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NEURO 210 > Lecture 3: Clinical and Research Techniques for Investigating the Human Nervous System > Flashcards

Lecture 3: Clinical and Research Techniques for Investigating the Human Nervous System Flashcards

1
Q

What are the different types of clinical methods in neuroscience?

A

clinical history and examination

neuropathology

imaging

electrophysiology

chemical studies

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2
Q

What is the clinical history evaluation in clinical methods of neuroscience?

A

general and targeted to specific problem

prove or disprove your hypothesis

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3
Q

What is the clinical examination in clinical methods of neuroscience?

A

systematic assessment from brain to muscle

look at the entire range of possibilties

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4
Q

How do neurologists try to localize problems in neuroscience?

A

in neurology we try to localize the problem as either central nervous system (upper motor neuron) and peripheral nervous system (lower motor system)

two different sets of problems and treatments for each neuron

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5
Q

What are neurological exams for the central nervous systems?

A

mental status

cranial nerves

cerebellar function

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6
Q

What are neurological exams for the central and peripheral nervous systems?

A

motor examination

sensory examination

deep tendon reflexes

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7
Q

How do reflex responses differ between upper and lower motor neurons?

A

increased reflex suggests upper motor neuron lesion above the level tested (the brain gives control to the spinal cord, inhibits jerking movements)

decreased reflex suggests lower motor neuron lesion (nerve damage, signal either doesn’t go in the spinal cord or come out of the spinal cord)

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8
Q

What is the purpose of clinical methods in neuroscience?

A

the neurological examination can help identify where the lesion would be

the history of the progression of the symptoms can indicate what the disease could be but can not confirm it

other methods are required to know what the lesion is exactly

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9
Q

What is pathological post-mortem examination?

A

methods of clinical neuroscience initially used anatomical examination of the brain after death

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10
Q

What was seen in Tan’s brain postmortem as presented by Broca?

A

damage of left frontal cortex associated with difficulty speaking (Broca’s area)

established lateralization of the linguistic function mainly in left hemisphere for right handed individuals

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11
Q

What can pathology identify?

A

pathology can identify post-mortem brain changes

such as, chronic traumatic encephalopathy (dementia pugilistica)

but can be seen in any kind of brain injury especially after repeated injury

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12
Q

What is chronic traumatic encephalopathy?

A

increased Tau protein accumulation in the cerebral cortex

Tau proteins are microtubular associated proteins

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13
Q

What are the advantages of CT scans?

A

relatively cheap and fast

most common scanning method in hospitals

very good at detecting blood

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14
Q

What are the disadvantages of CT scans?

A

limited resolution (the CT scan would look normal but the MRI would show tumor)

can miss acute stroke lesions

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15
Q

What are the advantages of MRIs?

A

MRI provides with very fine details of the anatomy

multiple sequences can be used to detect specific problem (inflammation, infection, small brain malformation, stroke)

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16
Q

What are the disadvantages of MRIs?

A

takes 1 hour (vs. 3 min for CT)

children will require sedation with special care because it is very loud and takes a long time

cost

availability limited

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17
Q

What is the relationship between volume measurements and MRIs?

A

volume measurement was one of the first application of MRI

brain shrinkage in the hippocampus associated with Alzheimer’s

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18
Q

How do MRIs identify strokes?

A

MRI sequences (diffusion weighted and perfusion weighted images) have been tailored to identify acutely ischemic stroke lesion that would not be visible otherwise

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19
Q

How are MRI methods used to measure movement?

A

use MRI methods to measure the movement (diffusion) of protons in water along fibre tracts

movement occurs more readily along tracts than across tracts

now being used to examine differences in tracts in patients with brain tumors

it can be used with illness (e.g. depression), developmental disorders (e.g. autism), and aging as research tools

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20
Q

What are the advantages of MRS?

A

provides quantification of specific metabolites or neurotransmitters in specific region of interest

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21
Q

What are angiograms?

A

an angiogram uses a radio-opaque substance, or dye, to make the blood vessels visible under X-ray

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22
Q

What are the advantages of angiograms?

A

very precise mapping of the blood vessels (even smaller ones)

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23
Q

What are the disadvantages of angiograms?

A

requires a catheter to put into blood vessels and injection of dye which can lead to vessels rupture or allergic reaction

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24
Q

What is an electroencephalogram (EEG)?

A

the EEG records difference in electrical potentials generated by the brain

grids are put directly onto the brain for precise mapping

depth electrodes are implanted into the brain for deeper structure recording

25
Q

What are the advantages of EEGs?

A

high temporal resolution

useful for monitoring state of arousal

cheap and available

26
Q

What are the disadvantages of EEGs?

A

poor spatial resolution

restricted mainly to cortical activity

27
Q

What is an electromyogram (EMG)?

A

the patient muscle activity is recorded either at the surface like here or using a needle inserted within the muscle

28
Q

What are the advantages of EMGs?

A

allows to measure precisely activity in the muscle

can also detect when the muscle is not getting enough nerve input and is “getting disconnected”

can help define the type of muscle disease

29
Q

What are the disadvantages of EMGs?

A

can be painful with insertion of needle inside the muscle depending on location (face for instance)

30
Q

What are nerve conduction studies (NCS)?

A

in NCS, the patient nerve activity is recorded by stimulating the nerve and recording the time for its connected muscle to be activated

31
Q

What are the advantages of NCS?

A

allows to measure precisely activity the nerve (both speed and wave form of the amount of muscle recruited)

can narrow down type of nerve disease by pattern of injury

32
Q

What are the disadvantages of NCS?

A

can be painful with the stimulation of the nerve

33
Q

What are karyotypes?

A

until year 2000, mostly used method

allows to visualize the different chromosomes using a straining method and microscope

defects in genes may not be seen in karyotype because of the compaction in DNA

34
Q

What is comparative genomic hybridization (CGH)?

A

obtain patient DNA (most of the time from blood leukocyte)

lab will provide DNA from control subjects

compare the number of copies of each gene

using multiple probes from all genes

if gain in patient: red

if deficit in patient: green

defects in genes may not be seen in CGH because they affect single base pair

35
Q

What are the advantages of CGH?

A

allows to map changes in copy number for the entire genome so do not need to know which gene could be affected in the patient

36
Q

What are the disadvantages of CGH?

A

will not be able to tell if a patient has a single base pair change

37
Q

What is lumbar puncture?

A

performed to look at the level of red blood cells, white blood cells, glucose, protein in CSF

very useful to assess blood and infection in CSF (aneurysm bleed, meningitis)

now used more for detecting auto-antibodies (anti NMDA and others)

38
Q

What are the advantages of lumbar puncture?

A

allows to get GSF which can help identify chemical, metabolic or immune differences

less invasive than getting brain tissue

39
Q

What are the disadvantages of lumbar puncture?

A

requires the patient to be collaborative

risk of pain and infection

40
Q

What is a functional MRI (fMRI)?

A

measure brain activity in specific locations

depends on the fact that the levels of deoxyhemoglobin and oxyhemoglobin are modified by neuronal activity

these levels influence the strength of magnetic dipoles of protons (measured in MRI machines)

41
Q

What are the advantages of fMRIs?

A

can show localization of brain activity at rest or when performing a task

42
Q

What are the disadvantages of fMRIs?

A

requires collaborative patient

43
Q

What is positron emission tomography (PET)?

A

inject radioactive compound that emits positrons (anti-electrons)

positrons collide with electrons and produce photons (gamma rays)

44
Q

What are advantages of PET scans?

A

measures precisely localization of brain activity

used to map cancer cells also as they have high uptake

45
Q

What are the disadvantages of PET scans?

A

requires injection of radioactive tracer

46
Q

What is single photon emission computer tomography (SPECT)?

A

is similar to PET except gamma ray emitting radioactive material injected

not as precise as PET, but simpler and cheaper

47
Q

What are the advantages of MEGs?

A

fast temporal resolution

48
Q

What are the disadvantages of MEGs?

A

very expensive

limited spatial resolution

49
Q

What is transcranial magnetic stimulation (TMS)?

A

uses a coil to form a magnetic field which then can depolarize or inhibit the brain cells underlying it

50
Q

What are the advantages of TMS?

A

used to understand localization of brain network without direct electrical stimulation

applied to the treatment of some conditions emerging (rehab post stroke, mental illness)

51
Q

What are the disadvantages of TMS?

A

requires cooperation from patient

risk of inducing seizure

52
Q

What is single pulse TMS?

A

mapping changes in cortical excitability during behavior

mapping changes in cortical motor maps after stroke and during rehab

53
Q

What is repetitive TMS?

A

inhibiting activity of specific cortical regions

enhancing functional recovery following stroke

reduction of chronic pain

treatment of depression, schizophrenia, addiction, anxiety

54
Q

What is deep brain stimulation?

A

used initially to map brain activity, DBS consists of insertion of depth electrodes into a specific area that then is stimulated either by a stimulator or by the patient which is now used clinically

current uses: Parkinson’s, dystonia, severe depression, epilepsy

55
Q

What are the advantages of deep brain stimulation?

A

can be very effective in some disorder and limit the need for meds

56
Q

What are the disadvantages of deep brain stimulation?

A

risk of infection

invasive

57
Q

What are the clinical methods of brain imaging?

A

clinical questionnaire/exam

imaging (CT, MRI)

electrophysiology

lumbar puncture, MRS

genetics

58
Q

What are the research methods of brain imaging?

A

PET

Magnetoencephalogram

TMS (both research and now used for treatment)

DBS (both research and now used for treatment)

NEURO 210 (23 decks)

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