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NCS Prep > NCS Neuroimaging and Stimulation > Flashcards

NCS Neuroimaging and Stimulation Flashcards

1
Q

true or false: following neurologic injury, you are only able to see local strucutral changes on imaging

A

false - there are local and wide spread changes you can see

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2
Q

what is the best imaging for neurological injury
a. MRI
b. PET scan
c. CT
d. DTI
e. multimodal imaging

A

e. multimodal imaging

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3
Q

the brain changes resulting from experience are associated with
a. gray matter changes
b. white matter changes
c. both gray and white matter changes

A

c. gray and white matter changes

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4
Q

the brain changes resulting from experience are associated with structural changes in the brain. if a person does not continue to use that skill, what brain structure changes do we expect to see
a. gray matter reduction
b. white matter reduction
c. both gray and white matter reduction

A

b. white matter reduction

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5
Q

which of the following imaging techniques is not sensitive enough to see microscopic structural changes in the brain
a. MRI
b. DTI
c. cortical morphometry
d. myelin weighted imaging

A

a. MRI

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6
Q

which of the following imaging techniques is not sensitive enough to see microscopic structural changes in the brain
a. CT
b. DTI
c. cortical morphometry
d. myelin weighted imaging

A

a. CT

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7
Q

true or false: DTI is an imaging technique used to assess structural damage of white matter pathways

A

true

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8
Q

true or false: DTI is an imaging technique used to assess functional damage of white matter pathways

A

false - structural

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9
Q

true or false: balance training has been correlated with white matter neuroplastic changes

A

true

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10
Q

which of the following patients has the best prognosis:
a. young patient with widespread white matter injury
b. old patient with widespread white matter injury
c. old patient with little white matter injury
d. young patient with little white matter injury

A

d. young patient with little white matter injury

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11
Q

which of the following is an MRI approach to assessing brain function
a. arterial spin labeling (ASL)
b. EEG
c. SPECT
d. TMS
e. functional near infrared spectroscopy (fNIRS)

A

a. arterial spin labeling (ASL)

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12
Q

which of the following imaging approaches uses blood oxygen level dependent levels to assess neural activity
a. EEG
b. fMRI
c. TMS
d. fNIRS
e. SPECT

A

b. fMRI

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13
Q

true or false: fMRI has good time resolution to assess brain function

A

false - assesses by second, not at the ms that the brain operates at

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14
Q

true or false: fMRI is an appropriate imaging technique to assess brain function for a patients hand dexterity in a seated position

A

false - cannot be technically complex as pt needs to be supine

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15
Q

true or false: fMRI is a direct measure of neural activity

A

false - indirect as looks at BOLD (blood)

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16
Q

which of the following is true: fMRI has
a. good spatial resolution and good temporal resolution
b. good spatial resolution and bad temporal resolution
c. bad spatial resolution and good temporal resolution
d. bad spatial resolution and bad temporal resolution

A

b. good spatial resolution and bad temporal resolution

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17
Q

According to Sagi et al., 2012, what is the shortest amount of time to create an acute brain change with performing balance training?
a. 45min
b. 1 hour
c. 2 hours
d. 4 hours

A

c. 2 hours

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18
Q

true or false: EEG is a direct measure of neural activity

A

True

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19
Q

Which of the following is not a positive of EEG imaging?
A. Direct measure of neural activity
B. Good temporal resolution
C. Good spatial resolution
D. Can assess electrical activity at rest or during activity

A

C. Good spatial resolution - incorrect, EEG has limited spatial resolution

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20
Q

Which of the following is not a con of EEG imaging?
A. Susceptible to noise
B. Requires training to interpret/perform
C. Poor spatial resolution
D. Non invasive

A

D. Non invasive

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21
Q

true or false: EEG is placed directly onto the scalp

A

true

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22
Q

true or false: TMS is placed directly onto the scalp

A

true

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23
Q

which of the following imaging techniques can give you a causative relationship between action/sensation and brain activation
a. fMRI
b. EEG
c. DTI
d. TMS

A

d. TMS
the others can only demonstrate correlations

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24
Q

which of the following imaging techniques is not feasible in the clinic
a. fMRI
b. EEG
c. TMS

A

a. fMRI

25
Q

which two imaging techniques are typically paired together as a multimodal approach to assess brain network/activation changes after injury
a. TMS and fMRI
b. TMS and EEG
c. EEG and DTI
d. DTI and fMRI

A

b. TMS and EEG

26
Q

true or false: TMS is used solely a neuromodulatory technique to excite or inhibit particular brain areas

A

false - TMS can be neuromodulatory or investigatory to measure response

27
Q

You have been seeing Johnny for persistent post-concussion symptoms. You want to assess Johnny’s brain function during UE activity in the clinic. You happen to have several imaging options at your disposal due to your affiliations with a teaching hospital. Which is the most clinically practical imaging tool to select and why?
a. fMRI
b. TMS
c. EEG
d. TMS and EEG

A

c. EEG
NOT fMRI: fMRI does provide a lot of useful information, including spatial resolution, it is quite impractical in regards to cost and efficiency.
NOT TMS: Evidence of using TMS in concussion assessment is limited. Also, TMS cannot be used for assessment while performing a motor task as its output measure is a motor evoked response.
YES EEG: is sensitive to the dynamic properties of the brain and can be used to assess brain function during a motor task, such as handwriting.
NOT TMS and EEG: Using both TMS and EEG in conjunction would minimize the inherent limitations of each approach, as well as provide both structural and functional information regarding Johnny’s concussion. However, it is not the most clinically practical due to increased cost, training required, and decreased portability.

28
Q

what is the most common imaging technique to assess CVA in chronic stages?
a. EEG
b. MRI
c. DTI
d. combination/multimodal imaging

A

d. combination/multimodal imaging

29
Q

true or false: CVA only affects white matter integrity

A

false - CVA affects both white matter and grey matter but greater white matter

30
Q

transcallosal inhibition results in significant impairment following which neurologic injury
a. PD
b. MS
c. ALS
d. CVA

A

d. CVA

31
Q

true or false: in CVA, high frequency excitation TMS to the affected hemisphere results in both improved motor and sensory function

A

true

32
Q

true or false: in CVA, low frequency inhibition TMS to the unaffected hemisphere results in both improved motor and sensory function

A

false - only motor function

33
Q

true or false - TMS alone is enough to create neuroplastic changes

A

false - need TMS and therapy

34
Q

true or false - TMS can help all individuals with chronic CVA

A

false - unclear of who will benefit
some people benefit, some people dont

35
Q

true or false: Tau protein deposition, reduced axonal integrity, increased incidence of cognitive deficits and earlier onset of dementia, presence of early depression are acute effects of recurrent mTBI

A

false - these are chronic effects

36
Q

what is the cause of migraine photophobia and phonophobia in concussion
a. abnormal ion flux
b. energy crisis
c. axonal injury and altered neurotransmission
d. abnormal protein and proteolysis leading to atrophy

A

a. abnormal ion flux

37
Q

what is the cause of slowed reaction and info processing in concussion
a. abnormal ion flux
b. energy crisis
c. axonal injury and altered neurotransmission
d. abnormal protein and proteolysis leading to atrophy

A

c. axonal injury and altered neurotransmission

38
Q

what is the cause of persistent impairment in concussion
a. abnormal ion flux
b. energy crisis
c. axonal injury and altered neurotransmission
d. abnormal protein and proteolysis leading to atrophy

A

d. abnormal protein and proteolysis leading to atrophy

39
Q

which of the following is associated with chronic phase changes in concussion
a. abnormal ion flux
b. energy crisis
c. axonal injury and altered neurotransmission
d. abnormal protein synthesis

A

d. abnormal protein synthesis

40
Q

following concussion, how many days do we expect 90% of cases to resolve
a. 2-3 days
b. 4-7 days
c. 7-10 days
d. 14-20 days

A

c. 7-10 days

41
Q

which imaging is typically used in concussion but is not diagnostic
a. MRI
b. CT
c. DTI

A

b. CT to r/o more serious

42
Q

true or false: according to the current consensus recommendations, following concussion, a person should rest for the first 24-48 hours

A

true

43
Q

true or false: ApoE-4 is the metabolic biomarker for concussion

A

false - there is none established

44
Q

which is the most common imaging technique to assess structural damage in concussion
a. MRI
b. EEG
c. TMS
d. DTI

A

d. DTI

45
Q

which is the most common imaging technique to assess functional damage in concussion
a. MRI
b. EEG
c. TMS
D. DTI

A

b. EEG

46
Q

true or false - a patients EEG following concussion would demonstrate delayed and reduced activation response to auditory stimuli

A

true

47
Q

what combination/mixed modal imaging would be appropriate to assess brain dysfunction/injury following concussion?
a. DTI and MRI
b. DTI and EEG
c. MRI and TMS
d. MRI and EEG

A

b. DTI and EEG

48
Q

what combination/mixed modal imaging would be appropriate to assess brain dysfunction/injury following concussion?
a. DTI and MRI
b. DTI and TMS
c. MRI and TMS
d. MRI and EEG

A

b. DTI and TMS

49
Q

true or false - normal populations would demonstrate brain changes on imaging in response to immobilization

A

true

50
Q

what brain changes do you expect to see in normal populations in response to immobilization
a. decreased white matter area of the affected arm
b. increased white matter area of the affected arm
c. decreased cortical thickness of the affected arm
d. increased cortical thickness of the affected arm

A

c. decreased cortical thickness of the affected arm

51
Q

what brain changes do you expect to see in normal populations in response to immobilization
a. decreased white matter area of the unaffected arm
b. increased white matter area of the unaffected arm
c. decreased cortical thickness of the unaffected arm
d. increased cortical thickness of the unaffected arm

A

d. increased cortical thickness of the unaffected arm

52
Q

which of the following interventions prevents the cortical loss of immobilization?
a. action observation
b. motor imagery

A

a. action observation

53
Q

true or false: immobilization results in peripheral local changes such as muscle atrophy as well as brain changes

A

true

54
Q

according to the SAFE (shoulder abduction, finger extension) PREP algorithm, a patient who scores 8 or more will
a. require TMS for recovery
b. have limited recovery
c. have complete recovery
d. cannot determine without MRI results

A

c. have complete recovery

55
Q

according to the SAFE (shoulder abduction, finger extension) PREP algorithm, a patient who scores <8 with absent MEP will
a. require TMS for recovery
b. have limited recovery
c. have complete recovery
d. cannot determine without MRI results

A

d. cannot determine without MRI results

56
Q

according to the SAFE PREP algorithm, your patient has notable prognosis which means you expect
a. the patient will have normal function in 12 weeks
b. the patient will be able to use their hand for most ADLs in 12 weeks
c. the patient will be able to move their arm without functional use in 12 weeks
d. the patient will have minimal movement/improvement in 12 weeks

A

b. the patient will be able to use their hand for most ADLs in 12 wekks

57
Q

according to the SAFE PREP algorithm, your patient has limited prognosis which means you expect
a. the patient will have normal function in 12 weeks
b. the patient will be able to use their hand for most ADLs in 12 weeks
c. the patient will be able to move their arm without functional use in 12 weeks
d. the patient will have minimal movement/improvement in 12 weeks

A

c. the patient will be able to move their arm without functional use in 12 weeks

58
Q

given that rTMS improved motor learning in some but not all individuals post stroke, which of the following assumptions may be true
a. in order to be a responder, you may need a certain neural tissue or cognitive reserve
b. in order to be a responder, you need to have a MCA CVA
c. there is no way to know who will be a responder and who will not

A

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