram

A

Radio-opaque substace is injected via catheter and monitored to track bloody flow through the brain (under X-ray)

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22
Q

Advantages of angiogram

A

Very precise mapping of blood vessels

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23
Q

Disadvantages of angiogram

A

Requires a catheter, which may cause damage.

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24
Q

Electroencephalogram

A

Records differences in electrical potential between populations of neurons.

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25
Advantages of EEG
High temporal resolution Useful for monitoring state of arousal Cheap and available
26
Disadvantages of EEG
Poor spatial resolution | Restricted to cortical activity.
27
Alpha rhythm
Resting while awake (closed eyes)
28
Beta rhythm
Aroused and awake
29
Gamma rhythm
Perception/binding brain activity (thinking)
30
Delta rhythm
Deep sleep
31
Theta rhythm
Exploration/memory and learning
32
How can the spatial resolution of EEG be improved?
1. Grids can be used to map finer locations. | 2. Depth electrodes can map neurons deeper in the cortex.
33
Electromyogram
Needles are inserted into muscles to record muscle activity.
34
Advantages of EMG
Precise activity measured. Can detect NMJ disability. Help define muscle diseases.
35
Disadvantages of EMG
Can be painful.
36
Nerve conduction studies
The nerve is stimulated. The propagation is then recorded in muscle activity.
37
Advantages of NCS
Precise activity of a nerve. | Narrow down nerve disease
38
Disadvantages of NCS
Can be painful
39
Karyotype
Visualization of stained chromosomes
40
Comparative Genomic Hybridization
Compares patient DNA to reference DNA to test for gene abnormalities.
41
Advantages of CGH
Allow mapping of changes in the entire genome.
42
Disadvantage of CGH
Will not be able to tell if the mutation is a single base-pair abnormality.
43
Why may defects in genes not be seen in CGH?
Single base-pair defects are not seen by CGH and therefore specific gene mutations are not recorded, only "whole-picture" abnormalities.
44
Next Generation Sequencing
Multiple DNA fragments are sequenced at once and run through bioinformatics to be analyzed.
45
Advantages of NGS
Faster and cheaper sequencing of exons or entire genome.
46
Disadvantages of NGS
More error-prone than Sanger sequencing (one gene at a time). Requires a reference genome.
47
How would you test for brain metabolites?
Lumbar puncture. | Magnetic resonance spectroscopy
48
Lumbar puncture
Performed to look at level of RBC and WBC, at well as nutrients in the cerebrospinal fluid. A needle in inserted between the L3, L4, or L5 vertebrae to collect CSF. Can also detect auto-antibodies
49
Advantages of lumbar puncture
A valuable collection of CSF, which is representative of brain health and less invasive than a collection of brain tissue.
50
Disadvantages of lumbar puncture
Requires cooperation. ay result in injury or infection.
51
Functional MRI
Levels of deoxyhemoglobin and oxyhemoglobin are different and separated by magnetism. Represent modification in neuronal activity (metabolism).
52
Advantages of fMRI
Localization of brain activity at rest or performing a task.
53
Disadvantages of fMRI
Requires collaborative patient.
54
Positron Emission Tomography
Injects radioactive compounds that emit positrons observed by emission of photons (after collision with electrons) Flow of blood through brain depending on activity, used to record metabolism.
55
Advantages of PET
Measures precise location of brain activity. Can map cancer cells (which have increased metabolic function)
56
Disadvantages of PET
Requires injection of radioactive tracer.
57
Single Photon Emission Computer Tomography (SPECT)
Injection of gamma-ray emitting material. Not as precise, but simpler and cheaper.
58
Magneto-encephalogram
Records magnetic field caused by electrical potential in neural populations (due to propagation of impulse caused by brain activity).
59
Advantages of MEG
Fast temporal resolution
60
Disadvantages
Very expensive, limited spatial resolution
61
Why would you ever use MEG over EEG?
Magnetic waves pass through the brain without distortion (unlike EEG), therefore readings in deeper neural tissue are more precise in MEG (without risking damage and less intrusive than depth-probe EEG)
62
What is the difference between the fMRI scan and the PET scan?
The fMRI requires no injection of radioactive material and has greater resolution and precision. However, the PET scan is far simpler and cheaper (especially SPECT).
63
Transcranial Magnetic Stimulation
A coil forms a magnetic field that disrupts the brain cells beneath it, causing significant effects (due to inhibition of neurons in that region). Used to explore and modulate behaviours.
64
Advantages of TMS
Understand brain networking without permanent damage or direct electrical stimulation. Used to treat some conditions involving repetitive behaviour.
65
Disadvantages of TMS
Cooperation needed. Risk of inducing a seizure.
66
Single-pulse TMS
Used for mapping cortical region functions and excitability during behavior.
67
Repetitive TMS
Used for treatment
68
Deep brain stimulation
Insertion of depth electrodes to stimulate particular cortical areas. Used to treat Parkinsons, dystonia, depression, and epilepsy.
69
Advantages of DBS
Can be very effective, limits needs for medication.
70
Disadvantages of DBS
Risk on injury and infection, very invasive.

NEURO 210 (13 decks)

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